Data & Analysis

Positioned for Growth: The Anatomy of Value-Based Primary Care

3 minutes

While value-based care has become a well-recognized way to align economic interests with activities that should improve patient outcomes and reduce unnecessary spending, ensuring that physicians can deliver against a value-based care mandate is another matter.

Survey Highlights What Enables PCPs to Actively Participate in Value-Based Care

We fielded and analyzed a survey of over 300 primary care physicians (PCPs) across the United States to shine light on current practices and anticipated trends in the value-based care space.

We analyzed the responses across 3 categories of PCPs to understand how the degree of alignment to value-based care affects their practice, decision-making, and competencies:

  • Leaders: those who are actively participating in capitation models within their practice
  • Experimenters: those who participate in some other form of value-based care model (e.g., accountable care organizations)
  • Abstainers: those who either don’t participate in any value-based care contracts or are unaware whether they do

What Makes a PCP Leader in Value-Based Care Payment Models

We found that those in the Leader cohort tended to be more experienced, saw more patients a day, and were more open to growing their panels. Despite the greater volume of patients, these PCPs also worked fewer hours each week than those who are Experimenters or Abstainers.

Leaders were also more aligned with the payment models they participated in. Leaders were more likely to receive performance-based compensation, know and consider cost when referring patients, and were more likely to successfully drive patients to specific health plans or products.

Leaders had more advanced practice infrastructure and were more likely to engage in activities that can lead to better risk adjustment outcomes than their peers. Similarly, Leaders were more likely to utilize advanced practice providers (APPs) like nurse practitioners and physicians’ assistants. Leaders had a ratio of 1 APP to every 2 PCPs, as compared to 1:3 for Abstainers, enabling them to treat more patients and to practice at the top of their licenses.

These trends, and more, should be considered by primary care practices that are looking to adopt or expand value-based care models. Overall, physicians in the Leader cohort are well-positioned to thrive as value-based primary care advances in the industry. 

PCPs See Room for Growth, But Supporting Practice Infrastructure Will Be Key

71% of PCPs surveyed believe their capabilities required to deliver on value-based care will improve over the next 5 years, but practices will have to be intentional in their plans to adopt value-based care models. Of the 3 cohorts, Experimenters were most likely to report experiencing burnout, which points to the fact that value-based care models must be implemented with the proper infrastructure to best serve physicians and patients alike. Importantly, 20% of physicians didn’t know whether their practice was engaged in a value-based care payment model, highlighting the significance of shared goals and clear communication between clinicians and those at the executive level. 

Read the Reports to Dig into the Details

Part 1: Value-Based Primary Care Practices Are Positioned for Growth

Value-based care models are highly prevalent, but those that involve explicit risk-taking are less so. The physicians who are aligned with these payment models stand out from their peers, as measured by several key metrics.

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Part 2: The Degree of Value-Based Care Alignment Influences PCP Decision-Making

This report examines how referrals are managed, how compensation is aligned to value participation, and whether PCPs can influence the products or plans their patient panel enrolls in to consolidate lives in value-based products.

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Part 3: More Advanced Practice Competencies Are Required to Achieve Value-Based Care Alignment 

This report looks at how the foundational infrastructure of the practice itself has a considerable impact on the ability of PCPs to manage in a value-based environment.

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© 2022 The Chartis Group, LLC. All rights reserved. This content draws on the research and experience of Chartis consultants and other sources. It is for general information purposes only and should not be used as a substitute for consultation with professional advisors.

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