Alignment isn’t a buzzword. It’s a survival strategy.
We hear the word “alignment” a lot – in relationships, in medical terminology and in financial and business strategy. But it’s often treated like an aspirational tagline that’s only vaguely strategic and at best, a pipe dream.
Alignment is so much more than that.
In healthcare, alignment is a key differentiator between organizations that comply with value-based mandates and those that compete in value-based models. It’s the difference between data as a static report and data as a strategic lever. Think coordinated action versus disconnected effort.
In 2023, 28.5 percent of U.S. healthcare payments came through risk-bearing value-based models almost doubling from 2019 (MedCity News, 2023). With this increase, the path to value-based models is clear. But are healthcare organizations equipped to deliver what success with these models demand. Alignment isn’t a nice-to-have, it’s the difference between participation and performance.
The impact of alignment in value-based care
Alignment is a construct for success. Syncing clinical, operation and financial decision-making aspects of the healthcare continuum impacts outcomes across every layer of the organization.
When alignment is achieved clinical staff understand the cost implications of decisions. Finance teams can grasp the downstream impact of delayed coding or inaccurate risk capture. Operational leaders can accurately prioritize outcome-supported workflows over general output.
Healthcare organizations that thrive in value-based environments don’t just collaborate between departments, they integrate. They build connected systems that reinforce accountability and clarity across every function of the business and care continuum.
The cost of misalignment
For provider groups and value-based organizations, misalignment isn’t an abstract concern, it’s a daily operational liability that’s also a financial risk.
When clinical teams are unable to analyze performance data in the moment, they miss risk flags. When finance and operations track KPIs separately, incentives fracture. And when leadership lacks a unified view across the entire business, investment decisions become reactive instead of strategic.
Let’s look at CMS’s Physician Group Practice (PGP) demonstration, the first pay-for-performance initiative for physicians under the Medicare program. Ultimately, the precursor to Accountable Care Organizations, this program offered incentives for care quality and cost savings, similar to ACO’s Shared Savings incentives. Health systems and physician groups with tight clinical-financial integration generated millions in shared savings while those with siloed infrastructures underperformed.
Data continues to impact the return of value-based healthcare organizations. In 2023, ACOs in the Medicare Shared Savings Program delivered a record $2.1 billion in net savings, equating to the highest annual total since the program began. It took more than fancy systems to return a number that large – it took organizations that broke down operational silos, aligned care, and operational alignment with finance deliver more favorable outcomes and lower costs.
Alignment in practice
Beyond boardroom strategy sessions, alignment takes form throughout business systems. It looks like:
- Data that’s accessible and interpretable by clinical, operational and financial teams without dependance on IT.
- Analysis and data intelligence that’s contextualized and decision-ready, not just a performance report.
- Incentives that reward collective outcomes, not isolated actions.
- KPIs that connect executive objectives to frontline behavior.
When you tightly align care coordination, analytics and delivery under value-based contracts, the results speak for themselves. One independent physicians group (IPA) in Mississippi realized a 12% reduction in hospitalizations for patients in chronic care management (CCM) programs, 25% fewer hospital readmissions and $66 million in Medicare savings since 2016.
Performance like this reflects an overall methodical alignment of coordinated workflows, unified metrics and shared priorities across all business domains and the care continuum.
Actionable shifts towards alignment
Alignment doesn’t come overnight – creating forward momentum is the first stem. These actionable shifts will help you to begin:
- Map decision and data flows
Collaborate across teams and departments to understand the requirements for information access to inspire action? Outline delays, bottlenecks or duplications wreaking havoc on efficiencies and outcomes. - Redefine success across the business
Are quality teams, clinicians, finance and executive leadership working toward the same metrics? If not, identify the source and nature of the metrics so the model doesn’t break under pressure. - Invest in insight, not just information
You likely have more data than you could ever manage. It’s not about having data, it’s about access to the correct systems and structures to turn data into timely action for each and every team within your organization that needs it.
Geisinger’s Patient-Centered Medical Home efforts generated 18% fewer admissions and a 36% drop in readmissions showcasing the impact of coordinated, aligned care at scale.
Aligning to lead with impact
Alignment is a leadership decision that ripples through culture, systems and care delivery.
As healthcare payment models shift, organizational success won’t be afforded to those with the most data or the best intentions. Healthcare organizations that see the most success will tap into the competitive advantage of alignment, with actionable intelligence, frontline strategies and bold accountability for outcomes.
In value-based care, performance is a team sport. Are your teams playing from the same playbook?
