Value-based care isn’t code for more risk adjustment. It is a playbook for smarter care by keeping people healthier.
Value-based care is the target for plenty of rhetorical punches. I’ve heard that it’s everything from a consultant’s marketing gimmick to fears that it’s a euphemism for cut-rate medicine. That skepticism is understandable. Accountable care—which is a term we prefer that’s doesn’t carry the same connotation—is full of jargon, acronyms, and complex policies that make the movement easy to dismiss. But peel back the technical jargon and you’ll find a very real transformation underway in clinics, hospitals, and community programs across the country.
Accountable for Health, a nonprofit advocacy organization based in Washington, D.C. committed to accelerating the adoption of effective accountable care, in partnership with West Health, a California-based nonprofit working to improve the quality and cost of care, distilled accountable care into six hallmarks that any organization can embrace:
- Improved access to primary and preventive care
- Data-driven population health management
- Shared financial responsibility for patients’ total cost of care
- Accountability for quality and outcomes
- Seamless data exchange that follows the patient, not the billing system
- Care that extends beyond clinic walls into homes and communities
These hallmarks require ditching “heads-in-beds” thinking, investing in robust data infrastructure, and most importantly re-engineering culture so that every decision starts with patient need rather than finding more billing codes.
Critics often ask for evidence that value-based care works. Here’s what they miss: Thousands of clinicians are already operating under risk-based contracts that reward wellness, prevention, and prudent use of hospital care. The Medicare Shared Savings Program alone covers more than 11 million beneficiaries and has returned billions to taxpayers while improving quality scores year after year. Meanwhile, provider groups we work with are deploying home-visit programs for frail seniors, embedding pharmacists in primary-care teams, and flagging rising-risk patients before an avoidable emergency visit.
That’s not a fad—that’s a decade of iteration and measurable results.
Most of these wins are invisible to the average patient, policymakers, and most people who don’t work in accountable care programs. Changes are occurring with care-coordinator phone calls, scouring data for opportunities to intervene, and quietly averting hospital admissions. Without a punchy story, detractors fill the void. Accountable for Health is telling patient stories, sharing evidence of savings, and translating technical jargon into tangible stories.
- For entrepreneurs: build tools that make the six hallmarks cheaper and easier to adopt.
- For policymakers: double-down on incentives that reward accountability for total cost of care, not volume.
- And for my fellow insiders: spend less time debating the label and more time showcasing the lives changed when accountability is put into action.
Accountable care or value-based care isn’t some buzzword. It’s the quiet but deliberate turning of a super-tanker, redirecting our $5 trillion health economy from volume to value. The bow has already shifted. Now let’s power the engines so the whole fleet changes course.
Mara McDermott is CEO of Accountable for Health, a Washington D.C.-based advocacy organization committed to accelerating the adoption of effective accountable care.
