Rising costs, an aging population, and increasing chronic disease are putting real strain on the U.S. healthcare system. A recent McKinsey analysis makes it clear: the current model isn’t sustainable, and the industry needs a new path forward.

To respond, organizations across the sector should consider four outcome-focused models that balance cost, quality, and access: 

• Shifting-sites-of-care (episodic care): Moving elective procedures and care (e.g., joint replacements) from hospitals into ambulatory centers or home settings. This can cut costs by 8–10 % while improving convenience and maintaining quality. 
  
• Payer-led utilization, benefit & care management: Using data and analytics to identify high-risk patients, manage chronic diseases, and intervene early. This model can reduce the total cost of care by 2–3%.
  
• Primary-care provider (PCP)–led, value-based care (VBC)/risk-bearing models: Comprehensive care and chronic disease management through coordinated care and risk-sharing. Where implemented well, these can shrink costs by 6–10%. 
  
• Specialty-led care for complex diseases: Integrated, high-touch specialty networks for conditions like oncology, nephrology, orthopedics, and behavioral health. In some specialties (e.g., nephrology or oncology), cost reductions of 8–10%, and in the case of kidney disease, up to 25–27% appear possible

But McKinsey emphasizes that none of the models are silver bullets — realizing value at scale requires aligning payment mechanisms, investing in enabling technologies (data, analytics, automation), addressing regulatory and operational barriers, and coordinating across stakeholders. 

Bottom Line for Leaders: Healthcare organizations must rethink not just how care is delivered — but how it’s financed and organized. By embracing innovative, outcome-oriented care models, the sector has a real opportunity to deliver high-quality, cost-effective, and equitable care for growing and aging populations.

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Jim Thomas is a Senior Sales Executive focused on Healthcare for Ascend, Inc., a UKG Premier Partner. If UKG optimization, data accuracy, and operational efficiency are a priority for your organization, please contact Jim here.