- On Monday, speakers at the 2016 National Health Policy Conference in Washington, D.C. discussed the issues surrounding physician payment reform while the country shifts towards a value-based healthcare system.
- Physicians are likely to be burdened by changes to their practices during the transition, according to Lois Nora, MD, president and CEO of the American Board of Medical Specialties.
- There are several changes required to move the system to the new model, including increased transparency.
As healthcare leaders discuss how to shift the system to value-based care, the impact on physicians has been somewhat neglected. Figuring out how physicians can adapt to this new model in a way that will not cause disruptions in their practice is imperative, especially because of the reportedly high burnout rates.
At the conference, speakers from CMS, the Network for Regional Healthcare Improvement, and the American Board of Medical Specialties discussed issues around new physician payment models.
“Why are we moving to value-based payments?” Network for Regional Healthcare Improvement CEO Elizabeth Mitchell asked. “Because we simply can't afford to have fee-for-service anymore. It doesn't add up anymore so the urgency is quite high.”
Everybody is getting on board, like it or not, Mitchell said about involving more than just the healthcare community in the transition from the traditional fee-for-service to value-based payments and lower costs.
“We're trying to shift to the healthcare system to better care and smarter spending,” CMS' CMO Patrick Conway said at the session.
According to Mitchell, some of the required changes for the transition include:
- New measures of quality and costs;
- Alignment across all payers;
- New shared data infrastructure;
- New incentives; and
- New community partners.
One of the humps needed to be overcome involves how practices are changed, Nora said. From the perspective of access, physicians and other providers shouldn't be lost along the way, she added.
About 400 physicians are expected to commit suicide next year due to burnout associated with changes in medical practice, including new employment models and EHRs, Nora said.
How can physicians be supported during the transition, which is contributing to their burnout?
The profession is poised to act on these efforts because high quality care means a great deal to physicians, Nora said. However, with regards to creating new measures of quality of care and costs, physicians have emphasized the focus should be on what is important to measure, rather than what is easily measurable, she said. Physicians have also expressed concern about lack of consensus among measure sets.
The Medicare Access and CHIP Reauthorization Act (MACRA) presents an important opportunity for physicians because it offers new approaches and opportunities. MACRA links payments to value through the Merit-Based Incentive Program and measures physicians in four areas: Quality, cost, technology use, and practice improvement, Healthcare Dive previously reported.
In addition, Nora expressed effectively engaging physicians could lead to improving the development and implementation of quality measures.