Data-Driven VBC: How Tech and AI Are Transforming Value-Based Care

The transition from fee-for-service to value-based care (VBC) puts continued pressure on the healthcare industry, especially as organizations push to remain relevant in a competitive environment while improving patient outcomes. The primary goal of VBC is to enhance clinical results and reduce overall healthcare costs, aligning care delivery with the evolving expectations of payers and patients. Learning to utilize comprehensive, real-time, and actionable data from advanced technology will fully enable this transformation. Once this is accomplished, ideas can be put into action that guide clinical decisions, optimize workflows, and drive further innovation. 

According to McKinsey & Company, value-based care will touch 90 million lives by 2027, a drastic increase from 43 million in 2022. This expansion will be fueled by rising commercial VBC adoption, greater penetration of Medicare Advantage, and the Medicare Shared Savings Program (MSSP) model in Medicare fee-for-service. Data-backed knowledge and integrated systems will facilitate this evolution in care and shape the future of care delivery, impacting every provider’s approach to patient care. 

Utilizing Technology to Ensure the Efficacy of Treatment

Technology will play an important role as clinicians evaluate the efficacy of treatments by analyzing patient outcomes from across the healthcare system. Machine learning (ML) and artificial intelligence (AI) are already being utilized to comb through extensive patient data, clinical trial results, and outcomes. In turn, these tools can be used to determine which treatments point toward the best long-term results. Predictive analytics is also helping forecast patients who are at higher risk for readmissions or complications, allowing clinicians to proactively adjust patient care plans before it’s too late. The ability to determine the effectiveness of care tactics and strategies more precisely helps guide treatment decisions that align with the core goals of value-based care — enhancing patient outcomes while managing costs effectively. However, despite the growing interest in AI applications across the industry, there is still a need to understand its impact and identify areas for further improvement in its implementation. 

Patient history and clinical study data enable physicians to deliver more precise and personalized care to their patients. This is where advanced technology comes in — leveraging vast datasets and automating information sourcing from electronic health records (EHRs) will allow providers to identify the most effective treatment plan for their patients. This data-backed knowledge will be pivotal in delivering the right care that helps to improve outcomes across the board. As organizations continue to invest in digital transformation, this data utilization will be foundational to the success of these technologies and, in turn, VBC initiatives. Developing a clinical decision support system that integrates this data directly into the care process will allow clinicians to make more informed decisions throughout care delivery. Additionally, those support systems will enable more accurate performance tracking, making it easier to assess the quality of care delivered and meet the benchmarks of value-based care programs.

Integrating Technology for Improved Workflows and Outcomes

Strategically bringing interoperable technologies into healthcare workflows is helping streamline operational processes and enhancing the quality of care being delivered. For example, automation tools that take over routine administrative tasks free up clinicians’ busy schedules and allow them to focus more on patient interactions and care coordination, ultimately working towards improving patient outcomes. With ongoing workforce challenges, organizations must maximize their staffing power by implementing tools and technology that support everyone from providers to administrative staff, ensuring that patient and provider experiences are top of mind. 

In a value-based care model, where outcomes and patient satisfaction are top priorities, technologies that reduce manual workloads and optimize workflow efficiency directly contribute to better care delivery. For example, platforms that integrate EHRs, patient scheduling, and billing systems help reduce the amount of tedious paperwork in provider workflows, lowering the chances of administrative errors and ensuring that clinical data is easily accessible. Integrated systems allow healthcare organizations to better coordinate care across different departments or even across care settings, which ultimately reduces care fragmentation, improves communication among providers, and ensures that patients receive the most appropriate care for their condition.

Value-Based Care Must Be Driven by Data and Technology

Approximately 60% of the U.S. population must manage at least one chronic disease, and 40% have to cope with at least two or more. Consequently, the country spends $3.3 trillion annually to address these healthcare expenses. To address these costs, the industry must take proactive steps to better care for a population with increasingly complex needs. This can be achieved through technology that enhances clinical expertise, improves the quality of services, and helps keep costs manageable.

The industry’s ability to leverage data-backed knowledge within advanced technology and interoperable systems is paramount as it works toward achieving a sustainable system for VBC. Leveraging available data to inform treatment decisions, assess and improve efficacy, and streamline workflows will enable providers to achieve two key goals: improving patient outcomes while reducing costs for both their organization and the broader industry. This strategy will help foster a more cohesive, efficient, and personalized healthcare experience for patients that also aligns with the other core goals of VBC initiatives.

About Kimberly Smith

Kimberly Smith is a Certified Wound Care Nurse with over 15 years of experience dedicated to advancing wound care across clinical, educational, and leadership roles. She has served at the bedside, contributed to national publications, and spoken across the country, sharing insights that blend clinical expertise with real-world solutions. Now, as a Senior Clinical Solutions Executive at Net Health, Kimberly partners with healthcare teams to drive better outcomes through smart, tech-enabled wound care strategies.