dr. fratkin too, and here we are in our house. who would even think of that? >> reporter: dr. clarke, who hadn't done video consultations before meeting the schlesigers, is impressed. >> this was my first experience with telemedicine. i found it, in fact, much more powerful than i was anticipating. i think this could be a really powerful tool to allow us to take better care of patients, particularly when they're becoming less mobile toward the end of life. >> reporter: but despite the promise, dr. clarke does not yet have a mechanism to bill for video consultations. for dr. fratkin's older patients, medicare often pays after an initial face-to-face visit. and, through a new pilot program for medicaid patients, he's trying to replace the traditional fee for service system with a so-called value- based payment model. here's how it works: >> for eligible participants, we'll be provided a per member, per month amount of money. with this value-based payment model, it doesn't matter whether we see the person once a month or twice a day. it doesn't matter if we send a social worker o