The advancing modern age of value-based health care (VBHC) signals a significant transformation in the functioning of health care systems, prioritizing quality, outcomes, safety, equity, and satisfaction of stakeholders. With these ambitious objectives, the environment is riddled with intricate, interrelated risks such as workforce shortages, clinical complications, safety of health care staff, cyberattacks, and disruptions in supply chains. Tackling these issues requires a strong commitment of resources to resilient, organization-wide risk governance and innovative strategies.

Central to this contemporary health care evolution is the enterprise risk management (ERM) framework, crucial for cultivating sustainable, value-driven systems. The ideal leader for steering through this new landscape is the chief risk officer (CRO), a strategic and progressive individual. The ERM framework, coupled with a skilled CRO, is vital for assuring the durability and prosperity of value-based health care systems.

A fundamental element of the VBHC model is nurturing a culture of safety, coordinated care, financial efficiency, and patient-focused innovation. The ERM framework aids these aims by proactively identifying risks across the system, averting their escalation into expensive failures, and incorporating ongoing monitoring of key risk indicators. Additionally, ERM supports regulatory compliance, aligns clinical safety with financial viability, and improves health care equity and access—elements increasingly associated with performance. Essentially, ERM strengthens VBHC by enhancing its safety, intelligence, and resilience.

In this context, the chief risk officer goes beyond the conventional duties of a passive compliance overseer. Within VBHC settings, the CRO evolves into a strategic consultant, systemic thinker, and driver of sustainable change. CROs undertake proactive risk monitoring, leveraging analytics to foresee clinical risks and initiate early interventions. By fostering a “just culture,” CROs cultivate an atmosphere where accountability supersedes blame, promoting enhanced error reporting, learning, and quality enhancement. They also act as connectors, integrating finance, informatics, operations, and clinical care through a cohesive risk perspective. Modern CROs champion environmental, social, and governance (ESG) risks, including the social determinants of health, clinician well-being, and community trust, all essential for long-term value creation.

For health care leaders dedicated to VBHC, the strategy includes deploying a dynamic ERM framework rooted in ISO 31000 principles and investing in an experienced CRO skilled in clinical risk, cybersecurity, finance, and strategy. This sync of ERM with quality enhancement, finance, DEI, and digital health governance harnesses data and narratives to motivate leadership engagement and frontline collaboration. Additionally, it is crucial to update the risk inventory to include emerging threats, like AI ethics, climate resilience, and global health crises.

Within the sphere of VBHC, the principle of delivering more with less becomes an ethical duty rather than mere rhetoric. Shortcuts are not a feasible solution. Instead, investments in intelligent systems and safer decision-making platforms are essential. This is where ERM shines. With a solid ERM framework and an innovative CRO, health care systems are prepared to navigate uncertainties, safeguard patients, support clinicians, and uphold value. In this modern era, risk is not just a factor to evade; it is an element to comprehend, manage, and turn into opportunities.