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Lack of resources, staffing among barriers to implementing value-based care

Internal and external gaps in interoperability were the second most-cited barrier to VBC adoption, at 19.7%.

Jeff Lagasse, Associate Editor

Providers are slowly but steadily transitioning to value-based care models, but staffing shortages and a general lack of resources are the most persistent barriers to achieving this transformation, according to a new Definitive Healthcare survey.

The poll of 1,090 healthcare leaders showed that this lack of resources was considered the top challenge to VBC adoption by 25.3% of respondents, the largest percentage of any single category.

The implication is that providers may need to learn how to capitalize on opportunities such as implementing health IT systems to handle population health initiatives.

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Internal and external gaps in interoperability were the second most-cited barrier to VBC adoption, at 19.7%. Since value-based care requires a healthy dose of healthcare data exchange and analytics, the adoption of interoperable electronic health record systems and patient engagement technologies -- such as telehealth -- will be paramount. But true interoperability has been elusive, and a source of frustration for many providers.

At 17%, the third top barrier was revenue stream unpredictability and the complexity of financial risk. Changing regulations and policies garnered 16.2%; while the shift to VBC has been occurring since the 2008 passage of the Medicare Improvements for Patients and Providers Act, or MIPPA, incentives from the Centers for Medicare and Medicaid Services didn't become mainstream until the Hospital Value-Based Purchasing Program launched in 2012, and CMS has been introducing and modifying VBC programs ever since.

Trouble with collecting and reporting patient information brought up the rear at 14.8%. If patient data is inaccessible to providers, it's essentially useless in terms of care coordination and preventative medicine, according to the survey.


Despite the barriers, providers remain optimistic that there are a number of factors that can help to accelerate the adoption of value-based care. At 44.8%, by far the most cited accelerator in the survey is appropriate provider compensation and initiatives. Under the current system, providers can opt into value-based purchasing initiatives, receiving bonuses for performing above average and being penalized for performing below average. But more clarity may be needed to entice providers to jump on board the VBC train.

Industry consolidation netted 18.9%. Small, independent physician practices are becoming less prevalent as healthcare's transition toward VBC care gains traction and in fact, the past few years have seen the highest level of healthcare provider consolidation in U.S. history. Last year, the number of accountable care organizations increased from 923 in 2017 to 1,011 by the start of 2018, and it's likely this number will only grow.

Respondents to the survey cited a number of benefits to value-based purchasing, including reduced costs, increased patient satisfaction and better clinical outcomes.


Providers in today's value-based care landscape are eager to improve clinical outcomes, since these models tie reimbursement to clinical quality. But they also want to cut operational costs to address persistently slim margins, and achieving both of those goals can be a difficult balancing act.

But leveraging technology in the right way can lead to operational improvements and efficiencies that allow healthcare organizations to actively increase their revenues. And it starts with the patient -- particularly when it comes to addressing their financial obligation.

Twitter: @JELagasse

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