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Study Finds One in Three Family Physicians Are Already Pursuing Value-Based Payment

Lack of time identified as one of the top barriers to implementing value-based care delivery

Tuesday, December 1, 2015 1:31 pm EST



Public Company Information:

"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"

LOUISVILLE, Ky.--(BUSINESS WIRE)--One in three (33 percent) family physicians are already actively pursuing value-based payment opportunities today, with another 19 percent developing value-based payment capabilities but waiting until results are better known before fully pursuing, according to a study conducted by the American Academy of Family Physicians (AAFP) and sponsored by Humana Inc. (NYSE: HUM).

The U.S. Department of Health and Human Services’ goal of tying 50 percent of traditional, or fee-for-service, Medicare payments to value-based payment models by 2018 is fast approaching. Considering the urgency of this transformation, the AAFP conducted the 2015 Value-based Payment Study to gauge family physicians’ perceptions of and progress toward making the shift from fee-for-service care to value-based care.

Key findings from the study were:

  • Family physicians have contracts with a substantial number of health plans. Sixty-one percent of family physicians receive payment from seven or more health plans, and of that 38 percent receive payment from 10 or more.
  • A substantial proportion of family physicians remain uninformed regarding value-based payments. One in four don’t know or are not sure of their practice’s status or current strategy toward value-based payments, and 32 percent don’t know if value-based payment models are available in their market. Among those participating in value-based payments, 33 percent didn’t know how the payments were being distributed within their practices (e.g., administration, physicians).
  • The necessary time commitment is a major concern among physicians. More than 90 percent of physicians surveyed indicated lack of staff time as a barrier to implementing value-based care delivery.
  • Health information technology investment and necessary resources to report, validate and support data affects practice sustainability. Eighty-seven percent of practices said they will have to make substantial investments in health information technology to be successful in a value-based payment model. In addition, 81 percent provided that lack of resources to support reporting, validation and use data also impacts their practice’s sustainability.

In addition, the study found that physicians are skeptical about the impact value-based payments will have on care outcomes. Of those surveyed, 69 percent of physicians believe value-based payments will not improve patient care and 59 percent believe they will increase work for physicians without a benefit to the patient.

“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 Wanda Filer, M.D., MBA, President of the AAFP. “Accelerating the adoption of value-based payment will require a commitment from physicians and health plans to share in the responsibility of delivering value-based payment.”

Among other key findings from the study, physicians chose the following success factors as most important in implementing a value-based payment model:

  • Practice sustainability – 92 percent
  • Clinical outcomes – 91 percent
  • Physician and staff morale – 87 percent
  • Coordination of patient care – 86 percent
  • Cost savings for physician’s practice – 84 percent

“The results of this study tell us that physicians are genuinely concerned about the time needed to transition to value-based payment and want to ensure that their efforts translate to care improvement,” said Roy A. Beveridge, M.D., Humana’s Chief Medical Officer. “The health care industry would benefit from improving its understanding of physician needs and how they can best alleviate burdens. Partnering with the AAFP through this study gives us an understanding of the unique needs of the family physician to accelerate their journey to value and realize improved care outcomes.”

The 2015 Value-based Payment Study was sent to 5,000 active members of the AAFP; a total of 779 surveys were completed and 626 were evaluated after a screening process. For a more detailed review, click here.

Humana has approximately 1.6 million individual Medicare Advantage and 200,000 commercial members, cared for by approximately 44,000 primary care physicians in more than 900 value-based payment relationships across 43 states and Puerto Rico. Currently, approximately 59 percent of Humana individual Medicare Advantage members are in value-based payment relationships. Humana’s goal is to have 75 percent of individual Medicare Advantage members in value-based payment models by 2017. For more information, visit humana.com/accountable-care.

About The American Academy of Family Physicians

Founded in 1947, the AAFP represents 120,900 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 214 million visits annually -- 48 percent more than to the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the specialty of family medicine, the AAFP’s positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website, www.FamilyDoctor.org.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

  • Annual reports to stockholders;
  • Securities and Exchange Commission filings;
  • Most recent investor conference presentations;
  • Quarterly earnings news releases;
  • Replays of most recent earnings release conference calls;
  • Calendar of events; and
  • Corporate Governance information.

Multimedia Files:

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Humana/AAFP survey looks at 5,000 physicians views' on readiness for value-based payment health care models. (Graphic: Business Wire)
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American Academy of Family Physicians
Megan Moriarty, 800-274-2237, ext. 5223
Humana Corporate Communications
Alex Kepnes, 502-580-2990