For nearly two decades, Better Health Group has been a leader in value-based care and operating top-rated primary care clinics. Our network of owned and independent clinics leverage our model to improve care for both Medicare Advantage (MA) and Traditional Medicare patients. Now, the Centers for Medicare & Medicaid Services (CMS) has ranked Better Health Group in the top 5% of Medicare Shared Savings Program (MSSP), Accountable Care Organizations (ACOs) for performance year 2023.
At a time when independent clinics face mounting challenges, our providers are exceeding CMS quality goals and maximizing shared savings revenue, in every state in which we operate—Florida, Alabama, Georgia, Texas, Oklahoma, and Tennessee.
If you've been practicing primary care for any length of time, you've spent most of your career getting paid for each visit, not for how your patients are actually doing between visits. That's the fee-for-service model.
Value-based care (VBC) works differently. And for independent primary care practices, it may be the most important shift happening in medicine right now.
The Simple Version
Value-based care is a payment model that ties your compensation to how well your patients are doing, not just how many times you see them.
In practice, that means: if your Medicare patients are staying out of the hospital, managing their chronic conditions well and receiving preventive care like annual wellness visits, you get credit for that. That credit translates into real money — shared savings, quality bonuses, and in some models, monthly care management payments.
The main federal framework for this is the Medicare Shared Savings Program (MSSP), which operates through Accountable Care Organizations (ACOs). When a practice's attributed Medicare patients cost CMS less than expected — because they're being managed well — a portion of those savings comes back to the practice.
Why Fee-for-Service Is Under Pressure
The fee-for-service system has been squeezed for years. CMS cut the Medicare Physician Fee Schedule by 2.83% in 2025 — the fifth consecutive year of cuts, according to the American Medical Association. Prior authorization keeps expanding. Staffing costs keep rising. And independent practices, without the scale of large health systems, take the brunt of it.
The result is that running a practice on fee-for-service alone is getting harder every year. More physicians are seriously considering selling to a health system not because they want to lose their independence, but because the numbers aren't working.
Value-based care doesn't replace your fee-for-service billing. In the MSSP model, your existing claims continue exactly as before. What changes is that you now have a second revenue stream tied to how well you manage your patient population. Practices in BHG's network average over $1,000 per patient per year in additional revenue through that model.
What the Model Actually Requires
The honest part of this conversation is that capturing value-based revenue consistently requires infrastructure that most independent practices don't have and can't build alone. You need:
- Accurate, complete coding that reflects how sick your patients actually are
- Proactive outreach to close care gaps — annual wellness visits, screenings, chronic disease management
- Data beyond your EMR — claims data, pharmacy data, hospital visits — so you can see what's happening with your patients when they're not in your office
- Quality reporting across multiple frameworks (HEDIS, MIPS, Star Ratings)
Most independent physicians are already delivering care that would score well under a value-based model. The problem is they don't have the systems to document, report, and capture that performance consistently.
That's what a good value-based care partner provides: not another portal, but actual operational support.
The 2030 Deadline
CMS has set a formal goal: 100% of Traditional Medicare beneficiaries in accountable care relationships by 2030. As of January 2025, about 53% are already there. The direction of travel is clear and it's moving fast.
Practices that build value-based infrastructure now have several years to learn the model, optimize performance and build a strong track record before 2030. Practices that wait until they're forced to transition will have far less runway — and far less leverage.
Value-based care isn't a future trend to monitor. For independent primary care practices, it's the present reality worth engaging with now.
If you've been practicing primary care for any length of time, you've spent most of your career getting paid for each visit, not for how your patients are actually doing between visits. That's the fee-for-service model.
Value-based care (VBC) works differently. And for independent primary care practices, it may be the most important shift happening in medicine right now.
The Simple Version
Value-based care is a payment model that ties your compensation to how well your patients are doing, not just how many times you see them.
In practice, that means: if your Medicare patients are staying out of the hospital, managing their chronic conditions well and receiving preventive care like annual wellness visits, you get credit for that. That credit translates into real money — shared savings, quality bonuses, and in some models, monthly care management payments.
The main federal framework for this is the Medicare Shared Savings Program (MSSP), which operates through Accountable Care Organizations (ACOs). When a practice's attributed Medicare patients cost CMS less than expected — because they're being managed well — a portion of those savings comes back to the practice.
Why Fee-for-Service Is Under Pressure
The fee-for-service system has been squeezed for years. CMS cut the Medicare Physician Fee Schedule by 2.83% in 2025 — the fifth consecutive year of cuts, according to the American Medical Association. Prior authorization keeps expanding. Staffing costs keep rising. And independent practices, without the scale of large health systems, take the brunt of it.
The result is that running a practice on fee-for-service alone is getting harder every year. More physicians are seriously considering selling to a health system not because they want to lose their independence, but because the numbers aren't working.
Value-based care doesn't replace your fee-for-service billing. In the MSSP model, your existing claims continue exactly as before. What changes is that you now have a second revenue stream tied to how well you manage your patient population. Practices in BHG's network average over $1,000 per patient per year in additional revenue through that model.
What the Model Actually Requires
The honest part of this conversation is that capturing value-based revenue consistently requires infrastructure that most independent practices don't have and can't build alone. You need:
- Accurate, complete coding that reflects how sick your patients actually are
- Proactive outreach to close care gaps — annual wellness visits, screenings, chronic disease management
- Data beyond your EMR — claims data, pharmacy data, hospital visits — so you can see what's happening with your patients when they're not in your office
- Quality reporting across multiple frameworks (HEDIS, MIPS, Star Ratings)
Most independent physicians are already delivering care that would score well under a value-based model. The problem is they don't have the systems to document, report, and capture that performance consistently.
That's what a good value-based care partner provides: not another portal, but actual operational support.
The 2030 Deadline
CMS has set a formal goal: 100% of Traditional Medicare beneficiaries in accountable care relationships by 2030. As of January 2025, about 53% are already there. The direction of travel is clear and it's moving fast.
Practices that build value-based infrastructure now have several years to learn the model, optimize performance and build a strong track record before 2030. Practices that wait until they're forced to transition will have far less runway — and far less leverage.
Value-based care isn't a future trend to monitor. For independent primary care practices, it's the present reality worth engaging with now.
If you've been practicing primary care for any length of time, you've spent most of your career getting paid for each visit, not for how your patients are actually doing between visits. That's the fee-for-service model.
Value-based care (VBC) works differently. And for independent primary care practices, it may be the most important shift happening in medicine right now.
The Simple Version
Value-based care is a payment model that ties your compensation to how well your patients are doing, not just how many times you see them.
In practice, that means: if your Medicare patients are staying out of the hospital, managing their chronic conditions well and receiving preventive care like annual wellness visits, you get credit for that. That credit translates into real money — shared savings, quality bonuses, and in some models, monthly care management payments.
The main federal framework for this is the Medicare Shared Savings Program (MSSP), which operates through Accountable Care Organizations (ACOs). When a practice's attributed Medicare patients cost CMS less than expected — because they're being managed well — a portion of those savings comes back to the practice.
Why Fee-for-Service Is Under Pressure
The fee-for-service system has been squeezed for years. CMS cut the Medicare Physician Fee Schedule by 2.83% in 2025 — the fifth consecutive year of cuts, according to the American Medical Association. Prior authorization keeps expanding. Staffing costs keep rising. And independent practices, without the scale of large health systems, take the brunt of it.
The result is that running a practice on fee-for-service alone is getting harder every year. More physicians are seriously considering selling to a health system not because they want to lose their independence, but because the numbers aren't working.
Value-based care doesn't replace your fee-for-service billing. In the MSSP model, your existing claims continue exactly as before. What changes is that you now have a second revenue stream tied to how well you manage your patient population. Practices in BHG's network average over $1,000 per patient per year in additional revenue through that model.
What the Model Actually Requires
The honest part of this conversation is that capturing value-based revenue consistently requires infrastructure that most independent practices don't have and can't build alone. You need:
- Accurate, complete coding that reflects how sick your patients actually are
- Proactive outreach to close care gaps — annual wellness visits, screenings, chronic disease management
- Data beyond your EMR — claims data, pharmacy data, hospital visits — so you can see what's happening with your patients when they're not in your office
- Quality reporting across multiple frameworks (HEDIS, MIPS, Star Ratings)
Most independent physicians are already delivering care that would score well under a value-based model. The problem is they don't have the systems to document, report, and capture that performance consistently.
That's what a good value-based care partner provides: not another portal, but actual operational support.
The 2030 Deadline
CMS has set a formal goal: 100% of Traditional Medicare beneficiaries in accountable care relationships by 2030. As of January 2025, about 53% are already there. The direction of travel is clear and it's moving fast.
Practices that build value-based infrastructure now have several years to learn the model, optimize performance and build a strong track record before 2030. Practices that wait until they're forced to transition will have far less runway — and far less leverage.
Value-based care isn't a future trend to monitor. For independent primary care practices, it's the present reality worth engaging with now.