Moving beyond typical discussions of value-based care, Dr. Mather reframes the entire conversation. "Value-based care is financial innovation to solve important healthcare problems," he explains. These problems extend far beyond cost control to address clinician burnout, prior authorization burdens, care gaps, declining profitability, and health equity. For surgeons planning their careers, understanding this broader context proves essential.

The discussion dives deep into why procedural bundles like CJR and BPCI have limitations despite their promise. "Bundles are a building block," Mather notes, explaining their volatility problems and how they've made value-based care appear to be a "joints and spine initiative" rather than engaging entire practices. He then explores the complex world of condition-based bundles, global risk, and capitation models, illustrating why the shift from fee-for-service feels like "entering a dark forest" for many surgeons.