09.18.2019

Current Value-Based Care Models Need Greater Emphasis on Specialty Care

This article provides an overview of the impact of specialty care and the opportunity for it to leapfrog primary care as a lead focus for accountable care.

Chronic Condition Special Needs Plans (C-SNPs). C-SNPs are coordinated care plans offered under Medicare Advantage with enrollment limited to individuals with specific severe or disabling chronic conditions, including, but not limited to, chronic heart failure, diabetes, cancer, and end-stage renal disease (ESRD).7 For patients with chronic illness, 132 C-SNPs were available throughout the United States in 2018.8 C-SNP beneficiaries experienced increased value—including cost-sharing reductions for Medicare-covered services—in 2018 relative to 2017, while premiums stayed relatively flat during this time frame.9 We present 2 examples of C-SNPs that have added value through improved outcomes: 

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