Two-Thirds of Responding Physicians Reimbursed for Quality, Survey Finds

March 1, 2017
In a survey of 866 U.S. physicians, two-thirds of “organized provider” respondents said they are reimbursed primarily through alternative payment models designed to hold them accountable for quality, cost and patient outcomes.

In a survey of 866 U.S. physicians, two-thirds of “organized provider” respondents said they are reimbursed primarily through alternative payment models designed to hold them accountable for quality, cost and patient outcomes.

The research study, “Tracking the Shift From Volume to Value in Healthcare” by Capgemini Consulting and Omnicom Health Group, included 866 U.S.-based physicians, representing 27 specialties across all 50 states, leveraging Omnicom Health Group’s proprietary HCP Insights database. “Organized providers” were classified as inclusive of integrated health networks, physician hospital organizations, accountable care organizations (ACOs) and large multi-specialty medical groups.

What’s more, respondents ranked real-world evidence as the most important data informing treatment decisions, followed by clinical trial data. The authors argue that this finding is just one of the ways providers are changing behaviors as their financial risk increases, and the pharmaceutical industry must rethink how it demonstrates the value of its products in response.

As financial risk shifts from the payer to the provider, new investments are required to achieve clinical and business goals. For example, to gain access to real-world data sets that can generate more powerful insights, providers are furthering technology integration with increasingly sophisticated digital health technologies, according to the research.

The research study explores other ways organized providers are at the frontier of health reform, and the corresponding ways that pharmaceutical companies are responding. For example, nearly 50 percent of organized provider physicians said that digital communication channels were their preferred method of communication, with health IT systems providing new engagement opportunities. The authors recommend that pharmaceutical companies continue to invest in digital communication channels and solutions that integrate pharmaceutical content into electronic health records and clinical decision support systems to engage providers throughout the care continuum.

These shifts drastically change the expectations that providers have for the pharmaceutical industry, and the role it can play in guiding and supporting customers through this evolving landscape. In response to the increased reliance on real-world evidence, pharmaceutical companies can look to collaborate with the most highly integrated health systems to co-develop and maintain appropriate real-world evidence databases that support care pathway development and track performance, the authors said.

“Our study reveals that 60 percent of physicians are employed by an organized provider, and two-thirds are already being reimbursed by mechanisms that share financial risk which is driving them to rank real-world data over clinical trial information, transforming the way they make treatment decisions,” Shiraz Hasan, a vice president in Capgemini Consulting’s North American life sciences practice, said in a statement. “The pharmaceutical industry is about to go through a complete reframing of how they market and provide value to the physician community given the changes in the landscape stemming from the shift to value-based care that is upon us right now.”

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