Following recent
announcements from the Health and Human Services (HHS) department on
new accountable care initiatives for primary care physicians, health
care executives presented a prescription for the growth of value-based
care at the 2019 World Health Care Congress.
“The proposed new models are very important because they create
additional pathways for primary care physicians to participate in
accountable care and population health,” said panel moderator Norman
Chenven, M.D., founding CEO, Austin
Regional Clinic; and Vice Chairman, Council
of Accountable Physician Practices (CAPP), a coalition of visionary
medical groups and health systems leaders. “To transform our health care
system to deliver better, more efficient care, we must change to a true
value-based system – not only in payment, but in scalable clinical and
operational methods as well. All players must be aligned in this seismic
shift – including hospitals, primary care, and specialists.”
The Centers for Medicare and Medicaid Services (CMS) Primary Cares
Initiative is described by HHS as a new set of payment models that will
further empower primary care to deliver better value for patients
throughout the healthcare system. CMS projects the new voluntary
programs will shift at least a quarter of people in traditional Medicare
out of fee-for-service. The focus is on smaller physician practices as
well as larger groups, giving options for participation and bonuses for
patients who are kept healthy and out of the hospital.
The World Health Care Congress panel, “Do Medicare Changes Enhance or
Hinder Clinical and Payment Transformation?”, also sparked
discussions of the magnitude of change required to go from a
100-year-old fee-for-service approach that focuses on sick people to a
paradigm that rewards the ability to keep people healthy and to manage
them efficiently if they are ill. The role of the primary care doctor is
critical to this shift because the patient-doctor relationship fosters
wellness and prevention.
Panelists included Valinda Rutledge, Vice President of Federal Affairs,
America’s Physician Groups and Vice President, Public Payer Health
Strategy, Greenville Health System; Niyum Gandhi, Executive Vice
President and Chief Population Health Officer, Mount Sinai Health
System; Melanie Matthews, Chief Executive Officer, Physicians of
Southwest Washington; and Paul Grundy, MD, Founding President,
Patient-Centered Primary Care Collaboration.
About the Council of Accountable Physician Practices
The Council of Accountable Physician Practices (CAPP), an affiliate of
the AMGA Foundation, is a coalition of visionary medical group and
health system leaders. We believe that physicians working together,
backed by integrated services, systems and data and technology, can best
shape and guide the way care is delivered so that the welfare of the
patient is always the primary focus. For more information, contact CAPP
at http://accountablecaredoctors.org/.
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