Half of healthcare payments to funnel through value-based care programs by 2020, Financial tools are top priority for ACOs, finds Black Book

Healthcare expenditures are projected to swell past $3.0 trillion by 2020, propelling the accountable care technology industry to deliver systems that align financial incentives and manage risk for providers and payers. Pressures to speed up the migration from a fee-for-service reimbursement system to value-based payment models are confronted by disconnects in clinical and financial data interoperability.

​Financial solutions are among the highest infrastructure priorities as identified by 95 percent of ACO and provider-based health plan executives, in a recently published Black Book™ survey of over 200 ACOs and 1000 provider organizations.  However, only 19 percent of operational ACOs and 8 percent of hospitals and physician groups sitting on the ACO sidelines believe they have the adequate installation of financial technology, outsourced services and consulting to be successful in the long term.

“Despite the growth in ACO contracts with payers, few ACO participants have access to reliable claims data and trouble taking consistent clinical quality data from electronic health systems due to interoperability challenges,”  said Doug Brown, President of Black Book Market Research LLC. “The majority (64%) of the healthcare provider industry responding to this survey is not moving with haste toward the objective of building a reimbursement model that features value-based  payments.”

Black Book™ has produced a series of three ACO infrastructure surveys: Financial Services and Software, Clinical Integration and Support, and Business Intelligence and Analytics; and the first client experience data set is released today.

59 percent of CFOs confirm they are caught between revenue management services that fast-track the inflow of cash to sustain present fee-for-service reimbursement, and selecting ACO strategic solutions to assemble the groundwork to succeed with imminent risk-bearing payment models (down from 78 percent last year).

“Large ACO’s have the capital and provider base to strategically select vendors who can deliver end-to-end financial services and software now, ahead of tackling population health, clinical integration and business intelligence tools into the technology amalgam,” said Doug Brown, President of Black Book. 

Black Book received 201 responses from 309 accountable care organizations at the time of the Q2 survey. Additionally, 631 commercial or combination Medicare/Commercial ACO staffers completed financial services and software evaluations from 819 various hospital and physician groups.

92% percent of CIOs, in a previous Black Book survey conducted in Q3 of 2013, found that their EHR system did not offer the functionality for ACO start up. However in 2015, some EHR vendors outranked several third-party vendors, in the user satisfaction scores, and 15% are optimistic with their EHR’s potential.

86 percent of hospital organizations late to form value-based care strategies, confirmed that problems with forecasting, coordination of claim and clinical data, and EHR replacements are delaying progress towards taking on higher-risk and incentivized contracts.

“Despite 40 percent of large hospital and physician organizations using big data population health solutions, only 14 percent have acquired  ACO-dedicated risk management, analysis and provider payment incentive tools,” said Brown. “Value-based payment contracts are in their infancy and providers are struggling to anticipate costs, patient populations and outcomes without more sophisticated IT capabilities.”

76 percent of newly-forming ACOs admit to having too limited capital to ramp up financial operations and technology fast enough to become eligible or competitive in value-based care in 2015 . In 2014, 67 percent of evolving ACOs indicated they were low on resources.

Black Book measured the user satisfaction of value-based care financial services and software vendors on 18 key performance indicators, and in four functional areas of end-to-end ACO financial solutions.

85 percent of all hospital CFOs and 81 percent of ACO executives agree that without a strong financial solutions vendor to provide value-based reimbursement software, outsourced services and support, and consulting, they will be forced to opt out of many key risk-based contract opportunities through 2016.

Twelve percent of health care payments are currently made through value-based programs which Black Book estimates to surge over 50 percent by year-end 2019. 

Payers and employers are demanding providers to assume greater levels of financial risk for managing the care they deliver to their covered populations, but most hospitals and physician groups don’t have the latest staff or technology competencies to be competitive,” said Brown.

Ranking first in the survey of value-based financial services outsourcing, consulting and software is Frisco, Texas based Conifer Health Solutions. This is the second consecutive year Conifer has earned top client experience scores over a growing field of ACO financial support vendors.

Other top ranked ACO software,  outsourced services and consultants named in the Black Book report “Top Twenty Value-Based Care Financial Services and Software Vendors” in 2015 are: The Advisory Board, Health Catalyst, Aetna Medicity, Medecision Cerecons, Allere Wellogic and McKesson RelayHealth.

About Black Book ™

Black Book Rankings, a division of Black Book Market Research LLC, provides healthcare IT users, media, investors, analysts, quality minded vendors, and prospective software system buyers, pharmaceutical manufacturers, and other interested sectors of the clinical technology industry with comprehensive comparison data of the industry's top respected and competitively performing technology vendors. The largest user opinion poll of its kind in healthcare IT, Black Book™ collects over 550,000 viewpoints on information technology and outsourced services vendor performance annually. Black Book was founded in 2000, is internationally recognized for over 15 years of customer satisfaction polling, particularly in technology, services, outsourcing and offshoring industries.

Black Book™, its founders, management and/or staff do not own or hold any financial interest in any of the vendors covered and encompassed in this survey, and Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results. 
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