Only 3% of providers feel ready for pay-for-value, HIMSS survey finds
One need is managing the exchange of clinical and financial information in an episode of care.
LAS VEGAS – As more healthcare organizations begin adopting some form of a value-based payment model, only 3 percent of providers believe their organizations are highly prepared to make the pay-for-value transition, according to the new 2016 HIMSS Cost Accounting Survey, which HIMSS unveiled Thursday at the Revenue Cycle Knowledge Center at the 2016 Annual HIMSS Conference and Exhibition in Las Vegas.
The acuity of the challenges associated with a pay-for-value transition varies by market, HIMSS said. With approximately half of survey respondents representing an organization participating in an alternative payment model, those serving an urban market (69 percent serve both urban and rural communities while 48 percent exclusively serve urban) were more likely to participate in alternative payment models than those exclusively serving rural markets (31 percent).
"As the industry moves to a more patient-centered, value-based system, it is exciting to see providers embracing this change," said Pam Jodock, senior director, health business solutions, at HIMSS. "But if we are to realize the projected cost savings of moving from fee-for-service to pay-for-value we will need to act in a thoughtful way when building the infrastructure and business processes to support these new payment models."
The findings of the cost accounting survey identify what providers perceive their top needs to be in transitioning toward pay-for-value as well as highlight areas of opportunity for the industry to help providers make a smooth transition, Jodock said.
"For example, it will be critical that the industry reaches some level of consistency in terms of how providers should manage the exchange of clinical and financial information between all parties involved in an episode of care, regardless of whether or not they are part of the same healthcare delivery system," she added.
HIMSS surveyed 102 executives and finance professionals from an array of U.S. healthcare provider organizations. Asked to examine their organization's readiness to move from a fee-for-service to value-based payment model, respondents indicated the top areas of need are tools to track and evaluate quality of care, better communication between disparate providers, and consistent definition of quality by specific type of disease.
Survey respondents also claimed they are looking for industry consistency in a number of areas, including cost accounting methodologies and tools, how pricing is determined and shared, and how the industry manages the exchange of clinical and financial information between all entities involved in an episode of care.
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