Feature May 11, 2022 John Bernot, MD

Pros and cons of centralized vs. decentralized staffing models for value-based care success

Health systems and ASCs cannot afford to overlook the importance of their staffing model when implementing value-based care initiatives.

Healthcare staff working together

The adoption of value-based care (VBC) programs reflects an enormous change in the delivery of healthcare that will have a ripple effect across the industry—impacting patients, providers, payers, third-party vendors, technology partners, and more.1

While ostensibly about the shift from a fee-for-service to a pay-for-quality and outcomes model, this change is a cultural one that extends far beyond payments and reimbursement programs. 

More than a decade of research2 has found an effective framework for VBC implementation includes:

  1. Understanding the shared health needs of patients
  2. Designing solutions to improve health outcomes
  3. Integrating learning teams
  4. Measuring health outcomes and costs
  5. Expanding partnerships

With so many elements contributing to value in healthcare, one aspect of VBC implementation that can be overlooked is the significance of your organization’s staffing model. 

As your health system or ASC defines and refines its VBC strategy, here are the pros and cons of a centralized versus decentralized staffing model that you may not have considered. 

Pros and cons of centralized staffing models

A centralized staffing model focuses on the standardization of processes and procedures, including the implementation of best practices across the enterprise. This staffing model can remove the burden of scheduling, hiring, and other administrative tasks that are not the core competency of care teams. It’s also linked to more equitable employee pay.3

Centralized staffing enables care teams to: 

  • Deliver the right care at the right time with staffing resources deployed when and where they are needed
  • Streamline processes for increased business and operational efficiencies
  • Focus on their core job functions 
  • Establish learning teams dedicated to specialized processes and technologies
  • Measure and collect outcomes data

However, centralization can result in: 

  • Less patient interaction
  • Rigid adherence to rules 
  • Depersonalization that contributes to burnout and poor patient outcomes4

Pros and cons of centralized staffing models

In contrast, decentralized staffing means the care team is more engaged in the governance and decision-making that impacts the day-to-day operations of their hospital department or ASC. This staffing model results in increased transparency and flexibility.3

Decentralized staffing enables care teams to:

  • Spend more time with patients
  • Gain insight into the patient journey and understand the population being served
  • Participate in RFPs and selection of technology solutions
  • Have flexible work schedules that result in better staff performance3

However, decentralization can result in: 

  • Inefficient use of resources
  • More time spent in internal meetings
  • Poor implementation of technology solutions due to irregular use

Effective technology implementation requires proper staffing

Health systems and ASCs cannot afford to overlook the essential role staff play in the effective implementation of technology in pursuit of value-based care initiatives. 

A dynamic patient engagement platform like Ayva helps organizations meet their VBC goals by reducing the cost of care while improving health outcomes. And implementation is easy—with a staffing model that supports the care team and patients throughout the care journey. 

Meet Ayva today!


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Shane Andreasen

Bravado Health


Bravado Health Media Line


(561) 805-5935