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ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
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statement to House Energy and Commerce Subcommittee on Health
provides framework for transition to value-based payment
February 14, 2013
(Washington) - "Repeal of Medicare's Sustainable Growth Rate
(SGR) is essential, but repeal by itself will not move Medicare to
better ways to deliver care," the American College of Physicians
(ACP), said in its statement today to the House Energy and Commerce
Subcommittee on Health. "We need to transition from a fundamentally
broken physician payment system to one that is based on the value
of services to patients, building on physician-led initiatives to
improve outcomes and lower costs."
The 25-page statement was submitted for inclusion in the record
for the committee's hearing today, "SGR: Data, Measures and Models;
Building a Future Medicare Physician Payment System."
A summary of ACP's statement included these highlights:
ACP supports a two-phased approach to eliminate the SGR and
transition to better payment and delivery systems that are aligned
with value. During phase one, repeal the SGR formula, provide at
least five years of stable physician payments, with positive
increases for all physician services, and higher payments for
primary care, preventive and care coordination services; and in
phase two establish a process for practices to transition to new,
more effective, models of care by a date certain. ACP is encouraged
that this committee's SGR proposal, as released jointly with the
Ways and Means Committee on Feb. 7, is largely consistent with this
ACP supports shorter-term reforms to start more physicians on
the road to better payment models, and reward "early adapters" who
already have taken the leadership to participate in payment
programs focused on higher quality, improved patient experience,
and greater value. This includes development and recognition under
Medicare fee-for-service payment polices of two new sets of CPT
codes for transition care following a facility-based discharge and
for chronic, complex care. These code sets are designed to allow
physicians to report their non-face-to-face time, and the clinical
staff (team) time spent on patient cases.
Create opportunities for performance-based payment updates based
on successful participation in an approved transitional value-based
payment program initiative that meets standards relating to the
effectiveness of each program, building on successful models in the
public and private sectors.
Existing Quality Improvement (QI) programs, such as Medicare
PQRS, e-RX, and meaningful- use programs must be better aligned
with each other, with private-payer initiatives, or with specialty
boards' maintenance of certification programs. While strides have
been made in aligning the measures, at a high level, the technical
requirements within each of the programs are different enough that
dual processes must be undertaken.
Improve CMS's ability to provide timely data to participating
physicians and practices, which is critical to enable physicians to
make adjustments to improve patient care.
In 2012, ACP released a paper, The Role of Performance
Assessment in a Reformed Health Care System, in which we laid out a
series of policy statements focused on the evolving roles of
performance assessment efforts within the realm of medical care,
including programs linking payments to reporting and performance on
specific quality measures.
The patient-centered medical home (PCMH) should be scaled up for
broad adoption within Medicare. The PCMH model is an approach to
providing comprehensive primary care in a setting that focuses on
the relationships among patients, their primary care physicians,
and other health professionals involved in their care. Key
attributes of the PCMH promote health care delivery for all
patients though all stages of life. Other promising care
coordination models include: medical home "neighborhoods,"
Accountable Care Organizations (ACOs), and bundled payments.
ACP supports bipartisan legislation, the Medicare Physician
Payment Innovation Act (H.R. 574), that has been introduced in the
113th Congress that provides a reasonable pathway toward achieving
a phased-in approached to repealing and reforming the SGR,
The American College of Physicians is the
largest medical specialty organization and the second-largest
physician group in the United States. ACP members include 133,000
internal medicine physicians (internists), related subspecialists,
and medical students. Internal medicine physicians are specialists
who apply scientific knowledge and clinical expertise to the
diagnosis, treatment, and compassionate care of adults across the
spectrum from health to complex illness. Follow ACP on Twitter and Facebook.
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