McKesson has commissioned a report, titled “Journey to Value: The State of Value-Based Reimbursement in 2016,” which lists results from a national study of 465 payers and hospitals. The work was conducted by ORC International.
Payors said they estimate that nearly 60% of payment will be a mix of capitation/global payment, pay for performance, and episode of care/bundled payment in five years, with bundled payment growing fastest.
Health plans project bundled payment will grow 6% over five years. However, only half of payers and only 40% of providers say they’re ready to implement bundles, and only a quarter have the tools in place to automate these complex models, the report said.
Network management has changed, with 80% of respondents saying they have become more selective about who is in their network.
Of the metrics in place for measuring VBR success, roughly one-fourth of hospitals are meeting their goal to reduce administrative cost of care and their goals to lower healthcare costs. A third said they are are meeting care coordination goals, and 40% are meeting goals for improving patient outcomes.
“Payers and providers are clearly beginning to scale VBR,” said Rod O’Reilly, president of McKesson Health Solutions. “The swift pace of change, coupled with the daunting complexity of these payment models, are putting extreme pressure on the healthcare system. As we move beyond pilots, the ability for payers and providers to automate the complexity inherent in these models will be a deciding factor to success.”
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