Industry Group Ties Half of Business to Value-Based Payments
Payer and provider members of the Health Care Transformation Task Force had 52 percent of their business in value-based payments by the end of 2018.
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By - Payer and provider members belonging to a group of leading healthcare stakeholders have increased the amount of business under value-based payments, even surpassing the 50 percent mark by the end of 2018.
In a recent announcement, the Health Care Transformation Task Force (HCTTF) reported that value-based payments accounted for 52 percent of the business from its payer and provider members by the end of 2018, up from 47 percent the previous year.
The increase in value-based payments among its payer and provider members, which include Aetna, Atrius Health, Dignity Health, Kaiser Permanente, and several Blue Cross Blue Shield companies, brought HCTTF closer to its goal of tying 75 percent of their respective businesses under value-based payment arrangements by the end of 2020.
“Task Force members have made important and impressive progress in moving the dial on value-based payment adoption,” stated Fran Soistman, executive vice president and head of government services with Aetna, a CVS Health Company and HCTTF chair. “HCTTF members are delivering on their commitment to moving health care delivery away from fee-for-service to innovative payment models that foster high-quality, patient-centered care.”
The payer and providers members of HCTTF are ahead of their peers in terms of value-based payment adoption.
According to the most recent report from the Health Care Payment Learning & Action Network on value-based payment adoption, only about 34 percent of all healthcare payments in 2017 were tied to value-based payment arrangements that meaningfully tied revenue to value, such as shared savings models, bundled payments, and population-based payments.
The transition to value-based payments has been a slow one despite evidence that the arrangements reduce costs and improve outcomes. Just like the leading payer and provider members of HCTTF, the number of healthcare payments linked to alternative payment models increased by just a couple of percentage points compared to the previous year, the Health Care Payment Learning & Action Network reported.
Payers and providers are still encountering significant barriers to value-based payment adoption and even the most sophisticated organizations are reporting challenges, Jeff Micklos, executive director of HCTTF, acknowledged in the announcement.
“As our members advance in value-based payment models, Task Force members continue to note obstacles that hinder industry progress in transitioning to value,” he stated. “While many Task Force members have achieved the 75 percent goal already, many willing organizations are finding it difficult to reach that threshold for various reasons.”
Organizations still lack the data access and collection capabilities they need for value-based payment adoption, payer and provider executives said in a recent Healthcare Financial Management Association survey. Other barriers to adoption identified by executives included inconsistencies between payers, lack of physician alignment and buy-in, and the inability to estimate costs, lost revenue, and/or risk.
These challenges intensify when payers and providers engage with more mature value-based payment arrangements that contain some level of financial risk, research has shown. For example, survey results released earlier this month by Premier found that timeliness of data and access to data were the top challenges of moving to risk-based models.
Respondents, which were healthcare professionals and physicians from hospitals and health systems, also reported that less than 20 percent of their population was covered by a risk-based payment model and they do not anticipate that percentage to move much in the next five years.
Shifting business away from the dominant, traditional payment structure will require additional energy, investment, and resources, and that requires time. But groups like HCTTF are committed to helping payers and providers move the bulk of their revenue to value within the next year.
The industry group offers resources to organizations, including a value partnership evaluation tool released earlier this year. The open-sourced tool helps healthcare stakeholders evaluate a potential partner’s core value-based care competencies, which is key to the success of those partnerships, the HCTTF states.
On the group’s website, organizations can also access resources on consumer engagement in benefit design, episode grouping, and outcomes-driven maternity care through value-based payments.
