18 Nov The Next Frontier: Specialty Integration in Value-Based Care
Specialty participation in value-based care (VBC) is a strategic priority for providers, purchasers, payers, and policymakers. Specialty care continues to drive a high proportion of health care spending, making specialist engagement key to achieving the goals of VBC: improving access, quality, and equity, while reducing the total cost of care.
In collaboration with senior leaders at payer, provider, and VBC enabler organizations, the Task Force developed a strategic framework to describe the breadth of specialty VBC models in the public and private sectors. There are three categories that may be layered to align incentives for value, quality, and equity across specialties and organizations: (1) longitudinal total cost of care, (2) conditions & episodes, and (3) performance incentives. This resource explores key clinical, operational, and financial considerations for each of the three model types. The resource also includes ten case studies, which provide operational insights into how organizations are addressing specialty integration across specialties, model types, and populations.
Special thanks to the Task Force’s Specialty Strike Group, supported by the Advanced Payer Provider Partnerships Work Group. The Task Force also wishes to acknowledge those who contributed to the case studies and other subject matter experts.