4 Key Lessons from Upperline about Value-based Specialty Care

Since value-based care first took shape in the U.S., a common assumption has been that primary care physicians are best positioned to drive its success. But what about patients who regularly see physician specialists rather than a primary care provider – or at least rely heavily on specialists? How can healthcare organizations and medical professionals make sure that these patients fully benefit from VBC? As value-based care evolves and questions like these arise, it is becoming increasingly clear that specialists have a critical role in the VBC ecosystem. 

To shed light on how physician specialists can make the most of value-based care, we recently hosted a fireside chat at ViVE 2025 with Dr. Christiana Beveridge of Upperline Health – the largest specialty-focused provider of VBC in the U.S. Drawing on Upperline’s vast expertise, Dr. Beveridge offered useful insights for anyone interested in the future of value-based care. Here are four key takeaways from our discussion.

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VBC can empower physician specialists to improve patient care

Dr. Beveridge underscored both the benefits of value-based care (VBC) for specialists and the common hesitations that may make them reluctant to adopt it. The key to getting physician specialists on board, she explained, is helping them see how VBC enhances both their efficiency and their ability to deliver the best possible patient outcomes. Rather than adding to their workload, a well-structured VBC model provides seamless access to critical patient information and ensures that their recommendations are followed through.  

“If I’m a surgeon, I don’t want to make an uninformed decision about taking a patient to surgery. I want to know what are all the other things they have going on. Do they have heart failure? Are they on a blood thinner? Did they just get treated for pneumonia?” Dr. Beveridge said, noting that this need for a comprehensive clinical picture makes the interdisciplinary, team-based approach of VBC especially valuable for specialists.“The biggest hurdle is reframing this to, “Hey, you already do this. You already talk to your patient about their health history. Now you actually have information at your fingertips to document that appropriately, so you don’t have to ask them every single time [and] you don’t have to get your MA to request medical records. You’re already doing this; let’s help you do it better and faster.’”

In addition, Dr. Beveridge underscored that in much of the healthcare system, it’s common for specialists to urge patients to follow up with their general practitioners about various issues – recommendations that in many cases are at risk of slipping through the cracks. In contrast, a specialty-focused approach to VBC helps specialists ensure that their general health recommendations are addressed adequately. “This helps me make my treatment plan,” she explained. “It also helps me guide you and say, ‘Hey, I want you to talk with my nurse about diabetes. I have a care team behind me now that can help manage some of these conditions so that  I’m actually able to help you find a path to improving your outcome.’” 

Don’t underestimate the far-reaching impact of improved chronic disease management

Highlighting the importance of managing chronic diseases, Dr. Beveridge explained the key understanding that led to the formation of Upperline Health as a trailblazing organization at the intersection of medical specialties and value-based care. She noted that Upperline’s founders had previously worked for organizations that focused on end-of-life and palliative care within the model of VBC. 

“Being non-clinicians, they thought they were going to see a lot of people that were dying of cancer, stroke, dementia – but instead, what they saw was a lot of people dying of poorly managed chronic diseases. These are people who are falling through the cracks, who are not getting the appropriate care for their chronic diseases,” she recounted. “We can change that trajectory with the appropriate additional care and the appropriate intervention at the right time. What we’re doing is [getting] to these patients earlier through their specialist – who they’re going to already, and they respect – and [making] sure that we make each of those visits count for all the things that contribute to their overall health.’”

People, workflows, and technology: The 3 requirements for excellence in VBC

Taking a broad look at the challenge of shifting towards a value-based care model, Dr. Beveridge broke down the essentials for success into three categories: people, workflows, and technologies. 

“The only way to take risk on patients is to feel confident that you’re going to improve their outcomes over time, and that you’re going to be able to accurately document what’s going on with your patients. To do both of those things, you need to have people that use workflows that are enabled by technology,” she said. “If you don’t have all three of those elements, then you cannot run a successful clinic or business.”

Dr. Beveridge highlighted a fundamental distinction between Upperline Health and many other VBC organizations: the specialist-patient relationship. “The people are our specialists. And the reason they’re incredibly valuable is because patients have already developed relationships with those specialists. They’re already engaged,” she said. “They see them more than they see their primary care doctor. Remember, 30% of Medicare patients aren’t seeing a primary care doctor at all. So let’s use that specialist relationship and engagement as the benefit that it is.”

She also discussed how Navina’s AI copilot, combined with Upperline’s emphasis on preventative care, and multidisciplinary approach contribute to workflows that meet the needs of both specialists and patients. “That’s where we use AI. And specifically AI developed by doctors, because the doctors are the ones using it and the ones that need to trust it. It’s as if you had a resident there who went through all the medical records and pulled out the most important stuff and put [it] in the right order, like we’re trained to do – but instead, the computer does that,” she explained. “Lastly, we ask our [care] team to address preventative care gaps with our patients. Those can be addressed at any doctor’s office. They do not only need to be addressed at a PCP’s office.”

Bringing it all together, Dr. Beveridge underscored Upperline’s holistic approach to patient care.“[Patients] are more than just their foot, more than just their kidney, more than just their heart,” she said. “Let’s just help them do the things they need to do to stay healthy. And let’s allow our tech stack, workflows, and people make that happen.”

What it takes for AI to reach a 98% clinician adoption rate

Beyond emphasizing the importance of technology in streamlining workflows, Dr. Beveridge shared key lessons Upperline has learned from its experience with AI. She highlighted two essential factors that drive physician adoption and engagement: convenience and trustworthiness.

Dr. Beveridge shared that Upperline’s requirement for technology is that it should seamlessly fit into physicians’ workflows. “And it needs to be trustworthy,” she added. “We can’t have them finding things where they’re like, ‘Oh no, the data’s wrong.’ Because as soon as a doctor says the data is wrong, you’re out. You’ve got to climb back up this hill so slowly to convince them that the data is not all wrong.” 

Upperline’s results quickly validated this approach. Trust and ease of use led to rapid and widespread adoption of Navina’s solution among Upperline’s physicians. “The fact that it was trustworthy got people’s buy-in. The fact that it was easy made them try it in the first place,” she said. “Within four weeks of us rolling out this new product, we had 90% of doctors interacting with the system, and we had [an] 85% address rate, which means they actually looked at each condition. And within eight weeks, we had [a] 98% address rate.”