Physician practice innovation

Monday, July 01, 2013 12:26 PM

AMA partners with RAND to study efficient delivery and payment models in Colorado

Kate Alfano, CMS contributing writer

Colorado physician practice innovations are once again the focus of national attention. The American Medical Association and the RAND Corporation have teamed up for a research project to study models of practice that deliver efficient and effective patient care and high physician professional satisfaction. Thirty physician practices across the nation are participating – five in Colorado – that represent a broad spectrum of specialties and practice settings. The Colorado Medical Society is collaborating on the project and hopes that the results will help physicians across Colorado better cope with changes and lead reform in how care is organized, delivered and paid for in the future.

This project falls under the AMA’s five-year strategic plan, which aims to ensure that enhancements to health care in the United States are physician-led, advance the physician-patient relationship and ensure that health care costs can be prudently managed. One of the strategic plan’s three core areas of focus is “enhancing physician satisfaction and practice sustainability by shaping delivery and payment models.”

The goal of this study is to identify and better understand models of practice that deliver efficient and effective patient care while simultaneously sustaining the physician practice and improving physician professional satisfaction.

The study began in December 2012 and will be completed by fall 2013. RAND’s experts collect data from the practices through three methods: a questionnaire for administrative and clinical leaders to examine the staffing, finances and overall structure of the practice; on-site visits for facility tours, to observe staff meetings, and to conduct in-person interviews with administrative leaders, clinicians and staff members; and a clinician experience survey.

After collecting and analyzing the data, each practice will receive a detailed practice assessment benchmarked against the other 30 practices as a population providing customized feedback on the practice’s efforts to transition and transform the way they provide and are paid for providing care. Practices will receive their reports in the summer of 2013 and a de-identified public report will be released in early October.

One of the Colorado practices is a self-employed internist group in Parker, which is actively positioning for health care reform by working toward NCQA certification for the patient-centered medical home as well as NCQA recognition for diabetes care and cardiovascular disease prevention. Another of the Colorado practices, a large group providing general surgical care, says their delivery model involves continually evolving their “successful approaches to patient care with successful navigation of increasing financial and regulatory hazards.”

A physician with the internist practice, kept anonymous at the AMA’s request, said he/she hopes that by participating in the study, the practice will gain perspective on its progress and understand which component of practice transformation to pursue next. “When we receive our results it will be interesting to see if we fit the norm or if we’re on one side or the other. That may give us a better sense of where things are headed and what other practitioners are doing. I think if we find that the majority of practices are doing something very different than we are, then we’d look at that and rethink our methods if that were appropriate,” the physician said.

Through research partnerships like this one, the AMA provides data, analytics and tools that can be used to improve critical indicators of physician satisfaction and practice sustainability. Additionally, the AMA will promote successful models in the public and private sectors, create tools that enable physicians to adopt proven models that fit with their respective practices, and work with hospitals and health plans to incorporate the findings and tools into their own operational models.

“As the nation’s health care system continues to evolve, the AMA is dedicated to helping physicians navigate the environment successfully by ensuring sustainable physician practices that result in good health outcomes for patients and greater professional satisfaction for physicians,” Jay Crosson, MD, group vice president of physician satisfaction and care delivery payment said in a statement.

“Because practice sustainability and physician satisfaction are essential to improving the health care system, health outcomes and patient satisfaction, the AMA wants to identify, support and grow the models of care delivery and payment that promote the long-term sustainability of and satisfaction with medical practice and that lead to improvement in the cost and quality of health care in the nation.”