The Tipping Point: How Transparency and Performance Tools Are Rewriting the Payer-Provider Power Dynamic
- kimriordan
- Apr 14
- 3 min read
The relationship between payers and providers has always been complex, but recent shifts have brought that tension into sharper focus. A recent Becker's Hospital Review article put it plainly: "Payers hold the power in hospital negotiations." Health systems are increasingly being asked to shoulder more financial risk without the tools, transparency, or leverage to do so effectively. The result? A growing sense of frustration and a clear call for change.
And the data backs it up.
According to the 2025 Reflections & Predictions report by Health Enterprise Partners (HEP), developed in partnership with L.E.K. Consulting, 47% of payers plan to increase risk delegation to provider groups in 2025, particularly within their Medicare Advantage (MA) portfolios. Meanwhile, 31% of providers are looking to reinvigorate their value-based care (VBC) contracting efforts — but with caution. Why? Because most providers still feel unprepared to navigate these complex arrangements.
The report also reveals that 69% of providers and 71% of payers are actively pursuing vendor consolidation, signaling a demand for fewer, higher-impact platforms that deliver both clarity and results. Across the board, organizations are prioritizing tools that support performance: 57% of payers are investing in analytics to close care gaps and enable coordination, while 50% are emphasizing risk contracting and quality analytics.
The Real Friction in Value-Based Care
Despite the rhetoric around collaboration, many provider organizations are still negotiating value-based contracts via spreadsheets and PDFs — with limited actuarial insight and no clear view of performance expectations. This leads to contracts that are either misunderstood or misaligned, creating distrust between parties and undermining the promise of VBC altogether.
From our vantage point at Syntax, we see this friction show up in three ways:
Administrative burden: Long, painful back-and-forth cycles that drain time and resources.
Opaque terms: Providers enter agreements without knowing how performance will be measured or paid.
No feedback loop: Once contracts are live, most providers lack tools to proactively track performance and course correct.
A New Era of Transparency and Performance
The good news? There’s a better way — and it’s already working.
At Syntax, we built an actuarial intelligence platform that replaces guesswork with grounded insights. Our clients — including community health centers, ACOs, and risk-bearing provider organizations — use our platform to:
Model contracts before signing, with a clear view of projected outcomes.
Negotiate digitally, cutting friction and making it easier to align incentives.
Monitor performance in real-time, so they can identify gaps, take action, and maximize earnings.
We’re not just simplifying workflows. We’re restoring confidence.
By giving providers access to the same rigor that payers use internally, Syntax levels the playing field — and helps organizations make decisions based on data, not assumptions.
It’s Time to Reset the Dynamic
If 2025 is shaping up to be a year of increased risk delegation, tighter margins, and mounting pressure to perform, then the need for clarity and transparency has never been greater. It’s no longer enough to talk about "collaboration" in VBC — we need tools that actually support it.
At Syntax, we believe providers shouldn’t be set up to fail. They should be set up to win.
We’re here to make value-based care make sense — and make it work.
Sources:
HEP 2025 Reflections & Predictions Report, in partnership with L.E.K. Consulting (March 2025)
Becker’s Hospital Review: "A shift in hospital-payer power dynamics" (April 2025)
Learn more at meetsyntax.com
