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AMA Proposing Specialty Care, Payment Models to CMS

Models, AMA says, should incorporate flexibility, accountability, sustainability, and protection

FRIDAY, May 16, 2014 (HealthDay News) -- The American Medical Association (AMA) and other specialty societies have created new care delivery and payment models that they expect to be supported by the Centers for Medicare & Medicaid Services, according to a recent AMA news release.

The AMA has recommended detailed actions CMS should take in developing new specialty payment models, including allowing flexibility; offering risk protection for physicians; and providing timely, accurate data so physicians can benchmark their progress.

While CMS sought comments on the procedural episodes and complex chronic disease approaches, the AMA suggested that a model designed around uncomplicated chronic disease management could help prevent patients from developing more advanced disease and experiencing acute episodes. In addition, the AMA suggested another potential model for specialty-specific, risk-adjusted global payments. This model would allow larger practices or multi-specialty groups to design comprehensive, specialty-specific or condition-specific global payments that would cover all services needed to treat a specific condition managed by that specialty.

"A relatively small number of different types of payment reforms can be developed that will be applicable to a broad range of specialties and the majority of patients within each specialty," the AMA said in its comments to CMS.

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