A new study of physicians and health plan executives suggests that progress toward value-based care has stalled, and it may have even taken a step backward over the past year. The study commissioned by Quest Diagnostics, points to physicians’ lack of tools and insufficient information about their patients as possible reasons. Other barriers include continuing misalignment of perceptions of physicians and health plan executives, particularly regarding the usefulness of quality metrics and technology in providing patient care.
“Stalled Progress on the Path to Value-Based Care” is the third annual study from Quest Diagnostics to gauge perceptions of physicians and health plan executives about the nation’s journey to value-based healthcare, which focuses on care quality and patient outcomes rather than the quantity of services delivered.
The study analyzes results from a survey of 451 primary care physicians and health plan executives collected earlier this year. It also reveals changes in perceptions over the past two years.
- Physicians and health plan executives agreed healthcare has made little progress toward value-based care since last year, and may even have lost ground. Among both physicians and health plan executives, more than two-thirds (67%) said they believe the U.S. has a fee-for-service system versus a value-based care system (27%). In last year’s study, those numbers were 63% and 29% respectively, which suggests a perception that the healthcare industry has taken a step backward toward fee-for-service.
- The majority of health plan executives said they now believe physicians do not have the tools to succeed under value-based care, a significant shift from last year when the majority said physicians had the tools. Fifty-seven percent of health plan executives agreed that physicians do not have the tools to succeed under value-based care, an increase of 12 percentage points from 45% in the 2017 study.
- Both physicians and health plan executives are much less confident that physicians have sufficient information about their patients. Nearly three-quarters (72%) of all survey respondents said physicians do not have all the information they need about their patients, an increase of 12 percentage points from the 2017 study. Additionally, only 39% of physicians said electronic health records (EHRs) provide all the data they need to care for their patients.
- Physicians and health plan executives are not aligned, particularly around quality metrics and technology. When asked, “How strongly do you agree or disagree that investments made in technology for quality initiatives have improved the value of healthcare for patients,” 80% of health plan executives agreed, compared to only 68% of physicians—a 12-point delta. Additionally, 62% of health plan executives said we’ve made progress toward alignment between payers and providers, but only 41% of physicians agreed.
- New technologies such as bioinformatics, artificial intelligence, and blockchain could be key to improving value-based care. More than six in 10 of all physicians and health plan executives agreed technologies such as bioinformatics, artificial intelligence, the SMART App Platform, FHIR (Fast Healthcare Interoperability Resources) and machine learning have potential to improve value-based care. Almost two-thirds (64%) of health plan executives said one advantage of blockchain in healthcare is that it can promote shared data across organizations to surmount interoperability.
The survey also revealed differing perceptions of the usefulness of consumer-based strategies and investments in new technologies versus existing technologies in advancing value-based care.