Relying on volume-based growth is increasingly risky for medical billing companies. Automation is accelerating and the industry continues its shift toward value-based care. Under a fee-for-service model, billing companies monetize volume, but under value-based medical billing, success depends on outcomes, data, and performance. The old model of "process more claims with fewer errors" is no longer enough to sustain growth.

A recent American Medical Association (AMA) analysis shows that while fee-for-service remains the dominant revenue source (67.7% in 2024), more practices are adopting alternative payment models, accountable care organizations, and patient-centered medical homes. 

To stay competitive and profitable long-term, billing companies must evolve by moving from volume-to value-based medical billing. This begins by aligning your business model with what practices actually need from a modern partner.

Practices need a revenue and operations partner to help them stay financially stable, compliant, and competitive. That means medical billing companies moving from volume- to value-based medical billing must look beyond claim submission to demonstrate measurable financial improvement. 

To prove value, billing companies must track and improve:

Use dashboards and monthly performance reviews to show the narrative behind the numbers: "Here is your baseline. Here is our improvement. Here is the financial impact."

Practices want a strategic partnership. They want to partner with a billing company that proactively identifies risks, prepares them for reimbursement changes, and supports expansion. Staying on top of payer trends and sharing best practices are critical capabilities when moving from volume to value. Your clients need a partner who can pivot quickly as the market evolves.

Many practices appreciate performance-based pricing (e.g., a base rate plus performance bonuses) because it aligns your incentives with theirs. 

Traditional volume-based pricing means, "You pay us a percentage regardless of the outcome." Value-based pricing says, "We share the risk and upside." This approach is essential when moving from volume- to value-based medical billing.

Consider offering tiered pricing to capture different value levels:

As payer rules and audits intensify, practices look to partners to reduce risk. Successful billing companies must master practice-specific requirements and stay current on regulation changes. Whether it is navigating telehealth updates or mitigating remote patient monitoring audit risks, leveraging compliance as a strategic advantage helps your business grow. 

Practices demand transparency into real-time reporting, A/R, and denials. Combining visibility and proactive communication builds trust and confidence, and both directly address the biggest client pain points: uncertainty and a lack of control.

If you're ready to start moving from volume- to value-based medical billing, these steps can help:

Today’s medical practices want a billing partner who improves cash flow, reduces workload, enhances the patient experience, and acts as a strategic ally. Future success will depend less on how many claims you touch, and more on the financial and operational improvement you deliver. The time to reimagine your business and focus on moving from volume- to value-based medical billing is now.

With the right approach and support from a partner like Tebra, you can build the foundation for sustainable, scalable growth for both your medical billing business and your clients. Learn more about how your medical billing company can partner with Tebra today.