Physicians are accustomed to reviewing and embracing new scientific and medical breakthroughs, but innovations on the payment side can come much more slowly.
In my own oncology practice, the fee-for-service model has resulted in an inability to give my patients needed services that would improve their quality of life. Because the current system has too many services for which there aren’t payments, I am actively looking for new methods to supplement this system so I can give my patients the care they need. Fortunately, many promising new payment methods have been under development in recent years.
Take bundled payments, for example. If I were to receive an overall payment for the care of my patients, I could allocate that to services that augment the cancer care, such as improved patient education, decision-support tools to help patients choose therapies, and calls or visits from nurses to check on how patients are doing at home.
Thanks to an award from the Center for Medicare and Medicaid Innovation, which I’ve written about before, I’m able to deliver those services in my practice and the other practices participating in the grant. The work we’re doing is helping us reduce costs and improve care by keeping patients healthier and out of the hospital.
But when the grant payments end, so would those services, without an alternative payment system that allows us to continue in this way. New payment models such as this can offer the opportunity to turn the traditional fee-for-service model and the fragmented care it produces into a more rational and patient-centered payment and delivery structure. Bundled payments can enable us to focus on care coordination across multiple physicians and other providers and simultaneously increase efficiency.
At the AMA, we’ve been urging the Centers for Medicare & Medicaid Services (CMS) to help physicians adopt new payment and delivery models. And it seems the agency is listening—in October, CMS announced a new initiative to give medical practices the technical assistance and peer-level support they need to deliver efficient patient-centered care. The Transforming Clinical Practice Initiative will award $840 million for the creation of evidence-based, peer-led collaboratives and practice transformation networks to support physicians in providing high-quality care.
This is an important step in the transformation of medicine, from enhancing the quality of care for patients to allowing more control over health care costs. It also aligns well with our Professional Satisfaction and Practice Sustainability initiative, which promotes sustainable practices that can result in improved health outcomes for patients and greater professional satisfaction for physicians.
The AMA is at the forefront of new payment and delivery models—just look at our Innovators Committee. Real physicians are sharing what they’re doing in their practices to improve satisfaction, care coordination and outcomes. The committee created a variety of resources for physicians across the country to adopt practical payment improvements, including:
- Guidance on how to “divide the pie” in new payment models
- Teachings from early payment and delivery innovators
- How to implement innovative strategies in your practice
- Webinars on many different aspects of payment reform
It’s exciting to be a part of changes that hold so much potential for improving the health of the nation. If you’re not already looking into new payment models that could help your patients and practice, I encourage you to consider doing so. Keeping the voice of physicians at the leading edge of payment reform debates will ensure future changes accomplish our main goals: improving the care experience and the health of our patients while reducing health care costs.
