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Home Global Executive Dashboard Investing in Value Based Care

Investing in Value Based Care

Expected Compounded Growth Rate
Through 2027

0 %

Expected Market Size By 2027

$ 0 Bn

Rapid development in value-based
health care services

Is the main driver of the market

North America

is the largest region in the market

Source: The Business Research Company, 2023.

Annual new hospital construction vs value-based care capital inflows in billions

Value-based care investment inflows have grown faster than capital expenditures on new hospital construction

Source: Dodge Data and Analytics; PitchBook; McKinsey analysis 

Value-based care (VBC) adoption by medical specialty

Value-based care adoption is highest in primary care but other specialties see meaningful and growing traction.

HIGH ADOPTION
LOW ADOPTION

Specialty

Primary care

Enables primary care to act as the “quarterback” and take full responsibility for patient health

Nephrology

Enables nephrologists to succeed in CMS and MA VBCs focused on reducing CKD/ESRD costs

Oncology

Enables oncologists to prescribe an appropriate drug for the patient while maximizing practice margin from prescription

Orthopedics

Large spend area with significant employer focus and increase in penetration of episodes

Women''s health

Pregnancy episodes particularly in Medicaid and increasingly commercial

Cardio-vascular

Large spend area, particu- larly in MA, driving high inpatient and emergency department utilization; site-of-care shift for pro-cedures

Behavioral health

Episode-based models for facilities with more innovative approaches involving PCPs on integration of BH/physical health

Description

Enables primary care to act as the “quarterback” and take full responsibility for patient health

Enables nephrologists to succeed in CMS and MA VBCs focused on reducing CKD/ESRD costs

Enables oncologists to prescribe an appropriate drug for the patient while maximizing practice margin from prescription

Large spend area with significant employer focus and increase in penetration of episodes

Pregnancy episodes particularly in Medicaid and increasingly commercial

Large spend area, particu- larly in MA, driving high inpatient and emergency department utilization; site-of-care shift for pro-cedures

Episode-based models for facilities with more innovative approaches involving PCPs on integration of BH/physical health

Applicable CMMI model

Primary care

Primary care first, MSSP, ACO REACH

Nephrology

Kidney care choices, ESRD treat- ment choices

Oncology

Oncology care model, enhancing oncology model

Orthopedics

Comprehen-sive care for joint replacement, BPCI

Women''s health

n/a

Cardio-vascular

BPCI

Behavioral health

n/a

Sources of value for successful value-based care providers, and total cost-of-care savings, Medicare Advantage example, %

Successful value-based care providers will increasingly need to look into more innovative levers to maintain value.

Low-hanging fruit

3%-8%

The harder stuff

3%-6%

Future innovations

3%-5%

Source: McKinsey & Company, 2023.

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