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Miniseminar to Address Alternative Payment Models, Academy’s Advocacy for Physician Payment

The landscape of physician payment is changing with quality and measures becoming more intertwined in how payment is—and will be—provided for services.

These changes will be addressed during “Alternative Payment Models and Academy Advocacy for the Future of Physician Payment,” which will take place from 10:30 am-11:50 am Wednesday in Room W414CD. The Miniseminar will outline the efforts of the Academy, specifically the Physician Payment Policy Workgroup (3P) and the Ad Hoc Payment Model Workgroup, to prepare members for the continued implementation of the Affordable Care Act, so otolaryngologists have the tools to participate in diverse payment systems.

During the Miniseminar, attendees will learn about payment models as they relate to healthcare reform initiatives, new payment models, and Academy efforts to prepare members for changes to how they will receive payment for services; understand how measure sets (such as sinusitis, otitis externa/OM) are formally developed for otolaryngology, how otolaryngologists may track and report these measures, and how these measures may affect reimbursement; and learn about the Academy’s efforts to interact and collaborate with public and private payers related to alternative payment model options and opportunities for otolaryngologist-head and neck surgeons.

 “This is a very relevant and timely topic,” said Jane T. Dillon, MD, MBA, moderator for the session. “The Affordable Care Act included several new Medicare payment reforms designed to improve coordination and collaboration among physicians and other healthcare providers, moving towards integrating quality into payment systems.”

These reforms, she said—including the ongoing efforts on the Capitol Hill to repeal the Sustainable Growth Rate formula and create new systems for Medicare, the development of Accountable Care Organizations (ACOs), and episode groupers or bundled payments—may provide incentives for otolaryngologist-head and neck surgeons to use innovative products that improve quality and create efficiencies in the delivery of care.

“While the AAO-HNS is further investigating and reviewing these models, we realize bundling and other alternative payment models may not be the correct solution for reimbursement in all cases for otolaryngology-head and neck surgeons,” she said. “And, regardless of what reforms are ultimately adopted, the fee-for-service payment option will need to remain an integral part of physician payment for the foreseeable future. However, it is important for members to be knowledgeable of current CMS quality initiatives and pending changes in the marketplace so their practice patterns remain sustainable.”

Speakers will discuss the following topics during the Miniseminar:

Robert Lorenz, MD, MBA, will discuss new forms of payment, providing an overview of changes in the marketplace, and discussing bundled payments in general.

Randal S. Weber, MD, will provide a real world example of a Bundled Payment Trial for Single or Multimodality Head and Neck Cancer Treatment.

Emily Boss, MD, MPH, will provide an overview of quality measure development and reporting in otolaryngology, discussing how to navigate the complex system and providing an overview of some resources available to otolaryngologists to aid them in reporting.

Richard Waguespack, MD, will review the role of the AAO-HNS Physician Payment Policy (3P) Workgroup and payment and quality alignment, as well as providing highlights of 3P and Health Policy accomplishments during the past year, including interactions with private payers and updated practice management resources available to Academy members.

This session is interactive. Dr. Dillon will be polling the audience at the end of the session.

For ongoing updates on AAO-HNS efforts related to payment reform, visit www.entnet.org/content/payment-reform.

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