Premium Reports
Value-Based Care Timing 2016

Value-Based Care Timing 2016
The Transition from Fee-For-Service

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It’s been five years since Medicare kicked off an industry-wide transition from fee-for-service reimbursement to a system that rewards quality rather than quantity. Commercial payers are following suit, and providers expect participation is inevitable. Some providers are adopting value-based care (VBC) initiatives in an attempt to remain competitive, while HIT vendors are counting on VBC as a revenue stream. Based on 173 provider interviews, this report examines the progress of VBC and which HIT vendors and solutions are making a difference.

1. VALUE-BASED CARE SPEEDS UP...AND SLOWS DOWN: A GIFT TO EMR VENDORS

Providers are becoming more knowledgeable about VBC and about their own ability to transition from a fee-for-service business model. Rather than speeding up their plans, however, they are being more cautious—especially since incentives are not highly compelling. In many cases, providers are experimenting with vendors in the same way they are with VBC, and their hesitancy to make comprehensive investments benefits HIT vendors, who can use the time to enhance offerings. This is especially favorable for EMR vendors, who are almost universally preferred for integration benefits but generally criticized for the immaturity of their tools.

2016 Value Based Care Timing Riding the VBC Waves

2. THIRD-PARTY VENDORS ABOUND: NO CLEAR LEADER YET

VBC vendors often claim to be foremost in their field, saying their broad capabilities are a key differentiator. In reality, providers have yet to see a vendor take the lead. Respondents mentioned 125 unique vendors as currently helping or being considered—83 were only mentioned once. Best in KLAS population health solution IBM Phytel was mentioned only 9 times; second runner up Enli, three times. Providers report solution gaps, and several have told KLAS they cancelled vendor selection after putting out an RFP due to the lack of compelling options.

2016 Value Based Care Timing Most Frequently Mentioned Third-Party Vendors

3. ALLSCRIPTS, CERNER, AND EPIC AMONG THE MOST HELPFUL EMR VENDORS

A desire for simplicity and workflow integration increasingly leads providers to give first consideration to their core EMR vendors for VBC-related investments. Allscripts and Epic customers are most likely to say their EMR vendor has had a positive impact in helping them achieve VBC goals. Allscripts and Cerner have the highest pent-up demand from existing customers looking to make future investments. Beyond providing traditional EMRs, McKesson and MEDITECH are least involved in their customers’ current efforts. Epic customers are looking to third-party vendors to supplement the Healthy Planet functionality they already have.

2016 Value Based Care Timing Most Frequently Mentioned EMR Vendors

4. PROVIDER CONFIDENCE GROWS; RISK TAKING DOES NOT

Even though most providers are involved in at least one VBC contract, the majority are still in the shallow end of risk—68% say that 0%–10% of their revenue is tied to VBC agreements. Even so, two-thirds of study respondents are confident or very confident in their ability to manage populations when needed. They credit experience already garnered and supporting technology already in place. Less confident providers say technology is no substitute for experience. Organizational issues—such as a lack of resources, of physician alignment, and of a provider network— are also barriers, particularly for smaller organizations, such as standalone hospitals, that must rely on affiliated partners to help them move forward.

2016 Value Based Care Timing Confidence

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KEY TOPICS

  1. Value-Based Care Speeds Up... And Slows Down: A Gift to EMR Vendors
  2. Third-Party Vendors Abound: No Clear Leader Yet
  3. Allscripts, Cerner and Epic among the Most Helpful EMR Vendors
  4. Provider Confidence Grows; Risk Taking Does Not
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2018 KLAS Enterprises, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.