How Prepared Is Healthcare For The Coming Policy Changes?

MCOL and Payers & Providers jointly sponsored a survey of healthcare professionals during March on the preparedness or current effectiveness of stakeholders, compared to where the marketplace demands call for them to be for specified Initiatives. An exclusive report on the survey findings follows.

Participants were asked to respond to two items:

1. Please categorize your organization.

• Provider

• Payer

• Vendor or Other

2. What is your general assessment of how prepared or currently effective stakeholders are, compared to where the marketplace demands call for them to be at this point in time, for the following initiatives:(Rank each 1-5, with 1=Not at all Prepared/Effective and 5= Very Prepared/Effective for this point in time)

• Private Health Insurance Exchanges/Marketplaces

• Public Health Insurance Exchanges/Marketplaces

• Meaningful Use/EHR Implementation

• Readmissions Management

• Accountable Care Arrangements

• Leveraging mHealth Applications

• Value Based Payment Arrangements

• Leveraging Analytics for Performance and Outcomes

Key findings:

Overall, respondents did not think stakeholders were very prepared or effective on where marketplace demands call for them to be for specified initiatives, with no initiative having more than 10% of respondents saying stakeholders are very prepared/effective.

Private HIXs/Marketplaces

While a plurality of respondents thought stakeholders fell somewhere between not at all and very prepared on private HIXs and ranked them as a 3, when added together respondents ranking this as a 1 or 2 made up 55% of the total. Together, only 13% of respondents ranked stakeholders as a 4 or 5 on this initiative.

Payers were the most neutral respondent category, with 58.3% ranking this initiative’s preparedness/effectiveness as a 3. Providers were more evenly split, leaning towards the negative with between 26% and 32% selecting each 1, 2 and 3 as their responses. Those in the vendor/other category had similar responses to providers with 26.3% each selecting 1 and 3 and 36.8% selecting 2.

Public HIXs/Marketplaces

Respondents were fairly pessimistic on the preparedness of stakeholders on public exchanges, 63.8% ranked them as a 1 or 2 and only 7.2% ranked this initiative as a 4 or 5.

While both providers, and those in the vendor/other category fell within a few points of the average of those ranking this initiative as a 1 or 2, 75% of payers ranked it as so. No payers ranked this initiative as a 4 or 5, and only 10.5% of providers, and 5.3% of vendor/others ranked it as such.

Meaningful Use/EHR Implementation

Respondents thought stakeholders were the most prepared for this initiative compared to the others listed in this survey. 26.5% ranked this initiative with a 4 or 5, while just over one percentage point more (27.9%) ranked it as a 1 or 2. Just under half (45.6%) of respondents fell in the middle ranking it as a 3.

There was significant variation amongst respondent categories on this initiative. Around 30% each of payers and vendors/others thought stakeholders were closer to not prepared (1 or 2) while around 10% of each thought they were prepared (4 or 5). Providers, however, were more optimistic on preparedness with 40.5% ranking stakeholders as a 4 or 5.

Readmissions Management

Respondents leaned towards viewing stakeholders as unprepared (39.1% ranking 1 or 2) for where they should be with readmissions management, but were not as pessimistic as with other initiatives. 21.7% ranked stakeholders with a 4 or 5 on this initiative.

Again, both providers and vendors/others were not significantly different from the average. Payers were close to the average on those ranking 1 or 2, however, a much larger amount ranked this initiative as a 3 and no payer respondents ranked it as a 5.

Accountable Care Arrangements

Accountable care arrangements was one of the initiatives respondents were more doubtful on stakeholder’s preparedness for. 60.3% ranked stakeholder preparedness as a 1 or 2, while only 14.7% ranked it as a 4 or 5.

While no payer respondents ranked initiative this as a 5, 25% ranked it as a 4. Providers and vendors/others weren’t as positive about preparedness with 10.8% and 15.8% ranking it as a 4 or 5, respectively.

Leveraging mHealth Applications

Respondents did not think that stakeholders were at all prepared for leveraging mhealth applications. Only 6% of respondents ranked this initiative as a 4 or 5, the lowest out of any other initiative in this survey. The highest amount of respondents also ranked this as a 1 or 2.

No payers, and only 2.8% of providers ranked this initiative as a 4 or 5, though vendors/others were more positive with 15.8% of respondents saying stakeholders ranked as a 4 or 5 on the preparedness scale.

Value Based Payment Arrangements

Respondents ranked preparedness for this initiative similarly to that of accountable care initiatives, with the same amount of respondents (14.7%) ranking preparedness as a 4 or 5, though a small amount less, (54.4% for value based payment, 60.3% for accountable care) ranked it as a 1 or 2.

Both payers and providers had no respondents ranking this initiative with a 5 and around 10% each with a 4, while vendors/others had 5.3% ranking it as a 5 and 21.1% ranking it as a 4. The different respondent categories were closer on agreeing with how many ranked it as a 1 or 2, with between 50-60% for each.

Leveraging Analytics for Performance and Outcomes

This initiative along with value based payments and leveraging mhealth, had the lowest amount of respondents ranking preparedness for it as a 5 at 1.5%. In addition to that, 13.4% ranked this initiative as a 4. 59.7% ranked this initiative as a 1 or 2.

Vendors/others were more negative on preparedness for this initiative than any category on any initiative, with 84.2% ranking it as a 1 or 2. Payers and providers were less negative, with 41.7% and 52.7% ranking it as a 1 or 2 respectively.