Survey: Payers Embracing Value-Based Payment Models

An overwhelming majority (73 percent) of surveyed health insurance executives are planning major, technology-driven transformation at their organizations, with even more (80 percent) moving towards value-based payment models, according to recent research from Burlington, Mass.-based vendor HealthEdge.

The survey results of more than 100 payer executives show that while health insurers understand the significance of participating in a variety of new healthcare business models including value-based payments (80 percent), exchanges (69 percent) and accountable care organizations (ACOs, 55 percent), they remain hampered by a number of key factors that prevent them from effectively participating in these new approaches. These include a continued reliance on manual business processes, legacy technology and hard-to-maintain satellite systems, all of which are also contributing to the high administrative costs that currently plague the industry, survey found.

Further, health insurers face mounting pressure from consumers to provide an experience that mirrors that of every other major industry, such as retail, travel and banking. Also, the majority of senior health insurance executives surveyed (77 percent) are seeking ways to improve care coordination at their organizations, and are investing in approaches including member-facing social and mobile tools as well as wearables to promote member self-management, shared decision-making and collaboration, according to the research. Additionally, 63 percent of respondents are integration health information exchanges (HIEs) and electronic medical records (EMRs) to drive collaboration.

“An overwhelming majority of the health insurance executives surveyed are planning major, technology-driven transformation at their organizations,” Ray Desrochers, executive vice president at HealthEdge, said in a statement. “The transition to a digital business is now required to provide members with the consumer-friendly, retail-like experiences they expect, effectively participate in new healthcare business models and drive new levels of operational efficiency.”