Value-based Care Reimbursement: 4 Models, 2 Keys, 1 Solution
- Hadley Richards
- Jul 21
- 3 min read
Healthcare in the United States is steadily evolving toward value-based care (VBC)—and for good reason. The Centers for Medicare and Medicaid Services (CMS), which oversees the nation’s two largest public payers, has been leading this shift, pulling much of the healthcare ecosystem along with it.
While policy changes are never set in stone, momentum around VBC shows no signs of slowing. And that’s actually good news—because for all the growing pains that come with change, we’re entering an era where quality, equity, and efficiency are beginning to align.
So what’s next for value-based care? After years of experimentation, thoughtful innovation, and lessons learned, some meaningful trends are beginning to emerge.
What’s Shaping the Future of VBC?
Two big forces stand out:
Complexity of the Current Landscape - With so many VBC models running in parallel, providers and administrators alike are feeling the burden. While innovation has generated important insights, the patchwork of systems can lead to confusion and inefficiencies. Streamlining the landscape could unlock better care delivery and make providers’ lives easier.
The Time It Takes to Learn What Works - Healthcare transformation doesn’t happen overnight. Many VBC models need to operate for years before clear trends emerge. But with over a decade of implementation and analysis under our belts—especially following the ACA in 2010 and MACRA in 2015—we now have real data to help guide what comes next.
Where VBC Is Likely Headed
Here are some of the promising shifts we expect to see:
Simplification and Standardization - With clearer data on what works, CMS and insurers will likely narrow the range of active VBC models. That means more consistency across the board, less administrative burden, and better alignment between public and private payers. Innovation will still matter—but innovation with a purpose.
A Shift Away from Fee-for-Service - The industry may begin creating more explicit disincentives for traditional fee-for-service models. This will help push providers and payers alike toward structures that reward outcomes, not volume.
Smarter Risk-Sharing - While downside risk can be a deterrent for some providers, it has also been a feature of many of the most successful programs. The goal moving forward will be to build safeguards that ensure financial incentives don’t come at the expense of patient care—and to design oversight mechanisms that reinforce clinical integrity.
Fairer Comparisons and Better Benchmarks - Programs must be built in ways that avoid penalizing providers who are already efficient. That means creating standards that account for baseline performance, rather than favoring those who start lower and can more easily show improvement.
Greater Equity and Broader Reach - Historically underserved populations—whether due to race, income, geography, or other factors—must be fully included in VBC strategies. The more universally these models are applied, the more effective and accepted they become. Equity and outcomes go hand in hand.
A Final Word for Behavioral Health Providers
As the healthcare landscape continues to evolve, two things will remain essential for organizations like Certified Community Behavioral Health Clinics (CCBHCs):
Delivering meaningful outcomes for patients
Clearly demonstrating those outcomes to payers.
That’s exactly the philosophy we bring to our work at Garnet River, where we’ve developed Consa with Voicesense to support behavioral health teams in navigating this changing environment. By using voice analytics and AI-powered documentation, Consa helps providers improve outcomes—and back it up with real data.
In other words: as VBC continues to evolve, you won’t just be ready. You’ll be ahead of the curve.
Megan Christiana
Solutions Consultant for Garnet River & Consa