HIMSS Cost Accounting Survey to Gauge Health Provider Readiness for Value-Based Payment Models

Healthcare providers in all settings can now participate in the HIMSS Cost Accounting Survey, an industry-leading effort aimed at gauging the readiness of providers to participate in value-based payment models. The survey will be available through Dec. 31, 2015. Survey results will be released and presented in aggregate at the 2016 HIMSS Conference & Exhibition, to be held Feb. 29-Mar. 4, 2016, in Las Vegas. All individual survey results will remain confidential.

In an effort to contain burgeoning healthcare costs, Medicare has begun to move from a traditional fee-for-service payment model to value-based models, reimbursing providers for quality or clinical outcomes for patients rather than simply paying for the provision of care. The Department of Health and Human Services has announced its intent to tie the majority of Medicare payments to value and quality within the next few years.

However, to be financially sustainable within the value-based payment environment, a healthcare provider must understand the true costs of delivering care and price its services accordingly, said Pamela Jodock, HIMSS senior director, health business solutions. She noted that the cost of care includes services provided by both the provider and by external care partners participating with the provider in accountable care organizations or bundled payment programs.

“We need to begin thinking about how the industry can support providers in making the transition to value-based payment in a meaningful and widespread way,” she explained. “From a health IT perspective, what infrastructure do we need to have in place for a successful transition? The survey is intended to help us start that conversation.”

Survey divided into five parts
Coordinated by the HIMSS research department under the direction of HIMSS Senior Research Director Jennifer Horowitz, the survey is divided into five parts: demographics, the cost of healthcare, the price of healthcare, fee for service vs. value-based purchasing, and pricing transparency.

After gathering individual and organizational demographic information from the respondent, the survey asks what kinds of processes, automated abilities or cost accounting systems providers use to determine costs, as well as what factors they use to determine price and the relative importance they place on these factors. Through the survey, providers also rate their readiness to transition from a fee-based to a value-based payment model and identify what they need from an industry perspective to make this transition successfully. Finally, the survey asks providers to answer questions about the importance their organizations place on price transparency and whether or not they currently publish or plan to publish their prices.

Gaining a true understanding of costs and pricing is important for providers, Jodock explained, because the relationship between the actual cost of care and reimbursement rates has been distorted over the years by cost shifting from government to private payers, volume-based purchasing, and other factors.

“Today, the cost listed in a charge master is less a reflection of what it costs the hospital to deliver the related service and more a reflection of the price private health insurance companies are willing to pay,” Jodock stated.

Gaining an understanding of true costs essential to financial sustainability
Under the coming value-based payment environment, providers must understand the true costs of delivering care and how to price services to maintain financial viability and sustain the organization’s mission, Jodock said. As the healthcare market begins to more closely resemble the retail market, healthcare providers will most likely require cost assessment and revenue cycle management tools that will allow them to accurately capture or predict a wide range of factors influencing their clinical and operational costs. These same tools will help them respond to rapidly changing market conditions and develop business strategies that will ensure their long-term viability.

“HIMSS is eager to gain feedback from healthcare providers through the survey and stands ready to assist in the development of tools that enable them to stay financially sustainable while meeting the healthcare needs of the populations they serve,” Jodock said.

About HIMSS North America
HIMSS North America, a business unit within HIMSS, positively transforms health and healthcare through the best use of information technology in the United States and Canada. As a cause-based non-profit, HIMSS North America provides thought leadership, community building, professional development, public policy, and events. HIMSS North America represents 61,000 individual members, 640 corporate members, and over 450 non-profit organizations. Thousands of volunteers work with HIMSS to improve the quality, cost-effectiveness, access, and value of healthcare through IT. Major initiatives within HIMSS North America include the HIMSS Annual Conference & Exhibition, National Health IT Week, HIMSS Innovation Center, HIMSS Interoperability Showcases™, HIMSS Health IT Value Suite, and ConCert by HIMSS™. www.himss.org.

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