That’s the guiding principle of the Council for Medical Specialty Societies (CMSS) and AAHPM is their newest member! This month, Laura Davis, AAHPM Director of Marketing and Membership, and I represented AAHPM at the CMSS spring meeting in Washington DC.
What is CMSS and why did AAHPM leadership decide that it was important to participate? CMSS represents the needs of physician specialists and subspecialists in American health care. And, with complicated issues like the medical home and graduate medical education slots on the table, they represent an important voice. I liked their two overarching goals – (1) to create a culture of performance improvement and (2) to model professional and ethical medical practice. And they’re taking action. During the April meeting, CMSS approved a code for ethical interactions with health-care companies.
Michael Hash, Senior Advisor HHS Office of Health Reform and liaison to the White House Office of Health Reform, talked to the Council about the recent health reform legislations. He emphasized that Medicare and Medicaid will both focus on the subset of patients with multiple advanced chronic diseases. Hello?? Did someone say “Palliative Medicine?” On the GME issue, he did not expect any increase in the number of “slots”; instead, legislation is focusing on loans, loan forgiveness, and National Health Service programs. And last, he asked that physicians actively support Don Berwick’s nomination as director of CMSS – look for legislative action alerts!
Tom Nasca MD, CEO of ACGME spoke next about upcoming ACGME recommendations regarding resident duty hours. He strongly urged physicians to support the ACGME proposals, noting that, if the medical profession fails to act, someone else (i.e., the federal government) will do it for us.
Two panel discussions presented issues regarding the Patient Centered Medical Home (PCMU), the meaningful use (MU) of health information technology (HIT) – it’s Washington, loads of acronyms – and their intersection. I found a couple of useful take-home messages. First, current EMR (electronic medical records) are built to coordinate billing, not patient care. It’s SO true, but somehow I had missed that point before – I can be slow. Second, a new EMR needs to collect data on practice improvement, because performance measures are expected to be integral to proposed health care changes. And third, your EMR should support care coordination, the core principle of the PCMH model.
No one is quite sure what the PCMH model will look like, but it’s expected to follow NCQA guidelines. There’s talk of the “medical neighborhood” that includes specialists and subspecialists. And it’s likely that we’ll see non-physician providers (NPs and Pas) as PCMH practitioners soon. AAHPM needs to continue active discussion of how HPM physicians might fit into the PCMH model – Chad Collas and the Public Policy Committee are already at work.
Membership in CMSS is just another example of how AAHPM is working to meet members’ needs in a changing health care environment! Stay tuned for more. And leave your comments on these issues – we need to hear from you!!
See article below from NEJM on PCMH. Of particular interest is the comment that “specialist practices that provide long-term “principal care” for a chronic condition should be eligible to serve as medical homes”. Certainly, HPM physicians meet that standard.
Article from the New England Journal of Medicine: ‘Specialist Physician Practices as Patient-Centered Medical Homes’
In an article published on April 21, 2010 by authors, Lawrence P. Casalino, M.D., Ph.D., Diane R. Rittenhouse, M.D., M.P.H., Robin R. Gillies, Ph.D., and Stephen M. Shortell, Ph.D., M.P.H., the NEJM examines the specialist physicians role in the PCMH. According to the article, ‘This model [PCMH] is a prominent component of the health care reform bill recently signed by President Barack Obama and is being tested in dozens of pilot projects around the country; it has been promoted by the Patient-Centered Primary Care Collaborative, a coalition of more than 500 large employers, consumer groups, health plans, labor unions, and physician and hospital organizations.
Some specialist physicians are raising concerns about the medical home’s implications for their practices. Proponents of the model advocate reforms that would increase payments to practices that qualify as medical homes; these payments might well come, directly or indirectly, from funds that would otherwise have been used to pay specialists. In addition, some specialists who see patients frequently for a chronic disease believe that their practice should be able to serve as the medical home for those patients. For example, in recent testimony before a Senate committee, a representative of the Alliance of Specialty Medicine criticized the planned medical home demonstration project of the Centers for Medicare and Medicaid Services (CMS) for excluding surgeons and argued that a urology practice may be the most appropriate PCMH for patients with prostate cancer or bladder-control problems. The AMA House of Delegates recently passed a resolution in support of permitting specialist practices to serve as medical homes. The ACP Council of Subspecialty Societies has produced a detailed statement arguing that specialist practices that provide long-term “principal care” for a chronic condition should be eligible to serve as medical homes.’
Thanks for your comments, Steve. With coordinated interdisciplinary care at its core, Hospice & Palliative Medicine practitioners are perfectly positioned to be the medical home for patients with serious illness. Now, if we could only find the perfect information system with which to communicate…..