Why Efficiency Without Outcomes Is Just Automation Theater…
AI in value-based healthcare is finally showing its muscle.. Platforms like Hinge Health, Sword Health, and others are enabling providers to triple their patient panels. Of course, there are multiple startups claiming lower costs, improved access, and streamlined operations. Tech leaders are proclaiming this as the golden age of healthcare efficiency (notice efficiency isn’t the same as effectiveness?).
But here’s the question no one seems to be asking:
Does any of this actually improve outcomes that matter to patients?
Because when you strip away the dashboards and startup buzz, healthcare is still about one thing: delivering better outcomes at lower cost. That’s the core of value. And right now, too many systems are chasing “cool” artificial intelligence products without a plan to define or measure value.
The Difference Between Activities and Outcomes
AI is good at reducing effort. It can help automate workflows, summarize charts, and optimize clinician time. That’s great. But effort alone isn’t the goal.
Healthcare leaders must ask:
- Does this technology improve remission rates?
- Does it lower readmission rates or reduce chronic disease burden?
- Does it improve functional outcomes, not just response time?
AI may be scaling capacity. But without outcome tracking, we’re just scaling noise.
Where the Value Management Office Comes In
This is exactly where a Value Management Office (VMO) or system-led value team earns its keep. Not as bureaucrats. As outcomes enforcers.
Their job? Make sure every tech investment (especially AI) is mapped to actual clinical outcomes, linked to cost, and validated against meaningful benchmarks.
If you’re installing AI that saves 10 minutes per chart but doesn’t reduce medical error, you’re not improving value. If your virtual care tools increase access but don’t reduce A1C or ED visits, you’re not moving the needle.
Value = Outcome / Cost.
Not Hype / Activity.
A Checklist for AI-Driven Value
If your organization is deploying AI, here are three questions to force a value conversation:
- What outcome are we improving?
- Be specific. Avoid proxies. Pick a patient-centered result that matters (e.g., focus on a patient condition like reducing high blood sugars for Type I diabetics).
- Can we measure it?
- Pre/post data. Cost. Variation. Real-world performance, not just controlled pilots.
- Is this scalable and sustainable?
- Does it work outside the demo? Does it reduce cost per outcome long-term?
Tie-In to Federal and Commercial Use
Federal agencies are thinking about it, but don’t quite get it right because it’s not a “check-the-box exercise. For example, certain federal agencies could pilot outcome-linked AI programs that target radiology backlog reduction, diabetes monitoring, and chronic disease management. In other words, don’t focus on just the cost side, and ignore the outcomes side. At VA, we previously implemented my Value Realization Framework © and reduced veteran suicide events by 28% at 54% less cost. With the advent of AI it makes me wonder how we could take that to the next level and deliver even better outcomes?
Private companies like Omada Health is doing good things. They are tying digital interventions to measurable results in diabetes prevention and weight loss. The difference? They defined success before implementing tech. Other health orgs. are doing similar pilots and exploring how to leverage AI too.
The Bottom Line
AI can reduce effort. But only value management ensures it improves outcomes.
Efficiency isn’t enough.
Buzzwords won’t heal patients.
Dashboards don’t guarantee results.
Want to raise the standard? Then start here:
Define what good looks like. Measure it. Link it to cost.
And if you want a tactical playbook for how to do that, I wrote one: Value Management in Healthcare. It’s not theory. It’s a system to GSD.
Let’s stop chasing shiny objects and start measuring what matters… outcomes focused on the patient’s medical condition.
If interested, here’s some more thoughts on value in healthcare: What Value Does Your Healthcare Actually Deliver