AMAP gains steam as first physicians accredited

Collaborative builds stature for AMA's program

A new collaborative of three health care accrediting bodies boosted the stature of the American Medical Accreditation Program (AMAP) just as the first physician applicants received their accreditation decisions.

The American Medical Association (AMA) launched AMAP in New Jersey last year and received about 3,000 applications. One health plan, with a network of about 600 physicians, and a single-specialty independent practice association are using AMAP for their credentialing and have asked all physicians to participate.

But the applicants also represent those who simply want to be part of the first program to set standards for individual physicians. AMAP issued its first accreditation results in May.

Initial response enthusiastic

"We had a very large response from physicians who just wanted to apply," says William Jessee, MD, the AMA's vice president for quality and managed care. "It's really taking off more quickly than we had anticipated."

AMAP also is expanding to Washington, DC, as well as Montana, Idaho, and other states.

While credentialing and office site reviews currently dominate the AMAP process, plans call for performance assessment to become a mandatory element similar to the ORYX system of the Joint Commission on Accreditation of Healthcare Organizations, which accredits hospitals and other health care entities.

Currently, physicians can earn supplemental points toward their AMAP accreditation by participating in an information system that provides comparative clinical process or outcomes data. In 1999, the performance assessment standard will remain optional, but those who choose to participate must use a system approved by the AMAP governing board.

"In the next few months, we're going to invite vendors of information systems to have their systems approved," says Jessee. "When there are enough [approved] systems so that any physician who wants one can find it, [performance assessment] will become mandatory."

Through the Performance Measurement Coordinating Council, AMAP and the AMA will exert influence on indicators of clinical quality and how they are measured. AMAP is currently conducting a pilot test of a measure for otitis media, which is based on clinical practice guidelines developed jointly by the academies of family practice, pediatrics, and otolaryngology.

Depression, CHF indicators next

AMAP also has targeted depression, congestive heart failure, pregnancy, back pain, and diabetes for future indicators. "We looked at conditions that had high prevalence and significant morbidity or mortality if they were not treated [appropriately]," says Jessee. "The intent was to find a mix of conditions that cut across specialties."

To further ensure that specialty societies have a voice in developing quality indicators, AMAP created a Specialty Advisory Committee with representatives from 30 national medical societies. It will work together with AMAP's Performance Measures Advisory Committee, which is made up of experts in the measurement field.

Two of AMAP's five representatives to the Performance Measurement Coordinating Council will come from that committee of society representatives, ensuring that specialty physicians have a voice in HEDIS and ORYX, the performance assessment programs of the National Committee for Quality Assurance and Joint Commission, says Jessee.