A majority of health plans – nearly 60 percent – project that more than half of their business will be supported by value-based payment models in the next five years, according to a new research study from Availity.
The study, “Health Plan Readiness to Operationalize New Payment Models,” assesses commercial health plans and their progress as they expand from fee-for-service to value-based models of physician compensation.
The findings indicate health plans are taking emerging payment models seriously – models such as accountable care organizations and pay-for-performance. In fact, 82 percent of respondents said they consider payment reform a “major priority” at their respective organizations and are adapting their businesses accordingly.
But health plans also realize they can’t go it alone. Importantly, the study highlights the consensus among plans that information sharing with physicians must be automated – primarily in real-time – for these models to achieve success. And that means significant changes in how and what information is exchanged need to occur quickly.
Transitioning to payment models that base compensation on outcomes will require physicians and health plans to exchange new kinds of information – different than what is required under today’s largely fee-for-service arrangements. Although less than half of the health plans have real-time capabilities, 85 percent say the highest value will come from real-time exchange.
“The physician revenue cycle is changing and the data collected in this study gives us guidance on how quickly that may happen,” said Russ Thomas, CEO of Availity. “We’re seeing the shift begin; we’re excited about the future and the contributions we are making to ensure the health of our customers’ businesses.”
The study further details the lines of business targeted for new payment models, payment model maturity, and expectations for growth over the next 18 months. To download a copy of the study, visit the Resource Library.