Governments and healthcare organizations around the world are chasing a similar goal — better outcomes for the money they spend.
That is the promise of value-based care. It links payments with health outcomes compared to volume-based models, which reward providers for the number of times they see a patient. Success in adopting value-based care varies by region and is often slowed by silos between those payers, providers, and government, as well as outdated technology infrastructures. Breaking down those barriers is essential for scaling innovative ideas.
In Saudi Arabia, the transition to value-based care is entering a pivotal phase. Under Vision 2030, which was launched in 2016, the Kingdom has been working to modernize the healthcare infrastructure and shift toward a value-based payment model by the end of the decade.
Pilot projects across the Kingdom are showing positive results, including broadening access to care, linking more patients to dedicated care teams, and updating technology. But gains are frequently contained within individual projects rather than being spread across the system. Stakeholders point to execution as the main barrier: fragmented incentives, inconsistent data, and unclear ownership are preventing proof points from scaling.
Our research, conducted alongside Saudi Arabia’s Center for Value in Health, shows that greater collaboration across stakeholders is essential for aligning incentives and creating more broadscale success.
This article draws on structured, cross-sector interviews across Saudi Arabia, quantitative perception scoring across five adoption dimensions, and sentiment analysis of interview transcripts to describe what enables — and what slows — wider adoption of value-based healthcare (VBHC) in the Kingdom.
What stakeholder perceptions reveal about value-based healthcare adoption
The research found a widening divide in how VBHC is perceived. While innovators and early adopters reported meaningful results, most interviewees remained cautious due to operational complexity and alignment challenges. This pattern mirrors Everett Rogers’ Diffusion of Innovation framing and helps explain why successful pilots have not yet become routine practice.
Voices from the industry illustrate the divide. One senior leader at a regulatory body said, “I have lost belief in VBHC; it is too hard to implement, and I am not sure the region needs it now.” By contrast, a chief medical officer at a private provider noted, “The patient data from VBHC driven interventions revealed real time perceptions of the needs of the patients.”
Why value-based care scores high but still struggles to scale
Stakeholders scored VBHC across five adoption dimensions (that are reflective of the Diffusion of Innovation theory). The results show strong belief in the benefits of VBHC, but also highlight concerns with the complexity of making the transition:
- Relative advantage (4.9/5): Stakeholders overwhelmingly see VBHC as delivering better patient outcomes and clinical effectiveness
- Compatibility (4.8/5): VBHC is viewed as aligned with organizational missions and national priorities
- Complexity (2.3/5): Stakeholders view implementation as challenging, citing unclear roles, multifactor coordination, capability gaps in data standards and change management, and clinician hesitancy
- Trialability (4.6/5): Stakeholders are confident in piloting innovations
- Observability (4.4/5): Visible results help build trust and support diffusion
An important takeaway is finding ways to not just celebrate wins from pilot projects, but also building on the momentum to scale them and encourage peers to adopt similar approaches. “We have generated data showing better patient outcomes, fewer complications, shorter lengths of stay, and increased volumes,” said one private provider.
To move from belief to broader execution, stakeholders emphasized two critical enablers of adoption: social influence and communication.
- Social influence: Peer validation, visible leadership and external recognition legitimize efforts and encourage replication. Publishing outcome data internally and externally can inspire healthy competition and wider adoption.
- Communication: Clear, consistent narratives and trusted channels for sharing evidence are essential. Personal engagement — workshops and peer-to-peer forums — strengthens understanding and buy-in, while fragmented messaging undermines alignment.
Stakeholders called for a common space where payors, providers, industry and regulators can discuss VBHC candidly in a safe environment to share learning and scale pilots effectively.
Why institutional collaboratives are key to scaling value-based care
Institutionalized collaboratives can bridge perception gaps and move beyond pilot-level progress. To be successful, collaboratives must:
- Establish shared governance and cosigned condition-level outcome sets.
- Provide neutral, risk-adjusted analytics for apples-to-apples comparisons.
- Operate a fixed cadence of peer review workshops to surface practice variation and spread better methods.
- Create joint action charters with aligned incentives, clear ownership and timeboxed improvement cycles.
- Maintain a structured policy interface to channel field evidence to payors and regulators for timely decisions.
By pooling expertise, aligning incentives and offering trusted forums for transparent evidence review, collaboratives can make complexity manageable, connect fragmented efforts across the patient journey, and convert isolated proof points into coordinated performance improvement. This approach addresses the perception-related challenges identified in our research: execution complexity, fragmented implementation, pilots stalling, limited cross-system collaboration, and weak social influence reinforced by inconsistent communication.
The way forward for Saudi Arabia’s healthcare system
Saudi Arabia’s healthcare ecosystem is making progress on the shift to value. Scaling multi-stakeholder collaboratives will be critical: expanded collaboratives can provide clear clinical and administrative guidance, enable shared analytics for performance measurement, and support a coordinated program of work.
