American’s family physicians increasingly are preparing for value-based reimbursement and many of them want it, hoping that insurers will respond with increased payments that will stabilize practices and enable them to expand their technologies and services, says Wanda Filer, M.D., president of the American Academy of Family Physicians.
AAFP members lead the way in adoption of electronic health records, she notes, with 87 percent of practices having an EHR according to a recent survey of 626 member physicians, sponsored by health insurer Humana. One-third of members are actively pursuing value-based opportunities with another 19 percent developing a value-based program. And 40 percent of member practices are a medical home. Still, there is strong skepticism about value-based reimbursement, with 69 percent of surveyed family physicians believing the program won’t improve patient care.
If value payments are to work, physicians need help, Filer says. They need better EHRs that automatically import quality data rather than force a physician to sit at a computer and type in quality measures for each insurer that he or she deals with, Filer contends. Physicians need claims data from insurers and financial help in getting patient registries and analytics to query patients who are due for preventive care, or signed up but didn’t attend educational classes. They need higher payments to buy registries, analytics and other tools. And, practices need to stop spending so much time on the phone handing pre-authorizations and other insurance issues.
There are regions across the country with a poor information technology infrastructure that impedes physicians, Filer says. In some areas of Louisiana, for instance, physicians can’t attest for EHR meaningful use because they submit the required data and get a confirmation that it was received when it really wasn’t. So, they give up on attestation.
If value-based reimbursement is to come, it can’t just be on the backs of physicians, Filer says. Insurers, vendors and policymakers need to step up and make the program realistically feasible. “If this is to be done, it can’t be done only by the practices; it has to be all hands on deck,” she adds. “This is an opportunity for payers to increase payments to hire staff or bring in expertise to advise physicians. Lifting a practice to where it needs to be is good for all.”
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