In an October 15, 2012 letter to Congress, the American Medical Association (AMA) and 110 state and specialty societies emphasized that they and their patients must retain flexibility in determining how best to meet their health care needs in order to support a Medicare reform plan. The letter also indicated that payments under a new system must reflect the true costs of providing care and reward doctors accordingly.
It’s common knowledge among doctors that, for the past decade, Congress has maintained an unstable pay system that has hurt practices and prevented improvements in health care delivery. Until Medicare is fixed permanently, the ongoing threat of budget cuts puts the entire health system at risk.
How does a physician practice or hospital system stay in business when payment models are uncertain? The answer: it can’t!
A Game of Chicken
The annual ritual of threatening Medicare pay cuts provokes lawmakers to act, usually at the eleventh hour, to prevent paralyzing the health system. The ongoing challenge, of course, is where to find the approximately $300 billion to pay for a permanent solution.
But, organized medicine is tiring of the game simply because they cannot run their business or organization with ongoing uncertainty, especially when facing the impending “meaningful use” criteria.
The current sustainable growth rate formula used to help calculate Medicare physician pay rates is unsustainable.
Finding What Works — Together
One payment model won’t fit every practice, so it’s important that the next system include a variety of ways to deliver patient care, said Jerry Kennett, MD, chair of the American College of Cardiology’s advocacy steering committee.
Cardiologists have been participating in bundled payment and Accountable Care Organization (ACO) initiatives, both of which reward physicians who provide higher-quality care instead of simply more volume. They also have used EHR functions that ensure tests ordered for patients are appropriate.
“From the cardiology perspective, we have proven tools that work,” Dr. Kennett said.
“The AMA has consistently urged Congress to eliminate the broken Medicare physician payment formula so we can begin to transition to new payment and delivery innovations that improve patient care,” said AMA President Jeremy A. Lazarus, MD.
“Today, we offer principles that should be the foundation of a new system that supports physicians in improving the delivery of care with payment options that benefit patients, physicians and the Medicare program,” he added.
What are your thoughts on Accountable Care Initiatives? I encourage you to share your thoughts via a comment below.