Fee-for-service isn't going away just yet, but a trio of doctors told physicians attending the American Medical Association House of Delegates meeting that moving toward value-based payment allows them to use creativity in caring for certain patient populations while getting better work satisfaction.
The education session, called “New Models of Care,” featured AMA President Dr. Ardis Hoven speaking with Dr. Donald Klitgaard of the Myrtue Medical Center, Harlan, Iowa; Dr. Alan Spier of Cardiac, Vascular and Thoracic Surgery Associates, Falls Church, Va.; and Dr. Grace Terrell, CEO of Cornerstone Health Care, High Point, N.C.
The group shared stories of “burning-the-bridge-behind-you” moments, shared savings, regulatory concerns and creative payment arrangements. Their message was that, when you can get off the “hamster wheel,” you can more readily practice the way you want.
“The more we unhook ourselves from the fee-for-service world … the better we can do,” Klitgaard said. “It opens up a lot of doors. I didn't realize about how the way things we do day to day is driven by how we get paid.”
Cornerstone, which had been a medical home since 2003, transformed itself by becoming a “population health management hub” only recently, Terrell said. She noted, however, that this didn't start with primary care.