Greetings from sunny San Francisco and the opening of the 2026 OPEN MINDS Service Excellence Institute. Our focus this week is on the best practices and service delivery models that drive better outcomes for consumers with complex needs. And that discussion includes how to develop service systems that link consumer outcomes, experience, and payer value to provider organization reimbursement.

One challenge in the evolution of service delivery focused on performance is how best to include provider organizations without the capital to invest in value-based service delivery infrastructure and/or the financial reserves to accept contracts with downside financial risk. This includes smaller provider organizations and private practices. In fact, 84% of health care organizations have less than $25 million in annual revenue (see …