Health Plans Moving Toward Value-Based Payment Models

An Availity study finds that almost 60% of surveyed health plans expect to transition to value-based payment models over the next five years, with 60% of those respondents saying they are about halfway through adoption. The study also notes that 90% of health plans believe that automating the way new data that is required under such payment models is exchanged is crucial to success. The study highlights the consensus among plans that information sharing with physicians must be automated – primarily in real-time – for these models to achieve success. Transitioning to payment models that base compensation on outcomes requires physicians and health plans to exchange new kinds of information – different from what is required under today’s predominant fee-for-service arrangements. The study also details the lines of business targeted for new payment models, payment model maturity, and expectations for growth over the next 18 months.