DENVER – At about the same time the Senate Finance Committee voted 14-9 Tuesday to approve its healthcare reform bill, Medical Group Management Association President and CEO William F. Jessee, MD, took the stage in Denver to tell his audience healthcare reform can't occur without payment reform.

Physicians need to be paid on results, he said, rather than on the existing fee-for-service method that rewards volume over patient safety and quality of care.

Jessee, who heads the 22,500-member group, made up of administrators and managers of physician practices across the nation, urged his audience to take the lead in creating a culture of safety.

"In your own practices and in your own communities start to make these changes," he urged.

"To provide safe, quality care, quality measurement is essential," he said. However, "measuring everything but improving nothing is not the goal."

Many people question whether the country can afford healthcare reform, he noted. "Can we afford not to meet these challenges?" he asked. "I hope we're willing to make the necessary investment."

Jessee put forth a laundry list of challenges:

• Insuring the uninsured;
• Controlling costs;
• Assuring patient safety;
• Solving manpower shortages; and
• Sharing health information.

There are 47 million people without health insurance in the country – including 22 percent of Denver's population. "We all pay the price when these people become ill," he said. "It becomes a hidden tax on the rest of us. Health insurance must be made available for all Americans."

Employing information technology is a vital tool for transforming healthcare, he said. About 75 percent of MGMA members' practices do not yet employ an electronic medical record system, according to the association's calculations.

However, Jessee noted that practices are using the Web in innovative ways to connect with their patients. He highlighted the promise of telemedicine, especially in rural communities, and the "huge breakthrough"  in monitoring patients in their homes. He also talked about the growing physician focus on patient safety, quality measures and the MGMA's leadership in administrative simplification and Project Swipe IT, which calls for the adoption of standardized, machine-readable patient ID cards by Jan. 1, 2010.

The industry needs to strip out administrative costs, Jessee said. "Over 30 cents of every dollar healthcare dollar goes to administrative costs," he pointed out.

He also called for having "difficult conversations about end-of-life care."

"Twenty-five percent of Medicare costs occur at the end of life," he said.

Jessee called for training a new healthcare workforce now for 2020 and beyond and urged the creation of financial disincentives to help change behaviors associated with the use of tobacco, alcohol and drugs, dangerous sexual activities, violence and lack of physical activity.

"I definitely see opportunity," he said. "We can and he must find a better way. We're far from perfect, but we're making progress. I'm fired up and ready to go."