“Change before you have to,” as Jack Welch, Chairman and CEO of General Electric (GE), once noted. From the outside, healthcare stays stagnant and only changes when forced to. But for those paying attention, a proactive evolution in how we manage healthcare operations and how care is delivered is happening now due to the transformative shift to value-based care (VBC) models across the industry. Case in point, the Centers for Medicare & Medicaid Services (CMS) are actively driving and supporting a shift from fee-for-service payment models to achieve 100% of Medicare beneficiaries in value-based care arrangements by 2030.
This may seem bullish at best, given the current state of healthcare most people experience, but we have reached a new milestone in VBC adoption. Instead of battling against skepticism about its effectiveness, I would argue that scalability is the primary challenge for full VBC adoption across the industry. Incremental changes, piecemeal integration of VBC solutions, and the creation of more VBC point-of-care tools than there are doctors will never enable us to fully achieve the potential of a VBC-powered healthcare system.
To establish VBC as the standard of healthcare delivery, we must equip VBC enablers, such as Accountable Care Organizations (ACOs) and the provider care teams themselves, with the appropriate technology infrastructure that makes healthcare innovations accessible to everyone. This is where middleware platforms play a crucial role.
Pioneers of Scalable VBC in Need of Support
ACOs, Value-based care enablers, and VBC tech companies have been pivotal in championing the value-based care movement and have long battled against the naysayers. By aligning financial incentives, fostering care coordination, and ensuring high-quality patient outcomes (and proving it with time-tested results), these organizations have translated VBC principles into practice. They address critical challenges in patient engagement, quality metrics, and population health management, contributing significantly to the evolution of healthcare.
Despite these strides, even the most advanced VBC pioneers need more support to scale value-based care. Efficient integration across diverse systems—such as electronic health records (EHRs), practice management tools, and data analytics platforms—is often lacking, resulting in fragmented data and an administrative burden that impedes the ability to deliver coordinated, quality care. Scalability in VBC requires an accessible infrastructure capable of supporting holistic, real-time data integration.
The Challenge of Tech Silos
The struggle with fragmented technology is not just about integration but also about creating a seamless flow of information accessible by providers and their care teams so their actions can be tied directly to outcomes that support the foundations of value-based care operations, such as comprehensive, high-quality, and carefully coordinated care.
Because of the pervasive tech silos that plague health tech, VBC pioneers and their providers must navigate the data silos that are created by the very nature of this fragmented landscape. These silos often result from disparate systems that store and process information separately, leading to challenges for healthcare providers under VBC arrangements accessing the data they need when they need it. Such fragmentation generates inefficiencies, administrative overhead, data gaps, and an incomplete understanding of patient needs.
In an ecosystem characterized by fragmented technological solutions and data, middleware serves as the essential connector. Middleware is not a buzzword but a foundational infrastructure that enables scalable, efficient, and outcome-focused value-based care.
Middleware as the Bridge to Scalability
Middleware is a critical integrative layer that bridges disparate technologies, data, and stakeholders. Rather than replacing existing systems, middleware works in tandem, creating a seamless network that unifies isolated data into a comprehensive and actionable resource.
Consider how you might split a dinner bill with friends and use Venmo as the primary interface to send and receive money. Venmo is powered by Plaid, a middleware technology that acts as a middleman between financial applications and banks, allowing users to seamlessly interact with their bank accounts within apps like Venmo. When you send money to a friend, middleware technology ensures that your bank communicates with Venmo, and Venmo communicates with your friend’s bank, allowing these different systems to communicate smoothly without worrying about the complexity behind the scenes.
Middleware serves a similar role in healthcare. Like Plaid connects banks and financial applications to make user transactions seamless, healthcare middleware connects Electronic Health Records (EHRs) and other technologies and applications to give providers seamless access to critical patient-specific data. Middleware, combined with a provider-facing user interface (like Venmo), makes siloed data, applications, and insights actionable at the point of care, transforming value-based care from an aspirational concept into a scalable, operational reality. Instead of logging into separate systems or portals, providers can see the complete picture of a patient’s health right within their workflow, saving time and reducing administrative burden. That is the transformative power of middleware.
Breaking Down Barriers for Scalable VBC
While middleware has proven its ability to transform industries like finance and travel by integrating fragmented systems into seamless networks and user experiences, its potential in healthcare is even more profound. In value-based care, where the stakes are high and timely access to actionable data can mean the difference between success and inefficiency, middleware becomes not just a convenience but a necessity. At Vim, we’ve taken this foundational concept and tailored it specifically to the needs of VBC enablers and providers.
Our middleware platform integrates directly into clinical workflows within existing EHRs, breaking down the silos that have long prevented healthcare data and technology from reaching their full potential. By enabling curated data, applications, and patient-specific insights to flow directly within EHRs, we eliminate administrative barriers and enhance the provider experience, making it easier for the VBC pioneers and their provider networks to participate in VBC programs and scale them successfully.
When providers can access actionable data and novel technology that supports quality care precisely when needed at the point of care and without leaving their workflow, they can make informed clinical and operational decisions without hesitation. For instance, a healthcare provider using a middleware-powered platform can receive real-time alerts about preventive care gaps—such as overdue vaccinations or screenings—directly within their EHR with data from multiple sources. This information allows the provider to address these gaps promptly during a patient visit, ensuring patients receive timely interventions. This improves care quality and patient outcomes, reduces the need for follow-up administrative tasks, and supports the success of value-based care initiatives.
The Future of Scalable Value-Based Care Depends on Middleware
Building an infrastructure that connects rather than divides is becoming increasingly critical as we look to the future. Middleware is the solution to the scalability challenges that have held back value-based care. It is time to empower ACOs and other VBC organizations with a technology infrastructure that facilitates seamless care coordination and scales a model we know works and that our peers are ready to embrace.
The next era of healthcare demands scalability, efficiency, and outcomes-driven care—middleware is the key to achieving all three. For those on the value-based care journey, now is the time to embrace the transformative power of middleware.
