{"id":10273,"date":"2026-05-28T01:52:54","date_gmt":"2026-05-27T18:52:54","guid":{"rendered":"https:\/\/www.rldatix.com\/en-nam\/?p=10273"},"modified":"2026-05-28T03:56:55","modified_gmt":"2026-05-27T20:56:55","slug":"one-foot-in-two-canoes-why-the-shift-to-value-based-care-demands-leadership-at-every-level","status":"publish","type":"post","link":"https:\/\/www.rldatix.com\/en-nam\/resources\/one-foot-in-two-canoes-why-the-shift-to-value-based-care-demands-leadership-at-every-level\/","title":{"rendered":"One foot in two canoes: why the shift to value-based care demands leadership at every level\u00a0"},"content":{"rendered":"\n<p>The U.S. spends more on healthcare than any other country in the world &#8211; and gets worse outcomes than many. Something is clearly broken. Dr. Danielle Sheurer, chief quality officer at MUSC Health, has spent her career trying to fix it. In this video, she talks honestly about the structural tension at the heart of American healthcare: the competing pull of fee-for-service and value-based care &#8211; and why navigating it takes genuine leadership from every corner of the organization.\u00a0<\/p>\n\n\n\n<p>Watch Dr. Danielle Sheurer of MUSC Health talk candidly about the structural challenges facing U.S. healthcare and what it really takes to move the system forward.\u00a0<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-vimeo wp-block-embed-vimeo wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"freecompress-Danielle_Sheurer_v2_webversion\" src=\"https:\/\/player.vimeo.com\/video\/1189507666?dnt=1&amp;app_id=122963\" width=\"500\" height=\"281\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture; clipboard-write; encrypted-media; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\"><\/iframe>\n<\/div><\/figure>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--60)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Key takeaways from this conversation<\/h2>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>The U.S. spends more per capita on healthcare than any other industrialized country &#8211; and still\u00a0lags behind\u00a0many nations on actual health outcomes. The system is broken, and everyone in it knows it.\u00a0<\/li>\n<\/ol>\n\n\n\n<ol start=\"2\" class=\"wp-block-list\">\n<li>Most health systems are stuck between two conflicting models: fee-for-service rewards volume; value-based care rewards outcomes. Managing both at once is incredibly hard.\u00a0<\/li>\n<\/ol>\n\n\n\n<ol start=\"3\" class=\"wp-block-list\">\n<li>Shifting toward value-based care\u00a0isn&#8217;t\u00a0a top-down mandate. It requires understanding, buy-in\u00a0and active effort at every level of the organization.\u00a0<\/li>\n<\/ol>\n\n\n\n<ol start=\"4\" class=\"wp-block-list\">\n<li>It&#8217;s\u00a0a lot of work. But according to Dr. Sheurer,\u00a0it&#8217;s\u00a0the only path forward.\u00a0<\/li>\n<\/ol>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--60)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">The structural tension at the heart of U.S. healthcare\u00a0\u00a0<\/h2>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--40)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>There&#8217;s\u00a0a reason so many healthcare leaders feel like\u00a0they&#8217;re\u00a0being pulled in two directions at once. Fee-for-service healthcare rewards volume &#8211; more visits, more procedures, more services. Value-based care rewards outcomes &#8211; better health, fewer complications, lower cost over time. These models\u00a0don&#8217;t\u00a0just have different incentive structures; in some cases, they actively conflict with each other.\u00a0<\/p>\n\n\n\n<p>Dr. Sheurer&#8217;s &#8216;two canoes&#8217; analogy captures the problem perfectly. Health systems today have one foot in each boat, and the boats are drifting apart. Figuring out how to shift more of your business into value-based care &#8211; without destabilizing\u00a0what&#8217;s\u00a0keeping the lights on &#8211; is one of the hardest problems in healthcare right now.\u00a0<\/p>\n\n\n\n<p>It\u00a0can&#8217;t\u00a0be solved by leadership alone, but it\u00a0can&#8217;t\u00a0happen without it.\u00a0RLDatix\u00a0helps organizations build the data infrastructure and governance frameworks they need to make that transition &#8211;\u00a0demonstrating\u00a0the value of quality-driven care in terms that every stakeholder understands.\u00a0<\/p>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--60)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">The impact on teams and where this approach works<\/h2>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--40)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>When a health system successfully\u00a0aligns around\u00a0value-based principles &#8211; with leadership, incentives and operations all pointed in the same direction &#8211; things start to click. Clinical teams have clearer\u00a0direction. Administrators make smarter resource decisions. And patients get more consistent, higher-quality care.\u00a0<\/p>\n\n\n\n<p>Getting there is hard, and Dr. Sheurer&nbsp;doesn&#8217;t&nbsp;sugarcoat it. It takes sustained effort from everyone. But&nbsp;she&#8217;s&nbsp;equally clear that&nbsp;there&#8217;s&nbsp;no other&nbsp;option: this is the direction healthcare is heading, and organizations that figure it out early will be better positioned for everything that comes next.&nbsp;<\/p>\n\n\n\n<p>This perspective is most relevant to:\u00a0<\/p>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>Health system executives and boards wrestling with long-term strategic direction\u00a0<\/li>\n<\/ol>\n\n\n\n<ol start=\"2\" class=\"wp-block-list\">\n<li>Quality and clinical improvement teams building the case for value-based initiatives\u00a0<\/li>\n<\/ol>\n\n\n\n<ol start=\"3\" class=\"wp-block-list\">\n<li>Organizations managing the real-world complexity of operating under both payment models simultaneously\u00a0<\/li>\n<\/ol>\n\n\n\n<ol start=\"4\" class=\"wp-block-list\">\n<li>Leaders working to build genuine, cross-functional alignment around quality and outcomes\u00a0<\/li>\n<\/ol>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--60)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div data-wp-context=\"{ &quot;autoclose&quot;: false, &quot;accordionItems&quot;: [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-1&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\" style=\"font-size:30px\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-1-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-1\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><span class=\"wp-block-accordion-heading__toggle-title\">Video Transcripts<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-1\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-1-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p>Hello,&nbsp;I&#8217;m&nbsp;Danielle Sheurer.&nbsp;I&#8217;m&nbsp;the chief quality officer for MUSC Health and a practicing hospitalist.&nbsp;<\/p>\n\n\n\n<p>The healthcare environment is extremely complex. It is dynamic and ever-changing. In the U.S., we spend more per capita on healthcare than any other industrialized country in the world, and we lag significantly behind even some third-world countries in actual health.&nbsp;<\/p>\n\n\n\n<p>So&nbsp;the system today is completely broken. A lot of publications give this analogy of having one foot in two canoes.&nbsp;You&#8217;ve&nbsp;got one foot in a canoe&nbsp;that&#8217;s&nbsp;in the fee-for-service world, and&nbsp;you&#8217;ve&nbsp;got one foot in a canoe&nbsp;that&#8217;s&nbsp;in the value-based care world. And those feet are sometimes spreading in the opposite directions because the incentives are&nbsp;very different.&nbsp;<\/p>\n\n\n\n<p>And&nbsp;so&nbsp;it takes a lot of leadership to figure out how to shift more of your book of business into value-based care than fee for service.&nbsp;And I say leadership because it is all levels of the organization that have to understand it and be excited about it and work toward it and be incentivized to do it.&nbsp;<\/p>\n\n\n\n<p>It is a lot of work, and&nbsp;it&#8217;s&nbsp;the only path forward.&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--60)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">FAQs<\/h2>\n\n\n\n<div style=\"height:var(--wp--preset--spacing--40)\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div data-wp-context=\"{ &quot;autoclose&quot;: true, &quot;accordionItems&quot;: [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-2&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading has-medium-font-size\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-2-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-2\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What is value-based care, and how is it different from fee-for-service?\u00a0<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-2\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-2-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p>Fee-for-service pays providers based on how much they do &#8211; more appointments, more tests, more procedures, more revenue. Value-based care flips that logic: providers are rewarded for the quality of outcomes they achieve, not the volume of services they deliver. The goal is\u00a0better\u00a0health at lower cost. It makes a lot of sense in theory. The challenge is that most health systems are still heavily dependent on fee-for-service revenue while trying to build value-based capabilities at the same time.\u00a0<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-3&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading has-medium-font-size\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-3-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-3\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Why is the transition to value-based care so difficult?\u00a0<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-3\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-3-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p>Because you\u00a0can&#8217;t\u00a0just switch models overnight. Health systems have to manage existing fee-for-service contracts while simultaneously building the infrastructure,\u00a0culture\u00a0and clinical programs that value-based care requires. The incentives point in different directions. The workflows are different. And it takes real organizational discipline to keep moving forward on both fronts without losing ground on either. Dr. Sheurer&#8217;s honesty about this is refreshing &#8211; it is hard, and pretending otherwise\u00a0doesn&#8217;t\u00a0help anyone.\u00a0<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-4&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading has-medium-font-size\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-4-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-4\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What role does\u00a0leadership actually\u00a0play in quality improvement?\u00a0<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-4\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-4-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p>A huge one. Quality improvement\u00a0doesn&#8217;t\u00a0happen just because someone at the top says it should.\u00a0It happens when people at every level of the organization understand the goal, believe\u00a0it&#8217;s\u00a0achievable\u00a0and have the tools and support to do something about it. Senior leaders\u00a0set\u00a0the direction, but mid-level managers translate that into daily operations, and frontline teams are the ones who actually deliver.\u00a0All three have to be aligned &#8211; or improvement stays on paper.\u00a0<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-5&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading has-medium-font-size\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-5-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-5\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">How does\u00a0RLDatix\u00a0support the move toward value-based care?\u00a0<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-5\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-5-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p>RLDatix\u00a0gives health systems the data and governance infrastructure they need to track quality, reduce\u00a0variation\u00a0and\u00a0demonstrate\u00a0measurable outcomes &#8211; which is exactly what value-based care demands. Whether\u00a0you&#8217;re\u00a0managing accreditation requirements, reporting on clinical\u00a0performance\u00a0or building the evidence base to justify investment in quality programs,\u00a0RLDatix\u00a0gives you the tools to do it systematically rather than reactively.\u00a0<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-6&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading has-medium-font-size\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-6-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" data-wp-on--keydown=\"actions.handleKeyDown\" id=\"accordion-item-6\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What does &#8216;all levels of the organization&#8217; mean in real terms?\u00a0<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div inert aria-labelledby=\"accordion-item-6\" data-wp-bind--inert=\"!state.isOpen\" id=\"accordion-item-6-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p>It means the board\u00a0has to\u00a0understand why this matters strategically.\u00a0Senior clinicians have to champion it publicly.\u00a0Managers have to build it into how their teams operate day to day.\u00a0And frontline staff have to feel like their effort is seen and matters.\u00a0Dr. Sheurer&#8217;s point\u00a0isn&#8217;t\u00a0just inspirational &#8211;\u00a0it&#8217;s\u00a0practical.\u00a0Transformation that doesn&#8217;t reach the front line doesn&#8217;t actually transform anything.\u00a0\u00a0<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The U.S. spends more on healthcare than any other country in the world &#8211; and&#8230;<\/p>\n","protected":false},"author":40,"featured_media":10275,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[329],"tags":[],"class_list":["post-10273","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-videos","primary-category-videos"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>One foot in two canoes: why the shift to value-based care demands leadership at every level\u00a0 | RLDatix<\/title>\n<meta name=\"description\" content=\"Healthcare resources from RLDatix: One foot in two canoes: why the shift to value-based care demands leadership at every level\u00a0. 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