Physicians should not let their frustration over the still-unchanged sustainable growth rate formula distract them from the improvements that healthcare reform delivers to their patients and the profession, White House healthcare officials stated in a paper published in this week's Annals of Internal Medicine.

Rather, it's time to embrace change, wrote Nancy-Ann DeParle, director of the White House Office of Health Reform, and colleagues, indicating that post-reform survival virtually requires that change to include expansion and collaboration with other entities in the form of accountable care organizations or patient-centered medical homes.

"The economic forces put in motion by the Act are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger physician groups," the paper says. "The most successful physicians will be those who most effectively collaborate with other providers to improve outcomes, care productivity, and patient experience."

According to the Obama Administration authors, key ways the Affordable Care Act and the American Recovery and Reinvestment Act will change the practice of medicine include:

• Focusing care around exceptional patient experience and shared clinical outcome goals.
  
• Expanding the use of electronic health records with capacity for drug reconciliation, guidelines, alerts and other decision supports.
  
• Redesigning care to include a team of nonphysician providers, such as nurse practitioners, physician assistants, care coordinators and dietitians.
  
• Establishing, with physician colleagues, patient care teams to take part in bundled payments and incentive programs (e.g., ACOs and medical homes).
  
• Proactively managing preventive care--reaching out to patients to assure they get recommended tests and follow-up interventions.
  
• Collaborating with hospitals to dramatically reduce readmissions and hospital-acquired infections.
  
• Engaging in shared decision-making discussions regarding treatment goals and approaches.
  
• Redesigning medical office processes to capture savings from administrative simplification.
  
• Developing approaches to engage and monitor patients outside of the office (e.g., electronically, home visits, other team members).
  
• Incorporating patient-centered outcomes research to tailor care appropriate for specific patient populations.

To learn more:
- see the abstract in the Annals of Internal Medicine
- check out this Reuters piece

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