JIM LINCOLN
MEDICAL ECONOMICS
Most valuable players TMA PSO empowers physicians in new health care models
BY AMY LYNN SORREL The pressures of today’s health care system often force physicians to undervalue their practices in a fire sale to cope with mounting reg- ulatory and administrative burdens and diminishing fee-for-service payments. But health care consultant John G. Nackel, PhD, says the movement toward ac- countable care puts physi- cians in a unique position to meet increasing de- mands for high-quality and low-cost care.
Hospitals haven’t been able to do it, and pay- ers can’t do it alone. That makes physician practices more valuable than ever, which means they may want to reconsider selling or, if they do sell, recon- sider their worth for the crucial role they are poised to play in new value-based models. Whether those models are hospital-, pay- er-, or physician-driven, the patient-physician relation- ship remains at the heart of the health care delivery system, and collaborative, accountable care entities rely on physicians as those with the most influence on health care decisions, costs, and quality outcomes.
Enter the Texas Medical Association’s Physician Services
Organization (PSO), which will equip practices with the tools and strategies they need to remain competitive and in the driver’s seat in the future health care environment. The PSO
is still under development and expected to launch early this year.
“In all of these models
we are talking about — accountable care organi- zations [ACOs], medical homes, bundled payments — physicians are at the helm of the decisionmak- ing process with respect to patient care. They all require physicians to take significant accountability in that process, and you will not see the [desired] results [of the models] achieved without physi- cians playing a significant role,” said Dr. Nackel. His California-based consult- ing firm, Three-Sixty Ad- visory Group, is helping TMA develop the PSO. Ultimately, the desired
The patient-physician relationship is at the heart of the health care delivery system, and TMA’s Physician Services Organization (PSO) will equip physicians for the crucial role they will play in new care models, says John G. Nackel, PhD, a consultant on the PSO.
result is higher quality care at a lower cost. It’s also called a value-based sys- tem, in which payment is driven not by the number of services performed, but by patients’ overall health. And whether it’s getting an electronic medical record system up and running to
collect information on patients’ health or coordinating with other physicians to close identified gaps in care, practices must transform to meet today’s demands for more efficient patient care, says Dan McCoy, MD, TMA Board of Trustees member and chair of the PSO task force. “Payment methodologies for health care are changing, and part of that is prescribed by federal health system reform and
January 2014 TEXAS MEDICINE 23
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