Adopting care delivery reforms in your practice can help you achieve better physician-led, patient-centered care and increase your professional satisfaction. New resources from the AMA can help guide you through an appropriate payment system for new models of care.
Developed by the AMA Innovators Committee, a new guide (AMA login required) demonstrates how payments might flow to individual physicians, non-physician health care professionals and facilities under new delivery and payment models. The guide, “Where do I fit in? Dividing the pie in new payment models,” focuses on two types of fee-for-value payment models that aren’t as well-understood by physicians: global budgets and episode-based bundles.
The guide includes information on identifying the services, physicians and other health care providers to include in or exclude from a fee-for-value payment model. It discusses risk-based guidelines, incorporation of new payment models into governance and organization, alignment models that enable fee-for-value compensation and different payment options. The resource also includes a series of case studies, offering examples from real practices of how payments in new models can be divided.
A webinar at 7 p.m. Eastern time May 13, the ninth in a series hosted by the AMA Innovators Committee, will discuss the importance of organizational principles and governing structures as a means to ensure physicians have a seat at the table when the “payment pie” is divided.
Webinar participants will learn how to shift payment negotiations from fee schedules to risk-sharing agreement terms and the design of the risk bearing entity, and will hear why provider productivity will continue to be factored into fee-for-value payments.
Find the entire webinar series and more resources on payment and delivery reforms on the Innovators Committee Web page.
“As the transition toward value-based payments continues, all health care stakeholders will need to balance the use of nationally recognized and standardized measures with a more flexible approach that enables local providers to identify measures and targets, as well as payment mechanisms that take into account their unique circumstances,” the AMA Council on Medical Service stated in a report issued at the AMA Interim Meeting in November.
The report commented on physician-led, team-based models and payment mechanisms and highlighted some challenges to transitioning from volume-based to value-based health care.
The report supports physician leadership in decision-making regarding payment disbursement and states that physicians should work collaboratively with hospital and payer partners to design models best suited to their circumstances.
Through its Physician Satisfaction and Practice Sustainability initiative, the AMA is using research, data and analytics to identify effective delivery and payment models that lead to improvements in the quality of care for patients, better controlled health care costs for the nation, and greater professional satisfaction for physicians and their colleagues.
