Articles

How AI Is cracking the code in value-based care: 5 tips for healthcare organizations

By
Dana McCalley, MBA
October 1, 2025
How AI Is cracking the code in value-based care
Table of contents

The shift to value-based care is one of the most important trends in American healthcare in recent years, and that transformation is expected to continue in the foreseeable future.

With projected market growth from $12.2 billion in 2023 to $43.4 billion by 2031, healthcare organizations are well aware that they need to plan and adapt accordingly. Meanwhile, the development of increasingly powerful AI capabilities is creating new possibilities for organizations to ease the transition to value-based care.

But even with AI, they need to take the right steps to achieve the value-based results they want — for themselves, their providers and other team members, and their patients.

Here are five key tips for healthcare organizations looking to thrive as they progress on their value-based journeys.

Tip #1: Make quality performance a high-priority use case for AI

Value-based care requires healthcare organizations to close care gaps–for example by conducting preventive screenings and vaccinations, and by managing chronic disease—but even identifying those gaps is time-consuming, requiring combing through huge volumes of patient records.

But with the development of AI, organizations and clinical teams now have more efficient ways to achieve dramatic quality performance improvements.

That starts with using AI-powered technology to automatically scan EHRs and other information sources to identify care gaps. AI can also search for evidence allowing care gaps to be closed, either because a required intervention has already been performed or because a given patient should be excluded from that intervention.

Read the rest of this article here.

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Dana McCalley
About the author

Dana has over 15 years of experience in healthcare, with a focus on quality improvement and risk adjustment. She previously led one of the top-performing ACOs in the U.S. for nine years, helping over 700 clinicians provide value-based care to roughly 230,000 patients. Dana holds a Bachelor of Arts degree in psychology from the University of South Florida and an MBA from Liberty University.

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