Why the Next Chapter of Value-Based Care Runs Through the Independent Market
About 42% of U.S. physicians work in private practice, according to the AMA’s 2024 benchmark survey. That share was 60.1% in 2012, which makes the practices that remain independent more important to reach, not less. They operate outside the large hospital-owned systems that most payer technology was built around. They often treat a health plan’s most complex, highest-cost, and hardest-to-reach members, frequently in communities with the fewest alternatives.
That makes independent practice as much a payer-side opportunity as a provider-side story, even though the conversation about it has stayed mostly on the provider side.
Affordability pressure is coming from both directions
Healthcare is feeling the squeeze from both ends at once. Payers have to manage cost trend without compromising member outcomes. Independent and community-based providers are stretched thin trying to deliver preventive care with shrinking administrative bandwidth of their own. Each side’s fix tends to land on the other side’s desk, which is how a cost problem becomes an administrative one.
For years, the industry built technology to solve each side of that problem separately and treated the independent market as a footnote. That approach has run its course.
Two problems, one root cause
A payer can only manage cost trend by catching care gaps early and understanding each member’s real risk profile. That information then has to reach a provider before a routine issue becomes an expensive one. A provider’s ability to deliver that care depends on accurate, timely information at the point of care, without another system to log into or another workflow to learn.
Take a missed screening. The plan sees the gap in claims data, but the practice only learns about it if someone tells them. If an alert reaches the clinician in the EHR before the patient leaves, the gap can close that same day. Both sides are working the same problem from opposite ends of one data pipeline. When payer analytics, clinical data exchange, and provider workflows are built as separate investments, the industry pays twice for infrastructure that was always meant to be one connected system. Improving payer provider collaboration starts there, inside the workflow where care happens, and it builds on the kind of payer-provider relationship that rests on shared, reliable data.
Why independent practices are hard to reach with point solutions
Many independent practices run lean administrative teams. Every extra portal, manual data request, or chart pull competes with patient care for the same limited time. A health plan that adds one more outreach channel, however well designed, is asking a stretched practice to absorb more work. Plans have also learned that portals no one uses add cost without adding reach. Practices also differ in size, specialty, and workflow, so a request built for one rarely fits all.
That is why plans tend to see the best results when information reaches the provider where they already work, in the EHR, at the moment of care. A care gap that closes during the visit costs less to pursue than one chased by outreach weeks later, and it leaves the practice with fewer requests to manage.
Veradigm’s position in the independent market
Veradigm built this position from the provider side up. Long before payer analytics existed as a category, Veradigm was building the EHR relationships that connect independent, community-based providers to the rest of the healthcare system. That heritage puts Veradigm on both sides of the value-based care equation. It is an EHR vendor with deep, established reach into independent physician practices, and a payer technology provider building infrastructure for that same market.
That combination is rare. It also matches what the next chapter of value-based care requires, which is one connected view that serves the plan and the practice together. For plans, that means fewer handoffs between the system that finds a gap and the practice that closes it. Veradigm’s work to help independent providers close care gaps with confidence is one example of how that plays out at the point of care.
Built on infrastructure that already spans both sides
This is not a hypothetical. In May 2026, Veradigm launched its Health Network Architecture. It connects the clinical, financial, and operational systems independent practices already use, including EHR, practice management, clearinghouse, and patient portal, into one real-time view. As Tehsin Syed, Veradigm’s Chief Product and Technology Officer, put it at launch, “For years, healthcare technology added a new tool for every new requirement, but never a way to make them work together. Veradigm Health Network Architecture changes that.”
The payer impact of that shift is direct. Care gaps that close during the visit lower outreach costs and improve risk adjustment coding accuracy. Chart retrieval that once took weeks now takes minutes, because it runs on standards-based FHIR APIs instead of months-long custom integrations.
Veradigm Payer Platform spans analytics, clinical data exchange, and submissions on that same connected infrastructure. It helps more than 20,000 provider practices connect with health plans and biopharma, and it supports more than 80 health plan clients and over 20 million patients today. It was named the number one Black Book Payer Analytics provider in 2024 and 2025, and number two in KLAS Risk Analytics in 2025 and 2026.
Questions worth asking your plan
If you are improving payer provider collaboration with the independent market, a few questions show where your plan stands today:
- When analytics identify a care gap, does it reach the provider inside the EHR during the visit?
- Can your team retrieve supporting documentation without asking practices to use another portal?
- Are you reaching independent physician practices as consistently as hospital-owned ones?
If the answers are mixed, the gap is probably in the connection between payer and provider systems, not in either side’s effort.
Where this goes next
That shift also changes how plans measure success: by how many gaps close during the visit, not only by how many outreach attempts go out. The plans and providers who benefit most from where value-based care is headed will be the ones who stop treating the independent market as a footnote. The conversation might be about payer technology, provider connectivity, or which market segment matters most going forward. Either way, the answer keeps coming back to the same 42%. Improving payer provider collaboration depends on shared infrastructure that gives both sides the same view of the member.
For a closer look at how Veradigm Payer Platform connects health plans with the independent practices treating their members, visit Veradigm.com.