Health industry leaders don't see eye to eye on many key issues
"I don’t think we’ve seen health care industry leaders so polarized on some strategic issues and so tightly aligned on others."
A new survey of health care leaders finds some points of disagreement along with other areas of consensus in the areas of value-based care, AI in health care, and consumer engagement.
The 2020 Industry Pulse Report, published by Change Healthcare and the Healthcare Executive Group, is an annual survey of health care leaders from payer, provider, and third-party organizations across the country.
Related: 5 predictions for the health care and benefits market in 2020
The survey finds significantly divergent views, along with some agreement, between payers and providers in discussing the state of the health care industry. “This year’s report provides a fascinating look at where health care is in 2020,” said David Gallegos, SVP, Consulting Services, at Change Healthcare. “In our 10 years of fielding this research, I don’t think we’ve seen health care industry leaders so polarized on some strategic issues and so tightly aligned on others. These insights can help foster a dialogue between payers and providers about their priorities, driving collaboration to advance solutions on those issues in the year ahead.”
Areas of disagreement
The report said that payers and providers are in different places when it comes to consumerism. The analysis found payers are much more likely to have robust consumer-centric strategies in place, and that payers and providers disagree on who is best-positioned to provide cost and quality data to consumers.
The study does not, however, provide much explanation for the possible divergence of priorities between payers and providers. For example, capitation remains less popular with providers as compared with payers, possibly due to provider organizations being less able to assume risk. The Pulse Report said that only 2 percent of providers have fully capitated care, while 9 percent of payers offer full capitation. Fee-for-service models linked to quality was used by 43 of provider respondents, but only 25 percent of payer respondents. Lack of consensus about what economic models work best for stakeholders may drive these differences more than lack of consensus on how best to serve consumers.
There is also disagreement about interoperability across health organizations, with more than twice as many providers (23 percent) than payers (11 percent) saying that consumer demand will drive more interoperability. Payer respondents (36 percent) were more likely to say regulatory changes will drive interoperability than were providers (20 percent).
Areas of agreement: AI and … politics?
The survey found that both payers and providers broadly agree on the benefits of artificial intelligence (AI) and machine learning (ML) in health care.
The study said a relatively high number of respondents supported the proposition that smart technologies are having a positive impact on operations by improving health system efficiency (payers 38 percent, providers 56 percent) and reducing costs (payers 28 percent, providers 42 percent). A similar amount of consensus was found for the idea that AI and machine learning are improving consumer engagement, with 36 percent of payers and 39 percent of providers seeing a benefit in that area.
With an election year upon us, the survey also asked about possible disruption to the health care industry brought on by the elections. Respondents generally shrugged off the possibility of sweeping changes to the health care landscape. “‘Continued Unwinding of Affordable Care Act’ and ‘No Significant Changes’ were the two most popular predictions,” the report said. “‘Enactment of Medicare for All Legislation’ was predicted by only 3 percent of total respondents.”
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