Leaders, Laggards Emerge in Population Health Model

New survey shows that while there is widespread agreement that risk-based population health models are here to stay, a growing number of healthcare providers are reluctant to take on the risk.

Many healthcare providers are reluctant to embrace risk-based population health models and are falling further behind the pace setters in this space, a new survey shows. 

In their third annual survey, consultants Numerof & Associates queried more than 400 healthcare executives about their status risk-based population health models and found that:

• Progress has fallen short of expectations. In the 2015 survey, 59% of respondents said they would be at least "very prepared" to take on risk in 2017. This year, 21% felt they had achieved that mark.
    
• Risk-based contracts for organizations are mostly experimental. For 70% of respondents, lower than 20% reported revenue involvement.
    
• Financial loss is a deterrent for taking on risk. 25% of respondents noted financial loss as a roadblock to adapting a more risk-based model.
    
• Executives agree that population health is the future of healthcare. Respondents, on average, expect 15% revenue growth stemming from at-risk agreements over the next 2 years.
   
• Cost and quality management is lacking. 58% of respondents rated their organization as average, or worse than average, when asked about their management in cost variation.  

Numerof & Associates President Rita Numerof said virtually all healthcare providers believe that healthcare delivery is headed towards a risk-based, population health model, but that "a few leading organizations have separated themselves from the rest of the pack."

"The shift in the business model has proven difficult for many to achieve due to institutional hurdles and concerns over financial losses," Numerof said.

Numerof managing partner Michael Abrams said that at some point providers have to take the leap or risk falling even further behind.

"Hospitals that hedge their bets by experimenting at the margins with at-risk payment models underestimate the importance of moving up the experience curve," Abrams said. "Accountability for cost and quality is inevitable, and the sooner a commitment is made, the sooner the necessary competencies will be developed."

Survey collaborator David B. Nash, MD, dean of the Jefferson College of Population Health, said risk-bearing population health models have created "an apparent paradox in our country today."

"We want to improve health, but the numbers say that we are far short of previously stated goals," Nash said. "One is therefore forced to ask the question--what is the real mission of our industry at this key juncture?"