Survey: 1 in 3 Family Physicians Pursuing Value-based Payment

AAFP, Humana Partner to Assess Readiness

December 02, 2015 01:41 pm Sheri Porter

Getting family physicians ready for a health care delivery system that revolves around value-based payment is a key priority for the AAFP.

[Doctor checking yes/no box on virtual board]

It's a priority for many family physicians, too, according to a survey in which one-third of respondents said they are already pursuing such models. The Academy -- along with health insurer Humana -- hosted a congressional briefing on Dec. 1 in Washington to highlight findings from the survey.

The one-hour event was centered on learnings from a value-based payment readiness survey in which 626 family physicians participated earlier this year. The survey was expressly designed to evaluate how well-prepared America's family physicians are when it comes to implementing value-based payment models.

The AAFP and Humana partnered on the survey project, with Humana providing funding and the Academy handling survey distribution, data collection and analysis.

Survey Informs Legislators

Attendees at the briefing included congressional staffers and representatives from advocacy groups such as the Medical Group Management Association and the Patient-Centered Primary Care Collaborative, as well as members of the press.

Story Highlights
  • The AAFP and Humana hosted a congressional briefing on Dec. 1 in Washington to present findings from a value-based payment readiness survey that was completed by 626 family physicians.
  • The goal was to help those in attendance -- including congressional staffers and representatives from advocacy groups -- understand physicians' perceptions and attitudes about value-based payment models.
  • The survey found that 33 percent of respondents were pursuing value-based payment opportunities; the AAFP will use survey results to develop resources to prepare family physicians for future payment models.

The goal was to help those in attendance understand physicians' perceptions of and attitudes about value-based payment models. And for those congressional staffers, that means passing the knowledge on to legislators who have the political muscle to smooth the future payment path for busy physicians.

Perhaps one of the most important findings(2 page PDF) presented was that 33 percent of survey respondents are already pursuing value-based payment opportunities. Furthermore,

  • 19 percent say they are developing value-based capabilities but are waiting to jump completely in while they evaluate whether the models are worth pursuing,
  • 15 percent are focusing on optimizing fee-for-service payment, and
  • 25 percent say they don't know about or are unsure of their valued-based payment strategy.

Of note, less than half of respondents -- 46 percent -- say pay-for-performance programs are available in their area.

In a joint press release( issued by the AAFP and Humana shortly after the Dec. 1 event, AAFP President Wanda Filer, M.D., M.B.A., of York, Pa., noted that the hard work was just beginning.

"It is encouraging to see that many physicians are moving toward value-based payment, but what's clear from this study is that there is significant work to be done," said Filer.

She added that "accelerating the adoption" of valued-based payment would require commitment and shared responsibility from physicians and health plans.

Filer told AAFP News that the Academy would put the survey findings to good use "to further develop resources and educational materials to support family physician's transition to value-based care delivery."

FPs Highlight Success Factors, Barriers

When it came to factors important to the success of value-based payment models, physicians put practice sustainability on top (92 percent), with clinical outcomes close behind (91 percent).

Physicians also cited the importance of physician and staff morale (87 percent), coordination of patient care (86 percent), cost savings for the practice (84 percent), patient satisfaction (82 percent) and population health management (72 percent).

Survey respondents had mixed answers regarding distribution of value-based payments within their practices. More than one-fourth (26 percent) knew that payments were made to the practice but not directly distributed to physicians; nearly the same percentage (24 percent) knew that physicians received such payments.

A full 33 percent did not know how value-based payments were handled in their practices.

Physicians also expressed their views on the obstacles practices face when trying to implement a value-based payment model. Among those responses were

  • lack of staff time (91 percent);
  • concern about investments in health information technology (87 percent);
  • scant resources to report, validate and use data (81 percent);
  • inability to predict revenue stream (81 percent);
  • lack of evidence that performance measures improve patient outcomes (62 percent); and
  • anticipation that value-based payment would increase physician workload without benefiting patients (59 percent).

Concern about coordination of patient care was also high on physicians' list of barriers. Some 77 percent cited lack of transparency between payers and providers, and 76 percent noted the lack of interoperability between different types of health care providers.

Physicians also bemoaned the lack of information on cost of services provided for appropriate referrals (76 percent), a lack of standardized performance measures and metrics (75 percent), and lack of timely data that could be used to improve care and reduce costs (63 percent).

Academy leaders understand the urgency of getting family physicians up to speed in light of HHS' goal to tie 50 percent of traditional fee-for-service Medicare payments to value-based payment models by 2018.

Related AAFP News Coverage

QRUR 101: Understand, Utilize Quality and Resource Use Reports

CMS Request for Information
AAFP Expends Huge Effort to Shape New Payment System


No Pay Raise in 2016, but Shift to Value-based Pay Continues
AAFP Blasts CMS' Broken Promise of Positive Update in Fee Schedule


More From AAFP
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)