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AMA Renews Commitment to Public Health after Election Results

AMA leaders stressed the importance of public health, chronic disease management, and legislative advocacy as the industry faces the uncertainty of a new political era.

By Jennifer Bresnick

- Despite the “anxiety” and “dollop of dread” likely resulting from this November’s Presidential election, the American Medical Association will continue its fight to improve public health, educate providers about health IT, and advocate for medical practitioners, said AMA CEO James L. Madara, MD and President Andrew Gurman, MD.

AMA, public health, population health management

At the start of the AMA’s 2016 Interim Meeting on November 12, Madara and Gurman urged healthcare providers to continue developing strong partnerships across the industry to protect the interests of patients and enable stakeholders to provide optimal care, even in the face of regulatory and political uncertainty.

“May we never again have an election quite like that,” Madara said.  “But now that it’s over, we do congratulate all of the newly elected.  We commit to work with all on behalf of patients and their physicians.” 

The potential for significant changes to the Affordable Care Act was the elephant in the room, but was not directly mentioned by either speaker.

“Let’s not become blocked by needless worry that steals energy or sidetracks us,” said Madara. “Anxiety about the future, perhaps even a dollop of dread – we have work in front of us, for sure.  But let’s simply focus on our task.”

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“Despite political divisions in this country, the AMA has always and will always commit to work with all elected bodies and appointed agencies on a bipartisan basis.  And we will continue to work towards advancing the mission that I so love to recite: to promote the art and science of medicine and the betterment of public health.”

Gurman also addressed legislators circumspectly after praising the AMA’s advocacy programs related to curbing gun violence, expanding funding for research into the Zika virus, and battling the ongoing opioid epidemic.

“What happens in the halls of Congress is as important to our patients and practices as what happens in the halls of academia, our offices, and our hospitals,” he said. 

“I view advocacy as a critical professional responsibility of all physicians.  The AMA Code of Ethics directs us to respect the law, but also to recognize our responsibility to seek changes in the best interest of our patients.  That’s exactly what we’re doing.”

Both Gurman and Madara praised AMA leaders for taking a stand against mega-mergers between insurers Anthem and Cigna as well as Aetna and Humana, stating that reduced competition between payers may prevent patients from easily accessing necessary care.

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“The AMA’s Code of Ethics state that we are to support access to medical care for all people,” said Gurman.  “We are to provide competent medical care with compassion and respect for human dignity and rights.  We are to regard our responsibility to the patient as paramount.”

“We cannot effectively serve patients if we are bogged down by burdensome regulations, or if our patients cannot access care because of insurance mergers or narrow networks.”

Madara and Gurman also urged attendees to look towards the future, and to help the AMA develop and disseminate the resources required to aid providers with the challenge of embracing population health management, chronic disease care, and new health IT tools.

“Throughout 2016 we expanded our Innovation Ecosystem to bridge the digital divide for physicians, and begin to address the immense problem of fragmentation across our disconnected health care non-system,” said Madara.

The AMA added a new innovation studio in Silicon Valley to complement its MATTER tech incubator in Chicago.  Health2047 was launched with the goal of developing technologies that are “optimized for more efficient, effective practices and continuity of care, and better health,” he said.

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AMA leaders have also embraced several significant population health initiatives, including a concerted effort to revamp medical school education and a campaign to expand adoption of Diabetes Prevention Programs.

“We applauded CMS’ landmark decision to expand coverage of the Medicare DPP model to Medicare patients at risk for developing type 2 diabetes – underscoring the value of prevention in reducing health care costs,” said Madara.

“This CMS decision also highlights the success of our own three-year DPP pilot – in partnership with the YMCA of America and the Center for Medicare and Medicaid Innovation – across eight states to increase physician referrals for patients living with prediabetes.”

The AMA also reached patients directly through a national ad campaign and online risk assessment tool that allowed consumers to gauge their likelihood of developing diabetes.  More than 700,000 people visited the program’s webpage, and 250,000 completed the personalized risk quiz.

Gurman took on the task of highlighting MACRA as a “top priority” for physicians across the country, while noting that CMS is moving away from using the acronym and is instead encouraging stakeholders to call the new framework the “Quality Payment Program (QPP).”

“QPP is the most significant change to Medicare’s physician payment system in a generation,” Gurman stated. “The AMA’s response is designed to meet the enormity of that challenge. We have been working nonstop on two fronts: both to modify the new regulations where necessary, and to help physicians navigate and prepare for this change.”

Modifications to the final rule reflect many of the AMA’s suggestions, he added, such as including a longer transition period to prepare for implementation, more options to avoid severe financial penalties, and more flexibility for providers who are likely to have difficulty attesting to the program despite their best efforts.

“Remember that the transition to Medicare’s Quality Payment Program will take years, but the AMA is committed to helping you prepare for every milestone,” Gurman said.

“Friends, this week we shared a moment of tremendous impact in our country,” he concluded. “A new day dawned Wednesday. To borrow the metaphor of sailing used by Cecil Wilson during his presidency: We don’t know if the seas will be calm or rough, but we do have our North Star to navigate with.  We remain devoted to our mission to promote the art and science of medicine and the betterment of public health.”

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