MMA News
Obama Speaks at AMA Meeting
President Barack Obama was warmly welcomed by several thousand physicians attending the American Medical Association’s (AMA) 158th annual meeting in Chicago on Monday as he called on them to work with him to reform the nation’s health care system.
The president outlined his proposals for providing high-quality care, while at the same time reducing the cost of care and ensuring that all Americans have health care coverage. Obama called for moving to electronic medical records, investing in preventive care, bundling payments for treating diseases such as diabetes, reducing the debt burden for medical students who go into primary care, and encouraging the use of evidence-based guidelines.
“Health care reform should be guided by a single principle: Fix what’s broken and keep what works,” Obama told the audience, which included nearly 20 physicians from Minnesota.
Minnesota Medical Association (MMA) President Noel Peterson, M.D., who heard the speech, said a number of the president’s ideas for reform, are already being implemented in Minnesota.
Peterson noted that many clinics here are already using electronic medical records and that the state is working on making patients’ records accessible to providers who work in different organizations. He said that the president’s idea of bundling payments is similar to the “baskets of care” concept that was part of the state’s 2008 health care reform legislation. With baskets of care, providers are paid for providing an entire package of care, rather than individual tests and services. He also said the president’s idea of creating affordable insurance options is similar to the idea of establishing an essential benefit set, which was proposed in the MMA’s plan for reform outlined in Physicians’ Plan for a Healthy Minnesota.
Peterson noted that one area where some physicians in the audience differed from the president was tort reform. Obama stated that he wanted to “scale back the current practice of defensive medicine,” yet he did not advocate capping malpractice awards. “But he did acknowledge the fear of lawsuits and the existence of defensive medicine and agreed that it needed addressing,” Peterson said. “And he promised to keep working with the AMA to come up with a workable solution.”
Dave Renner, the MMA’s director of state and federal legislation, noted that this was one of the longer speeches of Obama’s presidency, and he considers it a positive sign that the president wants to work with the AMA.
The MMA’s delegates to the MMA are Raymond Christensen, M.D.; Kenneth Crabb, M.D.; Anthony Jaspers, M.D.; Paul Matson, M.D.; Sally Trippel, M.D., and John M. Van Etta, M.D. John Abenstein, M.D.; Gail Baldwin, M.D.; Blanton Bessinger, M.D.; David Estrin, M.D.; David Luehr, M.D., and Benajmin Whitten, M.D., are alternate delegates.
MMA Co-sponsors Resolution
The MMA delegation to the American Medical Association (AMA) co-sponsored a resolution that called for the AMA to work with state medical associations, restaurant associations, departments of health, and others to create a method for displaying calories on all items on restaurant menus. Rather than accept the resolution, the AMA House of Delegates voted to reaffirm existing policy, which includes similar language.
In other action, the AMA adopted policy that
- Encourages testing of alternative physician payment approaches for Medicare
- Promotes health system reform alternatives that are consistent with AMA principles;
- Increases funding available to medical students through scholarships and loan repayment programs;
- Encourages medical schools and hospitals to serve as role models and educators about the importance of adopting a healthier and more sustainable food system;
- Outlines steps physicians can take in the event a patient’s electronic medical record is breached;
- Supports the efforts by the CDC to develop clear and consistent flu-protection guidelines for air travel;
- Promotes the study of electronic cigarettes as an option for helping patients quit smoking.
Governor Makes Unallotment Recommendations
Primary care physicians will be spared from additional reimbursement cuts in Gov. Tim Pawlenty’s recommendations for plugging a $2.7 billion gap in the state’s 2010-11 budget.
Through a process called unallotment, the governor used his executive power to recommend spending cuts in four areas: higher education, health and human services, local government aid, and state government agencies. He also deferred payments for K-12 education.
Most of the cuts will take place the second year of the biennium, giving lawmakers time to look for alternative solutions.
Although the governor preserved payments for office and outpatient services and preventive medical and family planning services provided by primary care physicians, he proposed an additional 1.5 percent reimbursement reduction for specialists on top of the 5 percent planned reduction that goes into effect July 1. Payments to hospitals for inpatient services, spending on medical education, disproportionate quarterly payments to safety-net hospitals, nursing home payment rates, and payments to mental health care providers remained unchanged.
The governor also discontinued the General Assistance Medical Care (GAMC) program as of March 2010, a month-and-a-half sooner than originally scheduled. He noted that about half of those who will lose GAMC coverage will be eligible to transition to the MinnesotaCare program. “This proposal continues to strip the health care safety net at a time when Minnesotans need help the most,” says Dave Renner, the MMA’s director of state and federal legislation. “It will result in fewer Minnesotans with health coverage.”
Klobuchar Introduces Medicare Inequities Bill
Sen. Amy Klobuchar, D-Minn., introduced a bill in June aimed at correcting the geographic disparities in Medicare payments and rewarding physicians for delivering efficient care.
Currently, Medicare does not take into account the value of care provided when determining payments. Instead, it rewards volume—paying physicians for tests and surgeries that may not improve a patient’s condition. The Medicare Payment Improvement Act would create a value index to determine physician fees that will link rewards to outcomes, rather than volume. The legislation would also encourage the development of integrated delivery systems.
As a member of the Geographic Equity in Medicare Coalition, which has been working to end the disparities in patient services and physician reimbursement, the MMA supports the idea of rewarding physicians for value.
Either the Senate bill (S1249) or its House companion (HR2844), which is co-sponsored by Rep. Tim Walz, D-Minn., is expected to end up in a larger piece of health care reform legislation. Both have bipartisan support.
MMA president Noel Peterson, M.D., says that if the proposed measures become law, “it’s likely that there would be increased reimbursement to Minnesota physicians because they’re already providing higher value service.”