Specialty Care Models
Expert articles and analysis related to specialty care models.
AI Summary — Last 30 Days
Specialty VBC momentum is concentrating around oncology, orthopedics, and kidney care: new evaluation findings from Medicare’s Oncology Care Model show reduced chemotherapy use and lower Medicare spending for poor-prognosis cancers, reinforcing the strategic case for episode-based oncology models that reward guideline-concordant, patient-centered treatment rather than volume-driven infusion economics (AJMC). At the same time, market commentary around mandatory CMS orthopedic bundles and AI signals growing provider concern that the Trump administration’s CMS—under Administrator Dr. Mehmet Oz and CMMI Director Abe Sutton—may lean harder into compulsory specialty episodes, while integrated kidney care profitability for DaVita underscores that nephrology VBC is moving from policy experiment to scaled business model. For ACOs, payers, and health systems, the structural shift is clear: specialty care is becoming the next frontier for downside-risk management, requiring tighter referral governance, data-driven pathway adherence, and alignment with specialty groups whose economics may be disrupted by bundled or episode-based payment.
Related Articles
Oncology Care Model Tied to Reduced Chemotherapy, Lower Medicare Spending in Poor-Prognosis Cancers
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Early Integrated Kidney Care Profitability Could Be A Game Changer For DaVita (DVA) - simplywall.st
Early Integrated Kidney Care Profitability Could Be A Game Changer For DaVita (DVA)Â Â simplywall.st
Oncology Care Model Tied to Reduced Chemotherapy, Lower Medicare Spending in Poor-Prognosis Cancers - The American Journal of Managed Care® (AJMC®)
Oncology Care Model Tied to Reduced Chemotherapy, Lower Medicare Spending in Poor-Prognosis Cancers  The American Journal of Managed Care® (AJMC®)
What Medicare’s Oncology Care Model Has Taught Us About Value-Based Care
What Medicare’s Oncology Care Model Has Taught Us About Value-Based Care  Harvard Medical School
Oncology Care Model Tied to Reduced Chemotherapy, Lower Medicare Spending in Poor-Prognosis Cancers
Oncology Care Model Tied to Reduced Chemotherapy, Lower Medicare Spending in Poor-Prognosis Cancers  AJMC
STAT+: CMS, FDA team up to fast-track reimbursement for breakthrough devices
Federal regulators are proposing a new, faster Medicare coverage pathway for medical devices deemed by the FDA as breakthroughs.
STAT+: CMS proposes rolling back breakthrough device payment flexibilities
CMS is proposing to repeal a pathway that allows breakthrough devices to get supplementary payments.
Patient-Centered Oncology Care, Guidelines, and Expertise Drive Value in Practice: Seungjean Chai, MD
Patient-Centered Oncology Care, Guidelines, and Expertise Drive Value in Practice: Seungjean Chai, MDÂ Â The American Journal of Managed Care
Advancing Innovation in Community Oncology Through Collaborative Care
Advancing Innovation in Community Oncology Through Collaborative Care  Pharmacy Times