A Medicare payment system focused on quality

A guest column by the American Medical Association, exclusive to KevinMD.com.

Every physician caring for Medicare patients knows that the current payment system isn’t working. Most seniors know it too. For much of the last decade, patients and physicians have joined together to tell their elected officials that the system is broken. The response from members of Congress has been to stave off an immediate access to care crisis by delaying Medicare cuts to physicians in the short-term.

There is bipartisan agreement that these short-term patches grow the problem and aren’t a viable long-term solution. Now, Congressional leaders are asking physicians for their ideas on how to transition to a Medicare physician payment system that provides long-term stability and supports high-quality care. The AMA is eager to work with elected officials on both sides of the aisle to create an environment in Medicare where innovations in patient care can flourish and physician practices can thrive.

We are committed to working with Congress and the administration to address both immediate and long-term concerns about Medicare. It is time for a plan that stops the cut of nearly 27 percent scheduled to hit physicians who care for Medicare patients on January 1. We need to move away from the broken physician payment structure and toward a program that ensures the best health outcomes for patients and a stable, rewarding practice environment for physicians.

The AMA has long championed the idea that physicians are natural leaders to foster and implement positive change in health care. For the last two years, an AMA-convened group of physician leaders from state and specialty medical societies have worked to develop a strategy to stop the broken payment formula and put in place payment and delivery innovations that lead to well-coordinated, high-quality patient care and reduced health care costs.

With that solid foundation in place, we recently shared with Congress physician-supported principles that can serve as the basis of the transition to a payment structure for a higher-performing Medicare program that works for patients and physicians. The principles were endorsed by more than 100 specialty and state medical societies – the vast majority of physician organizations.

The principles stress that investment in, and support of, physicians and their practice infrastructure is a crucial part of delivery and payment reform. Medicare payment updates should reflect the costs of providing services to patients and physicians’ investments in quality improvement and cost management. These core elements provide a framework to help Congress restructure the Medicare physician payment system into a program that enables healthy patients and stable physician practices while maximizing the value of our health care spending.

In a program as large as Medicare change will not happen overnight, but even small changes can make an important difference in health care quality and cost. It is important to look at health plans, regional health care collaboratives and physician specialty organizations that have developed new models of care so we can learn from their experiences and use the best ideas in Medicare.

To ensure success, Medicare should provide a way to measure progress and should also provide stability for patients and physician practices during this time of transition. By providing a variety of payment models, physicians can choose what works best for their patients and their practice.

As the nearly 27 percent cut looms on January 1, there is an opportunity now to make real, long-term progress in Medicare. Instead of a roller-coaster future of short-lived interventions, the AMA is ready to work with our elected leaders on a system that emphasizes quality innovations for patients and reduces costs so Medicare will be there for seniors now and in the future.

Jeremy Lazarus is President, American Medical Association.

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