EP525: PMPM vs FFS—The Perverse Incentives Plan Sponsors Sometimes Miss, With Cristin Dickerson, MD
Summary
Host and Dr. Kristen Dickerson analyze perverse incentives in PMPM versus fee-for-service payment models. They argue that FFS can be viable for defined care pods if vendors lack referral power and provide transparent data. The discussion highlights how ethical alignment and auditability mitigate FFS volume risks better than capitated models.
Topics discussed
Intro: PMPM vs FFS and perverse incentives
Supply chain analogy and procurement strategies
Flavors of fee-for-service and price transparency
Risk allocation in PMPM vs FFS models
Mitigating volume incentives in radiology
Enlightened leadership and ethical alignment
Contract flexibility and termination rights
Data analytics and clinical expertise
Outro: Newsletter, social media, and donations
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