According to the Health Care Payment Learning & Action Network’s (LAN) 2022 Measurement Effort, 96% of payers surveyed agreed or strongly agreed that Alternative Payment Model (APM) (i.e., value-based arrangement) adoption will result in better quality of care and improved care coordination, and 82% agreed or strongly agreed that APM adoption will result in more affordable care. Additionally, the share of payments made in APMs (e.g., shared savings, shared risk, bundled payment, population-based payments, and integrated finance and delivery system payments) grew to 40% in 2021 vs. 29% in 2016. However, much of this progress has focused on primary care.
Over the past nine months, the Health Evolution Roundtable on Value-Based Care for Specialized Populations has been exploring the complexities of applying value-based care to specialized populations, with particular focus on three areas:
1. Key considerations for when the primary care provider (PCP) should be the quarterback of care versus when care should be carved out to a specialist.
2. Strategies and approaches to increase specialty care provider engagement in accountable care organizations (ACOs)/PCP-attribution models.
3. Current challenges related to specialty integration in advanced primary care models and ACOs.
Health Evolution has compiled key insights from the Roundtable into a report shared with the Center for Medicare and Medicaid Innovation (CMMI). We believe the insights shared in this report can help inform CMMI’s Strategy to Support Person-centered, Value-based Specialty Care, as well as other payers, providers, and cross-industry vendors interested in furthering value-based arrangements with specialists and specialized populations.
Fill out the form below to download the report:
Thank You to our Health Evolution Community
Thank you to all of the participants in the Health Evolution Roundtable on Value–Based Care for Specialized Populations for the recommendations and calls for further discussion included in this
report, as well as their ongoing action to work through the key challenges raised.
Special thanks to our Value–Based Care for Specialized Populations Corporate Members for supporting this work:
Health Evolution’s Adrienne Knowlton led the research and analyses that served as the basis for this report.