Trust

It’s what’s ailing healthcare.

The 10th Annual ReviveHealth Trust IndexTM reveals an alarming gap:

Hospitals don’t trust health plans. Health plans don’t trust hospitals. Physicians don’t trust either one. And in the absence of trustworthy data and information, patients are placing their bets with friends, family and the Internet.

A shotgun marriage

A low level of trust exists between the organizations that pay for health services and the organizations and caregivers that actually provide most of these services. On a 100-point scale, health plan executives have a higher level of trust in providers than either doctors or hospitals have in health plans.

Health Systems Executives
Level of trust in health plans
54.1
Range: 40.3 - 63.3
Physicians
Level of trust in health plans
55.0
Range: 52.7 - 57.2
Health Plan Executives
Level of trust in health systems
67.6
Range: 56.7 - 73.3

Composite score values are calculated as an equally-weighted mean of all three individual Trust measures (Honesty, Reliability, Fairness). Differences of less than 2 points are not statistically significant.

Transition to value is slow

The disconnect is real. While payors say they expect about 44 percent of 2016 claims will be based on value, providers say they expect only 13 percent of 2016 revenues from value-based payments. Either way, we’re less than halfway there, it’s clear health plans and providers have very different definitions of value-based claims and revenue.

Health System Executives

13% VALUE • 87% VOLUME

During the course of calendar year 2016, what percentage of your total commercial revenues will be based on volume versus value?

Health Plan Executives

44% VALUE • 56% VOLUME

During the course of calendar year 2016, what percentage of your the total claims you pay for commercially insured patients will be based on volume versus value?

Issues identified as “very important” factors driving/restraining the transition to more of a value-based payment structure:

Driving Forces
Fed. govt. initiatives
74%
Health Plan initiatives
64%
Increased trust
58%
Board directive
53%
Triple aim
50%
Restraining Forces
Lack of technology & processes
62%
Reluctance to assume risk
62%
Risk of losing competitive edge
49%
Decreased trust
48%
Physician resistance
45%

Issues identified as “very important” factors driving/restraining the transition to more of a value-based payment structure:

Driving Forces
Gain competitive advantage
69%
Increased trust
65%
Physician support
57%
Public sentiment
57%
Competitor intiatives
53%
Restraining Forces
Lack of technologies
61%
Lack of data
58%
Doubts about Fed. programs
49%
Lack of processes
48%
Decreased trust
47%

TRUST is the glue

All three sectors agree that for the transition to value to go more smoothly and rapidly, increased levels of trust will be necessary – based heavily on the new alliances needed to deliver bundled care, reduce readmissions, share in cost savings, and better manage the health of large populations. In fact, 94 percent of health plans and providers alike said decreased trust was either a very important or somewhat important factor restraining the transition to a value-based payment structure.

Health System Executives

Driving Forces
Increased trust
58%
Restraining Forces
Decreased trust
48%

Health Plan Executives

Driving Forces
Increased trust
65%
Restraining Forces
Decreased trust
47%

How do we build trust in this environment?

  • Know where you stand

    Do the research to understand where your organization stands on key issues and the size and nature of your Trust Gap with your key stakeholders.

  • Think differently about your payor/provider relationship

    Be willing to form new and different kinds of relationships. Aversion to taking on risk tops the list of factors stalling the transition to value-based care. At least 95 percent of health system executives say caution by leadership to take on additional risk is hindering the transition while 100 percent of health plan executives point to this provider resistance.

  • Start small, then build and scale up

    To the degree there has been any progress on the trust issue, it appears to be based on the various parties working together to implement pay-for-quality initiatives. Seventy-six percent of health systems executives and 64 percent of health plan executives cited pay-for-quality programs as the most popular strategy for making the shift from volume to value.

  • Secure partners to deliver relevant, trustworthy data

    Another key factor providers say holds them back from a more rapid transition to value-based payment arrangements is the lack of technologies and processes to support this transition, including access to timely, reliable, and actionable data.

  • Better communication and information sharing

    Communication, education and awareness, and physician and employee engagement play a huge role in driving trust among key stakeholders and in your brand. With better communication between and among health systems, health plans, and front-line physicians, trust will improve, which in turn will help improve the patient experience and (hopefully) consumer trust in the healthcare system.

Four C’s of building trust

  • Communication

    Internal communication is just as important as external communication. It’s important for everyone in your organization to know what you stand for, the direction you’re headed, and how you plan to get there. Share this with your external audiences, too, so they know what to expect and how to work with you.

  • Consistency

    What you communicate is as important as how and how often you communicate. Stay on message, keep the communication flowing on a regular basis, and have an omni-channel strategy to be sure you’re reaching your audiences where they are.

  • Compassion

    Do the research. Understand the challenges your audiences face, and demonstrate in your words and deeds that you not only feel their pain, but tell them what you’re doing to alleviate it.

  • Competency

    No organization is great at everything, nor do people expect them to be. Know what you’re good at, work to improve areas that need improvement, and tell people about both.

Looking for more?

Trust and its role in the transition to a value-based care delivery system is a seriously hot topic. We’re keeping a watch for some of the industry’s most relevant articles and studies to help you stay informed.

About this report

Audiences (hospital/health system executives, practicing physicians, and health plan executives) were surveyed by Catalyst Healthcare Research between the dates of April 25 and July 19, 2016. Composite score values are calculated as an equally-weighted mean of all three individual Trust measures (Honesty, Reliability, Fairness). Academic literature on the topic of trust informed the section of the trust, honesty and fairness attributes.

Participants ranked their responses using the following scale:

  • 0 Strongly disagree
  • 25 Disagree
  • 50 Undecided
  • 75 Agree
  • 100 Strongly agree
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