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AMA president says physicians need more payment-system consistency

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Steven J. Stack, M.D., says that physicians need  more consistency and predictability in new alternative-payment models.

He made his remarks in a Physicians Practice interview after CMS’s new multi-payer initiative  aimed at improving primary care was announced earlier this week.

The program will give practices an upfront care-management fee that they can  keep if they meet performance-based quality and use-performance thresholds.

Dr. Stack said, among other things:  “There needs to be predictability and stability. We need to not be changing the rules every 12 months to 18 months. You can’t run a business when the payment method is changing year over year. Predictability and stability are important. The other thing is there needs to be candor and transparency.”

“Some of the methodologies for the current programs — the Value-Based Modifier or Meaningful Use — have set physicians up for failure. They are not good methodologies to do some of the things that are required. The likelihood of failure is high. Meaningful Use is an all or none, pass/fail paradigm. You get 100 percent you pass, you get 99.9 percent, you fail. Those kinds of things I think most Americans would feel are unreasonable and not fair.

“CMS has to (design) programs that are reflective of the variation in healthcare that’s appropriate and (accommodate for the fact) there are multiple ways to achieve different outcomes. If CMS can design programs that reflect the variation in physician care and patient needs, and hold physicians accountable for more reasonable deliverables … if that’s able to be done over a period of years, physicians can come to learn to be accepting of CMS and less frustrated by it.”

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