Staff, Technology Investments Help Practices Shift to Value-Based Care

Staffing and technology are the top investment areas for primary care practice leaders as they manage the challenges of shifting from fee-for-service (FFS) models to value-based care, according to a report from Humana and the Medical Group Management Association (MGMA).

The report builds on a 2019 study from Humana and MGMA that identified the structural changes needed for primary care practices to successfully transition to value-based care. The recent data includes responses from 104 primary care practice leaders and expands on how the COVID-19 pandemic impacted their value-based care journeys.

Between 2019 and 2022, the share of total revenue that medical groups received from value-based arrangements remained relatively stable. For example, the percentage of practices with 5 percent to 30 percent of revenue tied to value-based arrangements was 59 percent in 2019 and 57 percent in 2022.

However, primary care leaders shifted in both directions during the pandemic. The share of practices with less than 5 percent of revenue tied to value-based performance grew from 23 percent to 28 percent. Meanwhile, the share of practices with 75 percent to 100 percent of revenue tied to value-based arrangements increased from 6 percent to 9 percent.

Since 2019, practices have gained more experience with value-based care. The percentage of primary care groups with more than five years of participation in a value-based arrangement grew from 41 percent in 2019 to 53 percent in 2022.

More than two-thirds of primary care practice leaders said that the level of quality care provided to patients was better in value-based care than in FFS models. In addition, 43 percent of respondents reported that value-based care helped improve financial performance compared to 31 percent who said the same about FFS.

Primary care leaders have faced challenges with value-based care during the pandemic, which has influenced their top areas of investment.

Almost three-quarters of respondents (70 percent) cited a lack of staff resources as a challenge to value-based care and 67 percent said that being unable to control patients’ care-seeking behavior is a challenge. Additionally, nearly half of respondents (46 percent) reported that a lack of data and reporting makes it difficult to support value-based care.

As a result of these challenges, primary care practices have focused their investments on staff, technology, and patient engagement resources.

Almost 75 percent of leaders said their practice has invested in additional staff to help accommodate the shift to value-based care. Seventy-one percent have added technology resources, while 59 percent of respondents have invested in patient engagement.

The most common staffing additions were in care coordination (72 percent), care management (67 percent), data analytics (57 percent), and quality improvement (56 percent).

Healthcare practices have been facing workforce shortages throughout the pandemic, making staff recruitment and retention a key priority.

According to the report, 64 percent of respondents said they were currently experiencing burnout. But 74 percent of practice leaders in organizations participating in value-based arrangements said they were somewhat or very satisfied with their current employer.

Value-based care arrangements have also motivated practices to enhance their technology. More than 80 percent of respondents said they have added data analytics and reporting tools to accommodate the shift to value-based care. Leaders also reported adding population health management resources (57 percent), EHR tools (49 percent), and registry platforms (40 percent).

“Fewer medical groups report a lack of data and reporting as a major challenge compared to the 2019 research, suggesting that these tools have been implemented and put to good use in support of the shift to value,” the report stated.

Industry experts have agreed that poor access to data and a lack of data sharing are significant barriers to value-based care adoption.

Additionally, Robert Fields, MD, MHA, EVP and chief population health officer at Mount Sinai Health System, said that providers should consider contracting, physician compensation, digital medicine, and care delivery when shifting to value-based care.