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Health systems are planning to advance their risk-based payment strategies by taking on more upside or downside risk, professional capitation, or global capitation in Medicare Advantage lines of business in 2022, according to a recent survey.
The executive survey conducted by the Healthcare Financial Management Association (HFMA) for the Guidehouse Center for Health Insights found that nearly 60 precent of health systems are looking to advance into risk-based Medicare Advantage models in the next year. That is a 14 percent increase compared to a June 2019 Guidehouse/HFMA analysis, Guidehouse pointed out.
But Medicare Advantage isn’t the only line of business that will take on risk in 2022, according to the survey of over 100 CFOs and finance and managed care executives from provider organizations.
Survey respondents indicated that health systems will diversify their risk-based payment strategy across various business lines. For example, over half (52 percent) of executives plan to increase risk-based payment or capitation in their commercial lines of business, while 49 percent anticipate taking on more risk or capitation through Medicare alternative payment models.
About 36 percent of executives said risk-based payments will increase in managed Medicaid, 33 percent in direct-to-employer arrangements, and 12 percent said “other.”