Issue link: https://beckershealthcare.uberflip.com/i/790284
24 POPULATION HEALTH Only 17% of Healthcare Providers 'Very Ready' to Take on Risk By Kelly Gooch H ealthcare providers remain committed to population health management but expect a slower pace of change under President Donald Trump, according to a study from Numerof & Associates. "Numerof 's second annual survey finds healthcare providers see population health as critical to future success and an opportunity to improve clinical costs, quality and outcomes. However, this essential business model change is difficult — even harder than many executives thought a year ago — and there's additional risk if the new adminis- tration moves away from value-based care initiatives," Rita Numerof, PhD, president of Numerof & Associates, said in a news release. For the study, researchers surveyed more than 500 executives and key decision makers across U.S. healthcare delivery organizations. Respondents included C-suite executives in urban, suburban and ru- ral areas nationwide. ese individuals represented various delivery organizations, including standalone facilities, small systems and inte- grated delivery networks; for-profit, nonprofit and government insti- tutions; and academic and community facilities. Here are seven survey findings. 1. Numerof & Associates said 95 percent of survey respondents rated population health between "moderately" and "critically" important for future success, with 43 percent calling it "critically important." 2. Seventy-four percent of survey respondents indicated their organi- zation has a designated division, department or institute for popula- tion health programs. Additionally, 64 percent of survey respondents said their organization has a formal process for working with phy- sicians who are outliers on cost or quality, and 53 percent of survey respondents said physician payment is based, at least in part, on the ability to manage variation. 3. The survey found more than 75 percent of healthcare provid- ers were in at least one agreement with a payer that included up- side gain and/or downside risk. However, the exposure to risk was nominal, with the majority of respondents saying 10 percent or less of their current revenue was in risk-based agreements, Nu- merof & Associates said. Only one in 10 survey respondents said at least 40 percent of their organization's revenue flowed through risk-based agreements. 4. Survey respondents projected 21 to 40 percent of their revenue will flow through alternative models within two years, down from 41 to 60 percent in the 2015 survey, according to Numerof & Associates. 5. Only 17 percent of survey respondents said their organization is "very prepared" to take on risk today, Numerof & Associates said. 6. e survey found 43 percent of respondents still view their organi- zation's ability to manage variation in quality at the physician level as "average" or worse. 7. Survey respondents reported payer enthusiasm for entering into risk-sharing agreements has declined. Numerof & Associates said payers on the other hand oen express reluctance to partner with providers that appear to lack the organizational competencies needed for successful population health initiatives. n Brown Study: No Way to Predict Readmission Risk Under CJR By Tamara Rosin C MS launched the Comprehen- sive Care for Joint Replace- ment model in April 2016 to compel hospitals to better coordi- nate care for joint replacement sur- gery patients in an effort to reduce readmissions and use of expensive post-acute services. The CJR model imposes penalties on hospitals for readmissions of lower extremity joint replacement patients within 90 days of surgery, but a new study from Prov- idence, R.I.-based Brown University finds there is no adequate index for predicting readmission risk. Some hospital systems have taken issue with the fact that the CJR's cur- rent payment model does not include a system for adjusting risk to account for variances in patients' medical complexity or functional status, said Amit Kumar, PhD, lead study author and a postdoctoral research associ- ate at the Brown University School of Public Health, according to a Brown report on the study. Dr. Kumar and his co-authors test- ed the three best joint replacement candidate risk adjustment indices, including one created by CMS, but determined that none led to accu- rate predictions of readmissions among patients who underwent joint replacement surgeries for os- teoarthritis, according to the report. The study authors concluded that there is a need for an index that can accurately predict the risk of patient readmissions to both improve patient care and help CMS fairly judge hospi- tals on the quality of their care, rather than impose penalties that do not ac- count for inherent risk. n 95% of survey respondents rated population health between "moderately" and "critically" important for future success.