More than two-thirds (68 percent) of healthcare executives responding to a Health Catalyst survey said population health management (PHM) is “very important” to their healthcare delivery strategy over the next two years. When it comes to having more patients covered through risk-based PHM contracts, however, organizations want more time.

The survey collected responses from 199 executives within hospitals, health system, group practices and insurers. Overall, executives seemed bullish on population health: 82 percent said they’ll be continuing their current PHM strategy, with only 4 percent saying they would be putting their plans on hold because of uncertainty over the Affordable Care Act. Fewer than 3 percent said PHM is “not important at all” to their near-term care delivery strategy.

“The bottom line is, providers see population health management as something they need to do and that they want to do to provide better care for patients, but they are struggling with the economics of operating in both the fee-for-service and value-based care worlds—having one foot in each canoe,” said Amy Flaster, MD, MBA, vice president of population health management and care management for Health Catalyst, said in a statement.

The difficulty of the balancing act was reflected in the more humble plans on risk-based contracts. When executives were asked how soon they expect to have more than 30 percent of their patients covered by contracts with downside risk, only 13 percent said they were already meeting that threshold. The majority said they would need either three to five years (37 percent) or six to ten years (14 percent) to manage that level of risk.

The most common barrier to moving forward or succeeding with population health, respondents said, were financial issues, like “getting paid for our efforts” and “balancing competing contract incentives,” which was the “one foot in each canoe” problem Flaster mentioned.

Those barriers have been identified by other reports, but there are signs the tide is turning, whether providers feel they’re ready or not. Francois de Brantes, MS, MBA, vice president of director of the Altarum Institute’s Center for Payment Innovation, has said providers can’t avoid downside risk much longer if they want to “actively participate in the restructuring of American health care.” Another recent survey from Avalere Health has said accountable care organizations tackling population health could be missing out on available CMS bonuses if they avoid taking on risk in the Medicare Shared Savings Program.

“The big picture takeaway from this survey is that healthcare executives view the move to value-based care as inevitable, regardless of the current political situation, and population health management is seen as critical to their success in transitioning to the new reimbursement structure,” said Marie Dunn, MPH, vice president of population health strategy for Health Catalyst.