A new study from The Boston Consulting Group (BCG) found that the United States lags in comparison to other countries when it comes to implementing value-based health care. The study looked at 12 countries and found that Sweden is the most advanced, followed by Singapore, Canada, and the United Kingdom. The United States appeared near the bottom with Germany and Hungary. According to the authors, national health systems were assessed along two dimensions — the degree to which key supports of value-based health care are in place at the national level and the quality of a country’s existing disease registries. The authors say the fragmented U.S. health system has limited the collection and use of national health outcome data. For the study, the authors assessed data in existing diseases registries across 12 major health conditions, used previous BCG research to develop 35 specific assessment criteria, conducted a comprehensive survey of the medical literature, and interviewed 139 representatives of national health departments and international health experts.

Hospitals investing in physician leadership

A new article from FierceHealthcare looks at how hospitals are beginning to invest in physician leadership. The article cites numerous examples of how this is happening. Examples include the American College of Physician Executives reporting it taught physician leadership courses for about 200 days in 2011, almost double the average of 100 days in previous years; Castle Medical Center in Kailua, Hawaii is developing a leadership institute, which meets quarterly to cover financial skills, managing productivity and team building; Newark (N.J.) Beth Israel Medical Center offers a nine-month leadership development program where senior management nominates employees based on their performance; and West Virginia United Health System funds further education for any department chair who wants to get a mini-MBA.

Survey says majority of docs would quit today if given the chance

A recent survey of more than 13,000 physicians by The Physicians Foundation found that if given the chance, 60% of doctors today would quit the profession, up from 45% in their 2008 survey. "The problem to summarize it is there is an imperative now for physicians to care for more patients, to provide higher perceived quality at less cost with increased tracking and reporting demands in an environment of high liability and problematic reimbursements," says Walker Ray, MD, vice president of The Physicians Foundation. Other findings from the survey include:

• 6% of physicians report working less than they did in a 2008 foundation survey
• 52% of physicians have already limited the access of Medicare patients to their practices or are planning to do so
• 26% have already closed their practices to Medicaid patients, blaming higher operating costs, time pressures and falling reimbursements
• 100,000 physicians will transition to employees over the next four years

Individual physicians and other eligible professionals and selected group practices can apply online for a hardship exemption under the 2013 Medicare Electronic Prescribing (eRx) Incentive Program beginning Nov. 1 through Jan. 31, 2013. This includes an exemption category for physicians and other practitioners who register to participate in the Medicare or Medicaid Electronic Health Record Incentive Program and adopt certified EHR technology. For help applying online, see the CMS user guide and website. Eligible professionals who do not meet the program’s requirements or qualify for an exemption face a 1.5% reduction in their total allowable Medicare Part B charges effective Jan. 1, 2013. Hardship exemption requests for the 2014 payment adjustment will be accepted during a separate timeframe later in calendar year 2013.

Over 110 physician groups and medical organizations have renewed their call to Congress to repeal the sustainable growth rate (SGR) formula. If implemented, come January 1, doctors would face a 27% cut in their Medicare pay. According to the Congressional Budget Office, the cost of repealing the SGR and restoring those payments would be $245 billion over 10 years. The physician groups and medical organizations are urging Congress to act on a number of points, including:

• Transitioning to "a high performing Medicare program that provides patient choice and meets the health care needs of a diverse patient population."
• Having the Centers for Medicare & Medicaid Services "invest and support physician infrastructure that provides the platform for delivery and payment reform."
• Making sure transitions reflect diversity of physician practices and provide opportunity for physicians to choose payment models that work for their patients practice, specialty and region.

A new survey from the MGMA-ACMPE finds 82% of physicians would be more likely to pursue new payment and delivery models if Medicare stabilizes its payment system. According to MGMA-ACMPE, if payments stabilized for five years, the majority of practices would consider alternative models such as the Medicare Shared Savings Program, bundled payments or comprehensive primary care initiatives. More than 26,000 doctors and 1,000 physician group practices participated in the survey. Other findings include:

• 18% said they are already participating in a new Medicare payment model
• 45% said they would cut back on appointments for new Medicare patients if Congress does not prevent sustainable growth rate cuts
• 31% said they will stop accepting new Medicare patients
• 76% said they might reduce staff salary
• 65% said they might cut administrative support
• 58% said they might reduce the number of clinical staff

The American Hospital Association (AHA) held a special conference call briefing on the current meningitis outbreak last Friday, October 19. This briefing was hosted by Nancy Foster, AHA vice president for quality and patient safety policy, and Roslyne Schulman, AHA director of policy. Dr. Janet Woodcock, the FDA’s director of the Center for Drug Evaluation and Research (CDER), was also on the call to share with members the most updated information and answer your questions. A free audio recording of the call can be downloaded by clicking here.

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