The RISE Value-Based Care Summit brought payers, providers, ACOs, and health plan leaders together June 28–30 at the Omni PGA Frisco Resort & Spa outside Dallas to talk incentives, outcomes, and what it actually takes to scale value-based care.
There was no shortage of big-picture strategy on the agenda. But the conversations that generated the most nodding heads weren't about where the industry is headed. They were about the unglamorous work of getting the basics right. Here's what stood out.
Encounter data can fall out of the submission process at nearly nine different points before it ever reaches CMS, and every one of those gaps is lost revenue or lost quality credit. Vendors rejecting claims before a clinical review, providers submitting vague diagnoses, pharmacy data missing deadlines: none of it looks urgent in the moment, but it adds up fast.
It also doesn't stay in the past. Risk adjustment audits can reach back years, and CMS is running audit cycles multiple times a year. The organizations that treat clean data as a day-one habit spend a lot less time and money defending it later.
Documentation training, coding queries, visit planning tools: engagement with all three was surprisingly low across the organizations that shared numbers at the summit. That's not a provider problem so much as a support problem. Incentives alone don't close the gap; providers need the education and workflow tools to act on them.
AI is starting to help here, but it's not a clean win yet. Ambient documentation tools can speed things up, and they can also introduce inaccurate information if nobody's checking the output. The organizations getting value out of AI are the ones still training providers to catch what it gets wrong.
Star ratings, wellness visit completion, medication adherence, and gap closure were all trailing target at the organizations presenting data. At the same time, ED visits, admissions, and readmissions were all climbing. Those two trends aren't a coincidence; they're the same underlying issue showing up on both a quality scorecard and a utilization report.
One shift worth watching: several speakers pushed back on the annual wellness visit as a finish line. A visit that closes a metric without documenting an actual condition doesn't move risk adjustment or quality forward. The better target is a comprehensive, condition-focused visit at least once a year.
Ask who owns a contract's success, who owns its failure, and who has the authority to fix what's broken. If the answer is unclear, or if it's "everyone," that's usually the clearest sign a program will underperform. Several sessions came back to this same diagnostic, whether the topic was a $2 million budget with too many competing priorities or a full risk contract an organization wasn't quite ready to sign.
The advice was consistent: let the data point to root causes, prioritize accordingly, and be honest about organizational readiness before taking on more risk than the operation can support.
Data lags, inconsistent attribution models, and opaque financial targets came up again and again as sources of tension, more so than clinical disagreements. Standardizing quality measures and reporting is helping, and so is a broader market recalibration that's pushing providers toward contract types that actually fit their scale and capabilities.
But the fix that got the most agreement in the room wasn't a bigger committee. It was smaller, more frequent conversations between the people actually doing the work.
None of these five themes are new problems. What's changing is how directly organizations are naming them. The strategy for value-based care is mostly settled; the differentiator now is execution, clean data, engaged providers, and governance that assigns real ownership.
At Concord, we work with payers and risk-bearing providers on exactly that layer, connecting the data integrity, interoperability, and analytics infrastructure behind risk adjustment, quality reporting, and care management performance. If that gap between strategy and execution sounds familiar, we'd welcome the conversation.
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