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ACP Expresses Support for Representative Nancy Johnson’s “Medicare Value-Based Purchasing for Physicians’ Services Act of 2005”

July 28, 2005

Bill Includes Key Policies Advocated by ACP

(Washington, DC): C. Anderson Hedberg, MD, FACP, president of the American College of Physicians, spoke today at a press conference with Representative Nancy L. Johnson, chairman of the House Ways and Means Committee, Subcommittee on Health, in support of her “Medicare Value-Based Purchasing for Physicians’ Services Act of 2005.”

In his remarks, Dr. Hedberg stated that the bill is consistent with the College’s recommendations on key elements that should be included in any proposed legislative framework for value-based purchasing:

  • The bill sunsets the Sustainable Growth Rate (SGR) formula, recognizing that it is fundamentally incompatible with continuous quality improvement. The SGR would be replaced by updates based on the Medicare Economic Index.
  • It provides positive updates to all physicians and additional payments for those who participate in performance reporting and improvement.
  • It gradually phases in performance reporting and improvement; voluntary reporting of quality measures would begin in 2007 and 2008 and pay-for-performance would be implemented in 2009.
  • It calls for evidence-based quality and efficiency measures that are developed by medical specialties and validated through a consensus building organization.
  • It includes safeguards to assure that performance measures take into account differences in individual health status, do not create incentives for selection or deselection of patients, and use appropriate statistical methodologies
  • It enables physicians to share in programmatic savings that result from their participation in quality improvement activities, such as from preventing complications that result in unnecessary hospitalization.

“Chairman Johnson’s bill provides a practical framework for phasing-in evidence-based performance measures, while assuring that all physicians receive positive reimbursement updates and the opportunity for additional payment for voluntarily participating in performance improvement programs” Dr. Hedberg noted. “It recognizes that quality improvement cannot take place in an environment where physicians’ fees are being cut. Most importantly, it will benefit patients by creating incentives for physicians to engage in continuous quality improvement. We are pleased to support the legislation.”

ACP also provided Chairman Johnson with recommendations on issues relating to implementation of the Value-Based Purchasing program as established by the bill. The recommendations include providing more direction to the Secretary of HHS on implementation of performance measures to take into account severity of illness and non-compliant patients; safeguards against potential unintended adverse consequences of public reporting; the timing of additional payments for reporting and implementation; and providing additional payments to physicians commensurate with effort. The College expressed confidence that such implementation issues would be addressed as the bill makes its way through the legislative process.

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 119,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.

Contact:
Richard Trachtman (202) 261-4538, rtrachtman@acponline.org

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