New Study of Physicians and Health Plan Executives Reveals Actions Needed to Accelerate Value-Based Care

HIGHLIGHTS FROM THE QUEST DIAGNOSTICS/INOVALON STUDY INCLUDE:

  • Seventy-four percent of physicians and health plan executives said that quality measures are too complex, making it difficult for physicians to achieve them.
  • About two-thirds (65 percent) of physicians said they do not have all the healthcare information they need about their patients.
  • Sixty-four percent of physicians and health plan executives said that physicians do not have the tools needed to succeed in a value-based care system.
  • Eighty-five percent of physicians were likely or very likely to use a tool that provides on-demand patient-specific data to identify gaps in quality, risk and utilization as well as medical history insight within the clinical workflow in real time.

MADISON, N.J. – June 14, 2016 – A new study of physicians and health plan executives suggests that the complexity of quality measures and physicians’ lack of access to patient data at the point of care are barriers to the healthcare industry’s adoption of value-based care. The study, commissioned by Quest Diagnostics (NYSE: DGX) and Inovalon (Nasdaq: INOV)), also reveals physicians and health plan executives hold starkly different perceptions about the importance of, and impediments to, value-based care adoption, pointing to opportunities for greater physician, health system and health plan collaboration.

“This study shows that physicians and health plan executives differ in their perceptions of how effectively the nation’s healthcare system is progressing toward value-based care,” said Harvey M. Kaufman, M.D., senior medical director, Quest Diagnostics. “It also reveals that complexity and incomplete access to patient information may be greater obstacles to adoption than previously realized. We hope the study’s findings spark greater collaboration by providers and health plans and dialogue about new solutions to improve quality outcomes and reduce overall costs.”

The study is based on a survey of hospital-affiliated primary care physicians and health plan executives. Key findings from the study include:

  • Complexity is impeding adoption: While three quarters of all survey respondents agreed that “quality measures are useful in improving care quality,” only about half (54 percent) of all respondents agreed that “it’s clear to physicians which quality measures apply to their individual patients under relevant value-based care models.” Seventy-four percent of respondents agreed that “quality measures are too complex, and this makes it difficult for physicians to achieve them.”
  • Access to complete patient data is critical and still lacking: Eighty-seven percent of all respondents said that it’s very important (26 percent) or extremely important (61 percent) to have access to all of a patient’s medical records. Yet, about two-thirds (65 percent) of physicians said they do not have all the healthcare information they need about their patients. In addition, only 36 percent of physicians said they’re satisfied with access they have to patient data within their existing workflows. Limitations to having better information include: “patients can have many physicians [who] may not share information across EHRs or other channels” (78 percent), “lack of interoperability” (74 percent) and “no way to integrate into current workflow” (37 percent).
  • New tools are needed – and wanted – at the point of care: As to whether a tool exists within the physician’s workflow that is “aligned with providing quality and value-based care today,” nearly half (48 percent) of all respondents said no or they weren’t sure. And while 44 percent of health plan executives believed that physicians have the tools needed to succeed in a value-based care system, only 29 percent of physicians agreed. Acknowledgement that tools are lacking is important since more than four in five (88 percent) of all survey respondents agreed that such a tool would probably be useful. The survey also found that 85 percent of physicians were likely or very likely to use a tool that provides on-demand patient-specific data to identify gaps in quality, risk and utilization as well as medical history insight within the clinical workflow in real time.

In addition, health plan executives and physicians differed sharply in their perception of value-based care. According to the survey, 57 percent of health plan executives believed the United States healthcare system should be value-based (versus fee-for-service or some other approach), compared to 33 percent of physicians. Value-based care refers to healthcare delivery models on which payment is based on patient outcomes, care quality, appropriate utilization and other metrics, as opposed to traditional fee-for-service.

The study, “Finding a Faster Path to Value-Based Care,” can be downloaded here.

Methodology

The online survey was conducted by Regina Corso Consulting on behalf of Quest Diagnostics and Inovalon from May 6-20, 2016. Four hundred and fifty respondents participated in the national survey. Of these, 300 were primary care physicians employed in private practice but who have an affiliation with a hospital and 150 were health plan executives (director-level and above). The margin of error for the full sample was +/- 5 percent.

About Inovalon

Inovalon is a leading technology company that combines advanced, cloud-based data analytics, and data-driven intervention platforms to achieve meaningful insight and impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape. Inovalon's unique achievement of value is delivered through the effective progression of Turning Data into Insight, and Insight into Action®. Large proprietary datasets, advanced integration technologies, sophisticated predictive analytics, data-driven intervention platforms, and deep subject matter expertise deliver a seamless, end-to-end capability that brings the benefits of big data and large-scale analytics to the point of care. Driven by data, Inovalon uniquely identifies gaps in care, quality, data integrity, and financial performance – while bringing to bear the unique capabilities to resolve them. Providing technology that supports hundreds of healthcare organizations in 98.2% of U.S. counties and Puerto Rico, Inovalon's cloud-based analytical and data-driven intervention platforms are informed by data pertaining to more than 793,000 physicians, 277,000 clinical facilities, and more than 132 million Americans. Through these capabilities, and those of its subsidiary Avalere Health, Inc., which offers data-driven advisory services and business intelligence to more than 200 pharmaceutical and life sciences enterprises, Inovalon is able to drive high-value impact, improving quality and economics for health plans, ACOs, hospitals, physicians, consumers and pharma/life-sciences researchers. Data Diagnostics™ is a trademark of Inovalon, and the system and processes generally described herein are proprietary to Inovalon as the sole owner of the intellectual property. For more information, visit www.inovalon.com or www.datadiagnostics.com.

Contacts:

Media Contact
Lucy Muscarella, Greenough: 617-275-6527 or lmuscarella@gcgpr.com

Investors Contacts
Shawn Bevec, Quest Diagnostics: 973-520-2900
George Price, Inovalon: 301-809-4000 x1190