OMSS Education - Health Care Delivery Systems and Reform
--Free for AMA members; $30-45 for non-members.
CME credit is no longer available for this program.
Faculty
Paul R DeMuro, JD, CPA, MBA
Description
With the advent of Accountable Care Organizations (ACOs) physicians are interested in understanding what form(s) their relationship with any accountable care organization might take. This program will discuss the types of entities that may serve as accountable care organizations and the types of relationships that may exist between physicians and those entities. Those relationships may involve ownership, investment, provider or employment. It will also discuss the pros and cons of those potential arrangements and any ethical issues they may pose.
Learning Objectives
- Recognize the types of entities that may serve as providers of accountable care.
- Identify the forms of relationships a physician may have with an accountable care entity.
- Discuss the pros and cons of those relationships and any potential ethical considerations they may present.
View webcast to earn 1.0 AMA PRA Category 1 CreditsTM
Faculty
- Henry Allen, MPA, JD
- Elias Matsakis, JD
Description
The American Medical Association (AMA) adopted ACO principles on November 9, 2010, at its Interim Meeting in San Diego. The Association is advocating that participation by physicians be voluntary and that barriers for small practices to participate be eliminated. This program will discuss the soon to be released accountable care organization regulations and related issues (e.g. Antitrust). These regulations, will determine how ACOs qualify for CMS' shared savings program in 2012. In addition, the program will explain how ACOs are intended to help physicians and others, including hospitals, coordinate and provide effective quality care. Finally, the program will describe the new nonprofit, member-run health insurer ("CO-OP") program that provides federal loans and grants for start-up insurers that physicians and others might establish and operate, and that may collaborate with physician-driven ACOs.
Learning Objectives
- Describe what accountable care organizations (ACOs) are and the types of issues with which physicians will most likely grapple with when considering ACO participation.
- Discuss the Accountable Care Organization (ACO) Regulations.
- Describe the tools necessary to participate in ACOs.
- Discuss managing the antitrust ramifications of ACO formation and physician joint contracting with payors.
- Describe many of the specific issues that physicians must consider when deciding whether or not to create an ACO with hospital partners.
- Identify some of the key issues that should be considered by physicians deciding whether or not to partner with hospitals or health insurers to create an ACO.
- Discuss what CO-OPs are; the new opportunities for CO-OPs that now exist in a post-health reform world, and what those new opportunities may mean for physicians.
Download lecture materials:
View webcast to earn 1.0 AMA PRA Category 1 CreditsTM
Faculty
Bruce Johnson, JD, MPA
Description
This program will discuss physician compensation in today's environment. It will provide participants with information on variables that will assist them with understanding and making career choices that are more aligned with their professional and lifestyle interests. It will provide an overview of the basis for compensation and compensation methods used. It will provide an understanding of some of the differences experienced by physicians in similar specialties based on method of compensation, type of practice and practice ownership (solo, group, and hospital). Time will be made available for Q & A and resources to assist participants with further understanding of the environment and choices will be identified.
Learning Objectives
- Describe the basis for physician compensation and the methods used in today's healthcare environment.
- Discuss the likely impact of health reform on reimbursement and compensation.
- Examine differences in compensation based on geography, experience, specialty, type of practice and practice ownership.
- Identify resources to enhance physicians' understanding of compensation
Pathways for Physician Success in Accountable Care Organizations and Healthcare Payment Reform
CME credit is no longer available for this program.
Faculty
Harold Miller
Description
The Patient Protection and Affordable Care Act (PPACA) establishes voluntary pilot projects to develop three new care delivery and payment models: bundling, the medical home, and accountable care organizations (ACOs). In addition to these Medicare and Medicaid programs, the private market is rapidly moving to adopt these arrangements. Enabling individual and small group physician practices - which account for the majority of physicians currently practicing in the U.S. -- to participate in these new arrangements is a stated goal of many health care policymakers and of industry, and is a top priority of the AMA. The AMA is uniquely positioned to provide both education about these reforms and the "Pathways" for physicians to participate - i.e. a hands-on, "how to" guide for this critical segment of physicians.
Learning Objectives
- Explain the concepts of accountable care organizations (ACOs), bundling, and medical home.
- Identify the necessary pathways to enable physician participation in these reform models.
Legal Issues and Structures for Accountable Care Organizations
CME credit is no longer available for this program.
Faculty
Anthony Schiff, JD, MPH
Description
The Patient Protection and Affordable Care Act (PPACA) establishes voluntary pilot projects to develop three new care delivery and payment models: bundling, the medical home, and accountable care organizations (ACOs). In addition to these Medicare and Medicaid programs, the private market is rapidly moving to adopt these arrangements. Enabling individual and small group physician practices - which account for the majority of physicians currently practicing in the U.S. -- to participate in these new arrangements is a stated goal of many health care policymakers and of industry, and is a top priority of the AMA. The AMA is uniquely positioned to provide both education about these reforms and the "Pathways" for physicians to participate - i.e. a hands-on, "how to" guide for this critical segment of physicians.
Learning Objectives
- Describe the tools necessary to participate in ACOs, bundling and medical home.
Part 3 - ACO/Bundled Payment Panel Presentations and Discussions
CME credit is no longer available for this program
Faculty
- Theodore Mazer, MD
- Richard Afable, MD, MPH
- Hector Flores, MD
- Anthony Schiff, JD, MPH
- Harold Miller (moderator)
Description
The Patient Protection and Affordable Care Act (PPACA) establishes voluntary pilot projects to develop three new care delivery and payment models: bundling, the medical home, and accountable care organizations (ACOs). In addition to these Medicare and Medicaid programs, the private market is rapidly moving to adopt these arrangements. Enabling individual and small group physician practices - which account for the majority of physicians currently practicing in the U.S. -- to participate in these new arrangements is a stated goal of many health care policymakers and of industry, and is a top priority of the AMA. The AMA is uniquely positioned to provide both education about these reforms and the "Pathways" for physicians to participate - i.e. a hands-on, "how to" guide for this critical segment of physicians.
Learning Objectives
- Explain the concepts of accountable care organizations (ACOs), bundling, and medical home.
- Describe the tools necessary to participate in ACOs, bundling and medical home.
- Identify the necessary pathways to enable physician participation in these reform models.
Download lecture materials:
View webcast -- Note: CME credit is no longer available for this program.
Faculty
Mark Miller, PhD
Description
A primer on bundled payments is both needed and timely due to the recent events in Health System Reform. This program will address bundled payments as it occurs today and the role it will play as Health System Reform rolls out. An explanation of how bundled payments will effect the management of care and mode of practice for physicians will be discussed. This program will speak to the methodologies used for bundled payments. Specifically, references to the Medicare demonstration back in 1990's will be talked about. Physicians will be educated on how to help improve quality and provide better value to their practices.
Learning Objectives
- Discuss bundled payment as it occurs today and its likely role in Health System Reform.
- Explain how bundled payment does and will effect the management of care and mode of practice.
- Identify examples of how bundled payments are or can be distributed, the methodologies used and its impact on physician compensation.
- Assess what the likely impact of bundled payment will be on the provider/physician-patient relationship.
View webcast -- Note: CME credit is no longer available for this program.
Faculty
Rosemarie Nelson, MS
Description
Learn how best to transition your practice to an electronic health record (EHR). Whether you already have an EHR or you are in the selection process, identify the steps you need to take to best meet your practice’s requirements and qualify your physicians for the maximum stimulus incentives. Key issues such as creating your EHR team, managing change in your practice, and setting realistic expectations and goals. Lessons learned from the field will also be included.
Learning Objectives
- Describe the process of evaluation and selection
- Discuss “meaningful use”, interoperability and HIPAA requirements.
- Choose and prioritize unique office IT needs.
- Recommend steps to follow to successfully evaluate the available IT solutions.
- Illustrate tools to assist with vendor evaluation.
- Determine how to check references.
- Compare and contrast the various platforms (cloud, health system provided, standalone, etc.)
- Identify what form of agreement
- Demonstrate negotiating the agreement
View webcast -- Note: CME credit is no longer available for this program.
Faculty
Frank Opelka, MD, FACS
Description
As Health System Reform is implemented, Accountable Care Organizations (ACOs) will become more prevalent in the delivery of healthcare. This program will identify and discuss organizational structures for the future of physicians' practices. It will delve into the various forms of relationships a physician may have with these new structures. Real life case studies will be presented proving physician led ACOs have been successful. Physicians will leave with the tools and knowledge needed to organize and lead a new structure for physicians practices.
Learning Objectives
- Discuss the likely role of Accountable Care Organizations based on the status of Health System Reform initiatives.
- Identify and discuss organizational options for taking full responsibility for care, receiving and distributing bundled payment.
- Differentiate the forms of relationships a physician may have with these structures.
- Explain the role of physicians if they are to lead and control structural options for taking full responsibility for care, receiving and distributing bundled payment.
- Demonstrate real life case studies of physician led ACOs that have been successful.
- Citing real life example, explain the steps one could take to initiate and develop an Accountable Care Organization.
CME credit is no longer available for this program.
Faculty
Rosalio Lopez, MD
Description
As Health Care Reform continues to evolve and change, hospital medical staffs will inevitably change. In order to effectively perform in the shifting environment and to ensure patient safety and quality of care it is critical to organize your medical staff accordingly. In this educational program you will be armed with the knowledge to organize your hospital’s medical staff based on both consumerism and patient safety. This program will demonstrate how to compete and get organized in today’s challenging environment in order to successfully perform as physicians and provide quality care to your patients.
Learning Objectives
- Discuss how to organize your medical staff in the current environment.
- Demonstrate how your medical staff can compete in today’s healthcare setting.
- Create effective strategies to ensure patient safety and quality of care.
View webcast -- Note: CME credit is no longer available for this program.
Faculty
- Joseph Corkery, MD, Lahey Clinic (Mass.)
- Gary Piefer, MD, WellMed Medical Group (Texas)
- Mark Shields, MD, Advocate Healthcare (Ill.)
Description
In a frequently-cited New Yorker article, physician author Atul Gwande, MD, wrote, "As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of [accountable care organizations (ACOs)]." ACOs can include multispecialty medical groups, physician organization such as IPAs, regional information networks, PHOs, or any health system that strives to integrate and coordinate the work of a community of physicians and health care professionals to provide comprehensive care for patients. In an ACO, health care professionals work in teams and are supported by the organization's workflow processes, communications procedures, and payment systems. This program will demonstrate how health care professionals have contributed to the development of successful physician-driven ACOs. Physician attendees will learn how they can be involved in leading change in their own communities and advance or advocate for the ACO model.
Learning Objectives
- Summarize the ABC's of ACOs.
- Illustrate how different physician organization models have achieved varying degrees of accountability.
- Analyze how effective physician leadership can influence organizational change that leads to more accountable care.
Download lecture materials:
- Corkery persentation
- Piefer presentation
- Shields presentation and handout
