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Glossary / Value-based care

Value-based care

Definition

Value-based care (VBC) is a payment model where providers are paid for outcomes and total-cost management — through shared savings, capitation, or quality bonuses — rather than per service delivered.

By Lithos Staff · Updated July 2026

At a glance
  • Pays for outcomes and cost management, not visit volume
  • Mechanisms: quality bonuses, shared savings, capitation
  • ACOs are the flagship Medicare shared-savings vehicle
  • RPM and async care fit VBC economics naturally

How value-based payment works

The spectrum runs from light to full risk. Quality bonuses layer incentives onto fee-for-service. Shared-savings arrangements (the ACO model) pay providers a slice of the costs they avoid. Capitation pays a fixed amount per member per month, making the provider profitable only if the population stays healthy. Each step transfers more financial risk from payer to provider.

FEE-FOR-SERVICE — PAID PER ACTService deliveredvisit · test · procedureClaim per serviceCPT-codedPaid for volumemore activity, more revenueVALUE-BASED — PAID FOR RESULTSPopulation managedcontinuous careOutcomes measuredquality · total costPaid for resultsshared savings · capitation
Fee-for-service pays for activity; value-based care pays for results.

Why VBC matters to digital health

Continuous, data-rich care models are exactly what risk-bearing entities need: remote monitoring that catches deterioration early, async touchpoints that cost a fraction of visits, and engagement data that fee-for-service medicine never captures. Many digital health companies sell into VBC entities as cost-reduction tools — a very different pitch, and buyer, than DTC.

The honest caveat: most DTC telehealth is pure fee-for-service or cash-pay. VBC is a payer-side channel that becomes relevant when a program can prove it changes outcomes or total cost for a defined population.

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Frequently asked questions

Is value-based care replacing fee-for-service?

Slowly and partially — FFS still dominates, with VBC growing through Medicare programs and risk-bearing primary-care groups.

What is capitation?

Fixed payment per member per month regardless of services used — full financial risk for the population’s care.

Does VBC apply to DTC telehealth?

Rarely today — DTC runs cash-pay or FFS. VBC matters when selling into payers, employers, or risk-bearing provider groups.

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