Payment reform is coming

TAFP summit will help you prepare

By Kate Alfano

WHAT: Payment Reform Summit
WHEN: Oct. 1, 2011, 9 a.m. – 4 p.m.
WHERE: Austin, at the Omni Austin Hotel at Southpark

As health insurance premiums continue to spiral upward and patients are forced to take on a larger share of their health care costs, pressure is mounting for policymakers and stakeholders to find real solutions for an unsustainable system.

“Something is going to give,” says family physician Mark Laitos, M.D., immediate past president of the Colorado Medical Society. “According to our current payment and delivery system, the only tools that can put a lid on the inflation are either slashing fees or denying care. Doctors don’t like that and patients don’t like that either.”

He says physicians are in a unique situation to “take the lead, come up with our own proposals, and then work together constructively with the other stakeholders—the plans, the government, the employers—to figure out how to come up with something different from the old-fashioned system that we have that’s based on CPT codes and collecting RVUs.”

This is exactly the type of forward-thinking action the Academy hopes to spark at TAFP’s payment reform summit, “Lead or Be Led: How to Thrive in the Evolving Health Care Delivery System.” At the one-day conference on Saturday, Oct. 1, experts from around the country—including Laitos—will share their strategy for success and vision for the future, topping the event with a panel discussion to address attendees’ questions. The topics speak to family physicians in all practice types and at any stage of practice transformation.

“When people think of payment reform, they’re thinking of something coming out of Washington associated with the Affordable Care Act,” Laitos says. “What I see is that … the commercial world, the employers in my community, the patients and the plans that they work with, they are going to demand significant change. This has nothing to do with federal legislation; this has everything to do with the business of medicine and how we are organized.”

Fellow speaker François de Brantes, M.S., M.B.A., executive director of Health Care Incentives Improvement Institute, Inc., says, “The key to success in this changing environment is the ability of the physician to manage the health of the entire patient population in the practice.” HCI3 runs the innovative Bridges To Excellence and Prometheus Payment pilots.

“That means, first and foremost, having systems in place to understand how well patients are currently doing compared to how well they could be doing. Then you need people and systems to track patients, reach out to them, and manage their health as effectively as possible.”

Also speaking are Christopher Crow, M.D., M.B.A., founder and president of Village Health Partners and founder of Legacy Medical Village in Plano; W. Mike McCrady, M.D., M.B.A., vice president of clinic operations at the Trinity Mother Frances Health System; Eduardo Sanchez, M.D., senior vice president and chief medical officer for Blue Cross and Blue Shield of Texas; AAFP President Roland A. Goertz, M.D., M.B.A.; Gregory Sheff, M.D., medical director of the Austin Regional Clinic Medical Home Program; Gary Piefer, M.D., CMO of WellMed in San Antonio; and Dan Stultz, M.D., CEO of the Texas Hospital Association.

No matter the final product, physicians will be integrally involved in the delivery and success of payment reform. Mounting evidence shows that the care primary care physicians provide—coordinated, high-quality, preventive medicine—can reduce costs and improve outcomes. Physicians must now arm themselves with the knowledge and tools to be leaders in the new system.

Make plans to join the Academy on Oct. 1 at the Omni Austin at Southpark in Austin, Texas, for “Lead or Be Led: How to Thrive in the Evolving Health Care Delivery System.” To read more about the payment reform summit and to register, go to TAFP’s website.