Intro: 

Hey everyone and welcome to this episode of leading the rounds, where we look to inspire physician leaders through conversations about personal growth, leadership education, and health systems literacy. 

As always, if you like what we’re doing at Leading the Rounds, give us a positive rating on Apple Podcasts, Connect with us on Social Media, and you can now support us on Patreon. 

In today’s interview, we speak with Dr. Joshua Liao. Dr. Liao is a board-certified internal medicine physician and Associate Professor in the UW School of Medicine, where he is also the Associate Chair for Health Systems and the Medical Director of Payment Strategy. He is a national expert in health care payment and delivery policy. Dr. Liao's scholarship focuses on how systems of financing and delivering care work together with human behavior to affect health outcomes. He has published 200+ articles, including over 150 in peer-reviewed medical journals such as the New England Journal of Medicine, the Lancet, the Journal of the American Medical Association. His ideas have also appeared in outlets such as the Washington Post, Forbes, the Boston Globe, the New York Times, NPR, and the Hill. We hope you enjoy this episode with Dr. Joshua Liao where we discuss health systems science and physician payment models. 

Questions We Asked: 

• How did you become involved with health systems science? 
• What is your role as professor of health systems science? 
• Can you tell us some history of payment models in the US?
• What will be the tipping point to changing from FFS to PFV payment models? 
• Have there been studies that prove PFV is superior to FFS payment? 
• How can we provide better care for lower cost to marginalized groups? 
• Where does the transition to Pay-for-Value start?
• How do physicians get paid under Pay-for-Value?
• Who defines positive outcomes? 
• Does Pay-for-Value incentivize selecting healthy patients? 

Quotes and Ideas: 

• The transition from Fee-for-Service to Pay for Value 
• A transition to Pay-for-Value will not fix all the issues we see in health care 
• Capitation model: a fixed fee per patient do deliver care throughout the year 
• “The alternative to mandates is not nirvana, the alternative is how it’s always been.”
• “Payment is a powerful motivator” 

Book Suggestions: 

• “The Long Fix” by Vivian Lee