Relentless Health Value EP503: Smart Collaboration With Direct-to-Employer Specialty Care, With Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky
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Mar 12, 2026 Adam Stavisky, benefits leader who managed Walmart’s health programs; Ryan Wells, CEO building digital bridges for direct-to-employer specialty care; Leo Spector, orthopedic surgeon and OrthoCarolina CEO. They unpack why employers and specialists are disconnected. They explore administrative barriers, scaling curated specialty networks, outcome measurement, and how digital rails can enable direct contracting and better coordination.
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Collaboration Is The Breakthrough Innovation
- Collaboration between plan sponsors and specialists is the next breakthrough innovation to reduce waste and raise quality.
- Stacey Richter and Leo Spector explain the current misalignment leaves purchasers and specialists like two ships passing in the night, trapping value in lazy networks.
Disruption Analyses Preserve Low Quality Care
- Traditional carrier networks prioritize minimizing disruption which preserves low-quality clinicians in-network.
- Adam Stavisky argues disruption analyses cause plans to favor preserving every provider rather than excluding bottom-tier clinicians, sacrificing patient safety and quality.
Use Big Data To Identify Bottom Decile Clinicians
- Use large multi-year datasets to assess both appropriateness and clinical effectiveness rather than single metrics.
- Adam Stavisky recommends vendors with hundreds of millions of patient records to create statistically credible physician comparisons and identify bottom deciles to exclude.