Results from Health Plan Contracting e-Poll: Value Based Payment Models

By Clive Riddle, May 25, 2011

With respect to contracting opportunities, insiders say that value based and newer payment models continue to offer the most promise, analytics advances are this year’s darlings, and ACOs hold less hope.

Meanwhile, insiders think cost pressures from the economic downturn are even more of a challenge than last year, and they’re not quite as concerned about market consolidation as they were a year ago.

In conjunction with the 2011 Health Plan Contracting Web Summit, MCOL conducted an e-poll on contracting issues. Participants were asked “what are the greatest opportunities from a contracting perspective” and “what are the greatest challenges from a contracting perspective” in addition to if their organization is a provider, plan or other. These same questions were asked in conjunction with last year’s Health Plan Contracting Web Summit, allowing for comparison to last year’s results.

Here’s a summary of e-poll results for the past two years:

Greatest Opportunities	2011	2010
Emergence of value based and newer payment models	29.6%	26.7%
Advancements in analytics capabilities	19.4%	7.5%
Increased covered population due to health reform	13.9%	17.5%
Consumer engagement initiatives	12.0%	10.8%
Advancements in electronic health records and transactions	10.2%	16.7%
Formation of Accountable Care Organizations	7.4%	16.7%
Potential growth in patient centered medical homes	3.7%	3.3%
Other	3.7%	0.8%
Total	100.0%	100.0%

Greatest Challenges	2011	2010
Cost pressures due to economic downturn	33.3%	28.1%
Increased mix of government program vs. commercial covered populations	16.7%	14.9%
Issues related to new health reform provisions	15.7%	14.1%
Increased complexities of benefit design	11.1%	8.3%
Other	8.3%	4.1%
Continued market consolidation	7.4%	14.1%
Consumer engagement Initiatives	6.5%	9.9%
ICD-10 transition	0.9%	6.6%
Total	100.0%	100.0%

Here are the top two responses for 2011 broken down by type of organizational category:

Top Response
Provider	Emergence of value based & other applicable newer payment models (26.4%)
Purchaser	Emergence of value based & other applicable newer payment models (38.7%)
Vendor/Other	Emergence of value based & other applicable newer payment models (25%)

2nd Highest Response
Provider	Advancements in analytics capabilities (24.5%)
Purchaser	Increased covered population due to health reform (22.6%)
Vendor/Other	Tie: Analytics and ACOs (20.8%)