Value-based care promises improved outcomes for patients, healthcare providers, and health plans, and there is growing pressure for health systems to shift from a traditional fee-for-service model to a value-based approach. Yet despite policy momentum and payer incentives, many hesitate to embrace alternate payment models due to the risks and investments needed to meet contract performance standards.
At the same time, advances in precision medicine and artificial intelligence (AI) are changing the economics of care, though the clinical promise of these technologies often comes with upfront costs and delayed returns.
This is where structured capital strategies play a crucial role. Receivables financing, underwriting, and phased investment tools can help give healthcare organizations the financial runway needed to test, scale, and sustain value-based care efforts.
Below is an excerpt from our upcoming white paper, Financing the Future of Care.
Examining the Most Significant Challenges and Opportunities
The following outlines the most persistent challenges to adoption and the financing levers that can combat them across physician practices, hospitals, and specialty groups.
Challenge: Up-Front Capital Exposure
Genomic testing, molecular diagnostics, care navigation, and advanced data infrastructure don’t deliver positive returns for years – too long for most providers to sustain self-funded investments. Models suggest that well-implemented pharmacogenomics programs typically take one to three years to show positive ROI1, for example.
Opportunity: Strategic financing can spread these investments over time. Working capital facilities, structured loans, or phased financing aligned with milestones allows organizations to fund technology and staff now while linking repayment to MIPS performance adjustments, per-member-per-month (PMPM) incentives, or future shared savings.
Challenge: Slow Return on Investment
The timeline for shared savings, performance bonuses, and reconciliation payments following a VBC contract’s performance period can often trail months or a full year behind the clinical intervention.
Opportunity: Receivable financing can turn expected shared savings or bundled payment receivables into current liquidity. Physician practices could use the same approach to expected MIPS payment adjustments. By converting future dollars into available cash, providers can reinvest immediately into care management and performance improvement.
Challenge: Administrative Challenges and Data Interoperability
Integrating new technologies or workflows into existing systems adds layers of complexity most health systems are reluctant to take on: 75% of surveyed healthcare leaders identified data interoperability as a barrier to adopting VBC2. Providers relying solely on EHRs are at a disadvantage due to data sharing barriers, as genetic testing to improve drug therapies relies on that PHI being shared across a patient’s care network.
Opportunity: Automation tools, including AI-assisted coding, automated MIPS reporting, and claims reconciliation, aim to reduce manual workload. On the medical records side, partnering with vendors that embed genomic results directly into EHRs – or offer systems that can connect to EHRs – shortens the adoption curve and reduces errors. These integrations can be funded through staged investments, mitigating up-front burdens.
Challenge: Reluctance to Assume Risk
Heightened risk is one of the most significant reasons for health systems to avoid transitioning models or investing in personalized health technologies. The fear of downside exposure overshadows the potential for shared saving. A recent study found 87% of surveyed hospitals, ACOs, Federally Qualified Health Centers (FQHCs), Clinically integrated Networks (CINs), and specialty care providers cited financial risk at the top barrier to adoption2.
Opportunity: Underwriting mechanisms and reinsurance tools can limit exposure if health systems can connect with a financial institution willing to take on the risk. Financing options that cover initial capitalization for risk-bearing entities or carve-outs for high-cost therapies can give providers confidence to participate without jeopardizing financial stability.
Challenge: Scaling Across Populations
Genomic testing is valuable but expensive. Scaling across large patient pools requires substantial funding, not to mention vendor vetting to ensure results align with expectations.
Opportunity: Pooled funding strategies can support patient-level testing while capturing economics of scale. Investing at the population level lowers per-patient costs and spreads risk, accelerating the point at which ROI is achieved. Smaller practices can participate in pooled models through ACOs, CINs, or payer partnerships that distribute costs and reduce individual exposure. Working with financial partners with a known network of vetted or trusted vendors lowers concerns around finding the right vendor to reach value-based goals.
Executives who focus on strategic financial strategies and investments can help position their organization to capture measurable savings and improve patient outcomes.
Huntington Bank’s Healthcare Banking Team has worked with thousands of healthcare organizations across the country to design and implement capital strategies tailored to their unique needs. To learn how these approaches could work for you, reach out to start the conversation.
1American Pharmacogenomics Association. June 2025. “Pharmacogenomics ROI: Building the Business Case for Healthcare Systems.” Accessed September 3, 2025.
2Innovaccer and NAACOs. 2025. “The State and Science of Value-Based Care 2025.” Accessed September 3, 2025.
Disclosures
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