Today was my last Board of Governors’ (BOG) meeting as chair. Thad Waites, MD, FACC, governor of Mississippi, will now take the reins. It’s been a great year. I’ve met some amazing cardiovascular professionals and worked with fantastic ACC staff. I hope Thad has a similarly wonderful experience. After hearing his vision for the next year at today’s meeting – “Vision, Empowerment, Optimism and Opportunity” – I can only be excited for the direction the BOG is headed.

The keynote address at the meeting was given by Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform. Miller discussed how physicians could be successful under the health care payment and delivery reforms currently underway. According to Miller, there is a growing recognition that the structure of current health care payment systems frequently impedes efforts to improve the quality of health care and control health care costs. Because of this, a variety of different proposals to the payment system have been offered. These differ from the current fee-for-service system in one of more of the following ways:

• They pay more for certain services (such as currently unreimbursed or under-reimbursed services)
• They pay based on the quality of services
• They bundle payments for several services into one payment
• They make payment dependent on the amount and cost of services delivered by other physicians or providers (like gain-sharing or capitation)
• They pay to support specific provider structures, systems and locations

Under a new payment system, physicians would face both opportunities (i.e. being paid for desirable services not paid for today) and challenges (i.e. receiving inadequate payments for new services or bundled payments, or having performance standards set at unreasonably high levels). Successfully overcoming these challenges will require physicians to understand how to capitalize on these opportunities through improved efficiency, accessing sufficient capital, and being able to analyze their clinical and financial performance, as well as create organizational structures that support these key capabilities. 

Certainly, this is not going to be easy. The governors present at the meeting today have the challenging task of taking what they learned from Miller’s presentation back to their chapters to help their members adjust to the specific needs in their states. I’ll be doing the same in Indiana.

Thanks to all the governors today for a successful meeting!

*** Image credit: Harold Miller, from Mlive.com ***

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