American Medical Association members discussed how to enact permanent Medicare physician payment reform at the organization's semi-annual policy-making meeting Monday.
"Seniors and physicians achieved a great victory this summer when Congress stopped harsh Medicare cuts that would have harmed seniors' access to healthcare," said AMA board member Steven J. Stack, MD. "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."
Some of the specific reform proposals under review by the AMA 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," Stack said. "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."
Stack said that with millions of baby boomers reaching Medicare age in the next few years, payment reforms are necessary to make the program "strong and sustainable" for generations to come. He also noted that "widespread physician input and consensus" are critical to the Medicare reform process.
In addition to debating payment reform, the AMA also adopted principles to create a centralized comparative effectiveness research entity. The association argues that comparative effectiveness research is needed to help physicians gain knowledge about whether new treatments outperform existing treatments.
The new CER 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 high-quality, effective healthcare," said Stack. "These new principles can serve as a guideline as Congress works to develop a federally supported CER entity."