Massachusetts Medical Society Issues Support for Universal Health Insurance Coverage Adopts Guidelines for Physician Performance

May 15, 2005 -- The governing body of the state's physician organization today issued its support of universal health insurance coverage, and also adopted updated guidelines for measuring, reporting and rewarding physician performance. Those measures were two of the most significant of nearly two dozen resolutions considered by the Massachusetts Medical Society's House of Delegates at the Society's Annual Meeting at the Seaport Hotel and World Trade Center in Boston.

Delegates voted unanimously to adopt a resolution "supporting the achievement of universal insurance coverage" and adopt the five principles from the Institute of Medicine's (IOM) report "Insurance American's Health: Principles and Recommendations."
    
The IOM principles recommend that health care coverage be universal, continuous, affordable to individuals and families, affordable and sustainable to society, and enhance health and well-being by promoting access to care that is effective, efficient, safe, timely, patient-centered, and equitable.

Medical Society delegates also voted to continue to investigate options that work toward the goal of achieving universal insurance coverage, including "collaboration across all health care segments, including employers, health plans, health care organizations, legislators, and the administration for the State."

The resolution updating the Society's Guidelines for Measuring, Reporting, and Rewarding Physician Performance included a number of recommendations in five areas: (1) improving the quality of health care, (2) measuring quality, (3) evaluating patient-physician relationships, (4) public reporting of physician performance, and (5) pay-for-performance issues for physicians.

"The public expects and deserves valid reports on the performance of all health care providers, medical practices, managed care organizations, hospitals, nursing homes, and other services," the Society resolution stated, "and reports for public release must meet high standards for accuracy and statistical validity. Particular attention should be given to ensure that physicians are held accountable only for care for which they are, in fact, responsible."
    
The Society also stated that "reports that compare performance of physicians or practices to each other or to benchmarks must avoid using arbitrary cutpoints that designate practices as being 'superior,' 'above-average,' 'average,' or the like." Ranking, said the physicians, "should be based on clinically important and statistically significant differences."

With specific reference to pay for performance, the Society said "solid evidence is needed to establish that pay for performance actually contributes to higher quality and more cost-effective health care. Evidence supporting the value of such incentives in health care is, at present, limited." The Society also said pay for performance should be aligned and standardized across payers, physicians practices, and hospitals, and that funding of such initiatives should come from additional resources and "not from a redistribution of current physician and other health care provider reimbursement programs."
    
Physician pay for performance has become a growing issue in medicine and health care, as overall costs for health care continue to skyrocket, and more attention is focused on quality improvement programs. Medicare, health care plans and even some major employers have embarked on pay for performance programs.

Universal care and physician guidelines were two of about two dozen resolutions considered by the Delegates at the Annual Meeting. Among the others were policy issues such as physician credentialing, individual responsibility in health care, and continuing medical education, as well as administrative issues such as organizational by-laws changes, committee structure of the Society, and membership dues.

The Massachusetts Medical Society, with some 18,300 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes The New England Journal of Medicine, one of the world's leading medical journals; the Journal Watch family of professional newsletters covering 11 specialties; and AIDS Clinical Care. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts. Founded in 1781, MMS is the oldest continuously operating medical society in the country.




Massachusetts Medical Society Issues Support for Universal Health Insurance Coverage Adopts Guidelines for Physician Performance



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