AMA Current Advocacy Efforts for 2009

1. AMA Current Advocacy Efforts for 2009 Medical Society of Mobile County Medical Association of the State of Alabama Jeff Terry, MD (jeffterry@usa.net) May 12, 2009

2. - Health System Reform - Coverage for the Uninsured - Medicare Physician Payment Reform - Medical Liability Reform - Managed Care Reform - Antitrust Reform - Improving the Public Health - Patient Safety & Quality Improvement - Balance Billing - Funding Research & Medical Education

3. AMA Priorities for Health System Reform • Expand coverage and choice • Improve quality and patient safety • Reform government programs • Reduce costs and increase value • Enhance prevention and wellness • Payment and delivery system reforms

4. Expand Coverage and Choice • AMA Plan • Provide subsidies to low-income (e.g., tax credits) to help purchase health insurance • Make regressive tax policies more progressive • Support direct subsidies for high-risk patients (e.g., risk pools, reinsurance) • Require a greater level of individual responsibility • Implement health insurance market reforms • Continue to oppose single-payer plans • Council on Medical Service Reports

5. Improve Quality and Patient Safety • Develop quality measures and appropriateness standards (PCPI) • Develop evidence-based performance measures that enable continual QI and are the basis for rewarding high quality, cost-effective, safe care • Support practice-based solutions (e.g., HIT, decision support, continual performance monitoring) that enable incorporating measurement into practice to support QI • Evaluate and improve PQRI (Consortium) • Facilitate physician involvement with patient safety organizations (Patient Safety Act)

6. Reform Government Programs • Enroll SCHIP eligible children and expand eligibility to higher percentages of FPL • Eliminate existing Medicaid categorical requirements and establish uniform eligibility for all below 100% of FPL • Replace Medicare SGR with alternative update methodology & reform the Medicare program • Eliminate subsidies for Medicare Advantage • Improve physician payment levels

7. Reduce Costs and Increase Value • Reduce the burden of preventable disease and better manage chronic disease • Support comparative effectiveness research • Address variation in the utilization of health care services, particularly at the state/regional level • Make health care delivery more efficient • Reduce non-clinical costs that do not contribute value to patient care

8. Enhance Prevention and Wellness • Support integrated approach to encourage the adoption of healthy lifestyles for physicians and their patients • Urge the inclusion of wide range of evidence-based preventive services in insurance plans • Support adequate federal funding for biomedical research, including prevention • Encourage CBO to score the long- and short-term budget deficit reductions and costs associated with prevention • Eliminate racial, ethnic and gender disparities through infrastructure and programmatic change

9. Payment and Delivery System Reforms • Develop physician-relevant HIT systems (e.g., interoperability) and provide incentives to build the infrastructure • Develop value-based payment methodologies (e.g., patient-centered medical home, management of chronic disease) • Pursue antitrust relief, fair physician contracting, and greater transparency • Enact medical liability reforms

10. AMA Fully Engaged with Policymakers and Other Stakeholders • Ongoing meetings with HHS Secretary Kathleen Sebelius and other Administration officials • Meetings with Nancy-Ann DeParle head of the new White House office for Health Reform • Provided feedback to Sen. Baucus on health system reform white paper • Testimony before House W & M Health Subcommittee and ongoing meetings with Rep. Stark’s staff • Dialogue with Speaker Pelosi’s Office • Participating in the Health Reform Dialogue Group

11. Health System Reform=TransformationNot Incremental Change • Physicians and patients are not well-served by the status quo • Need to alter our daily focus and concentrate on working to advance HSR objectives • Some elements of reform will be beyond physicians’ current comfort level • Constructive engagement is key to success • Educate and activate physician and patient grassroots networks. Health System Reform Bulletin

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13. Other Health Reform Items • Health System Reform Bulletin (HSRB) Senate Finance Committee – Baucus • HSRB – Specialty Societies letter – Reid • HSRB – AMA letter on insurance reform • HSRB – MedPAC and health system reform • HSRB – President’s 8 health reform goals • Congressional Health Care Caucus – This is excellent from Dr. Rep. Burgess

14. Other Items • Right to Privately Contract Resolution • Why a new public plan will not improve American health care (excellent) • Coverage issues in health reform (excellent) • Canadian care • Defeat Obamacare • Six deal killers for national health reform • Top down or bottom up?