Article
How can we embrace value-based models in specialty care?
By Sean Burns of Highmark Health, Lawrence Kosinski of SonarMD, and Lili Brillstein of Bcollaborative.
Most accountable care models focus on primary care. This leaves specialists on the outside looking in, stuck, for the most part, in a fee-for-service world.
That’s despite the fact that specialty care accounts for about 70% of health care spend.
Primary care-based models are designed to keep patients healthy and prevent disease. That makes sense—work to keep the population healthy.
Specialty care models are different. Since individuals are already in need of specialty care, the models require a different level of risk stratification to ensure clinically similar populations. This allows for the study of variations in care and costs of care – and the model is designed to optimize both.
How can we embrace value-based models in specialty care?
1. Transparently share data. Data needs to drive decision-making when it comes to designing and implementing a value-based care model with specialists.