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AMDA, Much More Than a Rose by Another Name…
JAMDA 16 (2015) 172
JAMDA journal homepage: www.jamda.com
Letter to the Editor
AMDA, Much More Than a Rose by Another Name. To the Editor: A rose by any other name is said to still be a rose, but can that be said for an associationdspecifically our association. I would say no. The American Medical Directors Association’s recent name change to AMDAdThe Society for Post-Acute and Long-Term Care Medicine is much more than a simple name change while keeping some business as usual. AMDA is truly a new rose, as a result of its expanded scope and membership. These are in keeping with the changes occurring to long-term care (LTC). This shift has moved all the critical elements of LTC such as the where, who, and how (Table). Our name change reflects two important aspects involving our ‘where’ and ‘who.’ This permits us the opportunity to expand beyond the nursing home walls to the full spectrum of post-acute and LTC. It also allows us to expand our ‘who’ to now include NPs and PAs well beyond our historical sole focus of medical directors and attending physicians. Although these expansions are certainly in keeping with the evolution of LTC, it may leave a hole regarding the need to continue
a focus on safeguarding issues that are specific to the skilled nursing facility. This is especially critical at this time as we battle for equity, efficiency, and effective solutions involving concerns such as access to Schedule II medications, adjustments in the SNF quality reporting and bundled payments pilot programs. AMDA will still need to take charge as the primary advocate for SNF Medical Directors and their attending physicians for ours is such a very unique world and no other groups have the ability or interest to pursue our objectives and those of our residents. We must do this as we have done so well in the past while looking forward and even further outside to include additional LTC provider stakeholders, including hospitalists and other members of our interdisciplinary care team who are an essential component as we are on our patients’ quality of life. Together focused on this objective, we can continue to be successful for our patients and those of us caring for them in all post-acute and LTC settings.
Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD Thomas Jefferson University School of Population Health Philadelphia, Pennsylvania
Table LTC’s Change: The Where, Who and How. LTC Typical Focus
Past
Now/Future
Where
Location
Skilled nursing facility (SNF)
Who
Practice size/form
Solo physician
How
Reimbursement basis Reimbursement source Medical records Information (beyond medical records)
Volume Medicare/Medicaid Paper Limited access
LTC spectrum [SNF, assisted living community (ALC), continuing care retirement community (CCRC), adult day care (ADC), home] Interdisciplinary care team (IDT), physician extenders [nurse practitioner (NP), physician assistant (PA)], hospitalist/SNFist Accountable outcome/population health Integrated delivery system Electronic medical records (EMR) Expanded by technology (remote monitor)
http://dx.doi.org/10.1016/j.jamda.2014.11.005 1525-8610/Ó 2015 AMDA e The Society for Post-Acute and Long-Term Care Medicine.
JAMDA journal homepage: www.jamda.com
Letter to the Editor
AMDA, Much More Than a Rose by Another Name. To the Editor: A rose by any other name is said to still be a rose, but can that be said for an associationdspecifically our association. I would say no. The American Medical Directors Association’s recent name change to AMDAdThe Society for Post-Acute and Long-Term Care Medicine is much more than a simple name change while keeping some business as usual. AMDA is truly a new rose, as a result of its expanded scope and membership. These are in keeping with the changes occurring to long-term care (LTC). This shift has moved all the critical elements of LTC such as the where, who, and how (Table). Our name change reflects two important aspects involving our ‘where’ and ‘who.’ This permits us the opportunity to expand beyond the nursing home walls to the full spectrum of post-acute and LTC. It also allows us to expand our ‘who’ to now include NPs and PAs well beyond our historical sole focus of medical directors and attending physicians. Although these expansions are certainly in keeping with the evolution of LTC, it may leave a hole regarding the need to continue
a focus on safeguarding issues that are specific to the skilled nursing facility. This is especially critical at this time as we battle for equity, efficiency, and effective solutions involving concerns such as access to Schedule II medications, adjustments in the SNF quality reporting and bundled payments pilot programs. AMDA will still need to take charge as the primary advocate for SNF Medical Directors and their attending physicians for ours is such a very unique world and no other groups have the ability or interest to pursue our objectives and those of our residents. We must do this as we have done so well in the past while looking forward and even further outside to include additional LTC provider stakeholders, including hospitalists and other members of our interdisciplinary care team who are an essential component as we are on our patients’ quality of life. Together focused on this objective, we can continue to be successful for our patients and those of us caring for them in all post-acute and LTC settings.
Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD Thomas Jefferson University School of Population Health Philadelphia, Pennsylvania
Table LTC’s Change: The Where, Who and How. LTC Typical Focus
Past
Now/Future
Where
Location
Skilled nursing facility (SNF)
Who
Practice size/form
Solo physician
How
Reimbursement basis Reimbursement source Medical records Information (beyond medical records)
Volume Medicare/Medicaid Paper Limited access
LTC spectrum [SNF, assisted living community (ALC), continuing care retirement community (CCRC), adult day care (ADC), home] Interdisciplinary care team (IDT), physician extenders [nurse practitioner (NP), physician assistant (PA)], hospitalist/SNFist Accountable outcome/population health Integrated delivery system Electronic medical records (EMR) Expanded by technology (remote monitor)
http://dx.doi.org/10.1016/j.jamda.2014.11.005 1525-8610/Ó 2015 AMDA e The Society for Post-Acute and Long-Term Care Medicine.