Many skeptical doctors react to the mantra about revolutionizing health care delivery the same way John Lennon did when he wrote these lyrics for the 1968 Beatles anthem. Well you know, they’d all like to see the plan.
Well, you know, this week Medicare released two critical pieces of its plan to revolutionize health care delivery, naming the 27 medical organizations/groups selected for Medicare’s Shared Savings (Accountable Care Organization) program, and the geographic sites chosen for the Comprehensive Primary Care Initiative. (As I blogged in September, the Comprehensive Primary Care Initiative could be a game-changer for primary care, because it will provide sustained financial support and revenue opportunities from Medicare and private payers for participating practices.)
The Innovation Center’s announcements this week effectively counter two pernicious myths about the Affordable Care Act and physicians:
Myth # 1: That the government is trying to put independent physician practices out of business.
Myth # 2: That the government wants to put hospitals in control of physicians.
Actually, a majority of the organizations selected for the Shared Savings Program are "physician-led," as the AMA noted in praising the CMS announcement. But you don’t have to take the AMA’s (or my) word for it: just look at the descriptions from CMS and the physicians themselves of several of the 27 organizations who voluntarily agreed to join the Shared Savings Program:
The Atlantic Integrated Health Network "is one of the oldest self-sustaining physician-led networks in North Carolina."
The Coalition of Athens Area Physicians "represents 300 independent physicians from Athens, Georgia and surrounding counties."
Mississippi Coast Physicians "was founded by community physicians to offer accessible, cost effective and high quality healthcare services to employers and healthcare consumers along the Mississippi Gulf Coast."
North Country Physicians Organization "is a physician organization of 160 physicians" in upstate New York.
The Independent Physicians Network is "a Physician managed and controlled medical delivery network established in 1984" in the Milwaukee, WI community.
Accountable Care Coalition of Texas, Inc. is "an ACO created through a partnership between an affiliation of Independent Physician Associations, medical groups and health systems in the Houston/Beaumont area of Texas and Collaborative Health Systems."
"Owned and managed by physicians, AppleCare Medical ACO partners with more than 800 physicians in the region, as well as major hospitals and medical centers across Southern California to provide access to a full spectrum of facilities for receiving whatever care a patient may require."
"Located in Buffalo, NY, Catholic Medical Partners is a network of more than 900 independent practicing physicians."
"Coastal Carolina Health Care, the ACO’s sole participant, is a physician-owned and operated medical practice with over 50 providers."
There’s many more physician organizations in the 27 ACOs selected by CMS, but I think you get the point: physicians are the ones who will be leading the ACO revolution, through physician-controlled and owned organizations, ranging from tightly integrated group practices to looser coalitions and networks of independent smaller practices. The Comprehensive Primary Care Initiative will soon provide an opportunity for another 500 or so physician practices to lead the transition to the Patient-Centered Medical Home model, supported but not controlled by Medicare and other payers.
Well, you know, this is the way it should be: ACP has long argued that physicians are uniquely qualified to achieve the triple aim of better individual patient health outcomes, better population health, and lower per capita costs—not the government, not the hospitals, and not insurance companies. It is good to see this is Medicare’s plan as well.
Today’s question: What do you think CMS’s announcements say about its view of the role of independent, physician-owned organizations in revolutionizing health care delivery?