Employers and Physicians Disagree on Value-Based Payment

The value-based payment reform is well underway, yet there seems to be little agreement in the field of how best to move forward, according to a new survey from Leavitt Partners.

The survey assessed physicians, employers, and consumers in issues related to healthcare outcomes, cost, and payment models.

According to the survey, there is no consensus on which group is most responsible for pushing provider payment reform forward.

Employers and physicians were asked to choose who they thought was most responsible, and the answers were well-distributed among government, employers, insurers, health systems and hospitals, individual physicians, and patients, with no group receiving an overwhelming majority of votes. With no agreement on the responsible party and little responsibility placed on themselves, employers and physicians are neither especially motivated to acknowledge their role in change nor sure of who to look toward for progress.

There is also no agreement on the barriers to the adoption of provider payment reform.

50% of physicians surveyed believe that the most significant barrier to adoption is the fact that the regulatory burden is too high. While 26% of employers agree, 27% of employers believe that providers’ unwillingness to participate is instead the largest barrier. Neither employers nor doctors focused heavily on their own actions as a barrier to adoption.

In addition to the disagreement between employers and physicians over value-based payment, the survey also revealed a lack of physician familiarity with MACRA. Only 4% of respondents said they had an “in-depth knowledge of the law and its requirements,” while 47% of respondents said they “recognized the name but are not familiar with its requirements.”

Leavitt Partners notes that “frustration [with MACRA and value-based payment] on the part of physicians may come from experiencing existing challenges, but not having a sufficient understanding of either the underlying problems or the reform efforts.”

This survey demonstrates what many of us in the healthcare field perhaps already knew: the path to value-based payment that properly weighs healthcare outcomes and incentivizes providers to provide excellent care is not yet a clear one. As long as employers and providers alike struggle to agree upon who’s most responsible and where the barriers lie, it will be challenging to create reform that meets the goal of improving the quality and cost of medical care patients receive.