Every year. and this one is no exception, our predictions include moving closer to value-based care. And every year we find ourselves asking the same questions. Are we really moving as quickly as needed to change outcomes and lower costs? Are care models aligning with transformation? Are we really getting true buy-in from providers to see true value-based care?
We asked our experts what progress they think we will see in 2025. Here is what they had to say. And check out all our prediction posts looking to 2025
Anne Donovan, Vice President and General Manager of Health Language, Wolters Kluwer Health
LinkedIn: Anne Donovan
We’ve seen a notable uptick in the use of artificial intelligence at the point of care to improve the patient-provider interaction, increase efficiency and streamline workflows, but we can’t just capture more data – through AI or otherwise – for the sake of documentation. We need to be purpose-driven in thinking about how the data will be used within the healthcare system to facilitate care and financial related considerations between providers and payers. To ensure the meaningful exchange of health information, organizations need to proactively design strategies that share data while maintaining the intentionality behind the data capture.
Gary Hamilton, CEO, InteliChart
LinkedIn:Â Gary Hamilton
In 2025, value-based care will focus on both financial outcomes and patient-centered experiences, driven by AI, predictive analytics, and population health initiatives. Providers will leverage these tools to offer personalized interventions, improve adherence, and address barriers such as socioeconomic factors, creating more transparent and meaningful healthcare experiences. Patient engagement will play a pivotal role, empowering providers to make care more accessible and user-friendly through innovative digital solutions that extend the clinical setting and optimize clinician workflows. By aligning incentives for both providers and patients, this approach will enhance care quality, boost satisfaction, and drive cost efficiencies across the healthcare ecosystem.
Lissy Hu, CEO, Ascend Learning
LinkedIn: Lissy Hu
Changing care and reimbursement models will necessitate significant updates in how we educate, train, and retain the healthcare workforce. Technological advancements and changes in payment models will continue to alter how and where care is delivered, with care at home becoming more commonplace. As these changes continue to take hold in 2025, it will be essential that the organizations responsible for educating and training the nurses and allied health professionals providing this care revise how they do so. New care models and sites of care necessitate new skillsets for providers. Those who don’t adapt will risk falling behind competitors who are better able to keep up with changing norms.
Leah Kirby, Chief Product Officer, Red Rover Health
LinkedIn: Leah Kirby
As healthcare continues its shift towards value-based care, the critical barrier to success in 2025 will be data integration. With fee-for-service models still dominant in the U.S., integrating data from various sources and systems will be essential for improving patient outcomes and delivering streamlined, coordinated care. Organizations that prioritize seamless, secure data integration solutions will drive the transition to more sustainable, patient-centered healthcare.
David Lareau, CEO, Medicomp Systems
LinkedIn: David Lareau
The gap between value-based care aspirations and implementation will reach a critical point in 2025, as healthcare organizations recognize that their current documentation and clinical decision support tools aren’t sophisticated enough to truly support care transformation. We’ll see a shift toward integrated platforms that combine point-of-care documentation validation with real-time care gap analysis and clinical decision support. This technology evolution will finally enable the accurate quality reporting and outcome tracking needed to make value-based care financially viable for providers.
Ali Morin, MSN, RN, NI-BC, Chief Nursing Informatics Officer, symplr
LinkedIn:Â Allison Morin, MSN, RN, NI-BC
Healthcare organizations are realizing that you can’t successfully roll out new technology without everyone at the table – clinicians, IT, and operations. Inclusive decision-making, rather than top-down directives, is how health systems achieve success. Our 2024 Compass Survey shows that misalignment is still a huge barrier, but when we bring clinicians into these decisions, technology adoption improves, retention goes up, and organizations see results faster. Collaborative involvement will drive the next wave of digital transformation.
Michael Poku, M.D., Chief Clinical Officer, Equality Health
LinkedIn: Michael Kwame Poku, MD, MBA, FACP
With ongoing adjustments in the government-sponsored healthcare insurance space throughout 2024 and into 2025, independent primary care providers will face increasing financial pressure to innovate. Next year, we anticipate a significant shift as providers re-evaluate fee-for-service models and adopt sustainable value-based care strategies across Medicare, Medicaid, and all lines of business. 2025 could be the pivotal year for accelerating value-based care adoption and moving away from fee-for-service in the U.S. healthcare system.
Hari Prasad, CEO, Yosi Health
LinkedIn:Â Hari Prasad
Value-based care is advancing, but progress hinges on aligning technology and care models with outcomes-focused transformation. Providers need tools that simplify their operations while improving patient outcomes, and this is where innovations like Yosi Health’s real-time insurance verification and advanced intake solution can play a critical role. These systems help practices optimize revenue cycles, reduce administrative burdens, and focus on what truly matters: patient care. While we are seeing broader buy-in for value-based models, sustained success will require continued collaboration among payers, providers, and technology innovators to fully realize the promise of lower costs and improved outcomes.
Jake Pyles, CEO, CipherHealth
LinkedIn: Jake Pyles
Value-Based Care Adoption Across the Maturity Spectrum
While traditionally led by progressive health systems, value-based care (VBC) is now being embraced by more “middle-of-the-pack” organizations, catalyzed by CMS and initiatives like the TEAM payment model. In 2025, expect this trend to grow as healthcare providers across the board, regardless of their previous VBC readiness, recognize the need to move beyond fee-for-service models. This shift signals that VBC is no longer an optional pathway but a requisite for sustainable, quality care across healthcare settings.
Bobby Sepucha, Chief Executive Officer, Interwell Health
LinkedIn: Robert Sepucha
Over the last few years, the government and private payers have ramped up programs to incentivize value-based care among the most complex, expensive patient populations. In 2024, we began to see real proof that these programs are working; for instance, data from the first year of CMS’s Kidney Care Choices Model showed value-based care is improving outcomes among patients with chronic kidney disease. I believe we are at a tipping point for real transformation as payers evaluate this data and plan for further investment in value-based models. As for provider buy-in, physicians embrace value-based care because it enables them to provide the type of care they want to deliver for their patients. We hear from provider partners across the country that value-based care is here to stay and they are all-in on this model.
Jonathan Shoemaker, CEO, ABOUT Healthcare
LinkedIn: Jonathan Shoemaker
In 2025, value-based care will emphasize outcomes that merge financial performance with patient-centered success, supported by AI-driven analytics aimed at improving patient throughput. These technologies will guide patients through personalized journey, addressing barriers like socioeconomic challenges and improving adherence. By proactively engaging patients and streamlining care transitions, providers will bridge gaps in equity and enhance population health by ensuring that every patient receives the right care at the right time, aligning incentives across stakeholders.
Jeff Smith, CEO, Bamboo Health
LinkedIn: Jeff Smith
The transition to value-based care (VBC) has gained momentum, particularly within the Medicare population, but the pace of change broadly is still not fast enough to fully realize its potential. High-cost, high-need patients—those with complex behavioral health challenges and chronic conditions—represent a key opportunity to drive meaningful improvements. These individuals often account for healthcare costs at about five times higher than their peers, underscoring the need for care models that deliver targeted, timely support.
Behavioral health integration is a critical focus, as mental health-related conditions continue to drive preventable costs and poor outcomes. Expanding telehealth and leveraging digital tools can help close these gaps, particularly in underserved and rural areas. Proactively addressing social determinants of health (SDOH)—such as transportation, housing and food insecurity—is also essential to improving outcomes for these populations.
The success of VBC hinges on aligning incentives and outcomes across the healthcare system. Collaboration between payers and providers is essential to operationalizing shared quality metrics and creating seamless care pathways. By embracing innovations like care navigation and real-time data sharing, healthcare organizations can better guide individuals through complex care journeys. Progress is being made, but accelerating these efforts is vital to transforming care delivery and achieving the full promise of value-based care.
Mark Steiger, Chief Operating Officer, Confluent Health
LinkedIn: Confluent Health
When it comes to value-based care, we still have a long way to go to create value by emphasizing physical therapy early to maximize outcomes and reduce overall healthcare costs. Physical therapy especially is one area that many don’t realize has the potential for additional outcome shifts and lower costs; studies show that the right preventative physical therapy within 14 days of the onset of pain minimizes the average total cost of care by 50% not only for the patient, but for payers, employers and ultimately the larger health system. Additionally, the average cost of care was shown to be $4,793 more if a patient had an MRI first versus seeing a physical therapist first. This physical therapy first (PT-first) model is just one example of the many ways we can improve the quality of outcomes and transform the greater healthcare system.
Julia Strandberg, Chief Business Leader, Connected Care and Monitoring, Philips
LinkedIn: Julia Strandberg
This past year, healthcare continued its care delivery model evolution. In 2025, we will continue to see home-based care technology advancements support the industry’s mission to extend high-quality care beyond the walls of a hospital, improving patient outcomes, minimizing acute care setting stay lengths for patients, and reducing the strain on healthcare facilities.
While the benefits of value-based, patient-centered care have long been recognized, scaling this model with sustainable infrastructure support, incentive structures, and simplified workflows continues to be a challenge. However, health technology advancements position us to make patient-centered care the industry standard. Telehealth platforms, remote monitoring, data-driven insights, and more are transforming care delivery to move beyond hospital walls. By leveraging technology, providers can better manage in-person care demands, ensuring that all patients receive the high-quality treatment they deserve – wherever they are. This shift in care delivery will also lower healthcare costs and help establish a system that truly prioritizes value over volume.
Ruchika Talwar MD, MMHC, Medical Director, Office of Episodes of Care Population Health, Vanderbilt Health
LinkedIn: Ruchika Talwar
While bundled payment models have existed for years, the recent success of programs like Vanderbilt Health’s MyHealth Bundles demonstrates that these models are delivering significant, measurable results. By providing high-quality, patient-centered care and predictable costs for employers, they have shown significant reductions in costs and impressive improvements in outcomes. This progress signals that there are successful care models that align with transformational goals. What’s the difference? It’s a provider-led program.
However, the pace of adoption for value-based initiatives has been slow, ultimately affecting the ability to achieve widespread impact. Significant challenges remain in scaling these initiatives across healthcare systems and creating the infrastructure necessary to support broader implementation. Accelerating adoption and expanding access to provider-led bundled care models will be essential for driving systemic change.
Provider buy-in, a critical factor for the success of value-based care initiatives, is steadily increasing, especially as programs like MyHealth Bundles illustrate clear benefits for patients, clinicians, and employers alike by starting with the patient first, not the payment model. By actively involving providers in care redesign and then aligning payment structures to the clinical journey, these models are fostering the necessary conditions for a true transformation of healthcare—one that prioritizes improved outcomes and long-term sustainability over profit.
Kelly Villella-Canton, Segment Leader & Director of Product Management, Medical Education & Practice, Wolters Kluwer Health
LinkedIn: Kelly Villella-Canton
As healthcare shifts from reactive to proactive approaches, the demand for specialized care in physical therapy, occupational therapy, and exercise physiology is projected to grow significantly. The number of jobs in these three professions alone are projected to increase by 12-15% over the next decade.
Health professionals will play a crucial role in maintaining a healthy and active lifestyle and in treating both chronic and acute conditions globally. In response to these changing demands, the degree requirements for several areas of the health professions have been raised in recent years, reflecting a need for advanced knowledge and skills. As educational institutions grow these programs to meet demand and evolve to educate the influx of students, they will increasingly integrate technology into their curricula to enhance the learning experience, and to help students better understand complex concepts and practice applying foundational knowledge earlier in the curriculum. We expect educator’s use of technology—from virtual simulation and AI to video libraries and digital courseware—to accelerate as it better prepares prospective health professionals to achieve positive patient outcomes and excel in their future careers.
Johnathan Welch, Chief Product Officer, TrustCommerce
LinkedIn: Johnathan Welch
As the healthcare industry continues to offer more retail-like experiences, and as patients become more aware of their healthcare options including how they can access care, this is driving a transformation in the way in which providers are offering care and payment for services. This can be evidenced in provider adoption of digital payment methods, such as digital wallets, to offer modern payment methods and provide patients with seamless payment experiences. Providers are also increasingly taking advantage of shared token products which reduce friction throughout the patient engagement lifecycle, enabling seamless recurring payments that help reduce financial burdens, while aligning payment experiences with patient expectations.
Dave Wessinger, Co-Founder & CEO, PointClickCare
LinkedIn: Dave Wessinger
AI for Value-Based Care: Prioritizing Outcomes Over Volume in Healthcare
AI and value-based care are two of the top buzzwords in healthcare right now. Interestingly, the intersection of AI and value-based care is where real power lies for healthcare practitioners. Achieving new efficiencies by automating processes and reducing administrative burdens to enhance productivity seems straightforward, but trust is a significant barrier to automation of day-to-day processes. In 2025, despite the skepticism that still surrounds AI, industry leaders will increase awareness about AI to help show the real value of automation, especially through insights pushed proactively at the point of care. Integrating these tools into regular workflows as part of a consistent operating model can mitigate perceived risks, such as data security or compliance concerns, ensuring automation is an asset rather than a threat. Looking ahead, the reward of reinforcing the industry’s commitment to validating AI solutions and aligning them with real-world clinical needs will outweigh the risks.