Mounting financial pressures, workforce shortages, and rising patient demand are pushing health systems to rethink how they deliver care.

The traditional hospital-centered model is giving way to strategies that prioritize prevention, access, and efficiency. By embracing value-based care and new technologies, organizations aim to curb costly emergency visits, ease capacity strains, and deliver better outcomes while operating under tighter margins.

“Geisinger has a long tradition of value-based care models, and over the last year we’ve accelerated our strategies in VBC,” Terry Gilliland, MD, president and CEO of Geisinger Health in Danville, Pa., told Becker’s. “We are leveraging AI to identify patients at high risk for hospitalization or emergency department visits and engage them in our care management programs to reduce hospitalizations and more importantly improve the overall health and quality of life of these patients.”

Geisinger’s clinical team is using value-based care guidelines with real-time care recommendations for treating patients during primary care visits instead of referring them out to specialists. When patients are elevated to specialists, it’s more often the right patient who needs specialty care.

“This increases the value of referrals to a specialist and supports better access,” said Dr. Gilliland. “Intelligent triage leverages a personalized, AI-driven clinical assessment to guide patients to the easiest, most appropriate and affordable access points. These value-driven programs are helping us meet our communities’ needs for high-quality, affordable care with a great experience.”

Accessibility is becoming harder within the walls of the hospital; that’s why many health systems are turning to telemedicine, remote patient monitoring, hospital at home and more to prevent costly and unnecessary ED visits and inpatient admissions.

“A key to successful VBC models is keeping our patients healthy by making sure they have access to the care they need,” said Dr. Gilliland. “We have created programs throughout our system, virtual, on-demand, inpatient and outpatient with a team including all provider types, to improve access across all of our services.”

Geisinger has a “care without delay” program that added inpatient capacity, reduced emergency room wait times and improved throughout for the emergency department. The health system also added advanced practice providers to the staff, which now exceeds 1,200 APPs focused on primary care, urgent care, cardiology and more.

“We are also increasing our use of telemedicine, remote monitoring, and home visits,” said Dr. Gilliland. “Our goal is to be there when our communities need us, so we can help them stay as healthy as possible.”

Rush University System for Health in Chicago aims to lead in value-driven care by embracing innovation as a core value. This year, the health system expanded its primary care house calls program for patients living on the West Side of Chicago, an underserved area of the city. The program, dubbed Rush@Home, provides primary care for patients at high risk of poor outcomes.

“Through its comprehensive approach to caring for people with multiple chronic conditions and advanced care needs, Rush@Home has proven to improve patient experience, clinical outcomes and reduce total healthcare expenditures,” Matt Walsh, executive vice president and COO of Rush, told Becker’s.

That’s not all Rush is doing. The health system has also developed new capabilities in remote monitoring and taken steps to quality improvement for better patient outcomes.

“To extend patient care beyond the office visit, Rush began offering remote monitoring of chronic conditions, using a variety of wearable devices, AI-powered apps and smart phones,” said Mr. Walsh. “More than 3,000 Rush patients with hypertension, heart failure, and/or diabetes are using these innovative tools to partner with their provider at Rush to improve the management of their condition. These solutions have strong early results in improving control of chronic conditions.”

High-risk patient populations are a strong opportunity for bending the value curve. Froedtert ThedaCare Health in Milwaukee is using technology and data to make an impact.

“Over the past 12 to 18 months, Froedtert ThedaCare Health has made significant strides in value-driven healthcare through a comprehensive, patient-centered approach,” said Imran Andrabi, MD, president and CEO of Froedtert ThedaCare Health. “We’ve expanded AI and predictive analytics to better identify and manage high risk populations, while advancing chronic disease care through specialized congestive heart failure clinics, remote patient monitoring and sepsis prevention strategies.”

The health systems also integrated digital tools and home-based care models for high-risk patient populations, and are helping navigate their care transitions with post-discharge follow-ups to reduce avoidable ED visits and readmissions.

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