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OMSS Education - Health Care Delivery Systems and Reform

*View webcast to earn continuing medical education (CME) credit).
--Free for AMA members; $30-45 for non-members.
*ICD-10: Key actions for practices to prepare for the regulatory mandate (June 2014)
*A global perspective on accountable care organizations (June 2014)
*ICD-10: Actions physician's need to be taking now to prepare for the regulatory mandate (Nov. 2013)
*Care delivery: Physician satisfaction/sustainability (Nov. 2013)
*Win-Win-Win Approaches to Accountable Care (June 2013)
*Lessons Learned from Newly Integrated Medical Practices: Two case studies (June 2012)
Your Relationship with an Accountable Care Organization (Nov. 2011)

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

  1. Recognize the types of entities that may serve as providers of accountable care.
  2. Identify the forms of relationships a physician may have with an accountable care entity.
  3. Discuss the pros and cons of those relationships and any potential ethical considerations they may present.

Download lecture materials

Update on Accountable Care Organizations (June 2011)

CME credit is no longer available for this program.

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

  1. Describe what accountable care organizations (ACOs) are and the types of issues with which physicians will most likely grapple with when considering ACO participation.
  2. Discuss the Accountable Care Organization (ACO) Regulations.
  3. Describe the tools necessary to participate in ACOs.
  4. Discuss managing the antitrust ramifications of ACO formation and physician joint contracting with payors.
  5. Describe many of the specific issues that physicians must consider when deciding whether or not to create an ACO with hospital partners.
  6. 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.
  7. 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:

Leadership Perspectives on Providing Accountable Care -- Part 1 (Nov. 2010)

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

  1. Explain the concepts of accountable care organizations (ACOs), bundling, and medical home.
  2. Identify the necessary pathways to enable physician participation in these reform models.

Download lecture materials

Leadership Perspectives on Providing Accountable Care -- Part 2 (Nov. 2010)

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

  1. Describe the tools necessary to participate in ACOs, bundling and medical home.

Download lecture materials

Leadership Perspectives on Providing Accountable Care -- Part 3 (Nov. 2010)

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

  1. Explain the concepts of accountable care organizations (ACOs), bundling, and medical home.
  2. Describe the tools necessary to participate in ACOs, bundling and medical home.
  3. Identify the necessary pathways to enable physician participation in these reform models.

Download lecture materials:

Physician Led Organizational Structures for the Future (June 2010)

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

  1. Discuss the likely role of Accountable Care Organizations based on the status of Health System Reform initiatives.
  2. Identify and discuss organizational options for taking full responsibility for care, receiving and distributing bundled payment.
  3. Differentiate the forms of relationships a physician may have with these structures.
  4. 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.
  5. Demonstrate real life case studies of physician led ACOs that have been successful.
  6. Citing real life example, explain the steps one could take to initiate and develop an Accountable Care Organization.

Download lecture materials

Organizing your Medical Staff to Effectively Perform in the Evolving Environment (Nov. 2009)

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

  1. Discuss how to organize your medical staff in the current environment.
  2. Demonstrate how your medical staff can compete in today’s healthcare setting.
  3. Create effective strategies to ensure patient safety and quality of care.

Download lecture materials

Will Physicians Lead the Way in the Development of Accountable Care Organizations? (Nov. 2009)

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

  1. Summarize the ABC's of ACOs.
  2. Illustrate how different physician organization models have achieved varying degrees of accountability.
  3. Analyze how effective physician leadership can influence organizational change that leads to more accountable care.

Download lecture materials: