When I think about what defines high-quality health care, I don’t start with a single visit or a specific service. I start with a broad view of the full care experience: how care is delivered over time, across settings and among care teams. High-quality care is built through coordination, prevention and a deep understanding of each patient’s needs.
At its best, high-quality health care engages all physicians and clinicians, at every level, in every specialty within one system. The system is integrated so a patient’s entire care team has real-time access to their health data, and information flows easily, without barriers. Integration of primary, specialty and recuperative care eliminates redundant testing and limits prescription errors. This integration of care teams delegates routine administrative tasks, streamlines clinical workflows, and eases physicians’ workload, enabling them to focus on complex medical decision-making and patient relationships. The result: improved health outcomes, and reduced costs.
It also means patients don’t have to navigate their care journey alone. Every interaction builds on the last, ensuring a continuous, connected and coordinated care experience that leads to better health. Achieving this requires a value-based care approach that aligns financial incentives across the entire healthcare system — including care teams, health plans and hospitals — so all decisions are made with the patient’s best interests at the center.
Too often, that’s not how care works today, resulting in a fragmented, inefficient system that has sent total U.S. healthcare costs soaring in the past decade, from about $3.6 trillion in in 2018 to a projected $5.9 trillion in 2026.
Undermining care quality with fragmented care models
Traditional fee-for-service models tend to reward volume of care and services rather than outcomes. Systems are disconnected from each other, leading to scattered patient health data. Patients coordinate their own care between different physicians, specialists and care teams. They may have to repeat tests, juggle appointments and manage the onerous tasks of interpreting and paying bills from multiple healthcare entities.
They also may not receive support and guidance when it matters most.
Value-based care systems are built to coordinate, streamline and simplify the process of accessing and receiving care. For example, an AI-powered patient portal developed by Southern California Permanente Medical Group was recently launched to help get patients to the right care when they need it. Soon after the Kaiser Permanente Intelligent Navigator (KPIN) was deployed, it helped save one patient’s life, resulting in a remarkable story.
Two weeks after giving birth, the patient, Amber, suddenly had chest pain and difficulty breathing. She logged into the Kaiser Permanente Southern California portal to book a routine appointment. Because KPIN is built into the portal and powered by AI, Amber could describe her symptoms in her own words rather than select from a preset menu. Instead of presenting a list of available physicians, the portal displayed a red warning notice, telling her to call an advice nurse. Even after Amber tried softer wording, the system connected her to an advice nurse, who urged her to go to the ER.
At the hospital, Amber quickly learned she had suffered a heart attack and was able to get the care she needed — at a time when every minute matters.
Coincidentally, she was treated by Sinjin Lee, MD, a cardiologist who had helped design KPIN. He was grateful to be able to have that conversation with her, sharing that KPIN had done exactly what it was built to do: recognize a potential emergency and prompt immediate care. Amber’s coordinated care experience illustrates why the design of a care delivery model matters.
Building lasting patient relationships supports better outcomes
When care is structured around value, meaning success is measured by providing the right care at the right time and in the right place for the patient, the conditions for higher quality are created. Prevention becomes a priority, coordination is built into the system, and physicians and clinicians are supported with the information they need to be proactive. These are not just operational initiatives; they represent true advances in the quality of care provided.
Value-based care organizations that take a longitudinal approach build lasting relationships with patients. While most patients stay with a primary care provider for just three to five, Kaiser Permanente members often remain for more than a decade. These sustained relationships with patients enable physicians to better prevent, manage and reverse chronic diseases. For example, by preventing diabetes from ever progressing to kidney failure, an upstream intervention leads to downstream benefits for patients and health systems. These are just a few reasons experts predict that moving the U.S. healthcare system to value-based care could realistically unlock $1 trillion in annual savings.
Continuously raising the standard of care
Drawing from my journey as a practicing physician and as a physician leader overseeing multiple medical groups, I have experienced firsthand how a thoughtfully designed, value-based approach to care transforms quality outcomes: In 2025, Kaiser Permanente led the nation as the top performer in 71 HEDIS (Healthcare Effectiveness Data and Information Set) effectiveness-of-care measures — the most of any health plan. The closest national competitor led in only 30.*
This is why I am deeply committed to investing in a value-based approach to care, to set an example that benefits the patients we care for, the communities we serve and other healthcare delivery systems across the country and the world. Because when medical excellence is rooted in value and scaled across populations, we fulfill the fundamental promise of medicine: high-quality, accessible care for all.
Ramin Davidoff, MD, is executive medical director and board chair of the Southern California Permanente Medical Group, board chair and CEO of the Southeast Permanente Medical Group; board chair and CEO of The Hawaii Permanente Medical Group; and co-CEO of The Permanente Federation.
*Kaiser Permanente 2025 HEDIS® scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass® and represent all lines of business. Kaiser Permanente combined region scores were provided by the Kaiser Permanente Department of Care and Service Quality. The source for data contained in this publication is Quality Compass 2025 and is used with the permission of NCQA. Quality Compass 2025 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass® and HEDIS® are registered trademarks of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality.
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