Doctors are having a hard time figuring out the new value-based metrics that insurers and the federal government are increasingly using to determine reimbursement.
In a survey of 450 physicians and health care executives conducted by Quest Diagnostics of Madison, New Jersey, and Inovalon of Bowie, Maryland, 74 percent say the quality measures are too complex, suggesting they often don’t know what exactly is expected of them.
More specifically, half of physicians say it was not clear which value-based metrics applied to an individual patient.
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It’s not just that doctors lack the wits to understand the brave new world of medicine; the system in which they operate has not adapted yet to the demands of payers.
For instance, 64 percent of physicians of executives say they lack the tools necessary to fully implement a value-based care model.
Furthermore, two-thirds of doctors said they don’t have all of the necessary information on their patients. Information-sharing is an important part of the move away from a fee-for-service payment model.
While there appear to be few policymakers who doubt the wisdom of encouraging a more holistic approach to medicine, rather than a service-focused one, the concept is far from being universally embraced by medical professionals. While just over half (57 percent) of the 150 health care executives said they favored a value-based system, only 33 percent of the 300 physicians polled agreed.
The survey suggested that physicians are eager for tools that will allow them to quickly get a sense of a patient’s medical history. Eighty-five percent said they would be likely or very likely to use a tool that provides “on-demand patient-specific data to identify gaps in quality, risk and utilization.”
While such systems are clearly going to be a big part of the future of medicine, what is currently available has raised plenty of concerns. A recent study found that hospital computer systems often fail to alert doctors to prescriptions that may be harmful to a potential patient based on their medical history or other drugs they are taking.