Navigating Value-based Care (VBC) amid AI and Economic Uncertainty for Healthcare Providers

The shift from fee-for-service to Value-based Care (VBC) is increasing due to payer mandates and the long-term promise of improved outcomes and lower costs. However, this transformation is unfolding amid economic uncertainty, tariff-driven inflation, and healthcare provider financial strain. Several hospitals lack the capital, operational agility, or data integration required to scale VBC adoption effectively. As Centers for Medicare & Medicaid Services (CMS) expands its adoption through the Alternative Payment Model (APM) framework, healthcare providers struggle to align limited resources with long-term strategic goals.

To succeed in this evolving environment, healthcare organizations must invest in automation, analytics, and AI-enabled tools that improve financial and clinical performance. Agentic AI offers the potential to ease documentation burdens, close care gaps, and support compliance in a fragmented data ecosystem.

In this report, we highlight how the emerging divide in the VBC landscape, shaped by resource availability, risks exacerbating disparities in care quality and organizational resilience. The report offers actionable strategies to navigate payer demands, optimize contracts, and realign RCM provider partnerships to support value-based models.