Physician Groups Set 2011 Agenda: Medicare payment reform tops the list

Other Priorities

Two other items on the ACS agenda are accountable care organizations (ACOs) and the national bundled physician-hospital payment pilot program in Medicare. The ACS is working on principles and guidelines so that it can weigh in with official comments during the regulation-making process, Hedstrom said. “We want these alternative payment models to be patient-centered, to be physician-led and to be quality-driven,” she added.

The health care law aims to change the way services are paid for, from reimbursement based on quantity to reimbursement based on quality and efficiency, Dr. Batra said. “Otolaryngologists have to be cognizant of what kind of changes are going to be coming, because it’s going to completely change the way health care is delivered,” he said.

Many physician groups will continue to press for comprehensive tort reform that includes a $250,000 cap on noneconomic damages. Such legislation could pass in the GOP-controlled House but is expected to fail in the Senate. In this time of budget and deficit crises, however, tort reform with a cap on noneconomic damages becomes more attractive, Dr. Imber said, because it would produce billions in savings each year by reducing defensive medicine.

The ACS will continue to press for tort reform with a noneconomic damages cap, but it is also open to exploring other reforms, such as health courts and safe harbors for doctors who follow evidence-based treatment guidelines, Hedstrom said, although these ideas have yet to be tested.

Meanwhile, other AAO-HNS priorities include:

• Continuing to fight federal legislation that would give audiologists direct access to Medicare patients;
• Pressing for federal “truth in advertising” legislation that requires non-physician health professionals to make their education and training clear in advertising materials and in their dealings with patients; and
• Maintaining federal funding for early hearing detection and intervention programs.

The organization’s stances on audiologists’ access to Medicare patients and on truth in advertising are about patient safety, Dr. Imber said. “We don’t want people getting hurt,” he said.

A May 2010 AMA survey of 9,000 doctors found that 17 percent of physicians are already restricting the number of Medicare patients served by their practices.