News | Published: Thursday, October 16, 2025
Visit the CV Transforum Fall’25 conference coverage page for more content.
At CV Transforum Fall’25 in Austin, TX, payer and physician speakers came together for a timely panel discussion, titled “Value-Based Care in Cardiology Gets Real: Payers and Physicians in Action.” The session comes during a pivotal moment as the cardiovascular specialty increasingly transitions from fee-for-service to value-based models designed to reward quality, outcomes and efficiency.
Speakers emphasized that value-based care is more than a payment reform – it’s a philosophy centered on delivering patient care in an integrated, patient-centered way, improving both outcomes and experiences for patients and providers at a sustainable cost. “When most people talk about value-based care, they’re thinking about payment,” one panelist noted. “But payment models are just tools to let physicians practice this philosophy.”
Humana, where a majority of members are already in value-based arrangements, has been piloting specialty-focused models and sees cardiology as the next frontier, according to speaker Kanchan Barve, director of Clinical Strategy and Analytics/Strategy Advancement at Humana. While value-based contracting has historically centered on primary care, cardiovascular disease – responsible for a significant share of total healthcare spend – offers clear opportunities to impact both costs and outcomes. Patients with heart failure (HF), for example, represent a high-risk, high-spend group and are an ideal starting point for shared accountability models.
Panelists acknowledged that the shift is not easy. Medicare Advantage payers (including Humana) have been steering the methodology toward quality, outcomes and efficiency. “To do this, hospitals, health systems, physician groups and payers must align strategies and build trust,” said Barve. Data sharing and cultural change are just as critical as financial structures. Each stakeholder – hospitals, health systems, health plans, etc. – have to connect and collaborate within the value-based care philosophy and alternative payment models.
Stephen Seftchick, MBA, chief payor relations officer of Cardiovascular Associates of America (CVAUSA), shared their journey in forging a value-based partnership with Humana, leveraging one of the largest cardiovascular networks in the country. They began with low-risk models and HF-focused programs, gradually building toward more comprehensive arrangements. Success depended on a willing payer partner, measurable opportunities to influence care, and strong enablement support. Physician engagement, Seftchick stressed, was non-negotiable.
Enabler organizations are playing an increasingly important role, offering data capabilities, infrastructure and contracting expertise to help independent practices participate in value-based care. By integrating HF clinics, urgent care access and real-time data platforms, groups are finding ways to remain independent while improving care delivery.
The path to value in cardiology remains early, but momentum is building. Payers are testing new models, providers are aggregating into larger networks, and performance tracking is becoming more rigorous. Panelists agreed that the next five years will be critical for refining models, proving value and scaling what works. “It has to be a win-win-win – for patients, providers and payers,” said Kartik Giri, MD, FACC, partner at CVAUSA. “When we align those interests, real transformation can happen.”
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