The Final Four wasn’t the only thing happening in Dallas last week. The American Medical Group Association held its annual meeting in the Big D April 3-5.
Several PYA principals attended the meeting. After participating in several sessions and having numerous conversations with fellow attendees, we identified three big take-aways from this gathering of 1000+ healthcare professionals and executives.
Don’t expect a permanent SGR fix before the mid-term elections. Not surprisingly, there was a great deal of buzz around the newly-sewn “doc patch” legislation, including the ICD-10 delay. Those conversations, however, quickly turned to the fate of the permanent SGR fix legislation.
There appears to be near unanimous support for the structure proposed in the legislation, including the Merit-Based Incentive Payment System. MIPS would replace several existing Medicare incentive programs with a single, value-based purchasing metric.
The sticking point is the “pay-for” – how to fund the bill’s $180 billion price tag. The political professionals agree it is unlikely Congress will tackle this issue prior to the mid-term elections. Everyone hopes these prognostications are wrong, but there is no way forward at this time.
The HIT space is getting really crowded. Most of the vendors exhibiting at the conference were selling some form of health information technology (HIT): electronic health records, health information exchanges, billing systems, data analytics, and patient engagement tools.
We were reminded of the days before the dot-com bubble burst: lots of energy, lots of opportunity, but not a lot of clarity. Each technology solution sounds great in the abstract, but few have painted a picture of practicality.
HIT companies (and their customers) would be well-served by taking a step back and asking two questions: First, how exactly will a provider incorporate this technology into the provider’s day-to-day operations? Second, what specific, measurable improvements will providers realize by using the technology?
Like the dot-com bubble burst, there will be HIT survivors and HIT casualties. We expect those companies that offer customers compelling answers to these questions will be the survivors. Providers, therefore, should be asking these tough questions as they make investments in HIT infrastructure.
Quality-based compensation models are catching fire. Based on a very inexact survey, we estimate more than half of the sessions addressed in some way the need to infuse new incentives into physician compensation models. While most acknowledge the need to tie some compensation to performance, no one claims to have found the magic formula.
Big questions remain regarding the right measures to use. There are many candidates - PQRS quality measures, patient satisfaction scores, good citizenship measures, just to name a few – but no apparent consensus.
Also up in the air is the percentage of total compensation that should be based on performance. No one can say with authority what is necessary to incent certain physician behavior. Finally, there’s the question of how to get physician trust and buy-in.
But at least one question – and the one prefatory to all others – has been answered: straight production-based compensation models are not consistent with emerging value-based payment and delivery models. As we enter this period of experimentation, it will be critically important to remain informed about options and emerging trends and to engage physicians in the process.