Are Health Care Providers Ready for Value-Based Payment Models?


HIMSS is working to determine the readiness of providers to participate in the types of value-based payment models that CMS is moving toward.

As part of an effort to contain health care costs, Medicare has begun to move from a traditional fee-for-service payment model to value-based models, which reimburse providers for quality or clinical outcomes for patients rather than simply paying for the provision of care.

The Healthcare Information and Management Systems Society (HIMSS) has organized a Cost Accounting Survey, an industry-leading effort aimed at gauging the readiness of providers to participate in value-based payment models.

All providers can participate in the confidential survey, which can be accessed through December 31, 2015. Results of the survey will be released at the 2016 HIMSS Conference and Exhibition in Las Vegas from February 29 to March 4, 2016.

“We need to begin thinking about how the industry can support providers in making the transition to value-based payment in a meaningful and widespread way,” Pamela Jodock, HIMSS senior director of Health Business Solutions, said in a statement.

According to HIMSS, health care providers must understand the true costs of delivering care and how to price their services in this new system if they are to be financially sustainable in the value-based payment environment.

“From a health IT perspective, what infrastructure do we need to have in place for a successful transition?” Jodock asked. “The survey is intended to help us start that conversation.”

She added that the cost of care includes services provided by both the provider and by external care partners participating with the provider in accountable care organizations or bundled payment programs.

The survey is divided into 5 parts: demographics, the cost of health care, the price of health care, fee-for-service versus value-based purchasing, and pricing transparency.

After gathering individual and organizational demographic information from the respondent, the survey asks what kinds of processes, automated abilities, or cost accounting systems providers use to determine costs, as well as what factors they use to determine price and the relative importance they place on these factors.

Through the survey, providers will rate their readiness to transition from a fee-based to a value-based payment model and identify what they need from an industry perspective to make the transition successfully and be able to serve their patients.

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