A survey by the Medical Group Management Association (MGMA) found that almost half of physicians are split on their feelings around the shift towards value-based payment models.
Value-based healthcare is a hot topic for many medical groups and MGMA wanted to get a pulse on the matter from its member base. In a May 2 MGMA Stat poll, only 11 percent of physicians reported having positive sentiment around the shift towards value-based payment models, and 49 percent of physicians are split. The poll found that 40 percent of physicians have negative sentiment around the shift towards value-based payment models.
David Gans, MGMA senior fellow, industry affairs, says that he is not surprised by the results of the survey. “Physicians are uncertain how value-based payment is going to affect their practices and their patients. They are familiar with fee-for-service, and they have created the internal systems that you need to manage patients in that payment environment, and how to manage your payment. You’ve got billing systems that are optimized around identifying what the appropriate procedures are and billing those procedures and being paid. When you start looking at some of the mechanisms for value-based payment, we’re looking at either taking more risk at the practice or having certain types of bonusing systems based on patient outcomes or population health, and that’s uncertainty,” he says.
Gans continues, “A lot of physicians, to be honest, have had less than good experience with relationships with health maintenance organizations or other insurers, so there’s not necessarily a lot of trust in how the system is going to be implemented. So you have uncertainty about the unknown, versus what you know very well.”
Further, Gans says the survey results indicate that about half of physicians have mixed feelings on value-based care. “From a physician perspective, the concept of value-based payment is good. The implementation, on the other hand, is where the uncertainty is. So I think what we’re seeing is that physicians think that if properly reimbursed, this could be very positive, however, there is uncertainty about how it will be implemented.”
Moving forward, as the healthcare industry continues to push further into value-based care and value-based payment initiatives, Gans asserts that insurers, whether the Centers for Medicare & Medicaid Services (CMS), or commercial insurers, need to work more closely with physicians on developing definitive standards for evaluating patient outcomes and cost, and also should provide feedback to physicians to better manage costs. Value-based care and value-based payment programs are “really a partnership between the insurer and the doctor for information exchange that can help lower those costs,” he says.
