Dr Jason Mitchell Discusses Which Payment Models Have the Most Potential

Jason Mitchell, MD, chief medical and clinical transformation officer, Presbyterian Healthcare Services, discusses which payment models have the most potential for succeeding in value-based care.

What payment models do you think have the most potential for succeeding in value-based care?

I think we’ve all been challenged with all of the different value-based payment models. There’s been a lot of experimentation, which is good. We want to experiment and iterate and see what works. I know that capitation works well. We use a lot of capitation within our organization, both for employed clinicians as well as independent clinicians, and that really moves the funding closer to where the patient is to the clinicians and the patients together. I think that’s a really successful model, but it’s not the only one, and not everyone is ready for capitation.

So, I think the work of accountable care organizations is helpful, if you look at bundled payment, that could be helpful, as well. If you look at the new announcement from CMS regarding primary care, they’re really looking at ways to allow primary care physicians to take some risk for Medicare fee-for-service, which is a great thing. Some folks want choice, so they aren’t doing Medicare Advantage HMO [health maintenance organization]; they’ll do fee-for-service, and that creates a place for us to experiment, as well.

I think there’s a lot of models and I think what we want to do as a nation, locally and nationally, is to continue to iterate, reinvent, and I joke about fail fast. Try it and if it doesn’t work, do something different and keep working on it. I’m not ascribed to any particular model, I think we just have to keep working on them.