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Physicians Push for Say in Value-Based Payments Structure

Christopher Cheney, for HealthLeaders Media, February 12, 2014

If the SGR repeal deal becomes law, Roman says the transition to a value-based reimbursement system will be successful only if physicians are included on the panels that would design quality assessment programs and transparency rules for physicians. "You have to have some doctors involved if you want doctors to own it," he said.

Ardis Dee Hoven, MD, president of the AMA, told HealthLeaders on Monday that the reimbursement plan outlined in the SGR repeal deal "is a much better system than what currently is in place." But she insisted that doctors must play a role in determining rules for quality assessment and transparency. "We are the ones driving the bus on these quality issues," she said. "Physicians have led the drive for more accurate reporting."

While wary of the future course of Medicare quality assessment and transparency regulations, Hoven said the SGR repeal deal provides the framework to make significant improvements. "As a starting point, it's a reasonable place to start," she said.

'You're Going to Shop Around'
Physicians are crucial to moving the US healthcare industry to a value-based model because they understand the complexities of the field, says Anders Gilberg, senior vice president of governmental affairs at the Medical Group Management Association in Englewood, CO. "The challenge here is there's no one-size-fits-all program," he said.

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