The American Medical Group Association's annual meeting in Orlando, Fla., began with its top officers congratulating members for the leadership they have shown in helping to transform the healthcare system. And then they called on them to lead some more.

“This is our time,” said AMGA Board Chairman Michael Bukosky, CEO of University of Louisville Physicians. It's “time to step up and act.”

Bukosky described the problems in healthcare as a “personal leadership challenge and personal opportunity” to solve complex problems and find a sense of purpose along the way.

While other groups wait for and react to the latest rule changes from Washington and look to “government or someone else” to solve challenges, Bukosky said that it's up to AMGA members to take responsibility for shaping issues and fixing problems.

Bukosky called on members to tell their communities that the use of integrated systems of coordinated care is working. He also urged them to partner with patients and encourage them to be responsible for their health.

AMGA President and CEO Donald Fisher said that while the organization's member group practices have adopted the medical home model and implemented accountable and coordinated-care systems, the U.S. healthcare system remains too fragmented.

“There are many, many cracks in the system and duct tape won't cure our problems,” he said. “The problem is, not everyone has followed your lead.”

Fisher added that there “is no doubt we will all have to improve our efficiency” as implementation of the Patient Protection and Affordable Care Act continues. This is because their patient mix is going to change, he explained, with fewer people covered by employer-sponsored insurance, more people covered by Medicare or Medicaid, and more people using individual plans that provide less coverage while demanding higher copayments and deductibles.

Fisher mentioned the “striking” diversity in the practices included in the Centers for Medicare and Medicaid Innovation's bundled-payment initiative. He expressed concern that practices that did not have the proper infrastructure in place may be too slow in showing results for the government's liking, but he added that “Pay for value is here to stay.”

AMGA's members include such noted organizations as the Geisinger Health System and the Mayo Clinic, and—as leaders in delivering high-quality care—Fisher said, “You should be rewarded for your efforts.” He then repeated the AMGA's position that the CMS should offer a separate payment update for high-performing systems and restated his call for AMGA member groups to set an example.

“It's you who will have to lead the way for others as we transform healthcare,” Fisher concluded.