The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

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What You Should Know: 

– A new report from Sage Growth Partners reveals a striking disconnect in the healthcare industry: while only 20% of C-suite leaders believe progress has been made in value-based care (VBC) recently, 77% plan to increase their participation in these models over the next two years. 

– The “plot twist” indicates that despite operational hurdles and low revenue exposure today, hospital executives view VBC as essential for long-term financial survival. The data suggests a massive strategic pivot is imminent, with significant increases in Accountable Care Organization (ACO) and bundled payment participation.

Healthcare Executives Forecast Major Shift to Value-Based Models in 2026

For the better part of a decade, “Value-Based Care” (VBC) has been the healthcare industry’s horizon line—always visible, yet perpetually just out of reach. However, new data suggests we are entering a phase of forced acceleration.

Sage Growth Partners, a healthcare advisory firm, released its annual C-suite survey today, and the findings illuminate a fascinating contradiction in the market. According to the report, The C-Suite’s View on Value-Based Care: Investment Heats Up Despite Cooling Sense of Progress, confidence in the industry’s progress is at an all-time low, yet commitment to the model is hitting new highs.

The survey of 101 hospital and health system executives paints a picture of an industry cornered by macroeconomic pressure, choosing to innovate its way out through risk-based models despite the friction of transition.

The Sentiment Slump vs. Strategic Investment

The most jarring finding in the report is the collapse in sentiment regarding industry progress. Only 20% of C-suite leaders agree that the industry has made progress toward VBC in the last two years. This is a precipitous drop from 40% in 2023 and 37% in 2022.

However, this pessimism regarding past progress has not dampened future ambition. In a move that Sage Growth Partners CEO Dan D’Orazio describes as a “plot twist,” 77% of C-suite leaders say their organization plans to increase participation in VBC programs in the next two years. This is a significant jump from just 57% in the previous year’s survey.

“Value-based care is both a challenge for C-suites and a way to strengthen their organization’s bottom line as payer dynamics evolve and macroeconomic uncertainties persist,” said D’Orazio.

The Reality of Revenue at Risk

While the strategic intent is clear, the financial reality remains conservative. The report exposes that for many health systems, VBC is still a side project rather than the main revenue engine.

Currently, 54% of hospitals and health systems generate between 5% and 20% of their revenue from VBC arrangements. Only a small percentage of organizations have tipped the scales to earn more than 20% of their revenue from risk-based contracts.

This creates a tension between operations and finance. Executives know they need to move toward risk to ensure long-term viability, but the “revenue at risk” needle is moving slowly. This lag is likely due to the operational complexity required to manage these contracts effectively—a gap that health tech companies will need to fill.

ACOs and Bundled Payments See Resurgence

The specific mechanisms for VBC adoption are also shifting. The survey highlights a robust increase in structured participation:

  • 69% of organizations are now participating in an Accountable Care Organization (ACO), up from 53% in 2023.
  • 61% are leveraging bundled payment models, a sharp increase from 46% in 2023.

These figures suggest that health systems are moving past theoretical “value” and are signing ink on specific, federally and commercially recognized frameworks.

 

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