Dr. Liao’s scholarship focuses on understanding how changes in the health care system—via payment reform, care delivery redesign, and clinician behavior—contribute to value-based care transformation. He also directs the UW Medicine Value and Systems Science Lab (VSSL), the goal of which is evaluate and test innovative approaches to improve the way systems deliver care to patients and populations.
The Impact of Bundled Payments on the Value of Care
Dr. Liao co-leads a portfolio of work focused on understanding how Medicare’s bundled payments programs—value-based payment models in which providers are held accountable for the quality and costs of care across an episode of care—impact patient care. In a series of presentations at meetings such as the AcademyHealth Annual Research Meeting and papers published in peer-reviewed journals such as the Journal of the American Medical Association and Health Affairs, Dr. Liao and collaborators have demonstrated that (a) bundled payments may reduce costs of orthopedic joint replacement episodes with small improvements in quality; (b) bundled payments do not result in a significant increase in overall procedural volume or observable shifts in patient case-mix; (3) compared to hospitals in mandatory bundled payment hospitals, voluntary bundled payment hospitals are generally larger, more teaching intensive, and non-profit hospitals without differences in baseline cost or quality; and (4) Medicare could expand mandatory bundled payment to markets and hospitals very similar to currently mandated areas that would extend coverage to around 70% of beneficiaries nationwide.
The Impact of Behavioral Nudges on the Value of Care
Nudges are interventions that alter “choice architecture” and can lead to predictable changes in behavior without restricting choice. Leveraging insights from behavioral economics, Dr. Liao works with collaborators to design nudges to influence clinical decision-making that improves the value of care. For example, he currently helps lead a large-scale randomized trial of nudges embedded in the electronic health record to reduce unnecessary opioid prescribing across a network of 50 sites on the West Coast.
Value-Based Payment and Delivery Strategy
Through a body of work disseminated in peer-reviewed and other forums, Dr. Liao has become one of the leading authorities in organizational strategy related to value-based payment and delivery. Ongoing topics of interest in this portfolio of work have included (a) distinct strategies that different payers must adopt in their paths to value-based reform, (b) methods for more fully operationalizing population health initiatives, and (c) approaches for using proven tools such as clinical pathways in context and service of emerging value-based policy.