In the fourth and final session of the Chief Network Officer Roundtable, a panel of experts brought the conversation down to earth with practical, tested strategies for modernizing provider networks.
This session featured insights from Darla McGahee, VP of Network Development, XO Health, Colin Blaney, Senior Partner, HealthScape Advisors, and Mike Ferson, Senior Partner, HealthScape Advisors, who shared perspectives on the evolution of value-based care (VBC), the role of data and technology, and what it takes to support members and providers in a shifting environment.
Redesigning value-based care for what’s next
The discussion opened with a look at where value-based care stands today. Many legacy VBC models have hit a ceiling, especially in commercial markets where traditional primary care-led programs struggle to generate further savings.
But rather than declare the model broken, the panelists advocated for refining and expanding it. The next wave will focus on engaging specialists in meaningful, episode-based contracts and designing models that reward existing high performers—not just those who can bend a trend line.
“Going forward, the winners will be those who identify truly high-performing physicians and then create a sustainable value proposition that includes volume, reduced administrative burden, and aligned incentives.”
A model that works for providers and patients
Darla McGahee shared how XO Health has taken a fresh approach to network design with its episodes-of-care model. By combining predictable pricing, minimal administrative burden, and member-friendly billing, XO Health has created a framework that appeals to providers, meets employer expectations, and ensures better access and outcomes for members.
She emphasized that XO Health doesn’t ask providers to take on risk outside their scope of control, and instead pays claims in full upfront, handling cost share collections directly with members. That shift alone has earned strong support from provider groups and health systems.
“If we’re asking physicians to take on risk, then the plan needs to get out of the way. That means eliminating unnecessary prior authorizations and handling member cost shares ourselves, so care isn’t delayed and providers can focus on what they do best.”
The tech and data infrastructure still has work to do
The conversation came full circle when panelist Colin Blaney began highlighting how technology—and more importantly, the way organizations use it—must evolve to keep up with the new models being developed.
Legacy platforms still dominate many health plans, making true data interoperability difficult. Even when data is captured, it’s rarely embedded into workflows in a way that informs decision-making across teams. But the panelists remain optimistic as plans are beginning to think more holistically about data strategy, interoperability, and provider quality measurement, and are building the maturity models to get there.
“You can’t just capture data. You have to embed it into the right workflows. The organizations that align technology, governance, and operations around a shared strategy will be the ones that lead in the next generation of network performance.”
The future is cross-functional (and closer than it seems)
What stood out most from this session was the degree of alignment across disciplines. Whether from the lens of plan design, technology infrastructure, or provider engagement, the message was the same. The future of network strategy is cross-functional. Plans that can break down silos, align on shared goals, and act with purpose will be positioned to lead.
As value-based care evolves and new tools emerge, the CNO’s role will only grow in importance—bridging the gap between clinical performance, member outcomes, and strategic growth. This next era of network leadership will require a coordinated focus on the needs of the plan, the provider, and the member, as each are essential to building a truly high-performing network lifecycle.
If your team is ready for the next step and you want to start building better relationships and a higher-performing network, Andros’s NLP Transformation Services are ready to support you. Reach out to learn more today!
Did you miss the live webinar? We’ve got you. You can watch it back anytime you’d like on-demand.
And, in case you missed it, you can also watch the other three sessions of the Chief Network Officer Roundtable here:
