The Top 5 Barriers to Value-Based Care

November 13, 2019

A recent survey found what were the biggest issues facing value-based care.

It goes without saying that value-based care is growing in the United States. An analysis of the model from Definitive Healthcare, found that 48 states now have value-based care programs-up from just three in 2011.

While the value-based care model is growing, there are still several major barriers when moving to such a system. In a recent survey polling 1,090 healthcare leaders across various sectors, respondents identified five main challenges to shifting to a value-based model.

Here are the five barriers from least to most critical:

5. Difficulty collecting and reporting patient information

Approximately 14.8% of respondents reported that having trouble accessing patient information was a challenge that providers face when transitioning to a value-based care model.

 Since value-based care is centered around practitioner coordination, easy access to patient records and data is critical for successful wraparound care. Inaccessible patient information creates a huge barrier to coordinated care, and makes providing effective preventative care nearly impossible.

While almost 15% of those surveyed found this to be a critical issue, the adoption of more efficient ways to share patient data-such as online platforms-being implemented by many healthcare systems and practices push this problem to the bottom of the list for most of those surveyed.

Related: Three Reasons Why Value-based Care Works

4. Shifting policies and regulations

Continuously evolving value-based incentive programs continue to be a big barrier for 16.2% of survey respondents.  Since the introduction of incentives from the Centers from Medicare and Medicaid Services weren’t mainstream until 2012, regulations and policies have been constantly introduced and modified.

These changing regulations have made the shift from a fee-for-service model a challenge, as healthcare practitioners struggle to navigate the shifting value-based incentive programs.

3. Financial risk and unpredictable revenue streams

Many respondents reported that the bottom line of challenges they face was just that: their bottom line. Fears about revenue stability and sustainability when adjusting to a value-based payment system were reported by 17% of those surveyed to be a big barrier to switching to the value-based model.

In addition to concerns about unpredictable effects on their revenue stream, these respondents also cited difficulty understanding the financial complexities involved in value-based care incentive programs and the transition to these programs. Essentially, an overall lack of understanding of the financial risk of adopting a value-based care model was a formidable barrier.

2.  Technology interoperability challenges

Gaps in interoperability were the second-highest reported barrier for respondents. Much like those who reported concerns about collecting and reporting patient information, the 19.7% of participants who cited inoperability as a barrier were deeply concerned about the difficulties of data exchange.

The adoption of electronic health record (EHR) systems have been critical in managing the impressive amount of healthcare data and analytics that needs to be shared in a value-based care model. While the implementation of EHR technology has grown drastically since CMS’ meaningful use incentive payments initiative in 2011, 2% of hospitals still do not have EHR systems-many of which are psychiatric facilities, which can be a critical component in value-based care.

1.  Lack of resources

The number-one challenge reported was simply a lack of resources. Over a quarter of respondents (25.3%) cited staffing shortages, insufficient healthcare software and other deficits as the biggest barrier to value-based care. Without sufficient resources to make-and support-the switch to this model, it may not be sustainable for many practitioners.

For example, inadequate healthcare software won’t allow healthcare providers to assess and execute critical population health initiatives critical to the success of value-based care. And of course, a shortage of staff necessary for value-based wraparound care-such as registered nurses, behavioral health providers and pharmacists-make it nearly impossible to effectively fulfill the parameters of the value-based care model.

Laura Dorr is a freelance writer based outside of Cleveland. She has served as a writer and editor for a variety of publications and websites across the medical, dental, sports, education, and nonprofit industries.