Survey: Payers Embracing Value-Based Payment Models

Dec. 10, 2015
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.

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.”

Sponsored Recommendations

ASK THE EXPERT: ServiceNow’s Erin Smithouser on what C-suite healthcare executives need to know about artificial intelligence

Generative artificial intelligence, also known as GenAI, learns from vast amounts of existing data and large language models to help healthcare organizations improve hospital ...

TEST: Ask the Expert: Is Your Patients' Understanding Putting You at Risk?

Effective health literacy in healthcare is essential for ensuring informed consent, reducing medical malpractice risks, and enhancing patient-provider communication. Unfortunately...

From Strategy to Action: The Power of Enterprise Value-Based Care

Ever wonder why your meticulously planned value-based care model hasn't moved beyond the concept stage? You're not alone! Transition from theory to practice with enterprise value...

State of the Market: Transforming Healthcare; Strategies for Building a Resilient and Adaptive Workforce

The U.S. healthcare system is facing critical challenges, including workforce shortages, high turnover, and regulatory pressures. This guide highlights the vital role of technology...