NEW YORK – August 24, 2023 – EmblemHealth, one of the nation’s largest nonprofit health insurers, today announced results from its national study exploring the level of awareness of value-based care payments among employers and consumers. The study revealed that both groups are unclear on the difference between value-based care and fee-for-service payments, but when provided a definition of value-based payments, strongly prefer this model as the best way to provide the highest quality care that may also reduce costs.
“The survey data and information from our research demonstrate that both employers and consumers overwhelmingly prefer value-based care to fee-for-service payment models when they better understand the differences between each model,” said Karen Ignagni, Chief Executive Officer, EmblemHealth. “Achieving healthier outcomes more affordably will require all stakeholders to work together to educate the public on the benefits of a value-based care model.”
The study was conducted as a follow-up to the company’s previous consumer-focused value-based care study and surveyed nearly 125 employer health insurance decision-makers and nearly 750 consumers ages 18 and older nationally, with an oversample of the tristate region. The online survey of these groups focused on awareness and understanding of value-based care and fee-for-service payments; what consumers associate with value in health care; how important consumers feel it is for insurers and health care providers to utilize value-based payments; relevant messaging to describe value-based care; and who will be most impactful communicating about value-based care.
Key findings of the study include:
- The concepts of value-based care and fee-for-service payments are widely unknown and misunderstood by both employers and consumers, providing an opportunity for stakeholders to collaborate on education around these concepts.
- 60% of employers, were familiar with the term “value-based care” but only one-third could provide a definition; small group employers had less of an understanding than large group employers and were more likely to be unsure of whether value-based care plays a role in the coverage they offer.
- Only 26% of consumers surveyed had familiarity with the term “value-based care”; four out of 10 consumers were unsure whether value-based care is offered through their health plan.
- Quality is important when defining value in health care, and employers and consumers feel health insurers and providers are most responsible for adding value to health care.
- 42% of employers and 34% of consumers most associate quality of care received with value when thinking about health care, topping out-of-pocket cost (22% and 16%, respectively).
- Employers felt insurers were more responsible for adding value to their employee’s health care; consumers felt that providers should be more responsible for adding value (both groups placed insurers and providers at the top of their lists).
- Given the definition of value-based and fee-for-service payment models, there is a strong alignment towards the value-based payments compared to the fee-for-service payments across both audiences.
- 69% of employers (62% small group and 74% large group) and 61% of consumers preferred the value-based care model to the fee-for-service model.
More detailed study findings and recommendations on how employers and consumers can be better informed about the differences between fee-for-service and value-based care payment models can be found in EmblemHealth’s recently published 2023 value-based care white paper: “Moving from Volume to Value: Explaining the Difference Between Fee for-Service and Value-Based Payments.”
Additional information can also be found in EmblemHealth’s blog post, “Understanding Value-Based Care and Its Importance to Stakeholders in the Health Care System: The Experience of a Community-Based Non-Profit Health Plan.”