News in brief - May 11, 2009

Renamed organization gathers physicians' voices

Doctors for America is asking physicians to share their perspectives on health reform via the organization's Web site (www.drsforamerica.org).

The organization formed a year ago as Doctors for Obama to support the presidential candidate's health reform proposal. Its leaders are calling for measures that bring affordable health insurance to all Americans, ensure quality, expand access to care and foster practice environments that allow physicians to focus on patient care.

Vivek Murthy, MD, Doctors for America president and co-founder, said the group's purpose is not to replace existing physician organizations but to get individual doctors' opinions to a broader audience. "We don't speak for doctors. They speak for themselves."

The organization has nearly 11,000 members with a variety of backgrounds and ages from all 50 states, and it receives no external funding, Dr. Murthy said. Senate Finance Committee Chair Max Baucus (D, Mont.) said during a conference call about the organization that he's reaching out to all physicians.

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Insurers move forward with pay-for-performance

As the nation faces the crushing burden of health care costs, health insurance plans are teaming with physicians and hospitals through innovative pay-for-performance models in an attempt to improve quality and enhance patient satisfaction, according to America's Health Insurance Plans.

AHIP announced April 28 the release of a new publication, "Innovations in Recognizing and Rewarding Quality," that it says demonstrates how health plan payment models are improving outcomes and lowering costs. Some programs reward physicians for making structural changes, such as adopting electronic health record systems. Others involve rewarding doctors for more actively monitoring and coordinating care for patients with chronic illnesses.

The report contains views of physicians who observe that pay-for-performance has the potential to increase the use of best practices and promote access to appropriate and timely care, AHIP said. According to the insurance association, health plans typically use nationally recognized performance measures to evaluate physicians, including the Healthcare Effectiveness Data and Information Set, which was developed by the National Committee for Quality Assurance.

The full publication is available online (www.ahip.org/content/default.aspx?docid=26393).

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Illinois clinic settles Medicaid antitrust suit

An Illinois medical clinic settled an antitrust case brought by the state attorney general over allegations that the group refused new Medicaid patients in an effort to force higher payment rates.

The April 27 agreement resolves claims that Christie Clinic conspired with another medical practice to boycott new Medicaid patients, forcing them to seek more expensive care in emergency departments at the state's expense. The two groups employ roughly 90% of physicians in the Champaign County area, according to legal records.

Christie Clinic, which stopped accepting new Medicaid patients in 2003, agreed to provide primary care to an additional 8,500 Medicaid patients over the next three years. The group also is prohibited from turning away patients on the basis of medical debt and will contribute $120,000 to local programs providing primary and preventive care to low-income patients. The settlement awaits final court approval.

The other clinic named in the case, Carle Clinic, entered into a similar agreement with the attorney general in December 2008. Both medical practices denied any wrongdoing.

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