VBC Market Strategy

VBC activity is concentrating around risk intermediation and infrastructure: ACO conveners are reshaping MSSP participation behind the scenes, while vendors are launching tools to model exposure under CMS’s LEAD ACO program, signaling that providers are preparing for more sophisticated downside-risk participation rather than simple shared-savings upside. At the same time, provider strategy is bifurcating between scale and selectivity—home-based care organizations are moving beyond basic payer contracting toward value-based risk and MA payer curation, while specialty and rural providers are building clinically integrated networks and condition-specific models to plug gaps in population health management. With Medicare Advantage now covering 55% of eligible beneficiaries in 2026, VBC stakeholders face a sharper execution challenge: align coding, care management, and specialty/home-based integration while avoiding overdependence on payer contracts that do not support sustainable risk economics (ACO conveners in MSSP