Research & Insights

Value-based care

The value-based care (VBC) movement — intended to shift the industry away from volume-based reimbursement — has been slow thus far. The next decade of value-based care must be different. Our research explores the barriers to value-based care and identifies key action steps that each industry stakeholder can take to drive progress.

Featured Insights

Shaping the New Era of Value-Based Care Summit

On June 26 and 27, 2023, in Dana Point, California, Advisory Board will convene leaders from across the industry who are serious about making risk-based payment a reality. We will take stock of the current moment, examine lessons learned, and identify actionable steps for each stakeholder to move the industry forward. We hope you join us!

Infographic

The climb to value-based care

Value-based care is already an important part of Medicare. But the next 10 years of VBC will be shaped by the private sector. In this infographic, we detail the position of each major stakeholder: who's most motivated to act, how they can shape future reimbursement models, and what's standing in their way.

Research

Envisioning paths to nationwide VBC

How could nationwide value-based payment become a reality in the next 5 to 10 years? Looking to today’s market for clues, our team envisioned how influential stakeholders could make that happen.

Research

Comparison chart: 5 partnership models in commercial risk

Learn about five payer-provider partnership models being applied to commercial populations and why they may or may not be the right path for your organization.

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Commercial risk
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Care models

Value-based care is an industry-wide strategy to improve population health and reduce the total cost of care. The transition from fee-for-service to value-based care requires two simultaneous transformations in healthcare:

Care model transformation: Redesign the care delivery model with a focus on primary care, prevention, chronic care management, and high-quality, low-cost episodes of specialty care.
Payment transformation: Redesign the reimbursement model with a focus on paying for the quality and appropriateness of care.

Value-based care is a buzzword and has been for a decade.
While providers and plans have historically had a relationship that’s mostly contractual and negotiation heavy, successful value-based partnerships require a new degree of strategic rigor and collaboration.
The most successful partnerships effectively advance shared goals and make both sides more loyal (and ideally, indispensable) to the other.

Public programs continue toward population-based downside risk, but commercial plans and providers have not coalesced around a sustainable model to meet employers’ experience and cost needs.
The industry must decide which will yield greater savings: contracting based on employee utilization trends or following Medicare's lead by focusing on longitudinal population-level payment structures. Either way, commercial risk will decide the fate of value-based care.

While getting actionable, timely data is difficult, the ability to segment patients by level of risk is a fundamental capability for any organization to be successful under risk.
If there is a place where an executive should over invest their resources, this is it.

Success under value-based payment fundamentally means segmenting the patient population and providing varying levels of service based on patient risk. This requires doing some things differently for some patients and evolving care models to:

Quick reads from around the industry

Our Take

How health plans can support providers in risk

Providers often stall in upside risk and remain ill-prepared for downside risk. Here’s how plans can adapt their strategies to break through this plateau.

Research

Win physician buy-in for value-based care

Learn four principles to land your value-based care messaging with physicians.

Blog Post

3 opportunities and obstacles for digital health in advancing VBC

Digital health can be an integral component to any VBC strategy.

Research

The next chapter of population health involves specialists. Here’s where to start.

Specialists must be part of any value-based care strategy if we want to meaningfully reduce costs and improve population health.

Go deeper on our latest research

Value-based care

Strategic investments lower costs while improving care. See our comprehensive library of resources on value-based care.

Total cost of care

Prioritizing focus across different population health initiatives can be difficult. We highlight proven initiatives that have moved targeted metrics related to cost, quality, and utilization.

Primary care

Meeting patient needs in sustainable ways requires a diverse skillset and tailored workflows. Use our resources to build a sustainable care team to maximize ROI.

Care management

Successful risk-based contracts required comprehensive care management. Advance your care management strategy to improve quality, reduce downstream utilization, and lower the total cost of care.

Behavioral health

Behavioral health needs are increasing and are too costly to ignore, especially for those participating in risk-based contracts.

Health equity

With value-based care adoption, ignoring health equity concerns only furthers disparities. Leaders need to consider what they want to achieve and who's at risk for being overlooked.

Upcoming Event
June 26, 2023

Shaping the new era of value-based care

On June 26 and 27, 2023, Advisory Board will convene leaders from across the industry who are serious about making risk-based payment a reality. We hope you join us!

Request registration

Experts

Clare Wirth

Director, Value-based care research

Clare aims to revitalize the conversation around value-based care and inspire cross-industry stakeholders to take action.

Daniel Kuzmanovich

Managing director and expert partner

Daniel is an expert partner and national speaker who also leads the Advisory Board's team of expert presenters and facilitators.

Miriam Sznycer-Taub

Managing director, Cross-industry research

Miriam leads cross-industry research focused on value-based care and senior care.

Wes Campbell

Expert partner

Wes is an expert partner at Advisory Board supporting research across a variety of topics.

We help leaders and future leaders in the healthcare industry work smarter and faster by providing provocative insights, actionable strategies, and practical tools to support execution.

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Value-based care

Shaping the New Era of Value-Based Care Summit

The climb to value-based care

Envisioning paths to nationwide VBC

Comparison chart: 5 partnership models in commercial risk

How health plans can support providers in risk

Win physician buy-in for value-based care

3 opportunities and obstacles for digital health in advancing VBC