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

Tackle these challenges

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.

Quick reads from around the industry

Go deeper on our latest research

  • 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!


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.

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