Fewer than a quarter of US hospitals on track to hit value-based payment goal, survey finds

Hospitals are slowly progressing toward CMS' goal of transitioning half of payments to value-based care models by 2018, a new survey of healthcare executives from Health Catalyst reveals.

Here are seven findings from the survey.

1. Fewer than a quarter of U.S. hospitals are on track to hit Medicare's 2018 goal.

2. The survey revealed that only 3 percent of health systems today meet the target set by CMS.

3. Only 23 percent of health systems expect to meet Medicare's target by 2019, a year after CMS had hoped that half of all Medicare reimbursements would be value-based.

4. The majority of health systems — 62 percent —have either zero or less than 10 percent of their care tied to the type of risk-based contracts identified by CMS as "value-based," including Medicare accountable care organizations and bundled payments, according to the survey.

5. Small hospitals with fewer than 200 beds comprised the majority of those reporting no risk-based contracts. The survey notes that a contributing factor to this may be that smaller hospitals are five times less likely than larger organizations to have access to sufficient capital to make risk-based contracting work.

6. Although healthcare organizations may lag behind the federal government's goal, healthcare executives across the board intend to steadily increase value-based care and risk-based contracts, the survey found. In the next three years, all but 1 percent of survey respondents expect their organizations to be engaged in risk-based contracts. Sixty-eight percent expect risk-based contracts to account for less than half their total care in that time frame. Only 23 percent expect value-based care to account for more than half of their care in the next three years. Eight percent of respondents could not predict the answer.

7. In the survey, healthcare executives at small and large hospitals cited analytics as the most important organizational element needed for success with risk-based contracting. In fact, 52 percent of respondents cited the prime importance of analytics, more than double the second most-selected answer: a culture of quality improvement. Twenty-four percent of respondents cited cultural alignment on quality as having the most impact on value-based care success.

Survey results reflect the opinions of 78 healthcare professionals who responded to an online survey by Health Catalyst last May. More than half of the respondents (51 percent) were CEOs or CFOs of large hospital-owned physician groups and hospitals ranging in size from 15 acute care beds to more than 1,000 beds. The remaining respondents all held executive roles, including several CMIOs, CMOs and CNOs.

The organizations represented include many well-known multi-hospital and multi-state health systems with a cumulative 756 inpatient and outpatient facilities and 20,416 acute care beds.


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