Nov 13, 2012

AMA House: Save Medicare, Help Employed Physicians, Stop ICD-10

HONOLULU -- The American Medical Association House of Delegates wrapped up its 2012 interim meeting this morning after taking significant action to address some of medicine's most pressing problems.

Dr. Lockhart

Delegates completed a multi-year plan by adopting a framework to transition Medicare to a defined contribution program that would allow beneficiaries to either buy coverage of their choice from a wide variety of plans or stay in the traditional Medicare system. Tyler anesthesiologist Asa Lockhart, MD, said change is needed because the current system is not working and not sustainable.

"We have coverage without access, which I view to be the most cruel situation of all," Dr. Lockhart said. "Defined contribution would allow of multitude of options and expand choice, but it would do it under the current federal Medicare funding levels."

Jason Sharp, MD, a newly hired interventional radiologist in Dallas, said he expects the new AMA Principles for Physician Employment to be very helpful for young doctors who, like him, are coming out of residency and fellowship with no training on the business side of medicine. "It will help us know what the game is, what the rules are ... how do I compare and contrast the offers I get, Dr. Sharp said.

Dr. Sharp

AMA Board of Trustees member Joe Annis, MD, an Austin anesthesiologist, said the principles cover such aspects of the employee-employer relationship as conflicts of interest, advocacy, contracting, hospital-medical staff relations, peer review and performance evaluations, and payment agreement. "The guidelines reinforce that patients’ welfare must take priority in any situation where the interests of physicians and employers conflict," Dr. Annis said.

After winning a one-year delay in the mandatory implementation of the ICD-10 coding system, AMA delegates voted to "vigorously advocate" with the Centers for Medicare & Medicaid Services to make the change permanent. Austin colon and rectal surgeon David Fleeger, MD, past chair of the TMA Council on Practice Management Services, said he is concerned about the time, cost, and "an inefficiency that goes on forever" if physicians are forced to use ICD-10 for coding and billing.

Dr. Fleeger

"It's the private practice doctor in small groups that's going to have the biggest problem implementing ICD-10," he said.

Dr. Fleeger said medicine will find itself up against hospitals, health plans, and technology vendors that have invested much time and money into ICD-10. "Those are opponents, and they are people with deep pockets," he said.

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