Inside Medicare's New Payment System

Host: Matt Birnholz, MD

Guest: Richard Deem

Guest: Michael Tutty

Previously recorded in 2016 - For current information on MACRA, please visit reachmd.com/ama The Medicare Access and CHIP Reauthorization Act, or MACRA, has entered a critical phase of development as the Centers for Medicare and Medicaid Services responds to feedback from clinical stakeholders across the country. At the AMA, efforts are fully underway to update CMS and the physician community alike with the latest recommendations to maximize MACRA’s opportunities while avoiding potential pitfalls. Joining Dr. Matt Birnholz to provide updates from this organization-wide mission are AMA executives Richard Deem and Michael Tutty. Richard Deem is the Senior Vice President for AMA’s Advocacy Group, where he directs the organization’s federal and state and advocacy efforts. Michael Tutty is the Group Vice President of Professional Satisfaction and Practice Sustainability, where he manages AMA’s efforts to identify, support, and grow sustainable models of care delivery and payment.

Host: Matt Birnholz, MD

Guest: Robin Zon, MD, FACP

Value-based, patient-centered care has become the destination for all branches of medicine, and is the philosophy driving modern payment reform initiatives like MACRA. But the unique care delivery needs in each specialty challenge the notion that one payment model can serve everyone. And nowhere has this become more relevant than in the field of oncology.

Dr. Matt Birnholz joins Dr. Robin Zon, practicing oncologist and vice president and senior partner at Michiana Hematology-Oncology in South Bend, Indiana. Dr. Zon serves as Chair-Elect of ASCO's Government Relations Committee was Past Chair of the Clinical Practice Committee, which alongside other stakeholders at ASCO developed a Patient-Centered Oncology Payment (PCOP) model. Recently, Dr. Zon presented this information at the recent AMA House of Delegates meeting in June. She speaks to the phases of this model, how it can function as a defined APM under MACRA, and its demonstrated positive impacts on oncology care pathways.

Host: Matt Birnholz, MD

Guest: Lawrence Kosinski, MD

The advancement of the Medicare Access and CHIP Reauthorization Act (MACRA) has catapulted Alternative Payment Models into the spotlight for identifying new value-based approaches to care. But questions persist as to the roles that specialists can and should play in the design and implementation of APMs, how these models will cut healthcare costs, and which administrative partnerships are needed to make them successful.

Dr. Lawrence Kosinski, a practicing gastroenterologist with The Illinois Gastroenterology Group, is pioneering one such APM that applies an innovative method for tracking patients between clinic visits. The model, called SonarMD, for which Dr. Kosinski is founder and Chief Medical Officer, provides a web-based platform that pings patients beyond practice settings to help get ahead of issues before they become emergencies.

Host: Matt Birnholz, MD

Previously recorded in 2016 - For current information on MACRA, please visit reachmd.com/ama From the AMA's House of Delegates annual meeting in Chicago, Dr. Matt Birnholz joins AMA President Dr. Andrew Gurman to discuss current and future initiatives for the nation's largest physician organization. The two focus particular attention on reactions to physician payment reform and Meaningful Use updates from CMS's Medicare Access and CHIP Reauthorization Act (MACRA). Dr. Gurman, an orthopedic hand surgeon from Hollidaysburg, PA., became the 171st president of the American Medical Association on June 14th, 2016. In leading the nation's largest physician organization, Dr. Gurman will focus his tenure on advancing the AMA's three strategic focus areas: improving health outcomes for Americans living with pre-diabetes and hypertension; accelerating change in medical education and preparing students for today's health care system; and enhancing physician satisfaction and practice sustainability.

Host: Matt Birnholz, MD

Previously recorded in 2016 - For current information on MACRA, please visit reachmd.com/amaFrom the floors of the American Medical Association’s House of Delegates Annual Meeting in Chicago, Dr. Matt Birnholz speaks with Andy Slavitt, Acting Administrator for the Centers for Medicare & Medicaid Services. In his leadership role at CMS, Mr. Slavitt oversees the programs providing healthcare access to one hundred forty million Americans, including Medicaid, Medicare, the Children’s Health Insurance Program (or CHIP), and the Health Insurance Marketplace. He joins Dr. Birnholz to talk about the current state and next steps for the Medicare Access and CHIP Reauthorization Act (MACRA), a bipartisan legislation replacing the flawed Sustainable Growth Rate formula with a new approach to paying clinicians based on quality of care provided.