Financial Impact of Value-Based Care on Traditional RCM
- Value Based Care changes how revenue flows — payments are delayed, outcome-based, and less predictable, demanding better forecasting and reserves.
- Claims-only RCM is obsolete — real margin now comes from HCC capture, attribution accuracy, and contract modeling.
- Missed risk adjustment = lost revenue — poor documentation and attribution errors directly erase dollars.
- Reactive RCM firms lose — more billers and vague VBC contracts lead to margin compression.
- RCM must become risk-aware — add HCC pilots, analytics, patient financial experience, and incentive-aligned pricing.
- New KPIs matter — track RAF uplift, contract variance, payer-level AR, and attribution drift monthly.