AMA leaders recap year of promoting changes in health care

Chicago Culminating his year as president of the American Medical Association, Jeremy A. Lazarus, MD, told doctors how the AMA has helped make progress in health system reform, won legal and legislative victories for physicians and their patients, and worked to ensure access to care.

In his speech during the opening session of the AMA House of Delegates on June 15, Dr. Lazarus said the AMA teamed up with medical societies to oppose elimination of a Medicaid pay raise provision in the Affordable Care Act. The Association is working to reduce burdens that may be created by health insurance exchanges while assuring access to care, he said. Meanwhile, the AMA continues to pursue its campaign to get Congress to eliminate the sustainable growth rate doctor payment formula in Medicare, he added.

Working with state medical societies, the AMA scored more than 125 legislative wins at the state level on issues such as preserving medical liability reforms and ensuring doctor leadership of health care teams, Dr. Lazarus said.

Supreme Court sides with doctors

Dr. Lazarus noted that the Litigation Center of the American Medical Association and the State Medical Societies filed a friend-of-the-court brief that supported a New Jersey doctor whose case went to the U.S. Supreme Court. On June 10, the high court ruled in Oxford Health Plans LLC v. Sutter that individual doctors can join together as a group to battle unfair business practices of insurers.

“Thanks to this ruling, thousands of physicians will be allowed to use class arbitration against a health insurer that has underpaid them for more than a decade,” Dr. Lazarus told more than 450 delegates gathered at the Hyatt Regency Chicago. “This finally gives physicians a weapon to challenge unfair payment practices.”

Among other highlights, Dr. Lazarus said the AMA is offering online resources explaining the Sunshine Act to physicians (link). The act will require collection and reporting of drug and device industry payments to doctors. The AMA also launched the Integrated Physician Practice Section to address issues facing doctors in integrated and group practices.

“In my practice, I've seen thousands of patients one at a time,” said Dr. Lazarus, a psychiatrist in Colorado. “Now we can leverage what we can do for so many more patients by working together more effectively.”

The AMA president talked about how physicians and others responded to recent tragedies such as the Boston Marathon bombings. For example, he mentioned how one pediatric resident in the race helped tend to the injured on the scene.

The Aurora, Colo., movie theater shooting and the deaths of 26 people in the elementary school shooting in Newtown, Conn., spotlighted problems of gun violence and the mental health system, Dr. Lazarus said.

“We believe strongly that physicians must be able to have frank discussions with their patients and families about firearm safety issues and risks. Maybe fewer 4-year-olds will accidentally shoot a parent or sibling,” he said.

Strategic plan's progress

Also during the opening session, AMA Executive Vice President and CEO James L. Madara, MD, gave delegates an update on the AMA's three-part strategic plan, which includes improving health outcomes; enhancing physician satisfaction and practice sustainability; and accelerating changes in medical education.

In April, the AMA announced that cardiovascular disease and type 2 diabetes would be the first two conditions targeted in the initiative to improve health outcomes. At the opening session of the house, Dr. Madara described how the Association has partnered with the Johns Hopkins Armstrong Institute for Patient Safety and Quality for work relating to cardiovascular diseases and with the YMCA of the USA for work on type 2 diabetes. The effort with the YMCA includes increasing doctor referrals to the Y's diabetes prevention program.

“This relationship with the Y is a sign of our being out there in the community, on the ground, not simply theoretical,” Dr. Madara told delegates. “It is deemed so important that it is being funded by the CMS Innovation Center.”

The AMA also is working to identify and support models of care delivery and payment that promote doctor satisfaction and practice sustainability. The Association is partnering with RAND Corp. to conduct research on 30 practices in six states, with the goal of creating resources and tools that doctors can use to improve satisfaction and sustainability, Dr. Madara said.

On June 14, the AMA announced the 11 medical schools that will receive funding over five years as part of the accelerating change in medical education initiative. The $11 million will go toward educational innovations such as increased use of health IT and models for competency-based student progression. In his speech to delegates, Dr. Madara said 82% of the nation's medical schools had submitted proposals for funding.

“This tremendous response is a clear sign these schools had been considering structural change for some time — they simply needed someone to lift the gate and give support to make that happen,” he said. “We are lifting that gate — and also providing the support.”

The House of Delegates, the AMA's policymaking body, is scheduled to meet through June 19, with delegates discussing issues such as health system reform, practice sustainability, public health and delivery of care.