Assisting physicians in adopting new models of care and payment that will enhance quality and lower costs is the aim of a recent request for information from the Centers for Medicare & Medicaid Services (CMS). The AMA recommended detailed actions the agency should take. Among those at the top of the list were reducing regulatory burdens, ensuring flexibility in the new models, and improving the usability of electronic health records (EHR) without micromanaging how physicians use them.
CMS Administrator Marilyn Tavenner announced at the AMA National Advocacy Conference in March that the agency would send physicians a request for information about how CMS could best help them transition to new care delivery and payment models.
The AMA’s comments, submitted this month, recommended ideas for how CMS could best help physicians make these moves, including:
- Work with EHR vendors to improve the technology, making it more flexible, less expensive and easier to share data. Such changes would help facilitate coordination of care.
- Reduce physicians’ administrative burdens by making Medicare reporting requirements more flexible and better align quality improvement and EHR programs across payers.
- Remove policy barriers that limit transformation and stand in the way of team-based care.
- Provide technical assistance, data and financial support for practices, especially small ones, during the design and implementation of new care delivery approaches.
- Create new payment models that give physicians the flexibility to deliver care outside of traditional face-to-face office visits.
The AMA also urged CMS to adapt standards, quality measures and payment models at the community level, which would make it easier for payers to align in these areas. The comments also recommend that the agency host an online resource center.
“The goal of transformation should be patient-centered, not payer-centered, care,” the AMA comments said. “A physician practice should be able to provide the same kind of high-quality care to its patients regardless of who is paying for that care, and cannot tailor its operations to each payer’s requirements or narrow networks.”
As part of its work to improve Physician Satisfaction and Practice Sustainability, the AMA is developing a series of practice transformation modules that physicians will be able to use in making important changes to their practices. The modules will include practical information about implementing such improvements as effective pre-visit planning that maximizes the physician’s time with the patient and establishing a system to allow physicians to receive patients’ lab results before they arrive for appointments.
The modules also will cover team-based care, lean management tactics to maximize value and minimize waste, systematic prescription renewals and team documentation, and a method to share medical documentation with nurses, medical assistants and scribes.
In an AMA-sponsored study by the RAND Corporation, physicians said their main sources of professional dissatisfaction were challenges caused by EHRs and the amount of administrative work they are required to complete, which takes away from time spent caring for patients. The AMA now is working with RAND to study the impact of new payment models on different practice arrangements and market dynamics.
