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Report: Many Employers, Consumers Don’t Understand Value-based Care – MedCity News


Employers and consumers largely don’t understand value-based care or fee-for-service, but are mostly supportive of the value-based care model when provided the definition, a new survey discovered.

The EmblemHealth survey, published last week, received responses from 125 employers and 750 consumers. EmblemHealth is a nonprofit health insurer that offers commercial and government-sponsored plans to 3.2 million members. It sought to understand employer and consumers’ opinions about value-based care (in which providers are paid based on improving patient outcomes) and fee-for-service (in which providers are paid based on the number of services they provide to patients).

When asked if they’ve heard the term “value-based care,” 60% of employers said “yes,” 30% said “no” and 10% said they’re not sure, the survey found. About 26% of consumers said “yes,” 64% said “no” and 10% said they’re not sure. 

Despite 60% of employers saying they’ve heard of value-based care, only a third of employers were able to accurately describe it, EmblemHealth also found. 

Many employers and consumers don’t know what the fee-for-service model is either. About 65% of employers said they’ve heard of fee-for-service, 28% said they haven’t and 7% aren’t sure. About 46% of consumers said they’ve heard of it, 44% said they haven’t and 10% said they aren’t sure.

However, after being given the definitions for value-based care and fee-for-service, employers and consumers were mostly in favor of value-based care. About 69% of employers said they prefer value-based care, 20% said they prefer fee-for-service and 11% said they aren’t sure. Large group employers were more likely to be supportive of value-based care than small group employers. For consumers, 61% said they prefer value-based care, 17% said they prefer fee-for-service and 22% said they aren’t sure.

EmblemHealth stated in its report that insurers, healthcare providers and employers “need to work together” to move along the transition to value-based care. Some next steps for these stakeholders include creating understandable language around value-based care for insurers to use in employer handbooks and finding more medical professional advocates for value-based care who can communicate the benefits to their patients. In addition, the organization recommends supporting research findings on the model and working with lawmakers to make sure healthcare stakeholders all have an understanding of value-based care.

“The survey data and information from our research demonstrate that both employers and consumers overwhelmingly prefer value-based care to fee-for-service payment models when they better understand the differences between each model,” said Karen Ignagni, CEO of EmblemHealth, in a news release. “Achieving healthier outcomes more affordably will require all stakeholders to work together to educate the public on the benefits of a value-based care model.”

Photo: atibodyphoto, Getty Images



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