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Study: One in Three Family Physicians Already Pursuing Value-Based Payments

December 1, 2015
by Heather Landi
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A study conducted by the American Academy of Family Physicians (AAFP) and sponsored by Humana Inc. found that 33 percent of family physicians are already pursuing value-based payment opportunities, although lack of time was identified as a top barrier to implementing value-based care delivery.

AAFP conducted the study in light of the U.S. Department of Health and Human Services’ goal of tying 50 percent of traditional, or fee-for-service, Medicare payments to value-based payment models by 2018. AAFP’s 2015 Value-Based Payment Study gauges family physicians’ perceptions of and progress toward making the shift from fee-for-service to value-based care. The study was sent to 5,000 active members of the AAFP with a total of 779 surveys completed and 626 evaluated after a screening process.

As previously reported by Healthcare Informatics, HHS announced in January that it had set value-based reimbursement goals, which marked the first time the Obama administration has publicly set explicit goals for value-based payment and alternative reimbursement models.

The study found that 19 percent of family physicians are developing value-based payment capabilities but are waiting until results are better known before fully pursuing and 15 percent are holding off on making changes and are focused on optimizing under fee-for-service.

As background, a majority of family physicians have contracts with a substantial number of health plans, as 61 percent of those surveyed receive payment from seven or more health plans, and of that 38 percent receive payment from 10 or more health plans.

Less than half (46 percent) of family physicians indicated they have pay-for-performance programs available in their market and the remaining payment models, such as shared savings and bundled/episode-based payments, were cited with less frequency (30 percent of respondents or less).

And, a significant percentage of family physicians are uninformed regarding value-based payments, the study found, as one in four don’t know or are not sure of their practice’s status or current strategy toward value-based payments, and 32 percent don’t know if value-based payment models are available in their market. And, among those participating in value-based payments, 33 percent are not aware of how the payments were being distributed within their practices.

“It is encouraging to see that many physicians are moving toward value-based payment, but what’s clear from this study is that there is significant work to be done,” Wanda Filer, M.D., president of the AAFP, said in a statement. “Accelerating the adoption of value-based payment will require a commitment from physicians and health plans to share in the responsibility of delivering value-based payment.”

Of the family physicians surveyed, 91 percent cited lack of staff time as an important barrier to value-based payment implementation. And, three-fourths of physicians said lack of interoperability between types of healthcare providers is a significant barrier to implementation.

According to family physicians, the most important factors for determining the success of value-based payment models are practice sustainability (92 percent) and clinical outcomes (91 percent), followed by physician/staff morale and the coordination of patient care.

However, when it comes to practice sustainability as a success factor, family physicians also identified a number of barriers to implementation, such as the need to invest in health information technology and a lack of resources to support reporting, validating and using data.

In addition, the study found that physicians are skeptical about the impact value-based payments will have on care outcomes. Of those surveyed, 69 percent of physicians believe value-based payments will not improve patient care and 59 percent believe they will increase work for physicians without a benefit to the patient.

“The results of this study tell us that physicians are genuinely concerned about the time needed to transition to value-based payment and want to ensure that their efforts translate to care improvement,” Roy A. Beveridge, M.D., Humana’s chief medical officer, said. “The health care industry would benefit from improving its understanding of physician needs and how they can best alleviate burdens. Partnering with the AAFP through this study gives us an understanding of the unique needs of the family physician to accelerate their journey to value and realize improved care outcomes.”



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