A Surgeon's Field Guide to Value-Based Specialty Care.

Objective: To provide a comprehensive state-of-the-art review from the perspective of the surgeon and the surgical specialty academies of the conceptual shift from a volume-driven fee-for-service payment model to one of value-based accountable care payment. This field guide attempts to clarify drivers of surgical value-based performance and outline a comprehensive strategy to successfully engage this healthcare reform paradigm. Data Source: Pubmed/MEDLINE/Google search. Review Methods: Pubmed/MEDLINE/Google search was performed during June 1, 2024-May 17, 2025 for value-based initiatives, administrative, and government agency publications, Centers for Medicare and Medicaid Services, and Center for Medicare and Medicaid Innovation value-based care policy, directives, and programs. Conclusions: The transition from volume-based to value-based payment models necessitates rethinking how surgeons define, quantify, and engage the care they deliver. The social contract between the surgeon and patient is poorly aligned within the current fragmented fee-for-service payment model. Relative value units continue to function as a poor benchmark measure of the physician-patient relationship, which is foundational to achieving consistent patient engagement and favorable clinical outcomes. To facilitate this value-based realignment within surgical care, we introduce a novel three-dimensional framework for patient experience management (EM