18 Nov The Task Force Releases the Next Frontier: Specialty Integration in Value-Based Care
WASHINGTON (November 18, 2024) – The Health Care Transformation Task Force (Task Force) – a group of leading health care payers, providers, purchasers, patient organizations, and value transformation partners – released a resource titled 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.
“Specialty care plays a pivotal role in the success of value-based care models. This new resource highlights key operational and financial strategies that organizations are using to integrate specialists more effectively,” said Theresa Dreyer, Interim Executive Director at the Health Care Transformation Task Force. “The framework in this paper lays the foundation for future growth in specialty VBC models across the health care system and represents opportunities for the public and private sector to learn from one another.”
“Aledade’s kidney care management program is a testament to the power of proactive value-based care,” said Catherine Olexa-Meadors, Senior Vice President of Innovation and Partnerships at Aledade. “By leveraging data-driven insights and close collaboration between independent primary care physicians and specialists, we’ve improved patient outcomes and reduced avoidable hospitalizations. Programs like this show how specialty care can be integrated into value-based care models, creating scalable solutions that enhance quality while lowering costs.”
“Incorporating specialty care into value-based models is essential to addressing the complexity of care that patients with chronic or serious conditions, like cancer, often require,” said Tatjana Kolevska, Medical Director at Kaiser Permanente National Cancer Program. “At Kaiser Permanente, we’ve seen how value-based approaches in oncology can improve care coordination, reduce disparities, and enhance the patient’s experience. This resource offers practical strategies that can help more organizations implement these models successfully and improve the quality of specialty care across the board.”
“At Blue Cross Blue Shield of Michigan, we’ve spent over 20 years advancing value-based care by aligning incentives across primary and specialty care,” said Duston Pope, Senior Vice President of Provider Network Management and Operations at Blue Cross Blue Shield of Michigan. “Through initiatives like the Blueprint for Affordability and orthopedic episode-based payments, we’ve improved care quality while reducing costs. Engaging specialists is key to driving the next phase of value-based care, and we’re proud to share our experience in this effort.”