Internists Call for Freeze in Cuts to Teaching Hospitals, Other BBA Corrections
October 1, 1999
(Washington, DC): In a statement submitted today to a hearing of the Subcommittee on Health of the Ways and Means Committee, the American College of Physicians-American Society of Internal Medicine called for a halt to scheduled cuts in Medicare funding for teaching hospitals.
ACP-ASIM specifically urged Congress to halt further reductions in indirect medical education payments to hospitals mandated by the Balanced Budget Act of 1997. IME payments are designed to reimburse teaching programs for the added costs of supervision, caring for indigent patients, overhead, and other costs. The BBA was originally estimated to reduce IME payments by $103 billion over five years. Estimates now place its expected impact as $191.5 billion over the same five years.
"Teaching hospitals often serve as the providers of health care for inner city populations that are otherwise undeserved," the College writes. "Graduate medical education is the linch-pin for these inner-city 'safety net' hospitals, and they cannot survive if their educational programs are not adequately funded."
ACP-ASIM also urged Congress to correct the sustainable growth rate (SGR) formula that was mandated by the BBA 97. The SGR places an overall target rate of growth on increases in Medicare payments for physician services—the only provider group subject to such target. If the target is exceeded, payments to physicians are cut.
The Medicare Payment Advisory Commission (MEDPAC) has urged Congress to make several corrections to the SGR to assure that it keeps pace with costs due to the introduction of new technology and that it is based on accurate baseline data. ACP-ASIM's statement identified several specific legislative "fixes" to the SGR problems. Finally, ACP-ASIM told the Committee that the implementation and refinement of resource-based practice expenses is proceeding as intended by Congress and that no legislative changes are needed.
ACP-ASIM is the nation's largest medical specialty organization and the second largest physician group. Membership comprises more than 115,000 internal medicine physicians and medical students. Internists are the major providers of medical care to adults in America and treat more Medicare patients than any other medical specialists.
Jack E. Pope, ACP-ASIM Washington Office, 202-261-4556
Page updated: 11-04-03