By Sarianne Gruber
Twitter: @subtleimpact
Based on the opinions of 561 physicians, the results of the Deloitte 2014 Survey of U.S. Physicians examines current and expected levels of Value-Based Care (VBC) and what physicians need to feel more confident about VBC participation. This research was conducted by the Deloitte Center for Health Solutions (DCHS), the research division of Deloitte LLP’s Life Science and Health Care practice.
Report Summary: VBC payment models are on the near horizon for healthcare providers, and it is likely that these models will make up about 50% of physician compensation in the next ten years. The DCHS survey reports that the majority of physicians at high of 78% are content with the status quo, preferring traditional payment models over VBC models. The survey’s pertinent findings reveal which preferential factors and resources would be necessary for a successful transition to a VBC model. Specifically, physicians are asking for: expanded clinical support capabilities, more information technology tools, access to non-physician staff to coordinate patient care, fair value-based payment models that safeguard financial interests, improved business/managerial expertise and working knowledge/use of HIT. The survey also reports on the concerns physicians have most about VBC models, which are the consequences of financial risk and accountability for circumstances out of their control.
The report details the following notable findings:
Physicians seeking expanded clinical support:
- 50% of PCPs want clinical support vs. 33% of non-surgical specialists.
- 49% of physicians in academic or research settings want clinical support vs. 33% of independent contract with multiple plans/hospitals.
- 51% of those who prefer value-based models want clinical support vs. 37% who prefer traditional payment.
Physicians seeking information technology tools:
- 34% of PCPs and 37% on non-surgical specialists want more IT tools vs. 20% of surgical specialists.
Physicians seeking access to non-physician staff:
- 35% of physicians in practice 10 years or less seek access to non-physician staff vs. 22% of physicians in practice 21-30 years.
Critical success factors that protect physicians’ financial interest:
- 61% of physicians want limits to total financial risk exposure.
- 46% of physicians want equitable performance –based distribution of bonuses from shared savings.
- 43% of physicians want the ability to help set performance goals.
- 49% of PCPs also want information to identify and manage high risk patients.
Physicians wanting to improve their business knowledge and use of HIT:
- 91% of physicians want to improve interpersonal/communication skills.
- 80% of physicians want to expand their knowledge of HIT for communication/care management and EHRs.
- 74% of physicians want to improve managerial expertise leadership, strategy, planning and financial management.
- 64% of physicians want to improve their financial and actuarial literacy.
Physicians preferring the status quo:
- 78% of physicians are content with current fee-for-service system compared to 22% of physicians surveyed.
- Medical Specialty: Of the 78% preferring the status quo, 24% are PCPs, 31% are surgical specialists, 39% are non-surgical specialists and 6% are other medical specialties; compared to the 22% of the VBC supporters 44% are PCPs, 17% are surgical specialists, 31% are non-surgical specialists and 8% are other medical specialists.
- Practice Time: Of the 78% preferring the status quo, 36% have been in practice 10 years or less, 22% in practice between 11 and 20 years, 17% in practice between 21 and 30 years and 25% in practice 31 years or more; compared to those favoring VBC model 38% have been in practice 10 years or less, 23% in practice between 11 and 20 years, 25% in practice between 21 and 30 years and 14% in practice 31 years or more.
Physicians’ greatest concerns with VBC model:
- 78% fear being penalized for factors that are out of their control.
- 78% fear of not getting credit for improving quality in areas that are not included in specific performance goals.
The complete Executive Summary of the perspectives from the Deloitte Center for Health Solutions 2014 Survey of U.S. Physicians can be viewed online.