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10 year reflection on value-based care

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The American healthcare landscape has rapidly evolved over the past several years. With rising healthcare costs, persistent inequities in healthcare accentuated by the COVID-19 pandemic and a stressed healthcare workforce, an accelerated pace and scale of change to address these problems is imperative. In response, the healthcare industry seeks solutions that will provide meaningful improvements in the quality, equity and efficiency of care delivery. As detailed in our 10th value-based care (VBC) report, the value-based care economic model supports care delivery that enhances patient experience, improves population health outcomes, lowers costs and augments the experience of healthcare providers, thus making meaningful progress in healthcare.

With substantial experience and success with VBC in primary care, what is next? We, like others, look to expand the VBC model to care episodes and specialty needs being met beyond primary care organizations in Medicare Advantage.

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Recently, we’ve discovered strong evidence that indicates that applying VBC principles beyond MA, within the same studied framework, yields similarly positive outcomes.

Key insights

    VBC framework success seen in MA can extend to other sectors like Medicaid.

    Value-based payment models correlate with positive outcomes: improved health, cost reduction, and increased preventive care.

    Value-based care physicians earn more than those following the Medicare fee schedule.

    Exploration of Medicaid's role in value-based care reveals:            Equity promotion and high-value care across diverse member populations (pediatrics, low-income adults, maternal care, and older adults).

        Effective management of diverse care needs for members and providers of varying capacities.





As we’ve achieved primary care success in Medicare Advantage, our approach is validated, and moving forward we plan on extending to acute episodes and beyond primary care, enabling seamless communication among physicians and prioritizing patient health. Together, we encourage providers to embrace the transformative power of value-based care as we believe VBC can help drive meaningful change into the healthcare landscape.

Moving value-based care forward

VBC in action

We’re listening and are eager to engage with you and others in the industry

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