Review of Payment Reform Conference Points to Challenging Road Ahead in Massachusetts

Contact: Richard Gulla
Tel: 781-434-7101
E-mail: rgulla@mms.org 

Waltham, Mass. -- February 14, 2011 -- Payment reform will require "major changes in health plan operations"…the proposals will call for a "significant departure from the status quo…physicians and professional and institutional providers have concerns about both "the pace and direction of these policies"…and approaches to improving the value and reducing the cost of health care "require systematic reengineering of the delivery system and investments in both human capital and infrastructure."

Those were some of the conclusions drawn from a review of a conference on payment reform by Meredith B. Rosenthal, Ph.D., Associate Professor of Health Economics and Policy at the Harvard School of Public Health. Professor Rosenthal's comments were contained in her analysis of the October conference, Towards a Shared Vision of Payment Reform, sponsored by the Massachusetts Medical Society, the statewide association of physicians, and The Commonwealth Fund, a national private foundation in New York City that supports independent research on health care issues.

The conference featured national health care experts discussing the topics of payment and delivery systems, implementation strategies for payment reform, affordability of healthcare, and what the next steps for payment reform might be for Massachusetts. Professor Rosenthal's review was released this month.

In a 10-page summary of the conference, Professor Rosenthal writes that participants acknowledge the risks and opportunities of payment reform; that no evidence-based treatment yet exists for the problems of fragmentation, waste, and poor quality that Accountable Care Organizations and global payments are proposed to address; and that the design and implementation of reform must contain six attributes: transparency to providers and patients; flexibility; tailored locally with respectful engagement of physicians; undertaken through pilots with evaluation and dissemination of best practices; timely data sharing from payers to providers and throughout referral networks; and supported by resources adequate for providers and payers to make the transition to new models.

Finally, she concludes that conference participants agreed that a "truly collaborative effort among payers, providers, and government would be needed to identify and implement effective reform." 

Professor Rosenthal's complete analysis may be read at www.massmed.org/whitepaper/rosenthal

Conference participants included Stuart Guterman, Vice President, Program on Payment System Reform, The Commonwealth Fund; Howard R. Grant, J.D., M.D., Executive Vice President and Chief Medical Officer, Geisinger Health System; Michael van Duren, M.D., M.B.A., Chief Medical Officer, Sutter Physician Services; Sara Rosenbaum, J.D., Hirsh Professor and Chair of the Department of Health Policy at George Washington University School of Public Health and Health Services; James A. Hester, Ph.D., Director of the Vermont Health Care Reform Commission; JudyAnn Bigby, M.D., Secretary of Health and Human Services, Commonwealth of Massachusetts; Dana Gelb Safran, Sc.D., Senior Vice President, Performance Measurement and Improvement, Blue Cross and Blue Shield of Massachusetts; Gene Lindsey, M.D., President and CEO, Atrius Health and Harvard Vanguard Medical Associates; Barbara Spivak, M.D., President, Mount Auburn Cambridge Independent Practice Association.

The Massachusetts Medical Society, with more than 23,000 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, visit www.massmed.org, www.nejm.org, or www.jwatch.org.

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