A potential shake-up at the Department of Health and Human Services is putting a spotlight on one of the healthcare system’s most persistent failures: the neglect of preventive care. HHS Secretary Robert F. Kennedy Jr. is reportedly planning to dismiss all 16 members of the U.S. Preventive Services Task Force—the independent panel that determines which screenings and services must be fully covered by insurance. The move has sparked concern among healthcare leaders, who warn that it could limit access to vital cancer screenings and essential pediatric care.
But this controversy is just the tip of the iceberg. The U.S. healthcare system has long taken a reactive approach, treating patients only after medical issues arise rather than working to prevent illness through early detection. According to a PubMed study, only 8% of Americans receive routine preventive screenings—forcing providers to intervene later, when conditions are more serious, costly, and difficult to treat.
There are many reasons patients miss these early checkups: lack of access, high costs, and logistical hurdles among them. But the consequences can be severe. A single missed appointment may be the difference between a treatable issue and a life-threatening emergency.
Unsurprisingly, the strain shows up in emergency rooms. The CDC reports nearly 155 million ER visits per year, including 17.8 million that lead to hospital stays and 3.1 million that result in critical care admissions. While many of these are unavoidable, a separate PubMed study found that 28% of ER visits could have been prevented with better access to proactive care.
The costs—both human and financial—are immense. Patients face worse outcomes, hospitals bear the burden of avoidable care, and wait times increase for everyone, including those with true emergencies.
With growing staffing shortages only exacerbating the problem, this reactive model is becoming increasingly unsustainable. The solution? A shift toward value-based care—an approach that rewards prevention, improves outcomes, and reduces costs by catching issues early, before they escalate.
Proactive Care through Value-Based Care
The concept of value-based care was introduced nearly two decades ago by Michael E. Porter and Elizabeth Olmstead Teisberg, who argued that healthcare providers should be evaluated not by how much care they deliver, but by how much they improve patient outcomes. The Affordable Care Act accelerated this shift in 2010 by introducing Medicare payment reforms that reward hospitals, skilled nursing facilities, and other providers for quality outcomes rather than volume. The model aims to reduce hospital stays, lower readmission rates, and bend the healthcare cost curve by emphasizing quality over quantity.
At its best, value-based care incentivizes providers to make meaningful decisions that improve long-term outcomes. A central pillar of the model is whole-person, patient-centered care—recognizing that physical, mental, and social health are deeply interconnected. Rather than treating symptoms in isolation, providers work to support the full scope of a patient’s health, including chronic conditions, mental wellbeing, and social determinants like housing and nutrition.
For instance, a cancer patient struggling with depression may respond better to treatment and manage side effects more effectively if supported by integrated mental health care. To make this happen, care teams often include primary care physicians, mental health professionals, dietitians, social workers, pharmacists, and insurers who collaborate and share data to coordinate care more efficiently.
Technology plays a critical role in enabling this model. Remote patient monitoring allows providers to track vital signs from home, while AI-powered tools can help predict complications before they escalate. These tools are especially valuable in post-acute settings, like skilled nursing facilities, where patients are most vulnerable to setbacks. With AI-driven insights, staff can be allocated more effectively, and providers can intervene before a patient requires readmission.
However, value-based care is not without its flaws. Tying reimbursement to outcomes creates unintended pressures. In some cases, hospitals may avoid admitting patients with complex or poorly understood conditions—particularly if those patients are unlikely to produce the desired “outcome metrics.” This can leave vulnerable populations, including those with multiple chronic conditions or unstable living situations, at greater risk of being excluded from care. When financial incentives are misaligned with patient complexity, the very system designed to improve equity can end up reinforcing disparities.
These tensions underscore the need for thoughtful implementation. Value-based care has enormous potential—but only if systems are designed to reward improvement, not avoidance, and ensure that every patient, regardless of complexity or background, has a path to high-quality, coordinated care.
Taking Action
Value-based care, while slow to be fully adopted, has the potential to change the way the entire healthcare ecosystem operates. Patients and the industry cannot wait, though, and there is urgency to identify proactive approaches to care that are sustainable and technology-driven. Given this reality, healthcare facilities and executives are looking to partner with smart entrepreneurs who can bring innovative solutions to the table to help them deliver more preventative care approaches. Entrepreneurs who define their unique value proposition and are focused on driving better patient outcomes will be best positioned and will make the largest impact.
