AMA past president: AMA "policy triathlon" could transform health care environment

SAN ANTONIO – The American Medical Association is working toward numerous goals that stand to improve health care and the practice of medicine, including some that target issues of particular concern to psychiatrists, according to Dr. Jeremy A. Lazarus.

In general, the efforts aim to enhance professional satisfaction for physicians, improve outcomes for patients, and transform medical education to make sure that current medical students are prepared to practice 21st century medicine, Dr. Lazarus of the University of Colorado Denver and immediate past president of the AMA at said at the annual meeting of the American College of Psychiatrists.

During an update on the AMA’s efforts, Dr. Lazarus described several recent activities and successes, and reflected on the "tremendous partnership that the AMA has with psychiatry and the (American Psychiatric Association).""We have a long history of fighting together," he said, referring to successes such as the decade-long effort that resulted in getting the mental health parity bill passed, the joining together of more than 80 state and specialty societies to address and combat efforts – like a successful effort in New Mexico in 2002 – to give prescribing privileges to psychologists, and – recently – participation in the Joining Forces initiative to ensure that veterans with posttraumatic stress disorder, post-combat depression, or traumatic brain injury receive the care and resources they need.

Other recent AMA activities and successes outlined by Dr. Lazarus include:

• Testifying to the U.S. Senate regarding the Sunshine Act provisions of the Affordable Care Act.

Dr. Lazarus said he voiced the AMA’s support for transparency, but cautioned that physicians need to have the right to review reported information to ensure accuracy.

The AMA is committed to making sure that "the powers that be in Washington, D.C., hear physicians’ concerns loud and clear," he said.

• Working with state medical societies and associations on numerous legislative issues that affect physicians and health care.

"The AMA achieved many legislative victories in 2012-2013, including truth-in-advertising legislation, preserving existing medical liability reforms, protecting the patient-physician relationship, and also turning back and defeating many scope of practice expansions," he said.

For example, in conjunction with 10 other specialty groups, the AMA helped to overturn a Florida law that prohibited physicians from talking to patients/parents about guns in the home and gun safety, and from making any note about the conversation in patient charts.

"We feel it is imperative that lawmakers not get in the way of physician-patient communication," he said.

• Working toward Medicare reform.

Efforts toward reform have been ongoing for a decade or more, Dr. Lazarus said.

"We are close to the finish line," he noted.

Efforts to repeal the Medicare Sustainable Growth Rate formula and to move toward different systems of paying physicians continue, as scores of state and specialty societies work together to develop a system that will provide many options for payment for physicians that will reward physicians for savings in the health care system, support practice investments so that physicians can move to different forms of practicing, and tie physician payment to their own actions rather than to those of others whom they can’t control.

"We got great news on Feb. 6 – there is now joint legislation to repeal the SGR that’s advancing in both the House and the Senate," he said, noting that the impending legislation is the result of work by the AMA and other organizations working together to "keep this issue alive, to try to modify the bills as they were going through the House and the Senate, and to make sure we got to a positive outcome."

"We want the Medicare payment program to be a stable 21st-century program that can meet the growing health care needs of our senior population, and we’ve been very pleased that the committees have made many changes recommended by the AMA," he said.

The current bill under consideration – the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 – includes a repeal of the SGR formula, automatic positive payment updates of 0.5% for the next 5 years, a consolidated and simpler Medicare quality reporting program, and the ability to transition to different models of care.

"We’ve now got a March 31 deadline. If nothing is done, there will be a 24% cut in Medicare payments, so stay tuned. We’re looking for things to advance ... we haven’t been any closer than we are right now, so we’re very hopeful," he said.

Those interested in participating in the effort to reform Medicare can visit the AMA’s FixMedicareNow.org website for more information, he noted.

The efforts mentioned by Dr. Lazarus are among the matters "high on the list for AMA advocacy," but are just a small part of the AMA’s activities.

"We’re also looking at the big picture in terms of the health care system in this country to try to lead a major effort on the big issues," he said.

Among the concerns are the "tremendously overburdened system," with 50 million individuals uninsured and $2.7 trillion in annual spending (18% of gross domestic product) with outcomes that are poorer than those of other developed countries – and with an estimated increase of spending up to $4.6 trillion (20% of GDP) by 2020. The fragmented delivery system, with a lack of coordination of care and an epidemic of chronic conditions that account for 75% of the spending, also are among the concerns being addressed by the AMA.

Facing these tremendously complicated and difficult situations, the AMA decided to "take our years of training on addressing major issues, and put them to work on what amounts to an AMA policy triathlon," Dr. Lazarus said, referring to the three-pronged plan of enhancing physician satisfaction, improving health outcomes, and accelerating needed changes in medical education.

"We’ve committed to finishing this race," he said, noting that it will be a long one.

Efforts to improve care delivery models include collaboration with the RAND Corp. to conduct field research at 30 diverse practice settings across the country to identify factors associated with success and satisfaction.

Results are forthcoming, but initial findings suggest that what physicians care most about is the ability to deliver high-quality care.

The plan is to create tools to help physicians choose the best model for meeting their particular needs, and to advocate both federally and locally to promote adoption of models that improve physician and patient satisfaction, he said.

The AMA will continue to work to remove regulatory barriers that get in the way of providing quality health care, level the playing field with health insurers, help facilitate relationships with hospital and other payers to ensure a physician leadership role in emerging care models, and explore solutions to improve electronic health record platforms, he added.

As for improving health outcomes, efforts include several initiatives and partnerships designed to reduce disease burden and the cost burden associated with some of the most pervasive and troubling health conditions, such as diabetes. As for medical education, the AMA has issued $1 million in grants to 11 medical schools to advance new ways of teaching – such as through more flexible and individualized learning plans – to better prepare students for practicing in the changing health care environment.

"Just imagine the possibilities if we are even partially successful with this strategic plan – if we have increased quality of care, healthier patients, lower costs, and physicians working in a sustainable health environment that they have created themselves and that they think works for them, and if we have medical students trained for 21st-century medicine," he said. "It will take a lot of work and a lot of effort and a lot of focus, but at the end, we think there will be a healthier future for our health care system ... physicians, [and] ... our country as a whole."

SAN ANTONIO – The American Medical Association is working toward numerous goals that stand to improve health care and the practice of medicine, including some that target issues of particular concern to psychiatrists, according to Dr. Jeremy A. Lazarus.

In general, the efforts aim to enhance professional satisfaction for physicians, improve outcomes for patients, and transform medical education to make sure that current medical students are prepared to practice 21st century medicine, Dr. Lazarus of the University of Colorado Denver and immediate past president of the AMA at said at the annual meeting of the American College of Psychiatrists.

During an update on the AMA’s efforts, Dr. Lazarus described several recent activities and successes, and reflected on the "tremendous partnership that the AMA has with psychiatry and the (American Psychiatric Association).""We have a long history of fighting together," he said, referring to successes such as the decade-long effort that resulted in getting the mental health parity bill passed, the joining together of more than 80 state and specialty societies to address and combat efforts – like a successful effort in New Mexico in 2002 – to give prescribing privileges to psychologists, and – recently – participation in the Joining Forces initiative to ensure that veterans with posttraumatic stress disorder, post-combat depression, or traumatic brain injury receive the care and resources they need.

Other recent AMA activities and successes outlined by Dr. Lazarus include:

• Testifying to the U.S. Senate regarding the Sunshine Act provisions of the Affordable Care Act.

Dr. Lazarus said he voiced the AMA’s support for transparency, but cautioned that physicians need to have the right to review reported information to ensure accuracy.

The AMA is committed to making sure that "the powers that be in Washington, D.C., hear physicians’ concerns loud and clear," he said.

• Working with state medical societies and associations on numerous legislative issues that affect physicians and health care.

"The AMA achieved many legislative victories in 2012-2013, including truth-in-advertising legislation, preserving existing medical liability reforms, protecting the patient-physician relationship, and also turning back and defeating many scope of practice expansions," he said.

For example, in conjunction with 10 other specialty groups, the AMA helped to overturn a Florida law that prohibited physicians from talking to patients/parents about guns in the home and gun safety, and from making any note about the conversation in patient charts.

"We feel it is imperative that lawmakers not get in the way of physician-patient communication," he said.

• Working toward Medicare reform.

Efforts toward reform have been ongoing for a decade or more, Dr. Lazarus said.

"We are close to the finish line," he noted.

Efforts to repeal the Medicare Sustainable Growth Rate formula and to move toward different systems of paying physicians continue, as scores of state and specialty societies work together to develop a system that will provide many options for payment for physicians that will reward physicians for savings in the health care system, support practice investments so that physicians can move to different forms of practicing, and tie physician payment to their own actions rather than to those of others whom they can’t control.

"We got great news on Feb. 6 – there is now joint legislation to repeal the SGR that’s advancing in both the House and the Senate," he said, noting that the impending legislation is the result of work by the AMA and other organizations working together to "keep this issue alive, to try to modify the bills as they were going through the House and the Senate, and to make sure we got to a positive outcome."

"We want the Medicare payment program to be a stable 21st-century program that can meet the growing health care needs of our senior population, and we’ve been very pleased that the committees have made many changes recommended by the AMA," he said.

The current bill under consideration – the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 – includes a repeal of the SGR formula, automatic positive payment updates of 0.5% for the next 5 years, a consolidated and simpler Medicare quality reporting program, and the ability to transition to different models of care.

"We’ve now got a March 31 deadline. If nothing is done, there will be a 24% cut in Medicare payments, so stay tuned. We’re looking for things to advance ... we haven’t been any closer than we are right now, so we’re very hopeful," he said.

Those interested in participating in the effort to reform Medicare can visit the AMA’s FixMedicareNow.org website for more information, he noted.

The efforts mentioned by Dr. Lazarus are among the matters "high on the list for AMA advocacy," but are just a small part of the AMA’s activities.

"We’re also looking at the big picture in terms of the health care system in this country to try to lead a major effort on the big issues," he said.

Among the concerns are the "tremendously overburdened system," with 50 million individuals uninsured and $2.7 trillion in annual spending (18% of gross domestic product) with outcomes that are poorer than those of other developed countries – and with an estimated increase of spending up to $4.6 trillion (20% of GDP) by 2020. The fragmented delivery system, with a lack of coordination of care and an epidemic of chronic conditions that account for 75% of the spending, also are among the concerns being addressed by the AMA.

Facing these tremendously complicated and difficult situations, the AMA decided to "take our years of training on addressing major issues, and put them to work on what amounts to an AMA policy triathlon," Dr. Lazarus said, referring to the three-pronged plan of enhancing physician satisfaction, improving health outcomes, and accelerating needed changes in medical education.

"We’ve committed to finishing this race," he said, noting that it will be a long one.

Efforts to improve care delivery models include collaboration with the RAND Corp. to conduct field research at 30 diverse practice settings across the country to identify factors associated with success and satisfaction.

Results are forthcoming, but initial findings suggest that what physicians care most about is the ability to deliver high-quality care.

The plan is to create tools to help physicians choose the best model for meeting their particular needs, and to advocate both federally and locally to promote adoption of models that improve physician and patient satisfaction, he said.

The AMA will continue to work to remove regulatory barriers that get in the way of providing quality health care, level the playing field with health insurers, help facilitate relationships with hospital and other payers to ensure a physician leadership role in emerging care models, and explore solutions to improve electronic health record platforms, he added.

As for improving health outcomes, efforts include several initiatives and partnerships designed to reduce disease burden and the cost burden associated with some of the most pervasive and troubling health conditions, such as diabetes. As for medical education, the AMA has issued $1 million in grants to 11 medical schools to advance new ways of teaching – such as through more flexible and individualized learning plans – to better prepare students for practicing in the changing health care environment.

"Just imagine the possibilities if we are even partially successful with this strategic plan – if we have increased quality of care, healthier patients, lower costs, and physicians working in a sustainable health environment that they have created themselves and that they think works for them, and if we have medical students trained for 21st-century medicine," he said. "It will take a lot of work and a lot of effort and a lot of focus, but at the end, we think there will be a healthier future for our health care system ... physicians, [and] ... our country as a whole."

SAN ANTONIO – The American Medical Association is working toward numerous goals that stand to improve health care and the practice of medicine, including some that target issues of particular concern to psychiatrists, according to Dr. Jeremy A. Lazarus.

In general, the efforts aim to enhance professional satisfaction for physicians, improve outcomes for patients, and transform medical education to make sure that current medical students are prepared to practice 21st century medicine, Dr. Lazarus of the University of Colorado Denver and immediate past president of the AMA at said at the annual meeting of the American College of Psychiatrists.

During an update on the AMA’s efforts, Dr. Lazarus described several recent activities and successes, and reflected on the "tremendous partnership that the AMA has with psychiatry and the (American Psychiatric Association).""We have a long history of fighting together," he said, referring to successes such as the decade-long effort that resulted in getting the mental health parity bill passed, the joining together of more than 80 state and specialty societies to address and combat efforts – like a successful effort in New Mexico in 2002 – to give prescribing privileges to psychologists, and – recently – participation in the Joining Forces initiative to ensure that veterans with posttraumatic stress disorder, post-combat depression, or traumatic brain injury receive the care and resources they need.

Other recent AMA activities and successes outlined by Dr. Lazarus include:

• Testifying to the U.S. Senate regarding the Sunshine Act provisions of the Affordable Care Act.

Dr. Lazarus said he voiced the AMA’s support for transparency, but cautioned that physicians need to have the right to review reported information to ensure accuracy.

The AMA is committed to making sure that "the powers that be in Washington, D.C., hear physicians’ concerns loud and clear," he said.

• Working with state medical societies and associations on numerous legislative issues that affect physicians and health care.

"The AMA achieved many legislative victories in 2012-2013, including truth-in-advertising legislation, preserving existing medical liability reforms, protecting the patient-physician relationship, and also turning back and defeating many scope of practice expansions," he said.

For example, in conjunction with 10 other specialty groups, the AMA helped to overturn a Florida law that prohibited physicians from talking to patients/parents about guns in the home and gun safety, and from making any note about the conversation in patient charts.

"We feel it is imperative that lawmakers not get in the way of physician-patient communication," he said.

• Working toward Medicare reform.

Efforts toward reform have been ongoing for a decade or more, Dr. Lazarus said.

"We are close to the finish line," he noted.

Efforts to repeal the Medicare Sustainable Growth Rate formula and to move toward different systems of paying physicians continue, as scores of state and specialty societies work together to develop a system that will provide many options for payment for physicians that will reward physicians for savings in the health care system, support practice investments so that physicians can move to different forms of practicing, and tie physician payment to their own actions rather than to those of others whom they can’t control.

"We got great news on Feb. 6 – there is now joint legislation to repeal the SGR that’s advancing in both the House and the Senate," he said, noting that the impending legislation is the result of work by the AMA and other organizations working together to "keep this issue alive, to try to modify the bills as they were going through the House and the Senate, and to make sure we got to a positive outcome."

"We want the Medicare payment program to be a stable 21st-century program that can meet the growing health care needs of our senior population, and we’ve been very pleased that the committees have made many changes recommended by the AMA," he said.

The current bill under consideration – the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 – includes a repeal of the SGR formula, automatic positive payment updates of 0.5% for the next 5 years, a consolidated and simpler Medicare quality reporting program, and the ability to transition to different models of care.

"We’ve now got a March 31 deadline. If nothing is done, there will be a 24% cut in Medicare payments, so stay tuned. We’re looking for things to advance ... we haven’t been any closer than we are right now, so we’re very hopeful," he said.

Those interested in participating in the effort to reform Medicare can visit the AMA’s FixMedicareNow.org website for more information, he noted.

The efforts mentioned by Dr. Lazarus are among the matters "high on the list for AMA advocacy," but are just a small part of the AMA’s activities.

"We’re also looking at the big picture in terms of the health care system in this country to try to lead a major effort on the big issues," he said.

Among the concerns are the "tremendously overburdened system," with 50 million individuals uninsured and $2.7 trillion in annual spending (18% of gross domestic product) with outcomes that are poorer than those of other developed countries – and with an estimated increase of spending up to $4.6 trillion (20% of GDP) by 2020. The fragmented delivery system, with a lack of coordination of care and an epidemic of chronic conditions that account for 75% of the spending, also are among the concerns being addressed by the AMA.

Facing these tremendously complicated and difficult situations, the AMA decided to "take our years of training on addressing major issues, and put them to work on what amounts to an AMA policy triathlon," Dr. Lazarus said, referring to the three-pronged plan of enhancing physician satisfaction, improving health outcomes, and accelerating needed changes in medical education.

"We’ve committed to finishing this race," he said, noting that it will be a long one.

Efforts to improve care delivery models include collaboration with the RAND Corp. to conduct field research at 30 diverse practice settings across the country to identify factors associated with success and satisfaction.

Results are forthcoming, but initial findings suggest that what physicians care most about is the ability to deliver high-quality care.

The plan is to create tools to help physicians choose the best model for meeting their particular needs, and to advocate both federally and locally to promote adoption of models that improve physician and patient satisfaction, he said.

The AMA will continue to work to remove regulatory barriers that get in the way of providing quality health care, level the playing field with health insurers, help facilitate relationships with hospital and other payers to ensure a physician leadership role in emerging care models, and explore solutions to improve electronic health record platforms, he added.

As for improving health outcomes, efforts include several initiatives and partnerships designed to reduce disease burden and the cost burden associated with some of the most pervasive and troubling health conditions, such as diabetes. As for medical education, the AMA has issued $1 million in grants to 11 medical schools to advance new ways of teaching – such as through more flexible and individualized learning plans – to better prepare students for practicing in the changing health care environment.

"Just imagine the possibilities if we are even partially successful with this strategic plan – if we have increased quality of care, healthier patients, lower costs, and physicians working in a sustainable health environment that they have created themselves and that they think works for them, and if we have medical students trained for 21st-century medicine," he said. "It will take a lot of work and a lot of effort and a lot of focus, but at the end, we think there will be a healthier future for our health care system ... physicians, [and] ... our country as a whole."