How AI and Analytics are Advancing Value-Based Care

Use Cases

Value-Based Care

The Evolving Pressure on Value-Based Care Leaders

Healthcare executives are navigating an increasingly complex environment when it comes to population health. While the shift to value-based care (VBC) promises improved outcomes and cost-efficiency, the reality is far from simple. Regulatory pressures, operating costs, workforce shortages, and fragmented data all stand in the way of success.

For organizations to thrive under value-based models, leaders must look beyond traditional strategies. Data, analytics, and artificial intelligence (AI) are no longer optional—they are essential tools to drive sustainable transformation.

Strategic Challenges

The Four Biggest Barriers to Value-Based Care Success

Despite broad support for the value-based care model, healthcare leaders continue to face deep-rooted structural and operational hurdles. Understanding these persistent challenges is the first step toward crafting a sustainable, data-driven path forward.

Fragmented Data and Interoperability Barriers

Data is abundant, but it's often trapped in disparate systems. Without seamless integration across EHRs, claims data, SDOH, and patient engagement tools, leaders struggle to see the full picture needed for decision-making.

Escalating Operating Costs and Financial Risk

Fixed or performance-based reimbursements in value-based care contracts—often referred to as value-based reimbursements—can exacerbate financial strain, especially when patient complexity and service line inefficiencies go unaddressed.

Patient Engagement and Access Inequities

Engaging patients—especially underserved populations—remains a major hurdle. Disconnected outreach, poor follow-up, and limited personalization make it hard to close care gaps and build loyalty.

Workforce Constraints and Burnout

Staffing shortages make executing care plans difficult, let alone optimizing them. Technology must support lean teams, not create new burdens.

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The Role of Analytics

How Advanced Analytics Drives Value-Based Care Success

Data alone doesn’t drive value—insight does. Enterprise analytics equips executives with the visibility and decision support needed to address cost, quality, and access in a unified, measurable way.

Unifying Disparate Data into Actionable Intelligence

Enterprise analytics platforms can aggregate clinical data, claims, and operational inputs into a unified view. Executives gain access to real-time dashboards that measure performance across population segments, risk tiers, and service lines.

Predictive Analytics for Risk Management

By identifying patients at high risk of readmission, chronic disease escalation, or social vulnerability, leaders can proactively intervene—improving outcomes while reducing avoidable costs.

Performance insights for ACO and MA contracts to drive true population health improvement.
Embedded analytics and dashboards tailored for executive and operational use.
AI-powered decision support and automation tools.
Integrations with EHRs, CRMs, and patient engagement platforms.

Service Line Optimization

Analytics help identify bottlenecks, underperforming units, and care variations. With this insight, systems can better allocate resources and direct patients to the right setting at the right time.

Accelerating Value-Based Care Success

How AI Enhances Value-Based Care Execution

Artificial intelligence is becoming essential for scaling value-based care and improving operational efficiency. By automating routine tasks and streamlining workflows, AI frees up clinical and administrative resources to focus on higher-value activities.

At the same time, AI enables more precise population health management and personalized patient engagement, making it easier for healthcare organizations to deliver better outcomes at scale.

Automating Manual Processes

From scheduling to claims review to patient outreach, AI can automate routine tasks—freeing up clinical and administrative capacity.

Personalized Patient Engagement

AI tools can tailor messages, cadence, and channels based on patient preferences, risk profiles, and behavior, improving both satisfaction and clinical adherence.

Population Health Management at Scale

AI-driven stratification supports precision interventions across populations—whether managing chronic conditions or coordinating social services.

Strategic Technology

Building the Right Tech Stack: What to Look For

Value-based care success depends on more than just technology—it requires the right partner to unify data, empower teams, and scale sustainable change. Look for a platform that:

Performance insights for ACO and MA contracts to drive true population health improvement.
Embedded analytics and dashboards tailored for executive and operational use.
AI-powered decision support and automation tools.
Integrations with EHRs, CRMs, and patient engagement platforms.

A modular, open architecture is key to avoiding vendor lock-in and maintaining flexibility. It is also critical to consider long-term usability with AI-driven healthcare analytics that can turn fragmented data into actionable insights to improve outcomes and efficiency.

Get Started: Your Roadmap for Advancing VBC

The Path to Strategic Value-Based Care Success

Moving toward value-based care isn’t a single project—it’s a long-term organizational commitment that requires aligned leadership, robust infrastructure, and a focus on continuous improvement. Executives ready to lead should follow a clear, actionable roadmap.

Conduct a Baseline Assessment – Evaluate current capabilities, including data quality, care coordination, patient engagement, and financial performance under VBC contracts.
Align Leadership and Governance – Establish a cross-functional governance structure to set goals, drive accountability, and ensure strategic alignment across departments.
Build a Unified Data Foundation – Integrate clinical, claims, and operational data into a single source of truth that supports real-time decision-making and risk stratification.
Redesign Care Models Around Risk – Use predictive analytics to identify high-risk populations and develop coordinated care pathways that reduce variation and improve outcomes.
Strengthen Patient Engagement – Deploy scalable, data-driven engagement strategies that address individual needs and enhance the patient experience.
Modernize the Technology Stack – Invest in interoperable, scalable platforms that enable analytics, care management, and team-based collaboration.
Monitor, Learn, and Scale – Leverage real-time performance data to evaluate impact, refine interventions, and expand successful initiatives enterprise-wide.

If you’re ready to accelerate progress on your VBC journey, now is the time to act.

Turn Strategy Into Sustained Results

We work with you to solve your toughest healthcare challenges.

At Health Catalyst, we help healthcare organizations transform performance across clinical, financial, and operational domains. We work alongside you to solve the toughest challenges, including: