Survey respondents indicate that their organizations continue to focus on improving their ability to deliver value-based care, but progress has been slow.
Value-based payment models continue to be a central focus of healthcare providers, with care delivery, finance, and infrastructure undergoing transformation to support the new paradigm.
According to the 2018 HealthLeaders Media Value-Based Readiness Survey, modest progress is being made.
For example, 62% of respondents say that their level of strength is very strong (13%) or somewhat strong (49%) for overall preparation for value-based financial changes, and preparation for value-based care delivery changes is also encouraging, with 54% saying that their level of strength is very strong (13%) or somewhat strong (41%).
Preparation of a value-based infrastructure is slightly less positive, with 50% reporting that their level of strength is very strong (10%) or somewhat strong (40%).
Viewed another way, an equal number of respondents (50%) say it is very weak (12%) or somewhat weak (38%), meaning that there is work to be done in this area.
"The infrastructure changes to me are the hardest part because you have an asset base that, in many cases, could be a hospital that's been around anywhere from 40 to 80 years," says Karen Hanlon, CPA, executive vice president, chief financial officer and treasurer at Highmark Health.
Based in Pittsburgh, Highmark Health has a diversified portfolio of businesses, including Highmark Inc., a Blue Cross Blue Shield affiliate, and Allegheny Health Network, a health system that features eight hospitals.
"You have to figure out, how do you repurpose that asset base to be aligned with what your approach to care is in a value-based model? One where you're trying to keep people out of the hospital," Hanlon says.
Care delivery challenge
Although care coordination and patient engagement place high on the list of care delivery competencies, respondents indicate that existing processes and systems that support care teams and practices in coordination, communication, and patient outreach efforts require more work.
For example, 50% of respondents say that their care processes and systems are fully mature (3%) or that their care processes and systems are evolving to a mature state (47%).
On the other hand, an equal number (50%) say that they are still evaluating required changes (6%) or that they are in the beginning stages of evolving their processes and systems (44%).
And while it is not unexpected that few respondents say that their care processes and systems are fully mature, it is nonetheless surprising that in our survey data no respondent from either a health system or hospital says that they have achieved this stage of development.
Conventional wisdom is that health systems in particular are further along in the transition to value-based care, but this response highlights the challenge of achieving full maturity.
Jonathan Bees is a research analyst for HealthLeaders.