Change Healthcare and the HealthCare Executive Group (HCEG) has published the 2020 Industry Pulse Report, an annual study that takes the pulse of healthcare executives nationwide, and reports on the challenges, issues, and opportunities they see in the coming year for healthcare.
Conducted by InsightDynamo, and commissioned by Change Healthcare and the HCEG, this year’s 10th annual Industry Pulse Report exposes widely divergent readiness and perspectives among payers and providers around value-based care, consumerism, interoperability, and more. The report also reveals where payers and providers are well-aligned, such as around Social Determinants of Health, specific tactics to improve consumer engagement, and the immense potential for artificial intelligence (AI) and machine learning (ML) to improve healthcare. Also, for the first time in its history, report researchers asked participants what direction they anticipate healthcare will take after the 2020 election, regardless of how the fortunes of the political parties play out.
The report draws on responses from 445 healthcare leaders nationally from payer, provider, and third-party vendor organizations, and interviewed between October and December 2019. Of the respondents, 24% are C-suite, 15% are VP/SVP, and over 40% hold director titles.
Key takeaways from the report include:
· Payers report being much farther along the path to value-based care than providers, with nearly two-thirds (62%) indicating their organizations are using alternative payment models, and 9% using full capitation. Meanwhile, less than half (43%) of providers say they use alternative payment models, and a mere 2% report full capitation in use. Additionally, payers (25%) are much more likely than providers (8%) to cite IT Infrastructure as a key barrier to implementing value-based care.
· Only 18% of providers and 24% of payers say they have a “full consumer-centric strategy” in place. Moreover, 14% of providers say they have “no consumer-centric strategy,” whereas 100% of payers report having a strategy or one in development. Consumerization efforts overall are mostly in the early stages, with 34% of providers and 43% of payers calling their strategy “nascent,” and just 36% of providers and 33% of payers characterizing their efforts as “intermediate.” Payers and providers also disagree on who is best positioned to provide cost and quality data to consumers, both believing they are the best choice.
· More than twice as many providers (23%) than payers (11%) see consumer demand as driving interoperability, and nearly 40% of the C-suite believe interoperability will materialize when consumers insist on it. Payers, however, are nearly twice as likely (36%) than providers (20%) to cite regulatory changes as fueling interoperability, while 18% of providers think physician-driven initiatives are a key driver compared to just 2% of payers.
· Respondents say smart technologies are having a positive impact on operations by improving health system efficiency (payers 38%, providers 56%) and reducing costs (payers 28%, providers 42%). AI and machine learning are also improving consumer engagement, with 36% of payers and 39% of providers reporting a payoff.
· The majority of C-suite respondents (39%) believe there will be no significant changes to the U.S. healthcare system following the 2020 elections, and a majority (28%) of all respondents agree. The highest percentage of providers (31%) predict a continued unwinding of the Affordable Care Act (ACA), while 26% of payers expect the ACA to be strengthened. Just 17% of respondents expect to see a public option take hold, and only 3% predict America will move toward a single-payer, “Medicare for all” system post-election.
