Ready to Shift? 90% of Providers Are Interested in Value-Based Care

Adoption of value-based care (VBC) models is growing in U.S healthcare, and the dental industry may be doing more than simply keeping pace. According to a 2024 HealthScape report, within the next two to five years, 100% of the payers with more than five million members and 35% of payers with less than five million members plan to implement VBC. 

Are dental providers on board? SKYGEN’s 2025 PULSE Report indicates they are. Not only are a large majority (90%) of providers interested, but 87% of providers surveyed view value-based care models positively, and 89% believe value-based care models add value to their practice. Read more in the eBook.

Benefits for Payers, Providers and Patients
In VBC models, the emphasis is on prevention, patient satisfaction, and overall oral health, rather than the volume of treatments or services provided. VBC can create benefits for payers that are especially important in today’s healthcare environment, including:

• improved outcomes and cost control
• alignment with broader healthcare trends
• potential for better data and reporting

These models are also attractive to providers, as VBC puts the focus of oral healthcare services on prevention, integration with medical care, and patient satisfaction. However, as an article in The Journal of The American Dental Association suggests, the transition from fee-for-service to VBC requires “ clinical, financial, organizational, educational, and cultural paradigm shifts.” Implementing data analytics, agreeing on meaningful measures of oral health outcomes, and improving patients’ oral health literacy are just some of the challenges payers face on the road to VBC models.

SKYGEN Transforms Payer Challenges Into Advantages 
SKYGEN helps payers make a smooth transition to value-base care with technologies that simplify planning and adoption of VBC. SKYGEN also partners with payers to help them align provider incentives with quality outcomes. SKYGEN solutions that support payers implementing VBC include: 

• Provider Select Suite – This solution includes a Rating Tool, Recognition Program, and Enhanced Find-a-Provider to help dental payers to spotlight top-performing providers who consistently deliver exceptional care. More than just recognition, the Provider Select Suite creates alignment across the entire ecosystem—payers, providers, patients, employers, and state partners—uniting them around a shared mission: delivering high-quality, effective care while driving down costs. Learn more in our FAQ.
• Reimbursement Analysis – SKYGEN offers this service as part of the Enhanced Benefit Management & Analytics solution. After analyzing a payer’s reimbursement schedules and methodologies at both the provider and the program level, SKYGEN’s team of experts can develop recommendations and a plan to transition to VBC reimbursement models.
• Third-Party Dental Benefits Administration – SKYGEN’s end-to-end TPA services support VBC for dental on many fronts, including facilitating dental home care models and integration of automated incentive benefits into dental programs. 
• SKYGEN’s Dental Benefits Automation – The Enterprise System makes it fast and efficient to adjust dental programs to respond to changing markets, including the transition to VBC.  
• Patient/Member Connectivity – With SKYGEN’s Member Mobile App and self-service Member Portal, it’s easy for members to understand and use their dental benefits. Payers can push messages and share information that helps to improve members’ oral health literacy and program engagement.

Value-based care has the potential to alleviate many of the struggles dental payers face today. By focusing on outcomes instead of volume, payers can support better patient experiences, stronger provider partnerships, and meaningful cost savings. SKYGEN partners with payers to help them move confidently toward a system that rewards quality—and results.

To find out more about VBC’s potential for your dental program, request a call from a SKYGEN dental benefits administration expert. 

This is the second article in a series that uncovers strategies for payers to strengthen dental and vision provider relationships, boost revenue, expand networks, and enhance both provider and member experiences with innovative technologies. Read the first article.