The Journey from Population Health to Value-Based Care

My transition to a value-based care consulting role prompted me to look over the years I’ve spent in the healthcare field. The models we talk about are the result of almost 40 years of thought-leadership, pilot programs, and commitment by many constituents to improve the healthcare system.

I’ll start by reflecting on the roots of value-based care.

Before “value-based care” became the rallying cry across healthcare, the foundation was being laid in the emerging field of population health. In the 1990s and early 2000s, leaders were asking a bold question: how do we improve outcomes for entire populations, not just treat individual episodes of illness?

I had the privilege of working at Health Decisions International alongside Dr. Donald (Don) Vickery, a true pioneer in this movement. Dr. Vickery believed that empowering individuals with knowledge and tools to make informed decisions about their health was the first step in transforming healthcare. He founded the Self-Care Institute, authored groundbreaking books like Take Care of Yourself and Taking Care of Your Child, and championed decision aids long before “shared decision-making” became standard language.

His vision—prevention, wellness, and consumer empowerment—set the stage for the population health strategies that later evolved into today’s value-based care models. When the Affordable Care Act introduced ACOs and bundled payments in 2010, the industry finally had a financial structure to match the philosophy Dr. Vickery had been advancing for decades.

Today, as oncology and other specialties move deeper into value-based care, I often reflect on how far the field has come—and on the foresight of leaders like Dr. Vickery, who helped us imagine a healthcare system where informed patients, healthier populations, and sustainable value could align.