Making any additions or changes to your organization requires a lot of very careful planning and observation. While these additions/changes can be a huge benefit, opening up your organization to implement them can also cause a lot of problems. It can introduce new weak points for cybercriminals, it can cause friction with your existing systems, it can cause delays as your staff works to figure out the new systems, and much more.
Today, we are going to narrow our focus down to what to watch out for when integrating value-based care goals into your organization. And to get a better picture of this, we reached out to our brilliant Healthcare IT Today Community to ask — what challenges do healthcare organizations face in aligning their IT infrastructure with value-based care goals, and how can they overcome these barriers? Below are their thoughts.
Ram Sahasranam, Co-Founder at Fold Health
Aligning IT with value-based care sounds like a tech roadmap problem, but it’s really an operations problem: when you do value-based care right, it creates more work, not less. It demands proactive, team-based, person-centered care for whole panels of patients—on top of systems that were built for episodic visits and billing. That’s how we end up with an “intelligence everywhere, execution nowhere” problem: analytics, EHR reports, and AI can flag every high-risk patient and open gap, but they don’t control the schedulers, nurses, care managers, call centers, and digital front doors where the work actually happens.
The fix isn’t another dashboard; it’s an operating layer that orchestrates work across all those nodes—routing tasks, automating outreach and scheduling, enforcing closed-loop follow-up, and measuring success in gaps closed and readmissions avoided, not just reports generated. Let technology handle the choreography so human clinicians can focus on the moments that truly require their judgment and empathy.
Sonja Tarrago, VP of Clinical Strategy at DexCare
Health systems are investing heavily in digital health, but too many tools struggle to deliver real value because they don’t fit into clinicians’ workflows or capture the right metrics. Aligning digital health with value-based care requires a more interoperable infrastructure to promote seamless data flow, robust governance to ensure quality and accuracy, and early engagement with clinicians to design tools that genuinely support decision-making.
For example, effective solutions can automate appropriate data collection, like vital signs and lab results, at the point of care, eliminating the need for manual entry. They can then use embedded prompts to guide providers to capture other required elements and prevent messages days later about missing data, which ultimately prove fruitless. This kind of nuance is exactly why integrated, clinician-vetted digital health solutions matter.
Digital tools can serve so many purposes – helping identify and engage high-risk patients before they end up in the ED or hospital; filling gaps between visits by tracking blood pressures, glucose, or activity and recommending outreach by the appropriate provider; and facilitating coordination among care team members, ensuring the right tasks and insights reach the right people. Done right, these kinds of tools can improve outcomes without increasing care burden, supporting the core principles of value-based care.
Matt Ernst, VP, Technical Operations and Support at Tendo
Most health systems are still burdened by legacy systems that were built for fee-for-service models—optimized for transactions, not transformation. As a result, they face challenges integrating clinical, operational, and patient-generated data in ways that support longitudinal, coordinated care. Overcoming this requires more than just modernizing technology—it demands a mindset shift. Organizations need to embrace interoperability, open data standards, and patient-centric design. Equally important is cultural alignment: leaders must foster collaboration between clinical, IT, and operational teams so technology becomes a strategic enabler of care transformation, not a constraint.
Reva Sheehan, Senior Vice President of Health Solutions at DUOS
When it comes to value-based care goals, one of the biggest challenges facing healthcare organizations is fragmented legacy systems; specifically, instances where you see multiple EHRs in a single organization, disparate data warehouses, and a lack of centralized patient views. Assessments and investments must be made to unify these systems and their ability to support functional needs across all users.
Additionally, interoperability gaps persist. While created to support privacy and proper information sharing, data isn’t routinely shared and received from providers outside of the same organization. There is a lag or a lack in the sharing of pharmacy, dental, laboratory data, and more. The solution to this challenge will be FHIR (Fast Healthcare Interoperability Resources) adoption as a single data exchange or access point across multiple applications.
Lastly, a well-known and persistent pain point is attributed to clinician (provider and practice level) resistance. They’re inundated with alerts, workflow disruptions, multiple platforms, and goals across payer organizations. Successful organizations offer user-centered solutions and internal clinical champions to support practice-level goals that offer clear return on investment (both improved clinical outcomes and revenue-driving factors), and above all else, do not add to the administrative burden.
David Snow, CEO at Cedar Gate Technologies
Data fragmentation remains one of the biggest barriers. With patient data spread across multiple systems, it can become difficult for healthcare organizations to get a unified view of patients and their care. Along with mandated participation in alternative payment models, there is also a significant push for interoperability coming from CMS, increasing the pressure for organizations to have these capabilities in place in the short term.
Legacy data platforms often struggle to make this shift in a seamless way because they were designed for a siloed healthcare system where collaborative care and VBC goals simply were not a priority. When healthcare organizations prioritize technology that can pull data into one cohesive platform and share it seamlessly across internal and external teams, they can expect to achieve success and innovation in value-based care.
Jason Prestinario, CEO at Particle Health
Most healthcare IT infrastructure is EHR systems, and EHR systems were built for fee-for-service models to generate claims so providers get paid. They’re not designed holistically to show you what’s happening to a patient outside of the doctor’s office, and they’re definitely not optimized to think about the overall risk profile of the patient. That’s a problem when, as a VBC, your reimbursement depends on the total cost of care and population health outcomes — because you can’t manage what you can’t see. This is why you see so many specialty-specific EHRs. In short, value-based care requires fundamentally different technology to aggregate data across the entire care journey and then translate that data into actionable intelligence.
Janine Savage, Division President, Value-Based Care Solutions at Net Health
Healthcare organizations struggle with fragmented systems, limited interoperability, and a lack of real-time visibility – barriers that make it difficult to support value-based care workflows and analytics. Success requires selecting technology that operationalizes VBC goals, prioritizing interoperability, and strategically reinvesting incentive dollars into IT modernization. Reinforcing tech capacity is especially important for providers excluded from past federal EHR incentive programs but now expected to meet advanced VBC requirements. Aligning IT with VBC is not only a technology challenge but an equity issue that determines which providers can fully participate and succeed.
Patricia Hayes, Chief Medical Officer at Imagine Pediatrics
Healthcare organizations often struggle to align their IT infrastructure with value-based care because most systems were built for volume rather than integration and personalization of care. When data is trapped in silos, that same volume-based design becomes a barrier to the integrated, team-based care that drives outcomes. Interoperable, connected technology gives clinicians, care coordinators, and behavioral health teams a shared view of the patient so they can make timely, informed decisions. True value-based care requires infrastructure designed for integration and shared accountability.
Sagnik Bhattacharya, CEO at Rhapsody
Value-based care can’t deliver on its promise while running on fee-for-service-era technology. Health systems are being asked to predict risk, manage quality, and coordinate care with data scattered across dozens of siloed systems. The next phase of healthcare performance depends on secure, real-time data exchange that unites EHRs, imaging, claims, and digital tools into a single, interoperable fabric. When that foundation exists, analytics, AI, and clinical insight can work together, and value-based care can move from aspiration to execution.
Ron Margalit, Chief Information Officer at Evergreen Nephrology
One of the biggest hurdles providers and healthcare organizations face in shifting to a value-based care (VBC) model revolves around inadequate data collection and interoperability. VBC relies on clinical and financial data to inform care plans, but many organizations lack the robust systems for data sharing and analytics needed to manage population health and track outcomes.
However, the problem of interoperability runs deeper than data collection – fragmented care among providers across the healthcare ecosystem makes providing holistic care catered to individual patients challenging. While collecting and tracking relevant patient data is vital in delivering compassionate care, ensuring outcomes-based data is shared and utilized across healthcare specialties to meet quality metrics is just as important. Technology that not only supports data sharing but also enables interdisciplinary communication and education provides the groundwork for VBC to thrive.
Elevsis Delgadillo, SVP, Customer Success at KeenStack
Most organizations struggle with fragmented systems, poor interoperability, and a lack of trustworthy data. The answer starts with modern platforms and strong data governance, so IT teams can build reliable workflows that support value-based care instead of fighting against technical debt.
Shay Perera, Co-Founder & CTO at Navina
Most IT systems were built for fee-for-service billing, so data flows tend to be fragmented and retrospective, and organizations end up with multiple ‘sources of truth’ that don’t reconcile cleanly. On top of that, clinicians are already overloaded, so every additional screen or login makes adoption less likely. The organizations that make progress are those that implement technology that prioritizes interoperability, simplifies workflows, and designs with the exam room in mind rather than dashboards alone.
Oren Nissim, Co-Founder and CEO at Brook Health
Currently, most health systems are still struggling to connect what happens inside clinical settings with patients’ daily lives outside of clinic walls. Value-based care works best when we leverage technology to close that gap and drive continuous, data-driven support between visits. That requires combining intelligent tools with compassionate human guidance to increase patient engagement and give providers the real-world insights they need to make more informed decisions to drive better outcomes.
Linda Leigh Brock, Vice President of Product Management at NASCO
The most fundamental challenges healthcare organizations face in aligning their IT infrastructure with value-based goals are high-cost segments of the care continuum and the need to align their clinical pathways and adopt the necessary IT infrastructure to track and manage this significant financial risk. If a specialist faces an adjustment based on their ability to coordinate care and reduce utilization, they will want to invest in the analytical and care coordination tools their FFS stack cannot provide.
Investment needs to move beyond optimizing the administrative efficiency of FFS and towards a purpose-built VBC solution that provides real-time visibility and insights velocity into all aspects of performance across all delivery arrangements to understand how contracts are performing for patients, employers, providers, hospitals, and health plans.
What great inputs here! Huge thank you to everyone who took the time out of their day to submit a quote to us! And thank you to all of you for taking the time out of your day to read this article! We could not do this without all of your support.
What challenges do you think healthcare organizations face in aligning their IT infrastructure with value-based care goals, and how do you think they can overcome these barriers? Let us know over on social media, we’d love to hear from all of you!
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