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Remarks to the Physician-Focused Payment Model Technical Advisory Committee

Thomas E. Price, M.D.
Physician-Focused Payment Model Technical Advisory Committee (PTAC)
April 11, 2017
Washington, DC

We want to make certain that folks far and wide across this land who are caring for patients have an opportunity to have input into what a model for their care of their patients and the payment for that care ought to look like.

On April 11, 2017, Secretary Price addressed a meeting of the Physician-Focused Payment Model Technical Advisory Committee (PTAC). PTAC was created under the Medicare Access and CHIP Reauthorization Act of 2015 to make comments and recommendations to the Health and Human Services Secretary on proposals for physician-focused Medicare payment models, which can be submitted by individuals or organizations. This meeting was the first Secretary Price had addressed, and the first at which PTAC members publicly deliberated and voted on proposals.

Thank you, Dr. [Jeffrey] Bailet, very much. What a kind introduction. I appreciate that.

Good morning to all. It is wonderful to be with you, to welcome you to the Great Hall here in the Hubert Humphrey Building. I'm incredibly honored to serve in this capacity and remarkably humbled by the opportunity that presents itself. So I want to welcome you this morning, Dr. Bailet, Ms. [Elizabeth] Mitchell and the entire PTAC, for the work that you have done.

I know the sacrifices that you all make. You all have other jobs. I know that people remind you of that frequently when you're back home. So what you're doing is a service not just to health care in our country, but to every single citizen, and I thank you for that.

I also want to take time to thank the staff who have been engaged in participating and helping these folks do their job and do it better. We rely on a wonderful, wonderful staff here at HHS, and I am privileged to be able to help guide them as we move forward.

I am honored today to join you for this first PTAC meeting to deliberate and vote on physician-focused payment models. It is a foreboding task to be asked by your federal government to devise a payment model for physicians and be out there in what I call the “real world” and to think that anybody’s not just going to pay attention but going to care what they think. So I want to commend the folks who have submitted payment models and encourage others to do the same. And we'll talk a little bit more about that in just a moment.

I met with the committee just for a few minutes earlier this morning, and I mentioned to them that I think I'm probably in a fairly unique position as it relates to this task before us, and that is that I served in Congress, as Dr. Bailet said, from 2005 to just January or early February of this year. So I had the opportunity to work specifically on the Medicare Access and CHIP Reauthorization Act [MACRA]. And with my colleagues, we felt that it was incredibly important to get physicians involved in defining or assisting in defining what kind of payment model they felt would be the most appropriate to facilitate their care of patients.

And so the PTAC was one of those things that we were adamant about, that we wanted to make certain was put in place, because we wanted physicians to be able to have that input. To also have the opportunity to serve on the administrative side, on the executive branch side and to try to put in place that vision that we had on the legislative side is an opportunity that doesn’t always occur, so it's an incredible privilege for me to have that opportunity.

If we're honest with ourselves, as a nation, it’s important that we appreciate where we find ourselves now as it relates to the physician community. You read stories about physician burnout. You never read stories about physician burnout 20 or 30 years ago, and now you read stories about physician burnout. And we need to step back and say, “Why is that?” Part of that reason, I believe, is the payment model and the payment apparatus that docs find themselves working under.

Dr. Bailet mentioned that I'm a third-generation physician. My dad and my granddad were docs. My grandfather practiced medicine until he was 94 years old. Some said he probably shouldn't have practiced medicine until he was 94 years old, but he did, and he inspired in me a love of medicine. But you don't hear about physicians, by and large, practicing anymore into their 80s or 90s, or even their 70s. My peers, when they've reached 50, 55 years of age, a lot of them were looking for the exit doors. And you think about the intellectual capital that we're losing as a nation when docs 55, 60 years of age say, “How can I end this professional run?”  And so I want to commend again the committee for working in this arena and being focused on what physicians feel out there.

I think it's incredibly important to appreciate that what we're looking for is not just a single payment model. When I read that earlier with my legislative hat on before, I thought, well, are people going to think we’re just looking for one size fits all? And the answer to that is no. We want to make certain that folks far and wide across this land who are caring for patients have an opportunity to have input into what a model for their care of their patients and the payment for that care ought to look like.

So PTAC is incredibly important. The work that you're doing is incredibly important, especially at this vital, vital time. You will have the opportunity to validate really exciting plans that folks have come up with.

Dr. Bailet also mentioned the health care principles that I've talked about, and they kind of morph depending on what kind of focus we're putting on issues. These principles really run across the ideological spectrum. Everybody wants a system that's accessible for everybody. We want a system that's affordable for everybody. We want a system that's of the highest quality, provides the highest-quality care.  And we want a system that innovates, that incentivizes innovation, because that's the only way that you maintain the highest quality of care, and then a system that empowers patients. And in order to empower patients, we've got to have a system that's transparent and accountable and provides choices and is responsive to those patients.

This committee actually runs across many of those principles, whether it's accessibility, whether it's affordability, whether it's the kind of quality that you look at, and try to determine whether or not a different payment model will continue to incentivize the highest-quality care, and then obviously the innovation that is so necessary for our system. So I want to urge you to make certain that you're looking far and wide across the models that are coming before you.

I also want to urge others who may be listening or may be responding to the call to propose a payment model to not be bound by old ideas. This is a time of really great innovation in health care on the clinical side. We need to make certain that we're also innovating on the non-clinical side, on the side that allows us to have the finest and highest-quality health care system in the world.

So I want to call on physicians and other providers all across the land, truly far and wide, to think about what payment model might work better for them and their patients, and to utilize the opportunity to put forward that payment model, especially those in the rural and the underserved areas. I know that the docs out there in small communities, in the underserved areas, often times feel the rules that are coming down from on high from Washington are for those large, integrated groups, that they’re for the folks who are in the large practices and have all of that administrative help beside them. But I think there has to be a way if we're listening to the folks who are actually providing the care, there has to be a way to be able to allow them to have input into a system that would work much better for them and for their patients.

There’s no more important time to do this than right now, as we have the opportunities to transition to a model that tries to identify and adhere to those principles of health care, but make it so that we’ve got a system that works from a financing and delivery standpoint much more efficiently.

So the practicing doc out there, we need your help. Your participation is absolutely vital to the success of this wonderful, marvelous group that we've got before us with incredible experience and expertise that they bring to the table. They want to hear your ideas, and I would urge you to make certain that you provide those ideas and models for them as we move forward. This only works with everybody's involvement, so I encourage you to do that.

I look forward to your recommendations. I look forward to your continued work. And as I mentioned before, we look forward to assisting you to make certain that we're able to allow you and encourage you to do everything that you can to come up with positive solutions to the challenges that we face in health care financing and delivery.

It's an honor to be with you today. Thank you very much. God bless you.

Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on April 19, 2017