Value-based care reaches a quarter of revenue at 30% of surveyed health organizations

Value-based care accounts for at least a quarter of revenue at 30% of healthcare organizations surveyed, and more than 60% of respondents expected their value-based revenue to be higher in 2025 than in 2024, according to a survey reported by Fierce Healthcare. Wolters Kluwer Health put those two figures at the top of an analysis published November 3, 2025, and built an argument on them: the software sold into these contracts is now judged on whether the customer hit its incentive thresholds and avoided its penalties.

That is a different test from the one most clinical software was built to pass. Under fee-for-service, payment followed volume. In a value-based contract, as Wolters Kluwer frames it, payment follows outcomes, quality scores and cost reductions, which means the vendor's scorecard is the customer's quality scorecard.

What a quarter of revenue at risk demands from the reporting stack

Getting paid under a value-based model in the U.S. requires systems that capture outcomes data, track benchmarks, secure information and produce the documentation regulators expect, according to Wolters Kluwer. None of that is new work for a health system. What changes at the 25% mark is how much of the organization's income depends on doing it well.

A quarter of revenue is a useful dividing line, and that reading is ours rather than the survey's. Below it, value-based reporting can plausibly run as a side project owned by a quality team. At or above it, the outcomes-capture and documentation stack is revenue infrastructure, and the CIO who signs off on it is signing off on a share of the top line.

For a health system at or past that line, the question to put to a vendor shifts. It is no longer whether the platform can produce a quality report, but whether the methodology behind that report can survive a payer's audit. Wolters Kluwer makes the same point from the vendor side, listing transparent methodology as a requirement for withstanding payer and regulatory scrutiny.

The yardstick underneath all of this is older than the software. A 2017 paper in Cureus by Ikhwanuliman Putera defined value as the health outcomes that matter to patients relative to the cost of achieving them, measured across a full cycle of care, and listed enabling health information technology among the transformations providers would have to make to deliver it.

Six documented jobs, and the one platforms still struggle with

Wolters Kluwer leans on a systematic literature review published in the journal Digital Health to describe where digital tools have shown consistent value in value-based programs. The review, as summarized in the Wolters Kluwer analysis, groups that value into six areas.

• Identifying patients and stratifying them by risk
• Monitoring patients remotely and supporting their self-management
• Coordinating care
• Measuring outcomes, both for internal performance tracking and for external reporting
• Advancing health equity and reaching more patients
• Interoperability and governance

The same body of evidence carries a caveat. Wolters Kluwer reports that studies find digital tools are key facilitators of successful value-based programs, contributing to cost savings, quality improvements and better patient experience, but that many value-based platforms struggle to support standardized care. Five of the six jobs above are about measuring and organizing. Only one, and only indirectly, is about changing what a clinician does.

A 2025 viewpoint in JMIR Medical Informatics by Lan Zhang, Christopher Bullen and Jinsong Chen reaches a similar place from a different direction. The authors describe digital platforms in tertiary hospitals that use patient-reported outcome measures to guide treatment, and they name stakeholder engagement and the standardization of those measures as the hard parts of implementation, closing with a call for interoperability and standardization across stakeholders.

Put the two together and a sharper evaluation question emerges for anyone weighing a population health or care coordination platform: does it alter a decision at the point of care, or does it report afterward on what happened? Both have value under a value-based contract. Only the first reduces the variation that the contract penalizes.

Three obstacles Wolters Kluwer names for the companies building these platforms

The Wolters Kluwer analysis is addressed less to hospitals than to the digital health companies selling to them, and it is candid about where those companies get stuck. The first obstacle is content. Embedding clinical decision support in a workflow presupposes a trusted, evidence-based body of guidance to embed, and Wolters Kluwer says building that content or managing manual updates is difficult and time-consuming for developers.

The second is adoption that varies from one customer site to the next. Clinicians are more likely to adopt platforms with which they feel confident and comfortable, according to Wolters Kluwer, which argues that proven, familiar clinical resources with reliable editorial processes and expert contributors help earn that trust. The content also has to appear inside the workflow with context-specific recommendations at the moment of decision, which is a product design problem as much as a content problem.

The third is the one that decides contracts. Wolters Kluwer describes the difficulty of tying decision-support usage to measurable value-based outcomes, and says platforms need to surface real-time guidance at the point of care to help with patient tracking, treatment modalities and acceptance of value-based claims. A platform can log every time a clinician opened a recommendation. Showing that the recommendation moved a quality metric a payer recognizes is harder, and it is the evidence a customer will eventually ask for.

UpToDate Connect and the build-or-license decision

Wolters Kluwer's answer to all three obstacles is its own product. UpToDate Connect is described in the analysis as an API designed to let digital health technology companies embed trusted, evidence-based clinical content directly into their platforms, so that, according to Wolters Kluwer, developers can ensure users are working from the most current clinical guidance. The analysis is a vendor publication making a case for a vendor product, and it should be read as one.

That does not make the underlying decision less real. For a digital health company selling into value-based contracts, the three obstacles Wolters Kluwer lists amount to a build-or-license choice on clinical content: maintain an in-house editorial process that keeps guidance current across every specialty the platform touches, or license a maintained source and compete on workflow and analytics instead. The analysis does not disclose UpToDate Connect pricing or integration timelines, so the economics of that choice have to come from the vendor conversation.

For the hospital or health system buyer, the same list translates into two questions that are fair to ask any platform vendor: whose clinical content underpins the recommendations the platform surfaces, and how often is it updated? Wolters Kluwer's own framing establishes that content currency and editorial provenance are what drive clinician trust, so a vendor that cannot answer either is, by the analysis's own logic, going to have an adoption problem.

The figure to check next

The survey Wolters Kluwer cites captured an expectation, not a result: more than 60% of respondents expected value-based revenue to rise in 2025 over 2024, per Fierce Healthcare. Whether that held is the number worth checking when the next survey cycle reports, because it decides how many more organizations cross the quarter-of-revenue line and inherit the reporting burden that comes with it.

For the platforms, the test Wolters Kluwer sets is narrower and harder to fake. The company's own framing says a value-based tool earns its place when decision-support usage can be traced to a quality metric a payer accepts. Platforms that can show that trace have a sales argument no dashboard can match. Platforms that cannot will be measuring outcomes for someone else's contract.