96% of AHIP 25 Attendees Surveyed Rank Value-Based Reimbursement Optimization as Top Priority, Black Book Pre-Event Poll
Health Plans and Payers Align Around VBRO Technology to Meet CMS Payment Reform Demands; Top-Rated Vendors Identified for Impactful Results
LAS VEGAS, NV / ACCESS Newswire / June 12, 2025 / In preparation for AHIP 2025, Black Book Research surveyed 849 health plan and managed care leaders nationwide to evaluate current technology priorities and strategic investments, with half indicating they are AHIP attendees this year. Results overwhelmingly indicate that Value-Based Reimbursement Optimization (VBRO) is now critical to organizational success under CMS and state payment reforms.
Health plans utilizing top-rated VBRO solutions report up to an 81% improvement in cost containment, risk adjustment accuracy, and outcomes-based financial performance, highlighting the urgency for payers to modernize reimbursement infrastructures amidst increased CMS scrutiny and evolving alternative payment model (APM) requirements.
20 Top-Rated Vendors Driving Value-Based Reimbursement Optimization for Health Plans
Alphabetically Ranked by Surveyed Payer and MCO Leaders, Black Book Research Q1-Q2 2025
Vendor
Honored Payer-Centric VBRO Capabilities
Arcadia
Population health analytics enabling payer-driven quality tracking and member risk identification across VB programs.
Carelon Digital Platforms
Member engagement tools supporting Star Ratings, care-gap closure, and VB outcomes.
Cedar Gate Technologies
Bundled payment analytics for payers managing shared savings or downside risk.
Cotiviti
Comprehensive VB analytics, payment integrity, and quality monitoring aligned with Medicare Advantage incentives.
FinThrive
Real-time revenue insights, predictive VB payment modeling, and alignment with payer goals.
FTI Consulting
Strategic advisory for MCO transformation to outcome-based payment and member cost-value optimization.
Gradient AI
AI-driven underwriting and predictive tools for VB contract performance forecasting.
HCL America
Infrastructure integration supporting VB model administration and CMS compliance.
HealthEdge
VB administrative platform with automated contract management, claims integration, and provider reporting.
Innovaccer
AI-powered population health data platform providing payer-focused VB analytics and risk management tools.
Inovalon
Cloud-native tools for prospective risk adjustment, quality scoring, and audit preparedness.
IQVIA
Real-world analytics for evaluating cost-effectiveness and VB outcomes across populations.
Lumeris
Value-based operating system optimizing ACO and Medicare Advantage performance.
MedeAnalytics
Payer-focused business intelligence platform tracking quality, financial, and VB contract KPIs.
Milliman
Actuarial and data tools for shared savings optimization, bundled payments, and VB risk management.
Optum
AI-enabled solutions for provider alignment, utilization review, and VB financial performance monitoring.
Oracle Health
Cloud-based payer systems for VB claims processing, compliance, and financial outcomes tracking.
Persivia
Remote monitoring platform integrating SDoH into payer-side VB risk and quality models.
Premier Inc.
Analytics and collaborative tools supporting Medicaid MCOs and ACO quality management.
Veradigm
Data-driven insights for population-level risk management and commercial/public payer VB programs.
Why This Matters for Health Plans and Managed Care Organizations Now
With CMS rapidly expanding alternative payment models, payers face increased responsibility for managing downside risk, quality transparency, and medical loss ratio compliance. States including New York, California, and Texas have aggressive Medicaid value-based purchasing mandates, intensifying pressure on Medicare Advantage and commercial plans to deliver measurable outcomes.
“Health plans can no longer afford reactive strategies,” said Doug Brown, President of Black Book Research. “The vendors recognized in this report deliver proactive, quantifiable outcomes aligning closely with value-based mandates, making them essential partners for managed care executives at AHIP 2025.”
About Black Book
Black Book Research, celebrating its 20th anniversary in 2025, is the healthcare industry’s trusted source for unbiased, crowdsourced satisfaction insights. This report, derived from a national survey of nearly nine hundred health plan IT users and payer executives with a 95% confidence level, benchmarks VBRO solutions supporting Medicare Advantage, Medicaid Managed Care, and commercial alternative payment models.
For licensing the full report or accessing benchmark analytics, contact [email protected] or visit www.blackbookmarketresearch.com. Black Book also offers numerous gratis reports for stakeholders on the website.
Contact Information
Press Office
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SOURCE: Black Book Research
View the original press release on ACCESS Newswire
The post 96% of AHIP 25 Attendees Surveyed Rank Value-Based Reimbursement Optimization as Top Priority, Black Book Pre-Event Poll appeared first on European Business & Finance Magazine.
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