What’s Hindering Value-Based Care Growth in the U.S.?

Physicians are interested in adopting a VBC model, but only if the level of risk remains low.

For over a decade the United States has lagged behind other nations when it comes to the universal implementation of a value-based care model. Several factors are to blame for the U.S.’s hesitation to fully adopt a healthcare delivery system that pays physicians and hospitals based on the quality of care they provide patients, with risk to the providers being the biggest roadblock.

About 80% of physicians say they have an interest in participating in a value-based care program, according to a recent report from Bain and Company. However, that interest drops as the risk level to the provider rises.

"The mismatch between payers that want increased cost savings and providers that only want upside risk has restrained VBC growth in the U.S.," the Bain report says. "Physicians have well-founded concerns about their ability to take on risk, fueling their hesitation. Bain’s research shows physicians continue to face financial, operational, and administrative hurdles to adopting VBC." 

However, physicians say that they would be more disposed to adopt a value-based care model if they were guaranteed improved financial resources, medical coding and billing processes that are more effective, and adequate staff that can manage the reporting and outreach requirements. The majority of the physicians surveyed by Bain—37%—cite "sufficient financial resources" as the key factor in their willingness to adopt value-based care.