How Value-Based Care Can Help Control Total Cost of Care

For nonprofit leaders, every decision matters—especially when it comes to choosing health coverage that protects both employees and the organization’s budget. Traditionally, health care has operated on a fee-for-service model, where providers are paid based on the number of visits, tests, or procedures performed. While this system delivers care, it often results in higher costs, inconsistent outcomes, and added strain for both employers and employees. For example, consulting firm WTW expects employer medical costs to be between 2 and 3 times the rate of inflation next year.1

Value-based care however, offers a more sustainable alternative. Instead of paying for volume, it rewards providers for helping patients stay healthy, manage chronic conditions, and avoid unnecessary hospital visits. The focus shifts from treating illness to improving overall health outcomes through preventive care, early intervention, and cost avoidance—making care more efficient, more coordinated, and ultimately more cost-effective.

How Value-Based Care Reduces Total Cost of Care

When a value-based model is optimized, providers are rewarded to deliver quality care and ensure patients receive the right treatment at the right time. This means more preventive care, better communication among doctors, and fewer avoidable emergencies.

Employees get the care they need to stay healthy and productive, while employers see fewer large claims and more predictable costs. Over time, this approach helps control total health care spending—reducing financial surprises and supporting long-term stability.

What to Look for When Choosing a Plan

Selecting a value-based care plan is more than a financial choice—it’s a strategic investment in your workforce. By focusing on prevention, quality, and care coordination, you can foster a healthier, more engaged team and create a more sustainable benefits strategy.

When evaluating your options, consider the following:

• Ask about provider performance metrics. Look for plans that measure and reward quality, patient outcomes, and satisfaction. This ensures employees receive consistent, high-quality care.
• Prioritize preventive health programs. Wellness initiatives, virtual care, and chronic condition management programs empower employees to manage their health proactively.
• Look for integrated care coordination. Plans that connect primary care, specialists, and behavioral health services help reduce gaps in treatment and unnecessary costs.
• Evaluate total cost of care—not just premiums. A lower monthly premium can be appealing, but plans emphasizing quality and prevention often lead to greater savings over time.

Building a Healthier, More Sustainable Workforce

Choosing a value-based care plan allows you to take an active role in shaping a healthier future—for your employees and your organization. By working with an agent or your local Florida Blue representative, Ana Castellanos (Ana.Castellanos@bcbsfl.com), you can explore options designed to control costs while improving health outcomes.

Value-based care represents an opportunity to move toward a smarter, more sustainable healthcare system—one that strengthens both the well-being of employees and the financial health of your business.

Disclaimers

1https://www.wtwco.com/en-us/insights/2025/10/2026-global-medical-trends-survey

Health Benefit Plans have limitations and exclusions. Driven by its mission of helping people and communities achieve better health, Florida Blue serves more than 6 million members across the state. Headquartered in Jacksonville, Fla., Florida Blue, a trade name of Blue Cross and Blue Shield of Florida, Inc., is an Independent Licensee of the Blue Cross and Blue Shield Association. For additional information about Florida Blue, please visit www.floridablue.com or call (877) 352-5830.

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