Value-based care: Is it here to stay, despite what’s happening in Washington? What are its pitfalls? How do healthcare professionals feel about it?
All these questions (and more) were answered by physicians and health plan executives in a recent survey from Quest Diagnostics and Inovalon. The survey, which took place from April 7 through April 17, 2017, included responses from 452 individuals — 302 primary care physicians who are employed in a private practice but have an affiliation with a hospital and 150 health plan executives.
Overall, both physicians and health plan executives seem to believe there’s no stopping the push for value-based care. Eighty-two percent of the 452 respondents said the transition to value-based care will continue.
Yet fee-for-service is still the name of the game. Only 29 percent of respondents said the United States has a value-based healthcare system. This number is up four percentage points from Quest and Inovalon’s 2016 survey.
Though value-based care is not going away, it’s clearly not being implemented across the board, according to respondents. Why?
For physicians, it’s because of a lack of much-needed tools. Less than half — 43 percent — of physicians in the survey said they have the tools they need to succeed in a value-based care world. But that number appears to be on the rise. In the 2016 survey, 29 percent of physicians said they were equipped with the necessary tools.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Another reason behind the problem is the absence of coordination. Eighty-three percent of respondents said payer-provider alignment is more important to value-based care than ever before.
EHRs aren’t helping, either. While three-quarters of health plan executives said EHRs have everything physicians need, only 54 percent of physicians agreed. On top of that, 70 percent of physicians said they don’t see a link between EHRs and better patient outcomes.
So what can be done to close this gap?
EHRs could help, especially if their capabilities are expanded. Seventy-one percent of physician respondents indicated they’d be willing to spend more time using technology tools if their EHRs could give more insights unique to their patients. Recommended insights include everything from more information on a patient’s history to performance measures that apply to an individual patient.
Moreover, a greater investment in health IT could prove beneficial. Eighty-five percent of health plan executives noted that a co-investment in HIT by payers and providers could speed up value-based care adoption.
Although eventual widespread adoption of value-based care is still in the cards, we have a long way to go before it’s actualized. For now, perhaps looking to technology is key to dampening the fee-for-service delivery model. As David Freeman, general manager of information ventures for Quest Diagnostics, put it: “Extending the capabilities of existing technologies, most notably EHRs, and shared HIT investments by health plans and providers may speed physician adoption of value-based care.”
Photo: Buero Monaco, Getty Images
