Just over three-quarters of health system and hospital C-suites say they plan to increase value-based care model participation within the next two years, up from the 57% who indicated similarly back in 2023, according to survey data from Sage Growth Partners.
Though the advisory firm’s report, released last week, outlined greater rates of self-reported participation in value-based arrangements compared to earlier iterations of the poll, respondents appear to be skeptical about broader adoption of alternative payment models. Just a fifth agreed with a statement that the industry had made progress in value-based payment models within the past two years—down from 40% when asked the same question back in 2023.
"Here's the latest plot twist on the winding journey to value-based care: despite slow progress during the last two years, many of today's C-suites are developing strategies to expand their participation in [value-based care] models in the next two years," Dan D'Orazio, CEO of Sage Growth Partners, said of the findings in a release. "Value-based care is both a challenge for C-suites and a way to strengthen their organization's bottom line as payer dynamics evolve and macroeconomic uncertainties persist."
Sage’s survey was fielded in the second quarter of this year and reached 101 respondents with job titles ranging from chief medical officer and chief quality officer to CEO. More than a third of respondents represented a community or independent hospital, 35% an integrated delivery network and 25% an academic medical center or teaching hospital.
Sixty-nine percent said their organization is participating in an accountable care organization, which was up from 53% in 2023. Sixty-one percent leverage bundled payment models, also up from 46% in 2023. Reported rates of participation in a pay-for-performance program were roughly the same from 2023 to 2025, falling between 50% and 60%, as was participation in a value-based purchasing program.
Despite participation being common among many of the respondents, the firm found that many health systems have just a fraction of their revenue currently at risk in a value-based contract. Here, 37% indicated 5% or less of their revenue is generated under these arrangements, 54% indicated somewhere between 5% and 20% of their revenue, 8% between 20% and 50% of their revenue and the remaining 1% more than 50% of their revenue.
On forward-looking topics, 66% of respondents said they expect their value-based care participation to increase slightly in the next year or two, and 11% said they expect it to increase significantly. Just 1% said they expect a decline.
Free-text responses on the topic submitted by the executives pointed to a higher potential upside from the shift as well as growing pressure from payers and demographic shifts that are pushing organizations toward greater downside risk.
“Most hospitals and health system C-suites, in fact, are planning to ramp up their participation in [value-based care] models but will still be heavily reliant on traditional fee-for-service as the slow march toward [value-based care] continues in 2026,” Sage summarized in its report. “Ultimately, today’s C-suite executives should expect their peers and competitors to increase VBC investments—even as excitement about the transition remains tempered.”