A message from Robert Gluckman, M.D., chief medical officer for Providence Health Plan
With the election behind them, Democrats will keep the momentum on reforms in the Affordable Care Act, or ACA.
The election settles the question of whether ACA will move forward, and providers can now make decisions with more clarity. Work has already begun in Oregon, which is rapidly heading toward the Triple Aim of patient-centered, quality, affordable care.
Physicians now have an important leadership opportunity. As health care changes, we need to adapt and to revisit the fundamentals of our practice. It’s time for a fresh commitment, not only to our role in the equitable distribution of societal resources, but also to transparency about the quality and cost of the services we recommend and provide.
The promise of affordable, high-quality health care for all Americans depends on physicians helping patients understand that more is not always better; in fact, sometimes it’s worse. This is a challenge we can and should embrace.
Physician payment is tied to financial reform
Health care reform is not only bringing innovation in care, but also different payment mechanisms. Looming in January is a “fiscal cliff.” The pending 27 percent cut in Medicare physician payments likely will be resolved as part of the fiscal solution, but the bigger issue is how to reform the sustainable growth rate, or SGR, payment formula.
Reduced payments will require lower utilization, lower price or a combination of the two. Patients will be best served when physicians engage them and each other in a collaborative dialogue to help reduce lower-value health care.
A clear path in Oregon
States have a major role in what comes next for health care reform. Oregon is committed to expanding coverage, starting with Medicaid and the health insurance exchange.
The governor has made it clear he’d like to see further expansion in the future. With increased access, the new focus is on making health care affordable for all. To this end, coordinated care organizations and Cover Oregon are working through operational and funding challenges as they implement the state’s vision.
More change – and controversy – is on the way. But change is an opportunity. Physicians will need to create different, outcomes-based practice approaches that put patients at the center while emphasizing efficiency and quality. It’s a time for renewed professionalism as we maintain our “contract with society” in the face of waves of change.