Former Centene CIO on Why VBC Companies Are Cracking: 'Too Much, Too Fast'

Dr. Darren Schulte breaks down ongoing problems in the "new world order" of value-based, preventative health care programs.

Published on Feb. 27, 2026

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This article features an interview with Dr. Darren Schulte, the former chief innovation officer at Centene and current CEO of the health tech company Vynca. Schulte discusses the challenges facing value-based care (VBC) arrangements, including the mismatch between the time it takes to realize savings from preventative care and the short tenure of patients with health plans. He also notes that VBC models are uniquely exposed to federal policy instability, as changes to risk adjustment models can disrupt the financial benchmarks that these arrangements are based on. Schulte argues that the solution lies in a greater focus on actually managing care utilization and costs, rather than just optimizing for risk adjustment and quality scores.

Why it matters

The article provides valuable insights into the ongoing struggles of value-based care models, which are intended to shift the health care system towards a more preventative and cost-effective approach. Schulte's perspective as a former payer executive and current health tech leader offers a nuanced understanding of the barriers to successful VBC implementation, including the misalignment between short-term financial incentives and long-term population health goals. These challenges have significant implications for health care providers, payers, and patients as the industry continues to evolve towards value-based care.

The details

Schulte explains that a key barrier to VBC arrangements is the lack of education and awareness around how palliative care can help address costs and utilization for the sickest patient populations. He also notes that VBC models are built on a fee-for-service chassis, causing providers to still think in terms of reactive, episodic care rather than a more holistic, preventative approach. Additionally, Schulte highlights the instability introduced by changing risk adjustment models, which can disrupt the financial benchmarks that VBC contracts are based on. He argues that the solution requires a greater focus on actually managing care utilization and costs, rather than just optimizing for risk adjustment and quality scores.

  • Schulte was the chief innovation officer at Centene prior to joining Vynca in 2023.
  • Schulte's comments in this article were made in February 2026.

The players

Dr. Darren Schulte

The CEO of the health tech company Vynca, which specializes in palliative care and navigation/orchestration solutions. Prior to joining Vynca in 2023, Schulte was the chief innovation officer at Centene.

Centene

A large health insurance company where Schulte previously served as the chief innovation officer.

Vynca

A health tech company that specializes in palliative care and navigation/orchestration solutions, where Schulte currently serves as the CEO.

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What they’re saying

“Unfortunately, there's no benefit in Medicare for palliative care services, so traditional Medicare doesn't pay adequately for comprehensive palliative care to address the needs of the seriously ill.”

— Dr. Darren Schulte, CEO, Vynca

“The problem with value-based care is, if you delegate 1,000 patients to me, and I only reach 300, I'm not able to do much for the 700. A lot of care isn't really provided.”

— Dr. Darren Schulte, CEO, Vynca

“Effectively, the best way this works is if an individual sticks with a plan for a sustained period of time, however that can occur. There are plans that cover federal employees, where you're on for life after you know you're retired—that plan has a stake in covering you, because it's [paying for you] until you die, right?”

— Dr. Darren Schulte, CEO, Vynca

The takeaway

Schulte's insights highlight the ongoing challenges facing value-based care models, including the misalignment between short-term financial incentives and long-term population health goals, the instability introduced by changing federal policies, and the need for a greater focus on actually managing care utilization and costs. As the health care industry continues to evolve towards value-based arrangements, addressing these barriers will be crucial for ensuring the sustainability and success of these programs.