|June 2011||Mark W. Purtle, MD, FACP, Governor|
I will take this opportunity to introduce myself to the Iowa ACP Chapter membership. I am your new Governor for 2011-2015. I am a general internist and boarded in geriatrics as well. I grew up in Missouri Valley, Iowa and attended undergraduate at Creighton University, Omaha in chemistry and subsequently graduated from the University Of Iowa College Of Medicine in 1981. My residency was at the University Of Rochester Strong Memorial Hospital in Rochester, New York and then worked for two years in Syracuse, New York in the Public Health Service (under a NHSC scholarship) at the Syracuse Community Health Center. I returned to Des Moines with my wife and one child to join my father-in-law’s practice. Through a series of mergers in 1989, we formed the beginnings of what is now known as Iowa Physician’s Clinic (IPC). In 2001 I became the Vice President of Medical Affairs and Chief Medical Officer of Iowa Health Des Moines (Methodist, Lutheran, Blank Children’s Hospital, and Methodist West Hospital) which is part of the Iowa Health System.
I now have three children, the oldest of which is completing his first year of Internal Medicine Residency (yea!) at Brigham and Women’s Hospital, Boston, Mass. I believe the next few years will be some of the most challenging times for American Medicine. Budget deficits, threats of Medicare insolvency, medical workforce issues, the Affordable Care Act, ACOs, medical homes, bundled payments, Value-Based Purchasing will all conspire to create challenges, heretofore not experienced, for physicians in all fields but especially in Internal Medicine. We must be involved and create the right solutions or be subject to the solutions created by someone else. I look forward to serving you and the needs of our specialty over the next 4 years.
The annual Leadership Day was held in Washington, DC on May 24 and May 25. This meeting affords representatives of ACP chapters from across the United States to learn about ACP’s positions on important legislative issues and to lobby your respective Congressman on these issues.
The Iowa Chapter of ACP was represented this year by:
Peter Reiter, MD, Ottumwa – Chair of Health and Public Policy Committee
Steve Joyce, MD, Sioux City
Jon Van Der Veer, DO, R2, Methodist Des Moines
Austin Baeth, M3, University of Iowa
Mark Purtle, MD, Des Moines, - Governor
The following represents a summary of ACP’s priorities on workforce, payment, and delivery system reform:
- Eliminate the Medicare Sustainable Growth Rate (SGR) and Transition to Better Payment Systems
- Key Discretionary Workforce Programs that Congress Must Preserve and Protect Members of Congress should preserve and fully fund the following discretionary programs, at levels authorized under the Affordable Care Act (ACA).
- The National Health Service Corps
- Section 747, Training in Primary Care Medicine, the only federal program dedicated to fund and improve training of primary care physicians.
- National Health Care Workforce Commission, which will make recommendations on how to ensure a sufficient physician workforce to meet the demand, including examination of barriers to primary care.
- Key Mandatory Programs to Strengthen Access to Primary Care, Improve Quality, and Lower Costs Members of Congress should ensure the effective implementation of these key mandatory programs, as enacted under the ACA:
- Medicare Primary Care Incentive Program: Ensure continued mandatory funding at least through 2015 (bonus payment to primary care physicians)
- Medicaid Comparability Program: Ensure continued mandatory funding for this program and begin to xplore ways to re-authorize funding for the program beyond the January 1, 2015 termination date and to allow for services by internal medicine subspecialists to qualify (Medicaid payments brought up to Medicare payment levels).
- Center for Medicare and Medicaid Innovation (CMMI): Ensure continued mandatory funding at the current levels authorized by the ACA to allow the Centers for Medicare & Medicaid Services (CMS) to fully implement the CMMI. Mandatory funding is needed to ensure that the new Center has the resources needed to accelerate broad pilot-testing and adoption of new payment and delivery models to improve access to primary care services, improve outcomes, and achieve better value for beneficiaries and taxpayers, and to ensure that physicians and other clinicians and providers can count on the funding being maintained.
- Patient-Centered Outcomes Research Institute ;(PCORI): Ensure continued mandatory funding for the PCORI. Mandatory funding will ensure that the Institute will have the resources it needs to support, strengthen, and sustain research into the clinical effectiveness of different treatments to inform and empower patients and their physicians.
- Making Health Reform Better: Key Policies that should be Preserved, Improved, or Revised. Members of Congress should retain the key provisions in the ACA to provide coverage to nearly all Americans (tax credits, health exchanges, Medicaid expansion, and insurance market reforms) and also make the following improvements:
- Co-sponsor the Empowering States to Innovate Act (S. 248, H.R. 844), which will allow states to seek waivers three years earlier than the ACA to design their own plans to provide comparable levels of coverage to their residents.
- Co-sponsor the Patients Freedom to Choose Act (S. 312, H.R. 605), which will repeal a provision in the ACA that requires that physicians provide written authorization for over-the-counter drugs reimbursed by a Flexible Spending Account or Health Savings Account.
- Co-sponsor the Help, Efficient, Access, Low-cost, Healthcare (HEALTH) Act of 2011 (S. 218, H.R. 5), which would lower the costs of defensive medicine by capping awards for non-economic damages.
- Introduce and co-sponsor legislation to authorize and fund state pilots of health courts, a no-fault alternative that would have medical liability claims heard by expert judges instead of lay juries.
Senator Max Baucus (D-Montana) Chair Senate Finance Committee and the Iowa Delegation
Senator Harkins and the Iowa Delegation