Independent physicians obtain better outcomes for lower costs than large health organizations, but don’t always get the recognition they deserve when it comes to public policies on value-based care.
For example, a 2016 report on the Medicare Shared Savings Program found that nearly half of physician-only accountable care organizations (ACO) earned savings, and that they were significantly more likely to do so than hospital-led or hybrid ACOs.
A new coalition, the Partnership to Empower Physician-Led Care (PEPC), is committed to making sure independent physicians are recognized for the quality outcomes they provide by advocating for policies that support them moving to risk-based care models like an ACO. The partnership was founded by the American Academy of Family Physicians (AAFP), California Medical Association, Florida Medical Association, Medical Group Management Association (MGMA), Texas Medical Association/Practice Edge, and Aledade—a company that helps physicians create ACOs.
There are four policy priorities for PEPC: advancing physician-led alternative payment models, ensuring an equitable policy framework that promotes choice and provider competition, creating new opportunities for physicians in commercial markets such as Medicare Advantage, and supporting consumer-directed care.
Kristen McGovern, JD, the partnership’s executive director, says the group will explore making a difference through both regulatory and legislative change, and focus at the federal level. While some education may be done in the private sector, the main target is Medicare programs.
“Independent physicians aren’t being ignored in these programs, but we are starting to understand what works and doesn’t work [in the programs],” says McGovern. “It’s becoming clear that independent physicians are able to achieve results.”
The idea for the partnership came about from conversations among the founding members who realized that it was important that the voice of the independent practitioner was heard as value-based care moves forward in Medicare. “We did scan the landscape and realized there was a gap that the partnership could fill,” says McGovern.
The common objective of helping independent practices thrive in new care models attracted the AAFP to the partnership, says Shawn Martin, senior vice president of advocacy and practice advancement for the physician group. “This brings us the opportunity to work with specialists and other organizations who are coming at the same problem from different perspectives,” says Martin. “The partnership will create a collective voice and the policy-making apparatus will be a little stronger to advance policies that make value-based care more friendly to independent practices.”
He adds that independent practices, besides providing better care, also are important to local communities for another reason. “Community-based practices across the country are the economic and social anchors for their communities and it is important to help them continue to play that role.”
Halee Fischer-Wright, MD, president of the MGMA, said in a statement that independent practices play a critical role in the health system, and afford physicians the autonomy and flexibility to make decisions that are best for their patients. “We look forward to working with PEPC to ensure that the independent practice is a viable option for those that seek it.”