At the recent AMA annual meeting, delegates acted contrary to the wishes of their Board of Trustees and said they oppose private-payer or Medicare inititiatives if they do not meet the AMA guidelines for P4P. These include focus on improving performance and not cost control, allows docs to opt out without finanacial penalty and the programs must provide new funds-not just divide the pie differently. The Grassley-Baucus bill that was recommended by MedPac does not meet their standards. In that bill 1%-2% of physician payments would be withheld in a bonus pool to be redirected to the " top performers". Physicians who participate would have to essentially get a EMR system in place to allow performance data collected from their practices.
ACP, AAFP, ACOG and the AAP have all signed a letter to Bill Frist supporting the MedPac proposal . We all saw how "Go along to get along" worked with the gatekeeper Trojan Horse, it will work as badly with the P4P programs. Those who opposed the delegates' position argued that if the delegates ' hard line stance were accepted then physicians would not be in a leadership position. Who really believes physicians will be in a leadership position in any event?
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