Forum News & Updates

In this issue:

Appropriate Use of Medical Resources: Elective Percutaneous Coronary Intervention

To support the field’s efforts in the appropriate use of medical resources, the latest toolkit from AHA’s Physician Leadership Forum (PLF) addresses the appropriate use of elective percutaneous coronary intervention (PCI) for patients with acute heart disease. We collaborated with the American College of Cardiology, the American Heart Association and the Society for Cardiovascular Angiography and Interventions to bring hospitals and health systems resources and tools to help in their quest for safe, high-quality care.
Appropriate use of PCI with the right patient at the right time can improve outcomes, reduce hospital admissions and readmissions and lower costs.
A 2013 AHA white paper, Appropriate Use of Medical Resources, identified five areas where hospitals, in partnership with their clinical staff and patients, should look to reduce non-beneficial care. Previous toolkits focused on patient blood management, antimicrobial stewardship and ambulatory care sensitive conditions.

Register for our complimentary program on the governance of physician organizations

The transformation of health care toward more integrated and accountable delivery systems has brought physicians and hospitals together as collaborators in ever increasing numbers. With this shift has come a need to rethink and engage physician leaders in new roles, including governance.
To understand how the governance of physician-led organizations is different, and similar, to that of health care systems, the AHA’s Center for Healthcare Governance and Physician Leadership Forum, with generous support from Hospira, Inc., undertook a study to examine governance structures and functions in a diverse set of physician organizations.
Join your physician and hospital executive colleagues on Saturday, July 25 from 11:30 a.m. – 5:00 p.m. at the Marriott Marquis in San Francisco for this half-day complimentary program, in conjunction with the Health Forum/AHA Leadership Summit, to hear the highlights of the study, including case study presentations from three leading-edge physician organizations. Attendance is limited to ensure opportunity for dialogue.

To learn more or register for this complimentary program, click here.

CMS issues “strategic vision” for physician quality reporting programs

The Centers for Medicare & Medicaid Services (CMS) recently issued a “ strategic vision” for how it will administer the Physician Quality Reporting System, Physician Feedback/Value-Based Payment Modifier Program and other physician quality reporting programs. The document outlines five vision statements, or principles, and indicators of success for each. The principles are: input from patients, caregivers and health care professionals will guide the programs; feedback and data will drive rapid cycle quality improvement; public reporting will provide meaningful, transparent and actionable information; quality reporting programs will rely on an aligned measure portfolio; and quality reporting and value-based purchasing program policies will be aligned. “With passage of H.R. 2, key components of these physician programs will serve as the foundation for the Merit-based Incentive Payment System,” wrote Patrick Conway, MD, CMS principal deputy administrator and chief medical officer. “The Strategic Vision describes in concrete terms how we will advance the goals and objectives for quality improvement outlined in the CMS Quality Strategy through these quality measurement and reporting programs.”

AABB issues patient blood management resource

The AABB has released a white paper to help organizations overcome common hurdles associated with starting a Patient Blood Management (PBM) program – an evidence-based, multidisciplinary approach to optimizing care for patients who might need transfusion. The paper includes a review of the business case for a PBM program, a case example and transfusion committee resources. As part of its appropriate use of medical resources initiative, the AHA’s Physician Leadership Forum last year partnered with AABB on a PBM toolkit to encourage appropriate blood management in inpatient service. Learn more at www.aha.org/appropriateuse.

PCORI awards $120 million to compare treatments for certain conditions

The Patient-Centered Outcomes Research Institute recently awarded about $59 million for five “pragmatic clinical studies” to compare the clinical effectiveness of certain treatments in typical care settings. The studies will compare proton beam versus photon radiation therapy to treat breast cancer; lifestyle interventions alone versus with diabetes medication to reduce weight and metabolic problems in youth taking certain antipsychotic medications for bipolar disorders; biological versus conventional drug treatment for Crohn’s disease in children; nerve blocking regional versus general anesthesia for older adults undergoing surgery for hip fracture; and exercise coaching versus usual care for older adults with low-impact fractures from falls. The institute also awarded about $62 million for 29 studies that will compare options for improving outcomes for conditions such as opioid addiction, arthritis, stroke, Parkinson’s disease, leukemia and chronic kidney disease.

IOM panel proposes framework for prioritizing U.S. measures of health, health care

An Institute of Medicine (IOM) committee has recommended 15 core measures, or “vital signs,” and 32 related priority measures for tracking U.S. progress toward improved health and health care, citing the need to reduce the burden of unnecessary reporting and focus on “change that matters most.” According to the report, “Implementation of this measure set will depend on leadership at every level of the health system, but in particular on the leadership of the secretary of the U.S. Department of Health and Human Services, who is the natural mainstay of the coordinated, multistakeholder process for refining and implementing the core measures that the committee envisions in its recommendations.” The 15 core measures are life expectancy, well-being, overweight and obesity, addictive behavior, unintended pregnancy, healthy communities, preventive services, care access, patient safety, evidence-based care, care match with patient goals, personal spending burden, population spending burden, individual engagement, and community engagement. Participating in a recent national leadership panel convened by the IOM to discuss the implications of the report and actions for stakeholders, AHA President and CEO Rich Umbdenstock voiced support for the report, calling it “the type of direction, the type of common playbook that we need as a nation.”

Medical school enrollment projected to rise, physician shortage will continue to grow

A new survey from the Association of American Medical Colleges (AAMC) projects medical school enrollment to increase almost 30 percent by 2019. The survey found that two-thirds of the enrollment growth will come from medical schools accredited as of 2002 if their current enrollment projections hold true. The last one-third will come from newly accredited medical schools since 2002.
Even with the rise in medical school enrollment, another report from the AAMC estimates that by 2025, the nation will have a shortage of between 46,000-90,000 physicians. The study estimates a shortage of 12,000-31,000 primary care physicians, and a shortfall of 28,000-63,000 specialists. In a press release, AAMC President and CEO Darrell G. Kirch, MD, said, “The doctor shortage is real – it’s significant – and it’s particularly serious for the kind of medical care that our aging population is going to need.” To curtail the shortage, Dr. Kirch says they’ll have to find ways to deliver care more efficiently and continue to push for increased federal support for medical education.
The American Hospital Association (AHA) has voiced support for the Resident Physician Shortage Reduction Act (H.R. 2124), legislation that would add 3,000 residency positions each fiscal year from 2017 through 2021 for a total of 15,000 positions above the Medicare limit. The AHA also supports similar legislation in the Senate (S.1148).

How one organization implemented Choosing Wisely

A recent article (members only) from Spectrum, a bimonthly newsletter from the AHA’s Society for Healthcare Strategy & Market Development, discusses how Anne Arundel Medical Center implemented the ABIM Foundation’s Choosing Wisely initiative at their organization. One of the first things they did was identify their different audiences (medical staff, employees, community) and outline how they could use their communication tools to appeal to each group. For example, they made sure to have a strong physician champion to gain acceptance by the medical staff. The article also discusses the results they’ve seen, lessons learned, and what’s next for them.

Reminder: Apply for AHA health care transformation fellowship by June 1

Senior health care leaders may apply through June 1 to participate in the next AHA Health Care Transformation Fellowship, a nine-month program designed to give participants knowledge, tools and connections to transform their health care organizations. Through in-person learning retreats, webinars, one-on-one coaching and peer-to-peer networking, participants learn how to lead their hospital organizations in improving care while lowering costs. Curriculum topics include clinician alignment and leadership; new care delivery models; population health management; integration of health information technology; and evolving partnerships with payers, employers, community organizations and others. For more information, visit www.hpoe.org/hctfellowship.

Still time to apply to the ABMS Visiting Scholars Program

The deadline for applying to the American Board of Medical Specialties (ABMS) Visiting Scholars Program is May 29, 2015. The Scholars Program is an exciting opportunity for junior faculty, PhDs, residents/fellows, medical students, public health students, and graduate students in health services research and other relevant disciplines. Potential research topics include physician assessment and education, quality improvement in patient care, continuing professional development, and health policy, among others. Projects should build on existing research at the scholar’s institution and generate data, tools, and activities that could be useful to specialty boards in the Board Certification and Maintenance of Certification (MOC)/Continuing Certification (CC) process. For more information about the program and the application process, contact ABMS.