by
Lauren Dubinsky, Senior Reporter | May 21, 2014
Even though 75 percent of health care providers are involved in at least one value-based payment model and over 60 percent of them expect it to eventually become the dominant payment model, fewer than 30 percent think that the reward justifies the risk, according to a study published by Availity, a health information network.
The study, called "Provider Attitudes Toward Value-Based Payment Models," includes feedback from over 500 physician practices and hospital-based professionals across the nation. The Centers for Medicare and Medicaid reported that there are more than 360 Medicare Accountable Care Organizations in the U.S. and Puerto Rico, and it's expected to grow, according to the study.
"The health care revenue cycle is incredibly complicated and it's undergoing a transformation," Russ Thomas, CEO of Availity, said in a statement. "Unless we equip providers — and health plans — with the right tools and access to the information they need, we risk further complicating an already complex and fragmented system."
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The study details providers' main concerns and the gaps and barriers that have to be dealt with in order for the new models to be successful, he added. This study follows another study Availity conducted in September to investigate how ready providers and health plans were to implement value-based models of care and reimbursement.
Since providers have to manage value-based payment models, as well as the existing fee-for-service model, it's causing problems, including accurate revenue forecasting and workflow integration challenges.
"The administrative complexity of administering these plans is likely to be costly," one of the physician practice respondents said in a statement. "The unpredictability of the revenue stream is likely going to make administering some of these plans not worth the cost."
Over 80 percent of the respondents explained that there is a need for payment to the additional staff that value-based models require to be less than 20 percent of their current revenues. More than 75 percent indicated that meaningful workflow tools and real-time information access will aid in avoiding expensive, manual processes, which is a key factor in the success of value-based payment models.
