Bringing in the Specialists | Predictions for 2025

As we enter 2025, the healthcare industry is poised for a leap forward in the sophistication of value-based care (VBC) strategies. With CMS aiming to have all Medicare beneficiaries in value-based arrangements by 2030, the push is intensifying. In the coming year, I expect to see new entrants exploring risk-based contracts while existing players take on higher levels of risk. I also expect existing players to shift toward more mature and strategic approaches to VBC.

Meucci

While coding accuracy, quality documentation and gap closures are essential, they are no longer enough to drive differentiation or success in the increasingly competitive landscape. Practices and ACOs [accountable care organizations] that thrive in 2025 will move beyond these basic levers, tapping into strategies that foster integration and innovation across all levels. This means strategically bringing specialists into VBC arrangements to provide a holistic approach to patient care and aligning incentives across the broader care team.

Moreover, I anticipate a greater focus on understanding performance benchmarks, both at the practice and market levels. Leading VBC organizations will leverage advanced data insights to improve decision-making, assessing local and regional competitive benchmarks to refine who to add to an ACO and to set strategic performance targets for ACO members. This data-driven clarity will shine a brighter light on individual provider performance and push the industry toward more collaborative accountable care models.