To mark the 20th anniversary of value-based care, health care innovation and VBC leaders, including David Lareau, share thoughts on how the industry has evolved:

“Value-based care has the right intentions but has been held back by the fundamental problem that all the coding systems underpinning it—including HCCs, quality measures, and risk adjustment—were designed as discrete transaction systems that don’t communicate with one another, making truly integrated patient management nearly impossible.

“The real opportunity for 2026 and beyond is the convergence of ambient listening, large language models (LLMs), and a unified clinical data model that can finally bridge the gap between what a clinician documents and what the VBC system needs to act on.

“Until the industry stops trying to bolt value-based workflows onto a foundation built for fee-for-service billing transactions, progress will remain incremental at best.”