Why 1 in 3 Americans Can’t Get Specialty Care | Dr. Edmund Pribitkin, Jefferson Health

In the launch episode of Healthcare Autonomy, Dr. David Nace, Chief Medical Officer at Innovaccer, is joined by Dr. Edmund Pribitkin, EVP and Chief Physician Executive at Jefferson Health, who oversees $1.6 billion in physician care services revenue across the system. 00:00 The specialty care access crisis 00:34 Meet Dr. Edmund Pribitkin, Jefferson Health 03:49 The state of specialty care today 10:49 Cost and affordability as a barrier 17:12 Administrative barriers: prior auth and referrals 22:17 Care fragmentation and coordination 28:56 Virtualization, autonomy, and measuring real outcomes 36:59 From fee-for-service to value-based care 42:27 The one next step to close the gap 45:01 Closing The episode opens on a hard reality: one in three Americans face barriers to accessing specialty care, and in rural areas, where a fifth of the population lives but only one in ten physicians practices, the gap is even wider. From there, the conversation maps the forces driving that gap, including cost and rising out-of-pocket burden, difficulty accessing care for uninsured and Medicaid patients, geographic distance, administrative barriers like prior authorization and referral networks, and the fragmentation patients face when they see multiple specialists across multiple systems of care. The second half turns to what can be done. Dr. Nace and Dr. Pribitkin discuss virtualization technologies (virtual visits, virtual consults, and virtual checkout), the importance of engaging patients and their caregivers between visits, measuring true clinical outcomes rather than proxies, CMS’s new access model, and the broader shift from fee-for-service medicine toward value-based, population-level care. The throughline is the concept behind the show itself: greater autonomy for patients, physicians, and health systems, and the role technology can play in delivering it. Healthcare Autonomy is available on YouTube, Apple Podcasts, Spotify, and most major podcast platforms.