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?