Theme of leadership stressed at AMGA confab

Perhaps the greatest challenge before the integrated, multispecialty organizations that make up the American Medical Group Association is that they are now being called upon to live up to their reputations as leaders in providing high-quality healthcare at a lower cost.

“You in this room represent the greatest hope in making progress,” John Rother, president and CEO of the National Coalition on Health Care, said during a Saturday morning panel discussion on the “brave new world of healthcare” held at AMGA's annual conference March 14-16 in Orlando, Fla.

A few hours later, Dr. Janet Wright, executive director of the HHS' Million Hearts Campaign, noted that there were 36 million adults in the U.S. with uncontrolled hypertension. She challenged AMGA members to reduce that number by 12 million.

“You all could be the difference in America,” she said.

The AMGA, which lays claim to developing the concept of accountable care organizations, currently has about 430 member groups (the number fluctuates as members merge or acquire one another) in which 130,000 physicians practice. A record 2,000 people attended the event at the Hilton Bonnet Creek Resort, and there were 140 booths in the exhibit hall.

Donald Fisher, the AMGA's longtime president and CEO, set the tone early.

“It's you who will have to lead the way for others as we transform healthcare,” Fisher said in his opening remarks.

AMGA Board Chairman Michael Bukosky, CEO of University of Louisville Physicians, followed in kind.

“This is our time,” Bukosky said. It's “time to step up and act.”

During a session updating members on federal legislative and regulatory matters, Karen Kennedy, chief development officer for Irving, Texas-based USMD Holdings and chairwoman of the AMGA political action committee, said doctors in AMGA groups need to contribute financially to the group's advocacy efforts.

Kennedy noted that the AMGA PAC had only $42,000 to work with in the last election—compared with more than $4 million for the American Hospital Association's PAC and almost $2 million for the American Medical Association's PAC. She said that if the 130,000 physicians who practice in AMGA's groups contributed $20 each, that would infuse $2.6 million toward the cause.

This would include one of the AMGA's stated goals for 2013: Getting the organization's definition of a “high-performing system” inserted into healthcare legislation with the goal that there would be incentives for provided quality care at lower cost.

“You should be rewarded for your efforts,” Fisher said.

At the Saturday morning panel, Dr. Robert London, national medical director for Walgreen, gave a description of what a high-performing system does.

“We aren't just taking care of diabetics anymore,” London said. Instead, healthcare providers are being called upon to manage the conditions of diabetic patients with hypertension who are depressed and won't take their medication.

Being a high-performing system takes teamwork, said another Saturday panelist, Dr. Robert Nesse, CEO of the Mayo Clinic Health System, who noted how the roles of some members of this team are still being defined. In answering a question from the audience, Nesse said that it's wrong to view care coordinators as someone who merely “does chart review and gets into fights with doctors.”

Care coordinators have to become “owners of quality improvement,” Nesse said. This requires them to be “content experts—not policemen,” and become collaborating members of a group's mission and vision.

Nesse also issued a call to action to AMGA members.

“Become a reformer, become an activist,” Nesse said. “Create a smarter healthcare system.”