Physicians Caution that Transition to a New Payment Model must be Careful, Deliberate, and Thoughtful

Massachusetts Medical Society reacts to report of Payment Reform Commission

July 16, 2009

Contact: Richard Gulla
rgulla@mms.org
(781) 434-7101

 Waltham, Mass. -- July 16, 2009 -- Reacting to the recommendations in the final report of the Special Commission on Health Care Payment Reform, the President of the Massachusetts Medical Society today said that moving Massachusetts health care providers to a new payment model must be done carefully, deliberately and thoughtfully, and must provide physicians with significant support and resources to ensure success. The report, distributed at the Commission’s final meeting today, will be sent on to the state legislature for action.

Mario E. Motta, M.D., President of the Society that represents 22,000 physicians in the state, said, “We agree that patient care can be better coordinated throughout the health care system. A new kind of collaboration can improve the quality of care as well as promote efficiency and affordability. However, a big transition like this has never been done on such a broad scale, so it must be done very carefully, deliberately and thoughtfully.”

Alice T. Coombs, M.D., the Society’s president-elect who served on the commission as its sole physician member, said “The commission’s report is the first step in a very long process to creating a better health care system. There’s a lot at stake and there’s a lot of work to do. We will be working closely with government, payers and our colleagues in medicine to ensure that patients receive high-quality care that is affordable and accessible.”

Dr. Motta noted that physicians want to be part of the effort to build a better health care system, but will have many questions and concerns about this proposal. He said past experience has shown a high risk of unintended negative consequences exists with new programs. 

Dr. Motta said physicians will require several steps to make a successful transition to a new payment model.

The first is time, he said. “Very few physicians could succeed under this new system today, and their readiness to make such a transition is highly variable across the state.”

“Second, physicians will need significant support and help from government and payers around the financial, technical and legal aspects of a new payment model. They will need to acquire the expertise to manage the financial risk associated with caring for large groups of patients. This has so far been the province of insurers, not doctors.

“Third, they will need significant support to invest in, install and optimize the information technology tools that are fundamental parts of a more integrated payment system.

“Fourth, they will need considerable support in developing the legal and structural underpinnings required to succeed in a new payment system. This is a completely new way of organizing practices around patient care. Some laws will need to be changed to allow for this new kind of collaboration.

“Finally, they will need to learn new ways of organizing their practices and their care, so that patients get the most value from this kind of collaboration. Medical liability reform will be needed too, because the malpractice system encourages costly maximum care as a tactic to minimize legal exposure.”

The full report of the Commission may be found here.

The Massachusetts Medical Society, with more than 22,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information please visit www.massmed.org, www.nejm.org, or www.jwatch.org.