Cost And Payments: Investment Article
Providers agree that the level of quality patient care has increased
Staffing and technology remain the top areas of investment in value-based care models, according to new research on how practices position themselves for care-delivery success.
Quantitative data from primary care groups was combined with direct insights from practice leaders on their journey toward value. The return on investment thus far demonstrates the changes required to sustain value-based initiatives in the face of unprecedented difficulties.
While value-based care payment arrangements can look very different, researchers learned that common principles guide them. The 2022 Humana-MGMA research, which polled more than 100 primary care practice leaders, found that more than two-thirds (67%) of medical group leaders believe the level of quality care provided to patients is better than the fee-for-service (FFS) environment. Additionally, a higher share of practice leaders felt value-based care was better for financial performance (43%) than FFS (31%).1
Like most aspects of everyday life, the reality of medical groups’ approach to value-based care does not look the way it did prior to the COVID-19 pandemic. Beyond shifts in practice ownership and updates to practice facilities and safety measures to protect against COVID-19, approaches to updating care delivery models have reflected the changes in staffing and further investments in digital health tools.
The share of total revenue that medical groups received from value-based arrangements was largely unchanged in 2022 compared to 2019 reported levels, but the clinical and administrative practice leaders in primary care, internal medicine and family medicine, who responded to the latest survey, showed shifts toward either end of the spectrum of value adoption. These shifts come as more of these medical practices gain experience operating in value-based arrangements.
The 2022 Humana-MGMA research found that a lack of staff resources, difficulties with patient adherence and issues in managing care across patients’ encounters with other providers as major challenges for shifting to value-based care. Thus, it’s not surprising that staff, technology and patient engagement have been the primary focus of medical practices’ paid resources committed to making the shift to value-based care, researchers believe.
Care coordination and management workers remained the top types of staff added by medical practices to accommodate their shifts to value-based care models. “Those roles are indispensable,” says Karl Gyden, Director of Payer Contracts for Harbin Clinic in Rome, Georgia.
The latest Humana-MGMA research still points to data analytics/reporting platforms, population health management tools and EHR tools as the top technological additions to boost value-based plan participation. This broad adoption seems to be working: fewer medical groups report a lack of data and reporting as a major challenge compared to the 2019 research.
- “Shifting to Value Amid Pandemic and Staff Challenges,” Medical Group Management Association and Humana Joint Research Study Report (2022), last accessed November 1, 2022,