By Rob Stuart, Founder & President, Claim.MD

In the rush to scale value-based care (VBC), conversations often focus on care models, clinical outcomes, and quality measures. But there’s a quiet force in the background that determines whether those models can succeed: the revenue cycle. That’s why I was pleased to contribute a recent piece to Modern Healthcare on the overlooked but critical connection between revenue cycle management (RCM) and value-based success.

The article highlights the experience of GEOH, a provider support organization serving home health agencies navigating Medicaid complexity. When Indiana’s Medicaid system shifted from fee-for-service to managed care, GEOH’s partner agencies were thrown into operational chaos. Their challenge wasn’t clinical – it was administrative. They couldn’t get paid. And without financial stability, even the most mission-driven providers struggle to stay open, much less deliver consistent, coordinated care.

That experience reflects a bigger truth across the healthcare ecosystem: RCM isn’t just a back-office function – it’s a clinical enabler. If we want VBC models to truly deliver better outcomes and equity, we need to invest in the systems that support timely, accurate, and adaptable reimbursement. That includes clearinghouses, EHR vendors, payers, and anyone responsible for the digital rails of healthcare.

I hope this article helps broaden the conversation. We can’t talk about innovation and transformation without including the infrastructure that keeps providers financially afloat and patients consistently cared for. Read the full piece on Modern Healthcare here.