Survey Finds Health Plans are Struggling with Value-Based Reimbursement

Latest Voice of the Market Survey by HealthEdge and market research firm Survata reveals that internal and external barriers are hampering payers’ adoption of value-based programs.

Burlington, MA, February 13, 2019 – HealthEdge®, provider of the only integrated financial, administrative and clinical platform for health insurers, today announced the results of its latest Voice of the Market Survey, a study of 151 health insurance executives and their organizations’ adoption of value-based reimbursement. The survey findings indicate that, despite being embraced by the Centers for Medicare and Medicaid Services (CMS), value-based reimbursement has a long way to go before finding widespread adoption and success amongst traditional health insurers. The full report of the survey findings is available to requestors by clicking here.

“Our survey shows that, in order for value-based reimbursement programs to work as intended, health insurers first need trust and alignment with providers to create clear and shared goals and ensure that the intended program results are achieved,” said Steve Krupa, CEO of HealthEdge. “In order to be successful, insurers must leverage a modern technology infrastructure that is designed to support the complexities in configuration and administration of these risk-sharing arrangements across all stakeholders.”

Key findings from the study include:

  • Health plans are divided on which value-based reimbursement programs are most successful, and respondents were nearly evenly split between patient-centered medical homes, accountable care organizations, bundled payments and episodes-of-care programs.
  • Health plans are struggling with internal (technology, infrastructure and administrative burdens) and external (member and provider engagement) barriers as they look to implement successful value-based programs.
  • Given the data points above, respondents are hedging their bets on significant growth in value-based reimbursement over the next two years.

The survey was commissioned by HealthEdge and conducted by Survata, an independent research firm in San Francisco. Survata interviewed 151 health insurance executives online between December 18, 2018 and January 7, 2019. For further information, visit

About HealthEdge

HealthEdge® provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs and connect everyone in the healthcare delivery cycle. Our next-generation enterprise solution suite, HealthRules®, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. An award-winning company, HealthEdge empowers health insurers to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit