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The Slow Road to Value-Based Care

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A new report is yet another sign that the march toward value-based care has bogged down.

The Health Care Transformation Task Force, which is a Washington-based coalition of health systems, health insurers, business coalitions and patient advocacy groups, said that 14 of its members had 47 percent of their business run through value-based payment arrangements at the end of 2017.

The HCTTF based its figure on a year-end survey of 14 of the group’s health system and health insurer members.

The 47 percent reported by the 14 organizations is up from the 41 percent that they reported at the end of 2016 and the 30 percent that they reported at the end of 2015, according to the HCTTF’s latest value-based reimbursement progress report released on Dec. 18.

“The transition to value is a challenging journey, and much work lies ahead,” said Jeff Micklos, HCTTF’s executive director, in a press statement.  “While the uncertain landscape in 2017 around value-based care impacted overall performance, we’re pleased to see our members continue the forward momentum.”

“Momentum” was not a word typically associated with the transition to value-based reimbursement models this year unless you prefaced it by the words “loss of.” The six percentage point increase from 2016 to 2017 reported by the HCTTF members is about half of the 11 percentage point increase that they reported from 2015 to 2016.

The results mirror the conclusion of most reports and surveys released this year, and that’s that the pace of the transition to value-based reimbursement has slowed if not stalled.

For example, NEJM Catalyst released a report in early November that said 75 percent of provider revenue still comes from fee-for-service contracts, as we reported on our blog.

In another blog post, we wrote about a report from the Health Care Payment Learning and Action Network that said that 34 percent of provider payments were through alternative payment models in 2017, up from 29 percent in 2016 and 23 percent in 2015.

In the same post, we wrote about a survey of physicians and health plan executives by Quest Diagnostics that said that the transition to value-based reimbursement models as stalled.

True, things are still moving in the right direction. But, they are slowing down. The HCTTF’s goal is having 75 percent of its members’ business tied up in value-based payment arrangements by 2020. Umm, that’s a year from now. It really is time to pick up the pace again.


David Burda is a columnist for 4sight Health and news editor of 4sight Friday, our weekly newsletter. Follow Burda on Twitter @DavidRBurda and on LinkedIn. Read his bio here.

About The Authors
David W. Johnson
David Johnson CEO 4sightHealth

David Johnson is the CEO of 4sight Health, a boutique healthcare advisory and investment firm. Dave wakes up every morning trying to fix America’s broken healthcare system. He is a frequent writer and speaker on market-driven healthcare reform. His expertise encompasses health policy, academic medicine, economics, statistics, behavioral finance, disruptive innovation, organizational change and complexity theory. Dave’s book, Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare, is available on