Building Strong Provider Partnerships for Value-Based Care

Summary

Becker’s Healthcare Podcast: Building Strong Provider Partnerships for Value-Based Care

Release Date: February 4, 2026
Host: Scott King (B)
Guest: Christy Spencer (C), Vice President of Provider Partnerships, Elevance Health

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Episode Overview

This episode centers on the evolving nature of provider partnerships in the context of value-based care. Christy Spencer, a leader at Elevance Health, discusses practical strategies for building strong, mutually beneficial relationships between health plans and providers, with an emphasis on actionable incentives, digital enablement, and simplification. The conversation addresses industry challenges such as cost pressures, workforce shortages, and administrative complexities, offering concrete examples and future-focused insights for health plan executives and provider organizations alike.

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Key Discussion Points & Insights

1. Christy Spencer’s Background and Perspective

• [01:03] Christy introduces her role at Elevance Health, highlighting her leadership in provider partnerships and value-based strategy across Medicare, Medicaid, and commercial business lines.
• She brings multi-angle experience (hospital systems, primary care, health plans) and stresses the importance of practical, actionable, and supported value-based care.
• Quote:

  "Value based care only works when it's practical, when incentives are aligned, data is actionable and providers are genuinely supported and not overwhelmed."
  — Christy Spencer [01:35]

2. Evolving Provider-Health Plan Relationships

• [02:57] Relationships are shifting from transactional contracts toward pragmatic, interdependent partnerships.
• Key elements: effective engagement, well-designed incentives, and connected actionable data.
• Providers need friction reduced and clarity on what actions drive outcomes, not additional measures or reporting.
• Quote:

  "Providers don't need more measures or reporting requirements. What they need is help removing friction in their day to day operations, as well as clarity on what actually drives outcomes."
  — Christy Spencer [03:39]

3. Examples of Action-Driven Incentives

• [05:04] Elevance Health is expanding its pay-for-quality program:
  • Incentivizes providers to close quality care gaps and aligns/simplifies workflows.
• Quote:

  "We're beginning to expand our reach of inviting providers in to participate in our pay for quality program ... to close care gaps and aligns and simplifies the work."
  — Christy Spencer [05:12]

4. Bridging the Gap: Strategy vs. Execution

• [05:46] The industry is transitioning from fee-for-service to outcomes-based models.
• Elevance operates with value-based care at its core rather than as a pilot.
• Metrics:
  • In 2024, 65.5% of medical spend aligned to value-based care; 37% in shared risk (up from prior year).
  • Value-based providers in Medicare Advantage saw 3.9% lower MLR and improvement in 74% of STARS measures.
• Importance of integrating strategy into the provider’s workflow to reduce complexity.
• Quote:

  "The strategy is right, yet it really only works when it shows up simply and clearly. Ideally, it's directly within the provider's workflow..."
  — Christy Spencer [07:12]

5. High-Impact Investments & Initiatives

• [07:51] Partnerships—particularly with smaller and independent providers—are critical.
• Elevance’s national value partners extend capabilities to smaller groups: standardized data, closing care gaps, clinical prioritization.
• Focus is on ecosystem-wide improvement, not just larger providers.
• Quote:

  "The goal isn't to favor larger providers. It's really about lifting performance across the overall ecosystem to make value based care accessible and sustainable for providers of all sizes."
  — Christy Spencer [08:40]

6. Regulatory & Industry Practice Changes

• [10:03] Christy calls for simplification and standardization, especially in prior authorization and quality reporting.
• Administrative burden detracts from patient care; digital tools and AI are being adopted to streamline processes (e.g., claims review, provider data).
• Digital advances should remove, not introduce, friction.
• Quote:

  "I would simplify and standardize administrative requirements across the industry...particularly around two areas, prior authorization and quality reporting."
  — Christy Spencer [10:09] "We have enough adding to friction in the industry."
  — Christy Spencer [11:36]

7. Digital Tools Empowering Provider Partnerships

• [12:18] Elevance uses automation (e.g., post-call wrap-up summaries with issue detection and smart routing) to save time for associates and providers.
• Automation translates to roughly 1 million summaries a month, freeing up resources for patient care.
• Externally, these tools reduce provider administrative load.
• Quote:

  "Each month we're averaging about 1 million post call wrap up summaries, which translates into really meaningful time savings and better experience."
  — Christy Spencer [12:42]

8. Health Plan Margin Pressures & 2026 Strategy

• [13:46] Cost drivers: hospital prices, pharmaceuticals, technology, regulations.
• Elevance’s 2026 focus: optimize value-based portfolio, scale risk appropriately, deepen enablement, and drive outcomes and affordability through technology.
• Margin gains come from precise partnerships, calibrated risk, results-driven measurement—not just activity.
• Quote:

  "Margin improvement, from my view, comes from enabling the right partnerships at the right level of risk, with the right support, and measuring success by outcome and not activity."
  — Christy Spencer [15:25]

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Notable Quotes & Memorable Moments

• "Value based care only works when it's practical, when incentives are aligned, data is actionable and providers are genuinely supported and not overwhelmed."
  — Christy Spencer [01:35]

• "Providers don't need more measures or reporting requirements. What they need is help removing friction in their day to day operations, as well as clarity on what actually drives outcomes."
  — Christy Spencer [03:39]

• "We're beginning to expand our reach of inviting providers in to participate in our pay for quality program ... to close care gaps and aligns and simplifies the work."
  — Christy Spencer [05:12]

• "The goal isn't to favor larger providers. It's really about lifting performance across the overall ecosystem to make value based care accessible and sustainable for providers of all sizes."
  — Christy Spencer [08:40]

• "I would simplify and standardize administrative requirements across the industry...particularly around two areas, prior authorization and quality reporting."
  — Christy Spencer [10:09]

• "We have enough adding to friction in the industry."
  — Christy Spencer [11:36]

• "Margin improvement, from my view, comes from enabling the right partnerships at the right level of risk, with the right support, and measuring success by outcome and not activity."
  — Christy Spencer [15:25]

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Timestamps for Key Segments

• [01:03] - Christy Spencer’s background and approach
• [02:57] - Changing landscape of provider-payer relationships
• [05:04] - Action-based incentive programs
• [05:46] - Operationalizing strategy; value-based care performance data
• [07:51] - Investment in partnerships, support for smaller providers
• [10:03] - Regulatory reforms: standardizing administration
• [12:18] - Digital automation tools and their impact
• [13:46] - Margin pressure drivers and strategic responses

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Conclusion

This episode provides actionable insights into how health plans like Elevance Health are fostering deeper, data-driven partnerships with providers, using technology to reduce friction, and striving to align incentives and support across all provider types. The focus remains on outcomes, simplification, and scalability, moving the industry closer to a truly connected care ecosystem.

Transcript

[A]

This is where health insurance leadership comes together. Becker's 4th Annual Spring Payer Issues Roundtable brings together over 400 payer and health plan executives and more than 100 speakers to Chicago, April 13th and 14th. This year's event includes keynote conversations with the industry's top leaders and former President George W. Bush. For the full agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you here in Chicago.

[B]

Hello everyone and welcome to the Becker's Healthcare Podcast. I'm Scott King, thrilled today to be joined by a very special guest, Christy Spencer, Vice President, a provider partnerships with Elevance Health. Christy, how are you? Thanks so much for joining the podcast.

[C]

Yeah, I'm doing great. It's great to be here with you today.

[B]

You know, we have a lot of big topics new year, but some, some new topics and some old ones to get into in health care and with health plans. But before kind of jump into those, Christy, I was wondering if you could please just share a little bit about your background and your career journey.

[C]

Yeah, absolutely. So as you said, I'm the Vice President for Provider Partnerships at Elevance Health. In that role, I lead our national strategy for provider partnerships and value based care across our Medicare, Medicaid and commercial lines of business. So really focusing on improving cost, quality and our member experience. I bring a unique perspective to this work because I spent my career in health care, viewing health care from multiple different angles. So I've held leadership positions at hospital systems, primary care organizations, health plans. I've run value based physician partnerships with full PNL accountability. I've worked directly with providers as they have transitioned from fee for service into downside risk models. So that really, that experience really shapes how I approach the role. So I've seen firsthand that value based care only works when it's practical, when incentives are aligned, data is actionable and providers are genuinely supported and not overwhelmed. So my focus at Elevance is on enabling provider success, reducing friction and building partnerships that deliver measurable outcomes for providers, members and for the business.

[B]

Thank you Chrissy and appreciate you sharing all that background info. And yeah, you definitely have a unique perspective and not only are going to lean on that for with you today in the podcast, but we're really looking forward to having you speak at our event in April at the Spring Payer Issues Roundtable. So excited to have you there. And you know, the first question I want to get to from your perspective and something we hear about at our conferences especially, is how relationships are changing a bit, evolving a little bit with health plans and providers. How are your relationships with providers changing as both sides face, you know, right now, cost pressure and workforce shortages?

[C]

Yeah, that's such a great question. Those challenges are real. Provider relationships are becoming more pragmatic and interdependent as we look at the landscape, costs, workforce challenges and just overall industry complexity. It's forcing us to shift away from transactional contracting to true partnerships at a high level success from my provider partnership background, and it really requires three things working together. Effective provider engagement, well designed incentives, and connected actionable data. When those elements are aligned, you can really begin to create a connected care ecosystem. So what's changing most is the conversation. Providers don't need more measures or reporting requirements. What they need is help removing friction in their day to day operations, as well as clarity on what actually drives outcomes. That means designing incentives that focus attention on actions that matter most and investing in dedicated engagement teams that can meet providers where they are and delivering data through unified platforms that providers can actually use. When you combine that with innovative use of technology and artificial intelligence, you can really start to lower cost, improve outcomes and reduce burden all at the same time. Our strongest provider relationships today are the ones that are built on trust and shared accountability and a real commitment to making it easier to deliver care, not making it more complex.

[B]

Absolutely. I think those are a lot of things. They'll definitely strengthen that provider relationship with health plans. And Christy, do you have, do you have an example of. I think it was a great point you made. Do you have an example of an action driven incentive that you're trying to incorporate or have incorporated?

[C]

Yeah, one of the things that we're doing is really focusing around quality outcomes and looking at how do we reward providers for closing quality care gaps. So we in this year are beginning to expand our reach of inviting providers in to participate in our pay for quality program that really incentivizes providers to close care gaps and aligns and simplifies the work for them to actually do that. So we're super excited about being able to expand that program this year.

[B]

Where do you see the biggest gap right now between payer strategy and operational execution?

[C]

Yeah, I don't know that I would describe it necessarily as a gap, maybe more as a moment of transition for the industry. The future of healthcare really has to be built around outcomes. We've focused so much on transactions in the past. And moving forward, I think we really have to focus on aligning around incentives that improve health versus just focusing on delivery of services. Value based care for Elevance health. It isn't a pilot, it's not a site initiative. It's truly how we operate. You can see that embedded in our provider partnerships in the way that we're designing our products and how we're engaging our consumers. The results that we're seeing are real. In 2024, 65.5% of our total medical spend was aligned to value based care and 37% of that was in shared risk, which is an increase over the prior year. And the impact of that, the outcomes are really impactful. In our Medicare Advantage plans, we're seeing that value based providers demonstrated 3.9% lower MLR compared to non value based providers. And they've outperformed year over year on nearly 74% of our STARS quality measures. Additionally, 76% of our value based practices improve their overall STARS performance in that same period. The strategy is right, yet it really only works when it shows up simply and clearly. Ideally, it's directly within the provider's workflow where it can really reduce complexity. That's where the next phase of operational excellence really matters.

[B]

Along the same lines of reducing complexity. Christy, what's one investment or initiative you believe will most reshape how health plans operate over the next two to three years?

[C]

That's a great question. As I stated in my intro, I've worked across multiple components of the healthcare ecosystem. Hospitals, physician groups, health plans. And that perspective has reinforced one thing for me. Partnerships, when done well, are one of the most powerful levers that we have. Many providers, particularly smaller and independent groups, are operating in constrained environments. They have the ability to succeed in value based care, but they often just don't have the scale, the infrastructure or the support that's needed to make that transition effectively. That's where our national value partners play a really critical role. So we work with these partners to extend capabilities to smaller provider groups and they help those smaller provider groups standardize data flows, close care gaps and prioritize interventions that actually move outcomes at a clinical level. The goal isn't to favor larger providers. It's really about lifting performance across the overall ecosystem to make value based care accessible and sustainable for providers of all sizes. When payers and these national value partners team up with our local providers and share knowledge and operate in an integrated system, everyone benefits. Providers get the tools and support they need. Health plans see better cost and quality performance and members receive more coordinated and proactive care. So it's a true partnership model that's focused on enabling, that's really what's going to help reshape how health plans operate over the next few years.

[B]

Yeah, I really like that point about lifting performance across the board and kind of focusing there and not just, you know, it's just not just about paying attention to the big ones. I think, yeah, everyone benefits from that and it's such a great use of time and effort to focus on that. If you could change one regulatory or industry practice tomorrow to improve affordability and access, what would it be and why?

[C]

Yeah, that's another great question. You know, I think there's such a need for simplification in the industry. So I would simplify and standardize administrative requirements across the industry, particularly around two areas, prior authorization and quality reporting. Traditionally, health plans are focused on paying for care, managing cost and ensuring quality. Today though, we recognize that most of the drivers of health happen outside of the clinical setting. In excessive administrative burden, it really pulls time and resources away from where it matters most. At Elevance Health, we're using advanced digital tools and artificial intelligence to make healthcare simpler and more affordable and more personalized. This empowers our care providers to enhance health outcomes. So for example, we're using digital tools to help identify care gaps quickly and support treatment decisions and that really is helping improve health outcomes. We're also appropriately leveraging digital technologies for tasks like claims review and provider data updates. And it's helping us to ensure smoother and faster service. As a result, AI enabled tools are cutting down on time consuming tasks so care providers can focus more time with patients. My hope is that a more holistic and streamlined approach becomes the norm. One where digital advances are used to personalize care and eliminate friction, not add to it. We have enough adding to friction in the industry. So again, success really, really comes back to those three key elements working together in concert. Effective provider engagement, well designed incentives and connected data working together. So the big picture is then a connected care ecosystem.

[B]

Yeah, I think digital tools are obviously making a huge difference for health plans right now in so many regards. What digital tool do you think has helped elvince the most?

[C]

Yeah, I think that we're really focused on. There's several digital tools that we're working through. One of them is that we are using digital technologies to automate our post call wrap up summaries and we're incorporating issue detection and smart routing into each of those calls, which really helps to improve our associates ability to manage large call volumes and enhance the customer experience. Each month we're averaging about 1 million post call wrap up summaries, which translates into really meaningful time savings and better experience. Then we're using those same capabilities externally to help providers spend less time on administrative work and more time with patients. So that whether it's time spent reviewing claims or processing provider data updates, or identifying care gaps, the goal is really the same. We're simplifying how we work, we're personalizing experience and really empowering providers to enhance health outcomes.

[B]

That's incredible. Not only think about how much time is saved with that, but what people can do with that time. I think that's phenomenal. The last question I have for you, Christy, what issue is putting the most pressure on health plan margins right now? And how are you responding differently? Or how will you respond differently in 2026? Here.

[C]

Yeah, and we touch on that a little bit. Yeah. Health care costs, they're shaped by many forces. Hospital prices, pharmaceutical cost, health insurance costs, advances in technology, changing regulations. We all have a role to play across the entire healthcare ecosystem to help make sure that members are receiving the care that they need at the most affordable cost. It's a really important focus for elevance in 2026. My provider partnership team is focused on optimizing our value based portfolio and scaling risk where providers are ready and investing in enablement to really truly drive health care outcomes and affordability. And as we've talked about previously, technology and AI are such a critical part of that. And it's not about creating tech for tech's sake. The main goal really is about improving the healthcare experience for both providers and members. I talked a little bit about internal automation and how much time we're able to spend, or how much time we're able to save by removing those manual tasks and, and allowing greater focus for our members and for their experiences. And we're deploying those same capabilities for our care providers to really do the same and really enabling them to focus their time with patients. So margin improvement, from my view, comes from enabling the right partnerships at the right level of risk, with the right support, and measuring success by outcome and not activity. Again, success comes from those three elements working together. Effective provider engagement, well designed incentives, and connected actionable data. When those elements are aligned, you can really start to create a connected care ecosystem that produces better outcomes and affordability for our members.

[B]

Christy, thanks so much for joining the podcast. It was a great conversation. I look forward to working with you again soon.

[C]

Likewise. Thank you so much for your time and for having me today.