U.S. healthcare organizations are finding it increasingly difficult to transition from fee-for-service to fee-for-value care because of competing priorities and uncertainty over regulations according to a report released in July 2017 by Ernst & Young’s Health Advisory Services.  The survey queried 700 U.S. healthcare professionals.

Among the findings are four key factors that challenge the shift to value-driven care:

• System inefficiencies that escalate the cost of care delivery
• Clinical workforce challenges that increase the potential for exposing patients to medical errors
• The lack of standards for how quality is measured and defined
• A lack of trust between providers, payers, and regulators

The report further identifies “notable” trends across all sizes of U.S. hospitals and health care systems:

• Medical errors: Only 76% of respondents indicated that reducing medical errors is a priority and only 58% took initiatives to reduce medical errors. Further, only 18% have planned initiatives for this year.
• Talent engagement: Only 51% of respondents indicated that employee satisfaction drives patient satisfaction and only 35% had initiatives underway to create a more positive work environment. Only 10% had bothered to solicit employee input by survey.
• Patient experience: 93% of respondents are undertaking initiatives to improve patient experience but only 26% indicated that patient access/satisfaction is one of their top 3 priorities.
• Cost control: 95% of respondents are undertaking cost control measures, but 25% do not have any “value-based” reimbursement initiatives planned for 2017.

The survey also revealed a gap in core competencies and capabilities between large and small hospitals and healthcare systems, with smaller organizations lagging behind larger ones, exposing themselves to financial risk.

Recommendations include a considerable shift in the U.S. healthcare “culture” to embrace administrative as well as financial innovation to meet the future needs of consumerism and industry demands for value transparency. The report emphasizes that an engaged and satisfied clinical workforce is necessary to deliver improved clinical outcomes relative to the optimal cost of care and within an environment that fosters a good patient experience.