Oliver Wyman March 5, 2025
To get a hold of soaring costs, insurers have an opportunity to be more proactive and creative about partnering with specialists on value-based arrangements.
Healthcare’s yearslong experiment with value-based care has generated mixed results. While primary care-based models have long been the focus, there is a dearth of models for specialty care. If the industry wants to get a hold of soaring costs, payers have an opportunity to be more proactive and creative about partnering with specialists on new payment arrangements where possible.
Specialists influence more than 50% of healthcare spending for commercially insured patients, inclusive of such things as facility fees at various sites of care, diagnostics, and radiology. Estimates suggest that specialty care trailed only inpatient care and...
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