1. The Physicians Foundation Report to OSMAP June 2013

2. The Physicians Foundation Overview National non-profit organization formed in 2003 and dedicated to: – Improving the delivery of healthcare to all patients – Advancing the work of practicing physicians – Sustaining the viability of medical practice Pursues mission through grantmaking, research, national surveys and policy studies – Given more than $28 million in grants – Conducted three nationwide surveys of physicians – Graduated over 100 physician leaders from our Academy 2

3. The Physicians Foundation Signatory Medical Societies Alaska State Medical AssociationMedical Society of Northern Virginia California Medical AssociationMedical Society of the State of New York Connecticut State Medical SocietyNebraska Medical Association Denton County Medical Society (Texas)New Hampshire Medical Society El Paso County Medical Society (Colorado)North Carolina Medical Society Florida Medical AssociationSouth Carolina Medical Association Hawaii Medical SocietyTennessee Medical Association Louisiana State Medical SocietyTexas Medical Association Medical Association of GeorgiaVermont Medical Society Medical Society of New JerseyWashington State Medical Association 3

4. The Physicians Foundation Board Members Louis J. Goodman, PhD, Texas Medical Association Alan Plummer, MD, Medical Association of Georgia Walker Ray, MD, Medical Association of Georgia Robert Seligson, North Carolina Medical Society Larry Braud, MD, Louisiana State Medical Society Don Alexander, Tennessee Medical Association Subhi Ali, MD, Tennessee Medical Association Karl Altenburger, MD, Florida Medical Association Todd Atwater, South Carolina Medical Association James Cross, MD, Aetna, Inc. Lawrence Downs, Esq., Medical Society of New Jersey William Guertin, California Medical Association 4

5. The Physicians Foundation Board Members Jennifer Hanscom, Washington State Medical Association Paul Harrington, Vermont Medical Society Ripley Hollister, MD, El Paso County Medical Society (Colorado) Sandra Johnson, Nebraska Medical Association Palmer Jones, New Hampshire Medical Society Alex Malter, MD, Alaska State Medical Society Gerald McKenna, MD, Hawaii Medical Association Gary Price, MD, Connecticut State Medical Society Philip A. Schuh, Medical Society of the State of New York Claudia Tellez, Medical Society of Northern Virginia Joseph Valenti, MD, Denton County Medical Society (Texas) Timothy Norbeck, Chief Executive Officer William Mahon, Chief Operating Officer 5

6. The Physicians Foundation Communications Activities 2013 Physician Watch List – Identified five issues that are likely to have a significant impact on patients and physicians in 2013, including: Uncertainty over healthcare reform Consolidation means “bigger.” But is bigger better? 12 months to 30 million Erosion of physician autonomy Growing administrative burdens 6

7. The Physicians Foundation Communications Activities 2013 Physician Watch List Video – Hosted on dedicated Foundation YouTube channel – Includes research / commentary from Board members on major challenges facing physicians 7

8. The Physicians Foundation Communications Activities Media Outreach – Published op-ed on healthcare cost drivers on Forbes.comForbes.com – Conducted D.C. media tour Met with reporters from Bloomberg, Politico, Modern Healthcare, Kaiser Health News, and American Medical News Shared physician perspective on significant health policy / marketplace issues affecting doctors and patients 8

9. The Physicians Foundation Communications Activities Media Coverage 9

10. The Physicians Foundation Research Activities Healthcare Highway II – Prepared by Bostrom and Old Creekside Consulting – Third installment in series of comprehensive research reports regarding ongoing regulatory changes affecting private practice 10

11. The Physicians Foundation Research Activities Healthcare Highway II – Provides overview of ACA implementation and physician- focused policies, including: Medicare physician fee schedule and the sustainable growth rate Value-based payments and quality ACO growth and Medicare Shared Savings Program Health insurance market reforms Medicaid program expansions – Also highlights various challenges related to federal budget, debt ceiling, healthcare entitlement programs and federal tax policies 11

12. The Physicians Foundation Research Activities A Blueprint for a More Effective, Physician- Directed Health System – Authored by Jeff Goldsmith, Ph.D – Offers influencers and providers a different perspective on ways to strengthen U.S. healthcare system for physicians and patients 12

13. The Physicians Foundation Research Activities A Blueprint for a More Effective, Physician-Directed Health System – A “redesign” of the U.S. healthcare system is needed based on key principles, including: Offer patients multiple choices in relationships/clinical solutions Consolidate and simplify payment transactions Strengthen the patient-physician relationship Improve teamwork and continuity by making payments on a bundled basis for complete solutions to medical problems 13

14. The Physicians Foundation Research Activities The Unintended Consequences of Regulation – Authored by Fred Hyde, MD – Explains how federal initiatives are having a corrosive effect on physicians and their practice of medicine 14

15. The Physicians Foundation Research Activities The Unintended Consequences of Regulation – Identified Top 10 regulatory “irritants” driving physicians out of independent medical practice, including: Meaningless Work – Federal reporting requirements add to physician’s work without direct benefit to patient Data is replacing information – Under ICD-10, there are now more than 68,000 regulatory codes compared to 13,000 codes previously Comparative effectiveness research – Recommendations from groups such as IPAB and PCORI can be ineffective and confusing 15

16. The Physicians Foundation Research Activities Scope of Practice Report – Authored by Stephen Isaacs and Paul Jellinek – Examines growing trend toward expanding scope of practice for non-physician providers 16

17. The Physicians Foundation Research Activities Scope of Practice Report – Multiple factors are contributing to trend, including: Payers and large delivery systems trying to contain / reduce rising healthcare costs Growing patient access problems related to physician shortages Demand for mid-level providers by physicians seeking to sustain medical practices 17

18. The Physicians Foundation Grantmaking Activities Grantmaking promotions – NY / NJ Hurricane Sandy grant Provided $700,000 to assist doctors in New York and New Jersey with their rebuilding efforts following the devastation Collaborated and coordinated media efforts with MSNJ and MSSNY – Physician Leadership grants Awarded more than $1.5 million 17 grants aim to create resources / programs to train physicians and medical professionals in leadership, business management, communication and interdisciplinary collaboration State Medical Society President’s Leadership Academy at Kellogg School of Management 18

19. The Physicians Foundation Grantmaking Activities Leadership grant examples: – Awarded $338,135 to Institute for Medical Quality (IMQ) to expand physician leadership program to Texas and Washington, D.C. – Awarded $75,000 to North Carolina Medical Society Foundation to develop the Kanof Institute for Physician Leadership – Awarded $75,000 to The Daniel Hanley Center for Health Leadership (Maine) to expand physician leadership education in other states 19

20. The Physicians Foundation Works in Progress Ongoing physician workforce simulation with University of North Carolina at Chapel Hill due in late 2013 Launch of Foundation social media / digital communication channels Upcoming webinars: – Medical Society Communications Directors webinar – Medical practice innovation webinar 20

21. Questions or Comments? 21