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Aug 8, 2023

It’s no secret that the transition from fee-for-service to value-based care is accelerating in healthcare. While primary care has led the way so far, new models—and new investors—are emerging to position speciality care providers as the leaders of this transformation.

On this episode of the Innovation Accelerator podcast, host Steve Ambrose discusses the opportunities and challenges of VBC for specialty providers with Dr. Sanjay Seth, VP of customer success and value engineering at Innovaccer. Dr. Seth is an expert in value-based care and population health, having spearheaded ACO management and enablement in physician- and hospital-led ACOs for nearly a decade.

Steve and Dr. Seth investigate why specialists have been slower to adopt value-based models, including issues around financial incentives; design flaws in programs; challenges with data interoperability, transparency, and analytics; difficulties measuring performance, and more.

Despite these obstacles, Dr. Seth is bullish on specialty care to the extent that he sees specialists—such as cardiologists and nephrologists—as leading the next wave of VBC adoption and innovation going forward. He believes specialists are at an inflection point in the move to value, with the convergence of data-driven technologies and evolving payment models creating opportunities for better care and business growth.

Market trends support his view. Specialty practice transactions reached $22 billion in 2022, with venture capital and private equity firms accounting for 70%, according to the American Journal of Managed Care. And specialists are accelerating adoption of value-based care models as part of increasingly effective and scalable value-based care platforms, according to McKinsey.

Tune in now for a deep dive with Steve and Dr. Seth into:

  • Why specialists haven’t been involved in value-based care models from day one
  • What value-based care programs look like today for specialists, and how they differ from primary care models
  • What value-based care models are emerging for specialists
    Why providers now want to move lucrative specialty services into value-based models: opportunities and incentives
  • Which specialties are best positioned to be early adopters of value-based care, and why
  • What specialists say have been their top challenges in a transition to value
  • The crucial role patients play in accelerating VBC for specialty care
  • Closing care coordination and data sharing gaps with payers
  • How to manage the financial risks of value-based care
  • Innovation and emerging technologies, such AI, to enable value-based care success
  • How to capture, measure, and report value through outcomes and patient experience
  • Key metrics and data points different specialties should monitor and us

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