CEO, Dan Nardi, shared in a recent LRVHealth panel his thoughts on the future of extending cancer care beyond the clinic. At Reimagine Care, we are transforming the cancer treatment experience by delivering high quality care virtually and in the comforts of the home. Learn more by visiting reimaginecare.com.
When we think about the transformations in care delivery that have taken place over the last several years, much of the focus has been on at-risk primary care. However, there are limits to the clinical and financial results that can be achieved in primary-care-only models when the majority of healthcare spend continues to sit in specialty care. At the same time, health systems and independent specialists are redesigning their clinical enterprises in response to tightening market pressures by leveraging many of the learnings that fueled the explosion of innovation in primary care in the first place. We brought together a panel of leaders across the specialty care ecosystem a few weeks ago at our Annual Meeting to explore the intricacies of specialty care transformation, its challenges and opportunities, and what the future holds. Here are some of the top takeaways from the panel: 1) Accessing specialty care today is difficult due to a shortage of specialists, and made worse by uneven geographic distribution and increasing sub-specialization. 2) As risk adjustment becomes a less powerful tool in achieving medical loss ratio (MLR) targets, risk bearing entities are more heavily scrutinizing specialty spend, which comprises 60% of healthcare costs today. There are a variety of perspectives on who “owns” the management of specialty care. Some entities are expanding the walls of primary care as far as possible to absorb more specialty care. Others prefer to delegate any specialty spend that they cannot manage. For risk bearing entities, the decision to delegate or not has implications for scope of practice, as well as attribution of economics and outcomes. 3) For certain specialties where the costs of therapies are extremely high (e.g. oncology), the potential to lower the unit cost of treatment may be somewhat limited; however, at a population level, there is still an opportunity to contain cost and improve outcomes by expanding access to specialty care so that people can have timely access to diagnostics and treatment. Thank you to our incredible panelists Denise Basow, Ochsner Health; Dan Nardi, Reimagine Care; Scott Belsky, Oak Street Health; Dr. Stephen Schleicher, Tennessee Oncology; and Neil Hattangadi, MD, MSc, Cortica! If you are an entrepreneur innovating in this space, we’d love to chat with you! Reach out to Ellen Herlacher or Lise Courtney D'Amico, MBA at CareDelivery@lrvhealth.com!
