Access to specialty care can be limited by geography, capacity, and cost. To address these potential barriers, HealthPartners designed and implemented an e-consult model that features innovative financial and operational elements. The Minnesota-based vertically integrated system engaged with third-party payers, beginning with its own, to explore the value of providing specialty care advice directly to a referring provider. HealthPartners also created an in-house method to compensate primary care providers for their work in e-consult, as well as some flexibility for specialists to participate. In less than 1 year, more than 50% of the e-consults have been billed, and more than 60% of the requests from primary care providers have been addressed the same day, with just 12% exceeding the 2-day target.