'The challenge in American medicine is one of economics and mathematics and less about politics'.

Dr. Robert Pearl leads the 9,000 physicians employed by the Permanente Medical Group, which serves over 4 million Kaiser Permanente members in California and around Washington, D.C. A plastic surgeon by training, Pearl has emerged as a leading champion of using electronic health records.and new technologies to improve quality while lowering the cost of care. He was recently named chair of the Council of Accountable Physician Practices, or CAPP, which includes medical groups from the Mayo Clinic, Geisinger Health System, Intermountain Healthcare and other integrated delivery networks. Modern Healthcare Managing Editor Gregg Blesch recently spoke with Pearl about the advantages and challenges facing physicians working in large integrated delivery systems. The following is an edited excerpt.

Providers shouldn't worry about getting good at MIPS. They should get out of it.

Medicare's new payment system for physicians is causing anxiety because of the short stretch of road before their performance is judged for a raise or pay cut. In the long- term, though, Medicare and most everyone else want providers to leave that new system behind. It's value-based training wheels.

'This is not about gun control...this is about public health'.

Dr. Andrew Gurman, a hand surgeon from Hollidaysburg, Pa., became the 171st president of the American Medical Association earlier this month. He sat down with Modern Healthcare Managing Editor Gregg Blesch to discuss the major policy decisions made at the AMA's recently concluded annual meeting. The following is an edited transcript.

Docs on the Hill. ACA still prime target for GOP-dominated physician delegation.

Twenty physicians, including Rep. Tom Price (R-Ga.), left, will be part of the 113th Congress that gets to work early next year. But this GOP-dominated group of doctors will wield influence beyond their numbers on healthcare policy and are armed with focused agendas on what to do next. We looked at the legislative records of these representatives and senators and got their perspectives on some key issues.

Climate of confrontation. Health groups urge Congress: let EPA oversee greenhouse gases.

Health organizations have a new cause after helping push through the reform law: climate change. They see it as a public health issue since rising temperatures can create health hazards. "Any action that interferes with or dilutes EPA's efforts will have a very negative effect on our public health," says Nancy Hughes, left, of the American Nurses Association.

The high cost of fine print. Antitrust case against a major Blue Cross plan may redefine terms of contract negotiations.

With its challenge to Michigan Blues contracts with some hospitals, the Justice Department is doing something it hasn't in more than 10 years. The move means insurers need to carefully vet contracts for similar issues. "This signals they're still in the enforcement business as it relates to healthcare insurance," says lawyer David Marx Jr.