Among other thoughts: value-based specialty care *could* generate savings but *will it* generate those savings? Fee for service specialty care seems to be doing just fine on its current trajectory (broadly speaking quibbles aside). It will take a great deal more mandatory pressure to move the needle. I am curious to see how the nexus of CKD and HF continues to develop given the pressure on cardiology to lead the charge (see AMS model).
![Signals From [Space]](https://substackcdn.com/image/fetch/$s_!IXc-!,w_80,h_80,c_fill,f_webp,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9f7142a0-6602-495d-ab65-0e4c98cc67d4_450x450.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/$s_!lBsj!,e_trim:10:white/e_trim:10:transparent/h_72,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F0e0f61bc-e3f5-4f03-9c6e-5ca5da1fa095_1848x352.png)
Among other thoughts: value-based specialty care *could* generate savings but *will it* generate those savings? Fee for service specialty care seems to be doing just fine on its current trajectory (broadly speaking quibbles aside). It will take a great deal more mandatory pressure to move the needle. I am curious to see how the nexus of CKD and HF continues to develop given the pressure on cardiology to lead the charge (see AMS model).