All-Payer Models &
the Path to Sustainability

As the movement toward value-based care matures, the fragmentation across Medicare, Medicaid, and commercial payers continues to stall impact and scale. All-payer models and total cost of care frameworks are emerging as a path forward—aligning incentives, removing administrative friction, and shifting the industry from transactional reimbursement to coordinated, population-focused care.

In this recorded discussion, Dr. Dennis Weaver, Chief Clinical Officer at Pearl Health, sits down with Jessica Moschella (SVP, High Value Care, University of Vermont Health Network) and Stephen Rosenthal (SVP, Population Health, Montefiore Health System) to unpack the strategic, operational, and policy challenges of implementing all-payer VBC models—and what it takes to succeed.

They explore the infrastructure gaps facing rural and urban systems, the tension between reference-based pricing and true value models, and how care management, data interoperability, and aligned incentives are key to navigating chronic disease, aging populations, and regulatory complexity.

What will you learn?

• What all-payer, total cost of care models aim to solve—and how they differ from fragmented contracting or reference-based pricing
• How rural and urban health systems are adapting care coordination models to serve diverse populations with chronic disease and complex social needs
• Why infrastructure readiness—data interoperability, financial modeling, care teams—remains a barrier to scaling VBC and how leading systems are tackling it
• What health systems need from policymakers to make these models sustainable, and how leadership mindset plays a role in long-term transformation