Four solutions to value-based care challenges

June 16, 2017

An annual study commissioned by Quest Diagnostics and Inovalon reveals interesting findings to keep value-based care moving forward.

Progress has been made over the past year toward value-based care, but obstacles still persist, according to a new study.

First and foremost among them are differing perceptions of health plan executives and physicians about the tools and data needed to deliver on value-based care, according to 2017 Progress on the Path to Value-Based Care, the second annual study commissioned by Quest Diagnostics and Inovalon. The study gauges perceptions of physicians and health plan executives on the path to value-based healthcare over the past year. It also explores the potential keys to accelerating the shift to value-based care moving forward.

While 70% of health plan executives said progress has been made to better align health plans and providers, only 47% of physicians agreed, according to the findings. And 75% of health plan executives said EHRs have everything physicians need and only 54% of physicians agreed.

James

“Efforts in Washington to repeal and replace the Affordable Care Act may cast doubt on the future of some facets of healthcare, but the transition to value-based care is not one of them,” says Patrick James, MD, chief clinical officer of health plans and policy and medical affairs at Quest Diagnostics. “More than eight in 10 physicians and health plan executives [82%] said they believe the transition to value-based care will continue, regardless of legislative reforms spearheaded by the federal government.”

Here are the top 4 solutions to overcoming value-based care obstacles:

1.   Yield better data from EHRs. The study found “somewhat surprisingly,” says James, that physicians would be willing to engage their EHRs more if they provided better data. “Seventy percent of physicians said they do not see a clear link between EHRs and better patient outcomes. Yet, the majority of physicians said they’d be willing to spend more time using technology if EHRs could yield insights unique to patients and 85% agreed that access to quality and performance measures specific to patients would be key to achieving value-based care. These findings suggest EHRs could provide an avenue for physicians to actively seek out information to aid quality and performance measurement reporting. Extending current EHR offerings with this type of data could potentially unleash their value.”

2.   Align with physicians. The study showed that managed care executives may not be as aligned with physicians as they could, and that this lack of alignment may hobble value-based care adoption, according to James.

“For instance, 53% of health plan executives polled said physicians have the tools they need to succeed under value-based care, but only 43% of physicians agreed,” he says. “While that gap of 10 percentage points was less than the 15 percentage point gap we observed in our study last year, it shows health plans executives may not understand some of the hurdles physicians face in delivering on programs that influence the financial performance of the health plan.”

There is an opportunity for greater alignment between health plan executives and physicians, according to James.

“Time and again, we saw in our data that health plan executives believe physicians are better prepared to deliver on value-based care than the actual physicians themselves,” he says. “Executives may want to be more alert to opportunities to work with physicians. In that regard, a sizeable percentage of physicians said they’d be willing to consider co-investment strategies with physicians.”

3.   Develop quality metrics. Seventy-one percent of physicians said they’d be willing to spend more time using technology if EHRs could yield insights unique to patients, according to the study, while 85% agreed that access to quality and performance measures specific to patients would be key to achieving value-based care.

“Health plans executives may want to consider helping their network physicians adopt technologies that extend the capabilities of the EHR and provide critical data-such as on quality metrics-to help them deliver value-based care,” James says.

4.   Co-invest in health information technology (HIT). Eighty-five percent of health plan executives polled in the study said a co-investment in HIT by health plans and providers would accelerate value-based care. “This indicates that health plan executives are mindful of the significant investment required of physicians to implement HIT solutions, especially EHRs, and they see the potential for co-investment to help surmount this challenge,” James says. “If that’s true, it could be a good starting point for future collaboration.”

Tools to help minimize these challenges exist. For example, tools exist that bring actionable patient-specific data, including on quality metrics, to the physician in the EHR.

Quest Diagnostics and Inovalon partnered with a professional research company to administer an online survey from April 7 to 17, 2017. The study includes 452 respondents. Of these respondents, 302 were primary care physicians employed in private practice but who have an affiliation with a hospital, and 150 were health plan executives that hold positions at director-level and above.