Providers weigh the impact of value-based payment models on population health

By | 2 minute read | November 19, 2018

David Jackson is the Vice President Professional Services at IBM Watson Health.

Starting in 2019, providers around the country will see their Medicare Part B reimbursement adjusted up or down based on how well they performed in 2017 due to the Medicare Access and CHIP Reauthorization Act (MACRA), which adjusts payment based on outcomes. While that has many hospitals and health systems wringing their hands, others have plunged headlong into quality improvement initiatives designed to improve outcomes and maximize these value-based reimbursements.

Though U.S. healthcare provider organizations still receive the majority of their revenue from fee-for-service contracts[1], the tide is starting to shift as ever-larger numbers of hospitals and health systems start the process of linking value to outcomes. How do these hospitals feel about the transition?

To get some insight into how providers are handling the transition and how it has influenced their population health strategies, the HealthLeaders Media Intelligence Unit, in conjunction with IBM Watson Health, conducted the 2018 Population Health Survey.

In May 2018, an online survey was sent to the HealthLeaders Media Council and select members of the HealthLeaders Media audience. U.S. healthcare executives completed a total of 101 surveys that are included in the analysis. The survey found that, slowly but surely, providers are prioritizing value-based care, and are becoming more confident in the future viability of this strategy.

Following were some of the key insights:

  • Organizations confident in improving outcomes, less so in reducing costs: Sixty-nine (69) percent of respondents said their organization’s overall preparation for population health delivery changes was somewhat or very strong. That reflected a 12% increase from 2017 levels. Sixty-three (63) percent said their preparation of a population health organizational infrastructure was somewhat or very strong, while 60% said their preparation for population health financial changes was somewhat or very strong.
  • Opinions vary on links between population health and value-based care: Thirty-two (32) percent of respondents said that population health is the ultimate goal of value-based care, while 18% said it was a part of value-based care. Just 7% said population health was not at all related to value-based care. Nearly a quarter (23%) of respondents said that population health was more about purchasing and reimbursement systems, and as a result, different than value-based care.
  • Patient engagement portals and outreach programs remain a focus: Healthcare providers report employing a number of different strategies to implement population health management activities. The most popular patient engagement areas are patient portals (76%) and wellness or condition-related outreach programs (71%), nearly identical to last year’s survey.
  • Funding for IT infrastructure is a pain point: The three biggest barriers to successfully deploying population health programs are up-front funding for care management, IT, and infrastructure (51%), engaging patients in their own care (45%) and getting meaningful data into providers’ hands (33%).

As health care providers move forward with value-based strategies, they must be able to ingest data from many sources to clearly interpret the impact that quality measures will have on their overall reimbursement from CMS and private health plans. Thus far, by healthcare executives’ own admission, that has been a process, but ultimately, there has been progress.  To read the full results of the HealthLeaders Media and IBM Watson Health survey, please click here.

[1] https://www-01.ibm.com/common/ssi/cgi-bin/ssialias?htmlfid=GBE03782USEN&

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