What Are the Different Value-Based Care Models?

March 21, 2025

Leona Rajaee

The shift from fee-for-service to value-based care has transformed how providers deliver and are reimbursed for healthcare. But with so many models and acronyms—MSSP, ACO, PCMH, CPC+—it can be difficult to navigate the options.

If you’re a primary care clinician, understanding which value based care model best fits your goals is essential for improving outcomes, increasing revenue, and avoiding unnecessary complexity.

In this post, we’ll break down:

What value-based care means
The different types of value-based care models
How each model works and who it’s for
The role of technology in successful participation

What Is a Value Based Care Model?

A value based care model is a healthcare reimbursement structure that rewards clinicians for delivering high-quality, cost-effective care, rather than for the number of services rendered.

Instead of being paid per test or visit (fee-for-service), clinicians are compensated based on:

Improved patient outcomes
Reduced unnecessary costs
Effective care coordination
Preventive services and population health

According to the Centers for Medicare & Medicaid Services (CMS), value-based care is designed to improve care for individuals, improve health for populations, and reduce costs—the “Triple Aim” of modern healthcare.

Why Value-Based Care Matters in Primary Care

Primary care is the natural home for value-based care. Clinicians already focus on whole-person health, long-term relationships, prevention, and care coordination.

With the right tools and workflows in place, value-based care enables practices to:

Improve patient outcomes
Receive incentive payments or shared savings
Deliver more proactive and personalized care
Reduce the burden of reactive, high-cost treatments

📘 Want a deeper dive into how to succeed with these models? Check out our Value Based Payment Blog Series for tips and strategies

What Are the Different Value Based Care Models?

Here are some of the most common value-based care models available to primary care clinicians.

1. Accountable Care Organizations (ACOs)

Best for: Groups of clinicians who want to coordinate care and share savings.

How it works:
ACOs are groups of doctors, hospitals, and other healthcare clinicians who voluntarily come together to provide coordinated care for Medicare patients. The goal is to ensure patients get the right care at the right time, while avoiding unnecessary duplication and medical errors.

If the ACO meets quality benchmarks and reduces costs, it shares in the savings with CMS.

Types of ACOs:

MSSP (Medicare Shared Savings Program): The most widely used model for primary care practices.
NextGen ACOs (ended in 2021): Offered more advanced risk-sharing.
REACH ACOs: Newer model focused on equity and improved access.

Learn more from CMS’s ACO resources.

2. Patient-Centered Medical Home (PCMH)

Best for: Practices focused on comprehensive, team-based care and patient relationships.

How it works:
The PCMH model emphasizes team-based, coordinated, and accessible care. It includes preventive services, chronic care management, patient engagement, and quality improvement.

Practices are recognized by organizations like NCQA and may receive enhanced payments from payers for maintaining high standards of care.

Key elements include:

Comprehensive care teams
Enhanced access (e.g., same-day appointments)
Care coordination and follow-up
Quality and safety tracking
Strong patient-provider relationships

PCMH recognition can serve as a foundation for transitioning into more advanced value-based care models like ACOs or bundled payment programs.

3. Bundled Payments

Best for: Clinicians or groups focusing on specific procedures or conditions.

How it works:
Under bundled payment models, clinicians receive a single, fixed payment for all services related to a treatment episode or condition over a defined period (e.g., 90 days after a knee replacement).

If care costs less than the bundled amount, clinicians can keep the savings. If costs exceed it, they may owe money back.

Though less common in primary care, bundled payments may apply for chronic care episodes or transitions in care management.

4. Primary Care First (PCF)

Best for: Small to mid-sized primary care practices seeking simplified participation.

How it works:
PCF is a CMS Innovation model offering risk-adjusted, monthly population-based payments with performance bonuses for reducing hospitalizations and improving outcomes.

It simplifies reporting and offers an alternative to MIPS (Merit-Based Incentive Payment System). Practices must meet care delivery requirements such as:

24/7 patient access
Advanced care planning
Risk stratification and care management

PCF is especially attractive to independent practices wanting to scale value-based care efforts with predictable revenue.

5. Comprehensive Primary Care Plus (CPC+) (No longer available, but foundational)

How it worked:
CPC+ was a multi-payer model that aimed to strengthen primary care through payment reform, data sharing, and quality improvement. While no longer active, it laid the foundation for models like PCF.

Many of its principles—like care coordination, patient engagement, and team-based care—are central to current value-based care models.

6. Direct Contracting / ACO REACH

Best for: Larger primary care organizations comfortable with managing financial risk.

How it works:
ACO REACH (Realizing Equity, Access, and Community Health) is CMS’s evolution of the Direct Contracting Model, focused on health equity and improving access for underserved communities.

Organizations take on full or partial risk for a defined patient population and receive capitated payments—fixed per-member-per-month amounts—to manage care.

This model includes strong incentives for improving quality and reducing disparities.

Choosing the Right Value Based Care Model

The right model for your practice depends on:

Practice size and structure
Risk tolerance
Resources available for care coordination and reporting
Patient demographics
Technology infrastructure

Many practices start with PCMH or MSSP participation, then grow into more advanced models like PCF or ACO REACH as their capabilities and partnerships expand.

✅ Need help deciding which model fits your goals? Get more resources on the transition to value-based care

The Role of Technology in Value Based Care Success

To thrive in any value based care model, practices need more than clinical excellence—they need the right technology to support care coordination, population health, quality reporting, and patient engagement.

How Elation Health Supports Value-Based Care

Elation Health’s platform is purpose-built to support the needs of primary care practices shifting to value-based models.

💡 Explore how Elation helps primary care practices thrive in value-based care—request a demo today.

Real-World Outcomes with Value Based Care

Practices that successfully adopt a value based care model often report:

Higher patient satisfaction
Improved clinical outcomes
Reduced hospitalizations and ER visits
Increased revenue through shared savings and incentives
Better clinician morale due to meaningful, relationship-based care

Ready to Get Started with Value Based Care?

Choosing the right value based care model is more than a business decision—it’s a commitment to delivering smarter, more impactful care. With the right support, transitioning doesn’t have to be overwhelming.

Whether you’re just beginning the journey or ready to scale your value-based efforts, Elation Health is here to help.