In recent years, the healthcare industry has undergone a significant transformation, shifting its focus from volume-based, fee-for-service models toward value-based care (VBC) arrangements that reward outcomes over output. This change reflects a growing consensus that sustainable, patient-centered healthcare must align financial incentives with quality outcomes, care coordination, and cost efficiency. Now, new data reveals that healthcare leaders are more optimistic than ever about the future of value-based care. A recent joint survey by the National Association of Accountable Care Organizations (NAACOS) and health technology leader Innovaccer reports that over 60% of healthcare executives expect an increase in VBC-generated revenue in 2025 compared to the previous year.
This expected growth marks a turning point in the VBC movement, which has often faced slow adoption due to structural, financial, and technological barriers. Yet the current momentum signals that organizations are adapting, investing, and evolving to meet the demands of this new era in healthcare delivery.
The Growing Share of Value-Based Revenue
According to the survey, around 30% of healthcare leaders stated that a quarter or more of their organization’s revenue already stems from value-based contracts. Furthermore, over 20% indicated that more than half of their revenue comes from arrangements involving full capitation or downside risk—models that require providers to manage not only the care but also the financial responsibility for patient populations.
This data is a strong indicator that VBC is no longer on the periphery of healthcare economics. While many organizations still rely heavily on traditional fee-for-service arrangements, a substantial and growing minority have embraced more aggressive value-based payment models. This shift reflects not only policy-driven initiatives such as the Medicare Shared Savings Program (MSSP) and Direct Contracting, but also a broader strategic realignment within healthcare systems that recognize the long-term benefits of preventative, coordinated care.
The transition to VBC is also being driven by increasing scrutiny on healthcare spending, particularly in the United States, where costs are among the highest in the world with mixed population health outcomes. Payers, including both public programs like Medicare and Medicaid and private insurers, are pushing for models that deliver better results without skyrocketing costs. This pressure creates both a challenge and an opportunity for providers willing to innovate.
Key Barriers Still Stand in the Way
Despite the optimism, the survey also underscores persistent obstacles to full-scale VBC adoption. Chief among them is financial risk. Moving from fee-for-service to risk-based contracts means providers must develop new competencies in population health, care coordination, and financial management. Not all organizations—especially small, rural, or independent practices—are equipped to handle this transition alone.
Another major hurdle is provider readiness. For value-based care to succeed, clinical teams must be aligned, trained, and supported with the right workflows and incentives. Unfortunately, many physicians remain skeptical of VBC initiatives, citing concerns over increased administrative burden, loss of autonomy, and potential misalignment between quality metrics and real-world care delivery.
Technology poses yet another double-edged sword. On the one hand, advanced analytics and data interoperability are essential to making VBC work. On the other, the cost and complexity of implementing and maintaining these tools can overwhelm already strained IT departments. Survey respondents cited interoperability issues and technology investment costs as significant concerns. Disparate electronic health record (EHR) systems, lack of standardized data formats, and gaps in real-time patient information remain persistent headaches.
Regulatory challenges add an additional layer of complexity. Navigating multiple payer requirements, compliance frameworks, and evolving federal regulations can slow implementation and increase risk. The lack of standardized, industry-wide quality measures further complicates benchmarking and reporting efforts. Without uniform criteria, comparing performance across providers or across different VBC programs becomes difficult, diluting the impact of otherwise promising models.
Technology and AI Take Center Stage
Even with these barriers, the vast majority of healthcare executives surveyed are hopeful about the potential of technology—particularly artificial intelligence (AI) and data analytics—to drive successful value-based initiatives. In fact, 70% said they believe AI will play a critical role in scaling VBC programs, especially in areas such as population health, predictive analytics, and risk stratification.
AI offers the ability to analyze large volumes of patient data to identify care gaps, predict hospital readmissions, and flag at-risk individuals before costly complications arise. When integrated with robust EHRs and care management systems, AI tools can support more targeted, efficient interventions, reducing unnecessary utilization and improving patient outcomes.
Investments are being made accordingly. Survey respondents indicated that data analytics, AI tools, and care coordination platforms are top priorities for budget allocation in the next 12 months. Roughly one-third also plan to invest in patient engagement technologies, such as mobile apps, remote monitoring, and digital health coaching solutions.
The emphasis on technology also reflects a growing recognition that VBC cannot be implemented successfully in silos. To manage patient populations effectively, organizations must adopt a unified, data-driven approach that includes collaboration between payers, providers, and community resources. This is especially true in managing social determinants of health (SDOH), where non-clinical factors like housing, food security, and transportation impact health outcomes as much as traditional clinical care.
Building the Infrastructure for VBC Success
For healthcare organizations aiming to thrive under value-based care, strategic infrastructure development is key. This includes investing not only in technology but also in human capital, governance, and culture change.
Operationally, organizations must redesign care delivery models to support longitudinal, team-based care rather than episodic treatment. This involves building integrated care teams, embedding care coordinators in primary care, and enabling cross-functional collaboration between specialties.
Financially, transitioning to VBC means developing new competencies in actuarial modeling, risk adjustment, and contract negotiation. Healthcare leaders must learn how to evaluate capitation rates, understand shared savings formulas, and manage the downside risks associated with quality-based reimbursement.
Culturally, organizations must foster a shift in mindset from reactive treatment to proactive management. Physicians and clinical staff should be educated not only on the metrics that matter, but on why those metrics reflect better care for patients. Incentives should align accordingly—rewarding not just productivity but effectiveness.
Governance structures also need to evolve. Executive leadership should include representation from finance, IT, population health, and clinical operations to ensure an integrated approach to VBC. Dashboards and KPIs should track not only revenue but patient satisfaction, access, health equity, and long-term outcomes.
Policy and Market Forces Accelerating Change
The transition to value-based care is not occurring in a vacuum. Federal policy continues to shape the landscape through programs such as the Centers for Medicare & Medicaid Innovation (CMMI), which has rolled out numerous VBC initiatives over the past decade. The Medicare Access and CHIP Reauthorization Act (MACRA) and the Quality Payment Program (QPP) are also nudging providers toward value-based arrangements, with financial penalties or bonuses tied to performance.
Meanwhile, private payers are accelerating their own versions of VBC contracts. Many large insurers now offer incentive programs for ACO participation, bundled payments, and performance-based reimbursement. Employers, frustrated by rising healthcare costs, are increasingly contracting directly with providers who can demonstrate improved outcomes and cost savings.
This creates a competitive imperative. Healthcare systems that fail to adapt risk losing ground—not only in payer negotiations, but in patient volume and reputation. Consumers, too, are becoming more informed and value-conscious, choosing providers that offer better care experiences, access to virtual tools, and transparency in pricing.
How Healthcare Consultants Can Add Value
For healthcare consultants, this period of transformation offers significant opportunities to support clients in navigating the complexities of value-based care. Consultants can assist with:
- Readiness assessments to evaluate where an organization stands in terms of VBC capabilities, risk appetite, and operational gaps.
- Strategic planning to determine which value-based models best align with organizational goals and market conditions.
- Technology optimization to assess, select, and implement data platforms, predictive tools, and patient engagement systems.
- Workforce training to prepare clinical and administrative teams for new workflows and performance metrics.
- Contract negotiation support to ensure that payer agreements are financially sustainable and appropriately structured.
By providing tailored solutions and hands-on support, consultants play a vital role in ensuring that healthcare organizations not only survive the shift to value—but thrive in it.
Healthcare delivery is evolving from a fragmented, reactive model to a coordinated, outcomes-driven ecosystem. While challenges remain, the tide has clearly turned. The expectations set for 2025 indicate that organizations are not just preparing for value—they are beginning to realize it.