From volume to value: The shift in health care that’s helping put patients first

April 04, 2025

As the health care industry works to address rising costs and the challenge of consistent access to care for all, a recent study highlights the growing recognition from primary care doctors that value-based care models are essential for delivering high-quality, cost-effective care. While transitioning to value-based care can have its challenges, many providers recognize its importance and are pushing forward and collaborating with insurance companies to innovate and make health care work better. Prioritizing value over volume improves both patient experience and health outcomes. As a market leader in value-based care, Florida Blue is committed to expanding quality, affordable health care solutions for Floridians. One way to accomplish this goal is working closely with providers who share our vision to empower and support patients and save them money.

Value-based care 101 … and why it works

Value-based care is a patient-centered approach that focuses on delivering high-quality care to a population, rather than prioritizing volume-based care (where providers are paid for each test, procedure, or visit, regardless of the outcome). The many benefits include:

• Improved patient outcomes and quality of care — Florida Blue members who see value-based care providers typically engage more and build stronger relationships with their doctors, which results in about 6% fewer ER visits. This can also help reduce preventable hospitalizations.¹
• Reduced health care costs and increased affordability — Value-based care can help Florida Blue members save money. On average, they saw a 2% reduction in overall medical costs in 2023 when compared to those with traditional providers.¹
• Enhanced patient experience and satisfaction — Patients seeing value-based care doctors typically get more coordinated care, leading to better health outcomes, a more satisfying customer experience, and a stronger relationship with their doctor. In fact, they see their doctors about 3% more often.¹

The health care industry has an approach to value-based care called the quintuple aim, which is like a puzzle of five interconnected pieces — improving health outcomes, enhancing patient experiences, reducing costs, improving provider experiences, and reducing health disparities. This fosters collaboration and coordination between the insurance company and the doctor, with the patient always at the center. Value-based care takes time and an upfront investment with sustainable benefits for patients, doctors, and the health care system.

Overcoming barriers to value-based care

While the benefits are clear for value-based care, common barriers for providers include financial, workforce, and documentation challenges. To succeed in value-based care, providers need:

• A robust platform for data analysis and insights
• Staff who understand and support delivering value-based care
• A focus on preventive care, addressing social determinants of health, mental and behavioral health, and population health
• Providing care at the right time and place, for the right reasons, to deliver the best patient experience

How to start overcoming the barriers

Florida Blue is committed to collaborating with many providers to overcome these barriers by:

• Rewarding healthier outcomes 
• Investing in expanding access to value-based care — like with Sanitas Medical Centers.

Going deeper — Florida Blue | Sanitas Medical Centers

Each of our Florida Blue | Sanitas Medical Centers embrace value-based care and feature:

• A care team, led by a Sanitas doctor, that provides all primary care services and common lab tests, and coordinates care for complex health concerns. This helps patients achieve health goals and improve overall well-being. 
• Specialized care programs for mental well-being, weight management, and diabetes, as well as social support and connections to community services.

Florida Blue and Sanitas Medical Centers are expanding access to high-quality, affordable health care. This year, we’ve launched 10 new Florida Blue | Sanitas Medical Centers — bringing the total to 70 locations across the state.

This is a model for the kind of collaboration that the health care industry needs.

The takeaway: Providers need their teams to embrace the value-based care model and innovative collaborations between payers and providers are crucial in delivering high-quality, affordable care. 

The importance of collaborations in value-based care

Effective collaboration between payers and providers is key to addressing affordability and care that benefits patients and members the most. Some examples in Florida, include:

• In Jacksonville, UF Health and Florida Blue are ensuring continued access to quality care for members through a new alliance complementing their existing network.
• In Pensacola, Baptist Health Pensacola and Florida Blue are collaborating to enhance Advanced Primary Care initiatives, driving better health outcomes and a more seamless care experience for members across all lines of business.
• Across the state, Florida Blue is supporting the success of smaller independent primary care practices by connecting them with Accountable Care Organizations (ACOs) that can provide the data analytics, care coordination, and operational support they need to thrive in a value-based care environment.

As providers and insurance companies work together with a common goal to improve patient outcomes and reduce costs, value-based care is becoming a central part of their regular contract discussions. The benefits are clear for everyone — improving the opportunity for providers to earn incentives while driving even better patient experiences, higher Net Promoter Scores (NPS), and better health outcomes. For example, Florida Blue members with value-based care providers have seen a 9-point increase in NPS over the past five years.²

We must shift the paradigm of health care access and affordability for all

Florida Blue is committed to supporting providers in their value-based care journey. Across the health care system, everyone has a responsibility to make things better and we need to join forces to deliver quality, coordinated care, while improving population health, enhancing the care experience, reducing costs, improving the provider experience, and reducing health disparities. 

Together, we can deliver high-quality, affordable health care to more Floridians.

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Disclaimers:

¹ Analysis of calendar year 2023 value-based provider performance versus non-value-based providers prepared by Florida Blue in 2024.
² Analysis of calendar year 2019 - 2024 value-based provider performance versus non-value-based providers prepared by Florida Blue in 2024.

Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.