A new Quest Diagnostics and Inovalon study cites barriers to value-based care, but offers advice on how to overcome them.
Complexity and lack of access to patient data at the point of care may be slowing the adoption of value-based care for physicians and health plan executives, according to a new study.
According to the study from Quest Diagnostics and Inovalon, both physicians and health plan executives (74%) agree that quality measures are too complex, making it difficult for physicians to achieve them.
"Physicians are confronted with multiple quality scoring systems, risk adjustment models, reimbursement rules, and incentives that change from patient to patient," says Harvey W. Kaufman, MD, senior medical director, Quest Diagnostics.
The study is based on a survey of hospital-affiliated primary care physicians and health plan executives.
Lack of information is also an issue; 65% of the physicians in the study said they do not have all the healthcare information they need about their patients. And what they do have isn’t easily available within their current clinical workflow.
"Lastly, we learned physicians are hungry for solutions," Kaufman says.
Eighty-five percent of physicians said they were likely or very likely to use a tool that provides on-demand patient-specific data to identify gaps in quality, risk and utilization as well as medical history insight within the clinical workflow in real time.
"Because complexity and lack of information are continuing obstacles for physicians, it follows that its harder for managed care organizations to achieve quality and performance goals under associated value-based care models," Kaufman says. "By noting the differences in how these challenges are perceived, the study findings highlight a possible path forward for accelerating value-based care adoption. Clearly, having better tools at the point of care is one step in that direction."
The study suggests the following advice for executives:
• Invest in new technology that accelerates adoption of value-based care. The technology should make adherence to quality, risk score accuracy and incentive requirements easier and provide more patient data when and where it’s needed.
• Take a closer look at how the data you’re generating and tracking is making it back to the point of care as insights that inform clinical decisions. Do your physicians know which quality, utilization and other measures under value-based payment models apply to each individual patient? Can they access this information quickly, and within the workflow? If not, it may be time to consider investigating technologies, such as a point-of-care analytics technology, that can deliver this information during the patient consult.
• Talk to providers to ensure you are aligned.
"The obstacles impeding value-based care adoption are surmountable, but first physicians and executives need to communicate and collaborate," Kaufman says. "The study highlights obstacles to value-based care, but it also reveals that progress is being made. It shows the tremendous potential for greater collaboration between healthcare executives and physicians using national, objective data."
The study included 450 respondents: 300 primary care physicians employed in private practice but who have an affiliation with a hospital and 150 health plan executives (director-level and above).