Specialty Care Integration

Specialty care integration momentum this week centered on behavioral health and kidney care moving deeper into risk-based arrangements: Medicaid managed care contracts are increasingly using care coordination, quality metrics, and payment levers to integrate behavioral health, while CMMI’s ACCESS Model is being framed as a behavioral-health-relevant pathway for aligning specialty access with accountable care. Kidney care is also advancing as a mature specialty VBC category, with Strive Health’s risk-aligned, multidisciplinary CKD model emphasizing earlier identification and coordination, and Interwell Health expanding payer partnerships tied to Medicare kidney outcomes—reinforcing that specialty integration is shifting from referral management to shared accountability for longitudinal cost and outcomes (Strive Health kidney care case study; NASHP Medicaid behavioral health integration snapshot). The key tension for ACOs, payers, and health systems is operational: behavioral health crisis and inpatient costs remain difficult to finance under legacy reimbursement, even as VBC models increasingly require up-front specialty capacity, data sharing, and multidisciplinary infrastructure before savings materialize.