AMA Educates On New Payment Options: Meet Your New Options, Same as Your Old Options?

June 22nd, 2012

One thing we can say for sure about the last few years...there's been lots of changes. 

KLA joins many of our clients with nervousness as to what the future of healthcare reimbursement holds.  We are faced every year with the prospect of HUGE cuts in Medicare.  Rumors are rampant as to what the new models will look like.  Hospitals are working to establish ACOs.  Healthcare plans are establishing systems where doctors are reimbursed NOT to provide care.  We are having trouble even keeping up with the acronyms.

And no one in our office is psychic!

To the rescue, the AMA.  If you don't know the difference between Capitation, Risk Pools and Shared Savings, the AMA has the answer for you.

According to the AMA website:

A "how-to" manual from the AMA helps physicians evaluate, negotiate and manage these new budget-based payment systems. Developed with input from experts in physician payment issues, the manual, "Evaluating and Negotiating Emerging Payment Options," analyzes each payment option and provides essential information and practical tools that can help physicians:

  • Understand how budget-based payment systems differ from fee-for-service.
  • Master concepts associated with budget-based systems, including actuarial soundness, risk adjustment and risk mitigation.
  • Estimate, monitor and manage the financial risks and rewards of a budget-based payment system.

A brief introductory webinar offers an overview of the manual, and a more in-depth webinar details each chapter. The manual will be expanded and updated regularly to provide physicians with the latest information and tools on emerging payment arrangements.

"Evaluating and Negotiating Emerging Payment Options" is just one of many resources available free to all physicians on the AMA's online practice consultant. The AMA also offers related resources about ACOs; Consumer Operated and Oriented Plans, known as CO-OPs; and other new delivery system options.

(End of quote)

These are well researched and documented resources that help cut through the rumor mill and understand the various payment options being visited.

Truthfully, for those of us with a couple of decades in the business, most of these new payment options seem much like the same old payment options (that have been tried and failed before); wrapped up in new initials and verbage.

Tags: AMA, Accountable Care Organizations, Emerging Payment Options


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