Specialty VBC Models

Specialty value-based care remains a near-term execution gap: the latest AMA programming is pushing beyond primary-care-centric models toward specialist participation in episode-based, condition-specific, and longitudinal arrangements, with implications for attribution, referral management, and shared accountability between ACOs and specialty groups (AMA Ed Hub). For health systems, ACOs, and payers, the immediate tension is operational rather than conceptual: specialists need clearer incentives, data access, and risk-adjusted benchmarks, while primary-care-led ACOs must decide whether to build preferred specialist networks, co-management payments, or episode partnerships to capture savings without fragmenting accountability.