AMA launches seminar series on health care payment models

The educational events are part of the Association's work to help physicians understand the impact of health system reform.

By Victoria Stagg Elliott, amednews staff. Posted July 30, 2010.

Physician buy-in is key if accountable care organizations and bundled payments are to fulfill the goals of health system reform, said speakers at an American Medical Association seminar held July 12 in Chicago.

"I go to a lot of meetings about payment reform. The rooms are usually filled with people from health plans and people from hospitals and people from think tanks. I can usually count on my fingers how many actual physicians are in the room. That's a huge gap," said Harold D. Miller, executive director of the Center for Healthcare Quality and Payment Reform in Pittsburgh. "Physicians are critical to making things work better in health care reform, particularly payment reform."

The seminar, "Pathways for Physician Success Under Healthcare Payment and Delivery Reforms," is the first of several on the subject to be held across the country. It included presentations by Miller as well as physicians currently involved in payment reform pilot projects. An AMA website on the topic includes several resources for physicians, some of which are available only to AMA members, others accessible to all (www.ama-assn.org/go/paymentpathways).

"The proposed payment reforms are both opportunities as well as challenges for physicians," said Rebecca Patchin, MD, immediate past chair of the AMA Board of Trustees.

An accountable care organization is a group of physicians and other health care professionals who together manage and coordinate services for a specific patient population. The Patient Protection and Affordable Care Act stipulates that the Dept. of Health and Human Services will establish a program that supports accountable care organizations for Medicare fee-for-service beneficiaries by Jan. 1, 2012. There is also a provision for accountable care demonstration projects for the pediatric population.

Bundled payments cover an episode of care, including costs for hospitalization and physician services. This law also calls for a pilot project to test bundled payments for those on Medicaid.

Dr. Patchin also announced that a workshop planned by the Federal Trade Commission, clarifying how physicians and others in the health care system will be able to form accountable care organizations without running afoul of antitrust laws, will be held in September.

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