With scores of political offices in contention during this year's election, healthcare remains a complex and hotly debated issue -- prompting the Council of Accountable Physician Practices to issue a primer for candidates, detailing what the group has identified as the three most important health policy considerations.
CAPP's suggestions for candidates, be they local, state, or presidential, are to accelerate the movement to value-based payment; encourage the widespread use of health information technology; and improve and harmonize quality measurement and reporting.
A value-based payment system, CAPP contends, is essential since the traditional fee-for-service model "leads to billions of dollars in inappropriate and unnecessary care." Better, said CAPP, to pay healthcare providers for producing health, regardless of whether that entails doing more or less.
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Value-based payment models already exist; Medicare's Accountable Care Organization programs are but one example, and bundled payments for episodes of care are another. But CAPP recommends moving more quickly toward full global capitation for the total cost of care. ACOs, meanwhile, should facilitate positive outreach by providers to their patients, while payers should broaden the scope of bundled payment programs to include the most common chronic conditions, such as coronary artery disease and diabetes, the group said.
When it comes to a robust HIT framework, CAPP says this is "a prerequisite for putting an end to the fragmented, disorganized state of our healthcare system." Candidates, CAPP said, should demand full interoperability of HIT systems. Under the HITECH Act of 2009, the federal government invested $30 billion in incentives for healthcare providers to purchase HIT, yet different vendors' systems can't "speak" to one another -- which means a single patient's information can be scattered across multiple systems, operated by different providers, with no way to bring it all together. That results in fragmentation, which candidates should aim to fix, CAPP said.
In the group's ideal world, candidates would also support payment for the use of HIT to expand access to care in both rural and urban areas. As it stands, Medicare will not pay providers for patient interactions that take place over the phone, secure email or video unless they in rural areas -- which CAPP thinks should change.
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Quality measurement, the organization said, is paramount because the best practices of the highest-performing medical groups and organizations can be shared with the rest of the healthcare system. But since current efforts to measure quality are highly fragmented, CAPP is suggesting to candidates that they support a movement toward standardized quality measures across payers, including Medicare.
"The combination of 21st century information technology, tools to measure and improve quality and payment based on outcomes, not the volume of services provided, create the optimal conditions for physicians and their patients to work together to achieve and maintain health," said Robert Pearl, M.D., chairman of CAPP, executive director and CEO of The Permanente Medical Group and president and CEO of the Mid-Atlantic Permanente Medical Group, in a statement. "Regardless of the election results, the health of our nation must be a top priority. By bringing these healthcare issues into the political discourse, the leaders of CAPP believe physicians across our nation can begin to embrace those approaches that produce the highest quality and best health outcomes."
Twitter: @JELagasse