February 2, 2016

‘State of Population Health’ study provides first national look at pace of transition from fee-for-service to fixed payments linked to outcomes

A national study released today by Numerof & Associates, a healthcare strategy consultancy, finds most healthcare providers continue to lag in implementing population health management despite broad agreement that it will be important for future market success.

The study synthesizes survey responses from more than 300 executives and in-depth interviews with over 100 key decision makers across U.S. healthcare delivery organizations. It provides the first in-depth, national look at the pace of transition from fee-for-service to models based on fixed payments linked to outcomes.

“U.S. healthcare organizations are entering a period of greater change and disruption than any industry this side of taxicabs,” said Dr. Rita Numerof, the firm’s president. “However, our study finds that most providers are still just testing the waters with these models and to date there’s still far more talk than action when it comes to population health management.”

“The traditional players in the payer, provider and manufacturer spaces are wrestling simultaneously with not just the question of how to change – but how fast,” said Michael Abrams, managing partner of Numerof. “A select set of leaders are making real progress, but overall we’re still a long way from where we need to be.”

Numerof conducted the study in collaboration with the Jefferson College of Population Health and the school’s dean, Dr. David Nash. “Providers cannot wait any longer to implement the basic infrastructure necessary to practice population based care,” said Nash. “Payers cannot wait any longer to grasp the lessons from Medicare experiments and prepare for a world where ‘no outcome, no income’ will reign supreme.”

The full report is available at http://nai-consulting.com/numerof-state-of-population-health-survey/. Key findings include:

  • More than half of respondents (54 percent) rated population health as “critically important” to the future success of their organization; nearly all respondents (97 percent) said it was more than “somewhat important.”
  • However, the majority of respondents from organizations in agreements with upside gain or downside risk said that 20 percent or less of their revenues flow through them.
  • Two thirds of respondents rated their organization’s ability to manage variation in cost at the physician level as “average” or worse.
  • Only 58 percent of respondents characterized payers as more than “somewhat willing” to enter into cost/quality risk agreements.
  • Compared to those in the South, more respondents in New England reported that their organizations were in an agreement with the potential for both upside gain and downside risk (69 percent vs. 43 percent).
  • Nationally, if providers are moving ahead, it’s mission-driven. In large part, progress comes down to culture and to clinicians and employees recognizing “it’s the right thing to do.”
  • With many challenges to overcome in moving to this new business model, it’s no surprise that organizations with a focused approach and clear leadership accountability were much further along.

“We expect the push to value will only continue to accelerate, while the ‘wait and see’ approach that many organizations have adopted is highly risky,” said Numerof.