“The AHA recognizes the high (Congressional Budget Office) score associated with maintaining current physician payment rates, but paying for preventing such reductions by making drastic cuts solely from providers such as hospitals that are already seeing negative Medicare margins could endanger beneficiary access to those providers,” the association said in its letter to House Energy and Commerce Chairman Fred Upton (R-Mich).
High costs stemming from the current medical liability system “not only hinder access to affordable healthcare, they also threaten the stability of the hospital field, which employed 5.3 million people in 2009,” the AHA said. The association proposes the creation of an administrative compensation system, or ACS, to compensate patients for injuries that could have been avoided during medical care.
The association also said pay-for-performance through physician-hospital incentives would permit a performance-based payment program and reduce Medicare spending. “It also would allow physicians to earn more with increasing Medicare spending,” the letter said, citing gain-sharing demonstration programs in New Jersey and New York, where the average physician incentive was about $5,000 and $9,000, respectively.
And in the same way hospitals are required to implement value-based elements to Medicare reimbursement policy—such as payment reductions for hospital-acquired infections and the hospital value-based purchasing program—physician payment could be tied to value, the AHA said. The association suggests additional quality reporting and improvements, delivering coordinated care, and implementing “efficiency practices,” such as using an imaging order-entry tool to reduce unnecessary utilization, as components of such a program.