What Does Value-Based Healthcare’s Future Look Like? A New Survey Examines

A new survey of nearly 800 healthcare leaders sheds light on the biggest barriers that stakeholders face when transitioning to a value-based care system, the factors accelerating the adoption of value-based programs, and how executives envision the value-based care landscape shifting next year.

Data analytics company Definitive Healthcare recently polled an array of leaders across the provider, biotech, financial services, staffing, life sciences, IT, and consulting verticals to determine predictions for the future of the value-based care landscape in 2019 and beyond.

In the company’s first-annual value-based care trends survey, respondents said that a lack of resources (short-staffed, insufficient healthcare IT software, etc.) ranks as the biggest barrier (25 percent) to implementing value-based care. Other top challenges included internal and external interoperability gaps (20 percent); unpredictability of revenue stream and complexity of financial risk (17 percent); changing regulations and policies (16 percent); and trouble with collecting and reporting patient information (14 percent).

Other respondents chimed in with comments such as “It's not ‘there’ yet. It seems to be a mythical creature in many markets,” and "We are in a transition period. Tough to implement when [an] organization is 30 percent value-based care [and] 70 percent fee-for-service."

Meanwhile, when asked about the factors that folks think will accelerate the transition to value, respondents ranked “appropriate provider compensation and incentives” as the top element (44 percent). According to survey researchers, “Under the current system, providers can opt into value-based purchasing initiatives, receiving bonuses for performing above average and being penalized for performing below average. However, more clarity may be needed to entice providers to jump on board the value-based train.”

A consolidating market full with mergers and acquisitions, which in turn will move more providers into value-based care models, ranked as the second highest factor for acceleration (19 percent). Policy requirements (16 percent) came in third, while an increase in risk-sharing models like ACOs ranked fourth (12 percent).

One respondent commented, on what will accelerate the transition, “Anything that 'forces' each stakeholder, through incentives, to pay attention and devote brain power, time, and resources to the problem."

What does the future hold? Thirty-one percent of respondents ranked the evolution of ACOs and bundled payment arrangements as the top factor in the shifting landscape. According to Definitive Healthcare ACO data, there are nearly 1,400 active ACOs in the U.S., with approximately 560 participating in the Medicare Shared Savings Program. As these payment programs continue to evolve and become easier to understand, the more likely providers will make the shift toward value-based care, company officials opined.

What’s more, without a fundamental paradigm shift, it will be difficult for value-based care to become the go-to-standard. As such, 28 percent respondents ranked “a greater movement away from fee-for-service models as a result of mandatory regulations” as the top factor in value-based care’s future.

Additionally, providers will be more focused on benchmarking their success against that of their competitors. With 21 percent of the votes, benchmarking success will be a big factor in 2020 and years to come. According to Definitive Healthcare data, in 2019, 56 percent of hospitals participating in value-based purchasing received a positive adjustment, which means more than half of hospitals are performing "above average." “Many providers may be ill-equipped to benchmark performance, understand how payors stack up against each other, and lack a real sense of the competitive market,” the researchers noted.

In the end, 48 percent of respondents said that fewer medical errors and better outcomes rank as the biggest benefit of value-based purchasing in healthcare, with the idea being that with value-based care programs, providers can spend more time focusing on preventative medicine and population health issues rather than struggling to keep up with high patient demand and readmissions.

Meanwhile, 28 percent of respondents noted the cost benefits associated with value-based payments as the biggest upside factor, while 18 percent said that increased patient satisfaction is the biggest benefit.