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Fourth AAIM Retreat for Executive Directors Societies that Represent Internists

The Alliance for Academic Internal Medicine (AAIM) hosted the fourth AAIM Retreat for Executive Directors of Societies that Represent Internists—”The Future of Maintenance of Certification, Pay for Performance, and Reimbursement”—in September 2005. AAIM, the American Board of Internal Medicine (ABIM), and the American College of Physicians (ACP) organized the retreat with input from the Society of General Internal Medicine and the Society of Hospital Medicine.

With nearly 50 participants, the retreat featured speakers from several organizations influential to the internal medicine community, including the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare & Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC), and the National Committee for Quality Assurance (NCQA). These speakers provided participants insights on important changes in the ABIM Maintenance of Certification (MoC) program, public and private efforts related to pay for performance, and the current status of reimbursement for physicians by the Medicare program.

The retreat was structured as a series of panel discussions, each focusing on a specific topic. The first panel—moderated by Cary Sennett, MD, PhD, ABIM Senior Vice President for Research and Development—focused on the ABIM MoC program. Dr. Sennett presented an overview of MoC, discussing particularly how internal medicine specialty societies can help their members recertify through this process. Kristin McNiff, American Society of Clinical Oncology (ASCO) Assistant Director of Cancer Care Quality, Cancer Policy, and Clinical Affairs, provided an example of a practice improvement program ASCO developed to help its members improve the quality of care they provide, through which participants can also earn MoC credit.

Following Ms. McNiff, L. Gregory Pawlson, MD, NCQA Executive Vice President, presented “Quality Improvement, Certification and Recognition: Moving Towards Congruence.” NCQA is a nonprofit organization that unites diverse groups around a common goal—improving health care quality. Peter Hollmann, MD, Senior Medical Director of Blue Cross and Blue Shield of Rhode Island, concluded the first panel by discussing how the changes in MoC will affect managed care.

The second panel—moderated by John Tooker, MD, ACP Executive Vice President and Chief Executive Officer—focused on the future of pay for performance. Nancy Wilson, MD, AHRQ Joint Senior Advisor on Quality Improvement, started the discussion by providing AHRQ’s perspective related to pay for performance. Francois de Brantes, Program Leader of Health Care Initiatives at General Electric, discussed the "Bridges to Excellence" program that strives to "improve quality of care through rewards and incentives that encourage providers to deliver optimal care and encourage patients to seek evidence-based care and self-manage their own conditions." Don Liss, MD, Aetna Mid-Atlantic Regional Medical Director, concluded the second panel by discussing how Aetna has become involved with pay for performance.

The third panel—moderated by Michael Barr, MD, ACP Vice President of Practice Advocacy and Improvement— focused on the future of Medicare value-based purchasing. Trent Haywood, MD, JD, CMS Deputy Chief Medical Officer for the Office of Clinical Standards and Quality, discussed CMS’s position related to pay for performance and how that system will affect physician reimbursement. In particular, Dr. Haywood highlighted CMS’s “Pay for Reporting” demonstration that is scheduled to begin in early 2006.

Alan Nelson, MD, of MedPAC, discussed impending reform to the physician payment system and what potential impact that will have on internists. According to Dr. Nelson, “recognizing and rewarding internists for doing what they do best—managing the care of the patient—could be an important move toward keeping internists where they belong—at the center of patient care.” Robert Doherty, ACP Senior Vice President of Governmental Affairs and Public Policy, concluded the third panel and the retreat by providing ACP’s perspective related to value-based purchasing, particularly what impact cuts to the sustainable growth rate formula will have on physicians.

For more information on the four AAIM retreats for executive directors of societies that represent internists, please visit www.im.org/AAIM/Meetings/edhome.htm or contact AAIM Operations Coordinator Steven Humphrey at (202) 861-9351 or shumphrey@im.org.