Discussions about emerging payment models have flourished in recent years, however many providers are still rooted in conventional fee-for-service options. Although hospitals and health systems have acknowledged industrywide emphasis on quality-based reimbursement, it has been somewhat unclear how willing and ready they are to move away from traditional payment models and take on higher degrees of risk.
To learn more about providers’ interest in and capabilities for assuming risk, the Healthcare Financial Management Association (HFMA) surveyed a group of HFMA members about the topic. The survey was in the field for two weeks during May 2019 and involved 170 hospital and health system senior financial executives. This HFMA Research Highlight, sponsored by Navigant, discusses key takeaways from the survey.
Providers are poised to act
Nearly three out of four healthcare executives (72%) believe their organizations have the necessary capabilities to support increased levels of risk and plan to take on additional risk in the next one to three years. Health system leaders were more certain of their organization’s abilities, with 81% of them expressing confidence versus 68% of leaders in stand-alone hospitals.
“The Affordable Care Act left many providers assuming that risk-based models would be the new normal, but the transition has not been as successful or widespread as anticipated,” says Richard Bajner, Navigant managing director and healthcare value transformation practice leader. “With most health system leadership teams anticipating continued downward pressure on margins, accepting risk can represent a lever for revenue growth, as long as providers commit enough of their revenue and resources to risk-based models. The results of this survey show the value-based movement may be coming full circle, and this time providers will benefit from previous experiences in designing their approaches.”