American Medical Association Works On Permanent Medicare Physician Payment Reform

Main Category: Medicare / Medicaid / SCHIP
Article Date: 11 Nov 2008 - 3:00 PST

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Enacting permanent Medicare physician payment reform to preserve access to health care for seniors is a top priority of the American Medical Association (AMA), and AMA members discussed how best to achieve this goal at the organization's semi-annual policy-making meeting today.

"Seniors and physicians achieved a great victory this summer when Congress stopped harsh Medicare cuts that would have harmed seniors' access to health care," said AMA Board Member Steven J. Stack, M.D. "We must build on that momentum and use the 13 months left in the timeframe Congress provided, before cuts begin in 2010, to achieve consensus on how to permanently solve this problem. The discussion at this AMA meeting is an important step toward that goal."

Some of the specific reform proposals under review by the AMA and its partners in the state and specialty medical societies, and under discussion at the meeting, include: gainsharing, the medical home model, quality incentives, bundling payments for medical services and demonstration projects that test new payment models.

"There's a growing recognition that there is no one pathway to fix the broken Medicare physician payment system and achieve greater value for patients," said Dr. Stack. "The solution will involve a mix of promising proposals that can fix the payment system and also help improve the quality of patient care. For example, a patient-centered medical home has the potential to reduce fragmentation and improve treatment for millions of Americans with multiple chronic illnesses."

"Gaining widespread physician input and consensus for these reforms will help Congress achieve its stated goal of permanent Medicare reform in the next Congress," said Dr. Stack. "Millions of baby boomers will reach Medicare age in the next few years, and we must ensure that the reforms we work on now will make the program strong and sustainable for generations of patients and physicians to come.

To help achieve greater value in the health care system, the AMA built on its commitment to comparative effectiveness research (CER) by adopting principles to create a centralized comparative effectiveness research entity. CER is needed to help physicians gain knowledge about whether new treatments outperform existing treatments. The new principles include a call for transparent, rigorous scientifically sound research methods, oversight by patients and physicians and dissemination of research to health care professionals.

"It's vital that the nation invest in comparative effectiveness research to ensure the promise of high-quality, effective health care," said Dr. Stack. "These new principles can serve as a guideline as Congress works to develop a federally supported CER entity."

American Medical Association