AHIP August 31, 2020
Sean Burns, Highmark Health; Lawrence Kosinski, SonarMD; Lili Brillstein, 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...

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Topics: ACO (Accountable Care), Insurance, Payment Models, Physician, Primary care, Provider, Value Based
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