AMA calls for payment models that reward care of vulnerable, high-risk patients

The American Medical Association is calling for advanced alternative payment models that give physicians more incentive to care for vulnerable and high-risk patients, the group announced June 11.

The association said current advanced alternative payment models under the under the Medicare Access and CHIP Reauthorization Act may not intentionally provide incentive for physicians to care for these populations. It's seeking changes through new policies it adopted during this year's house of delegates meeting in Chicago.

"To effect change and truly realize optimal health for all, we must encourage care to specifically meet the needs of vulnerable populations," said William E. Kobler, MD, an AMA board of trustees member. "If patients' basic needs are not met, they are unlikely to stay healthy, regardless of the quality of care received. Because APMs are typically designed to be flexible to compensate for care that is not traditionally reimbursed, they present an opportunity to better care for and serve vulnerable populations."

One adopted policy stipulates that the group support payment models in which quality measures and payments are connected to outcomes focused on vulnerable and high-risk patients and reducing healthcare disparities.

Association representatives said the group is pledging to continue advocacy work related to appropriate risk adjustment of performance results based on clinical and social determinants of health "to avoid penalizing physicians whose performance and aggregated data are impacted by factors outside of the physician's control."


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