Succeeding in value-based payment: Beyond face-to-face visits

In an interview with Medical Economics following the ACP Internal Medicine Meeting 2025, Joshua M. Liao, MD, explains how primary care practices can adapt to value-based payment models that reward care delivered outside traditional office visits — without overwhelming clinicians.

“It is a false kindness that suggests that extra strategies do not create extra effort and therefore potentially burden,” said Liao, professor of medicine and public health with tenure, Walter Family Distinguished Chair in internal medicine, director and principal scholar, program on policy evaluation and learning at the University of Texas Southwestern Medical Center. “We just need to acknowledge that every effort requires some type of energy or investment.”

He offered two practical approaches. First, practices should maximize the value of in-office time — particularly during Medicare annual wellness visits — by using health needs assessments to uncover broader patient issues like medication risks, mobility concerns, or social determinants. “Those are captive moments where the things you do in the visit can dictate what you do outside the visit with nurse follow-up,” Liao said.

Second, practices can leverage existing reimbursement tools like chronic care management (CCM) and principal care management (PCM) codes. “Historically, all of that stuff went unreimbursed,” he said. “But now with these codes, you can actually be reimbursed… It’s like a monthly thing where you call a patient, you work on a care plan, and you check in on their conditions.”