News | September 10, 2013

Study Reveals Risk For Market Disruption With Move To Value-Based Care

Growth Expectations and Operational Readiness May Not Be Aligned

Providers and Health Plans Highlight Need for Automated Information Exchange

JACKSONVILLE, Fla. – Health plans and providers expect their participation in value-based care programs to more than triple in the next three to five years. For that growth to be successful, more than 90% of respondents from both groups agree they must automate the information exchange required by these programs. However, only a small percentage of providers and plans report having fully-automated capabilities in place – leaving a questionable gap in the current operational readiness of the market.

These findings and others are from a pair of recently-published research studies by Availity, a leading health information network. They shed further light on the need for automated information exchange solutions in the market to support emerging payment models, and call attention to the disruption the market may encounter if health plans and providers continue to rely on manual methods of exchanging critical data.

The Provider Readiness to Support Value-Based Payment Models report (the companion study to Availity’s health plan research published earlier this year) presents the physician practice and hospital view of their readiness to participate in value-based payment arrangements. The related Implications and  Recommendations report compares results from both studies and delivers an assessment of the current market path and recommendations for organizations planning to pursue these models. Please click here for access to all three reports, or visit

“We embarked on this research to identify the information-related challenges the market may encounter as it transitions to value-based care models,” said Russ Thomas, Availity CEO. “What we learned is that both health plans and providers have aggressive plans to migrate to value-based care arrangements, but the tools needed to manage the informational components of the programs efficiently and effectively have not been broadly implemented.”

With a determined path ahead, and the obvious potential for disruption to both provider and health plan operations, Availity also offers some practical guidance to consider in its Implications and Recommendations summary.

“Being engaged as a trusted partner with both health plans and providers has given us a unique perspective and early experience with a new level of information exchange,” said Thomas. “Sharing that with the broader market is the right thing to do. We look forward to continuing to communicate our knowledge, insights and best practices.”

About Availity

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change. To learn more, visit