Study Reveals Provider Concerns with Value-Based Payment Models

May 21, 2014
Although three-quarters of providers currently participate in at least one value-based payment model, fewer than 30 percent believe they offer a good level of reward for the risk, according to a study recently published by Availity, a Jacksonville, Fla.-based provider of healthcare business solutions.

Although three-quarters of providers currently participate in at least one value-based payment model, fewer than 30 percent believe they offer a good level of reward for the risk, according to a study recently published by Availity, a Jacksonville, Fla.-based provider of healthcare business solutions.

Additionally, 60 percent of respondents expect value-based payment models to become the dominant payment model. The “Provider Attitudes Toward Value-Based Payment Models” study highlights feedback from more than 500 physician practice and hospital-based professionals nationwide.

Managing value-based payment models alongside existing fee-for-service arrangements, and across numerous health plans, is creating issues that range from accurate revenue forecasting to workflow integration challenges, the study found. According to one physician practice respondent, “The administrative complexity of administering these plans is likely to be costly. The unpredictability of the revenue stream is likely going to make administering some of these plans not worth the cost.”

More than 80 percent of respondents cited the need for additional staff and time to manage value-based models that represent less than 20 percent of their current revenues. The need for meaningful workflow tools and real-time information access to help avoid creating expensive, manual processes was named by more than 75 percent as a key factor to value-based payment model success.

“The healthcare revenue cycle is incredibly complicated and it’s undergoing a transformation,” Russ Thomas, Availity CEO, said in a statement. “In addition to the challenges presented by rising patient financial responsibility and ongoing pressure to reduce operating costs, payment reform initiatives are driving the shift from fee-for-service to fee-for-value. But unless we equip providers—and health plans— with the right tools and access to the information they need, we risk further complicating an already complex and fragmented system.”

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