The value-based reimbursement model predicted by hospital/health system and payer leaders to dominate the reimbursement market is also the one they say will be hardest to implement.
A new survey examining the state of value-based reimbursement found that of the existing value-based models, payers and hospitals/health systems predict pay-for-performance will experience the most growth – increasing from 10 percent today to 18 percent in five years for payers and from 9 percent to 21 percent for hospitals/health systems.
But they also indicated that P4P will be the most challenging of the value-based reimbursement models to implement. Top obstacles to implementation include not having the technology or infrastructure needed in order to measure, analyze and capture data and not having clinician buy-in and engagement.
The survey, commissioned by McKesson, was conducted by ORC International. High-level executives from 114 payers and 350 hospitals/health systems were questioned about the value-based models they are using; where they are in the transition to value-based models; and how the financial impact of the models on their businesses.
Some of the findings include:
90 percent of payers and 81 percent of health systems/hospitals are already using a mix of value-based reimbursement models combined with fee-for-service. Those respondents using the mixed models project that value-based reimbursement will make up two-thirds of the market by 2020 (up from one-third today). Accountable care organizations are closer to value-based reimbursement adoption than non-ACOs, and larger organizations are further along in the transition to value-based reimbursement than smaller organizations. Of those payers using value-based reimbursement, P4P is used the most (65 percent), followed by capitation, global payment and total cost of care (64 percent). 60 percent of payers believe that moving to value-based reimbursement will have a positive financial impact; only 35 percent of health systems/hospitals feel the same way. Of the health systems/hospitals, 29 percent of small facilities said value-based reimbursement will have a positive financial impact compared to 40 percent of large facilities.