Precision medicine should have its place in new pay models

Brendan Murphy , Senior News Writer

Citing the movement to a health care system that is rooted in value-based care, the AMA committed to working to integrate precision medicine into alternative payment models (APMs) at the 2018 Annual Meeting in Chicago.  

Drive precision medicine

The AMA is leading research, advocacy and education efforts to guide physicians through ethical, regulatory and technical issues.

A report from the AMA Council on Medical Service touted precision medicine—a tailored approach to health care that accounts for individual variability in the genes, environment and lifestyle of each person—for having the “potential to revolutionize diagnosis and treatment of disease and, in doing so, improve health outcomes downstream.”

The implementation of that individualized approach in APMs, which emphasize cost efficiency, is stymied somewhat by the front-end price tag of certain precision medicine techniques.

To address the cost challenges associated with that integration, the AMA House of Delegates adopted new policy that:

  • Affirms clinical pathways should be developed by clinical experts, including national medical specialty societies, and should be leveraged by or integrated into electronic health records (EHRs) for decision support, seamless documentation, and automation of communication with payers for authorization.
  • Encourages alternative payment models to incorporate evidence-based clinical pathways as appropriate and as recommended by national medical specialty societies.
  • Supports transparent and accessible rapid-learning systems with the ability to extract clinically meaningful information and use it to modify clinical practice guidelines and pathways in real-time.
  • Supports assessment within new payment and delivery models of the value of evidence-based precision medicine tests and therapeutics to patients, families and the health care system, including the impact on patient experience, disease progression, quality of life and survival.
  • Encourages APMs to integrate precision medicine approaches, where appropriate, to improve the diagnostic process and personalize patient care.
  • Encourages APMs to measure patient outcomes and quality improvements over time to allow for the use of precision medicine tests and therapeutics that have clinical value.

Read more news coverage from the 2018 AMA Annual Meeting.