Internists React to Bipartisan Budget Agreement

Attributable to:
Wayne J. Riley, MD, MPH, MBA, MACP
President, American College of Physicians (ACP)

American College of Physicians says agreement makes positive improvements in health care

Washington, October 27, 2015 - The American College of Physicians (ACP) is pleased that today's proposed bipartisan budget agreement will provide two years of relief from existing "sequestration"-level spending caps that could result in cuts to programs that are vital to the nation's healthcare, including the National Institutes of Health, Agency for Healthcare Research and Quality, and Primary Care Training Programs authorized by Section 747 of Title VII of the Public Health Service Act. Moreover, it could prevent a potentially disastrous government shutdown and would prevent default on our national debt.

The agreement makes other positive improvements in health care:

  • We strongly support the proposal to ensure all new hospital acquisitions of private physician practices would only be eligible for Medicare payments equal to those for the same care services provided in the freestanding, community-based setting. This policy is a positive step forward in addressing inappropriate and wasteful payment disparities for identical clinical services provided in different healthcare settings. We believe that imposing higher costs on Medicare, and increased out-of-pocket costs to patients enrolled in Medicare, is inappropriate when the care that is provided is not dependent on the hospital facility and its associated technologies. We also believe that such facility fees should not be used as a mechanism for hospitals to recoup/stabilize funding or as a means of ensuring access to care. Ensuring adequate hospital funding and patients' access to care can better be addressed and supported through other means, such as increased/improved health insurance coverage, strengthened workforce policies, and delivery system reforms.
  • We strongly support the provision to require manufacturers of generic drugs to pay an additional rebate to the Medicaid program if the price of the drug has increased faster than inflation (CPI-U). This is an important first step to addressing barriers to patient access to needed medications because of the rising costs of generic drugs and other medications.
  • We agree with providing appropriate relief to Medicare enrollees from rising Medicare Part B premium increases that would create barriers to receiving needed medical care.

While we are concerned that the agreement again extends the arbitrary Medicare 2 percent mandatory sequestration cut in payments to physicians for another year through 2025, we strongly support the overall agreement and urge Congress to pass it without delay.

Yet Congress' work will not be complete with passage of this package:

  • We urge Congress to enact legislation to extend the Medicare Primary Care Incentive Payment Program (PCIP), which expires at the end of this year. Should this program--which provides 10 percent bonus payments to primary care physicians for their designated primary care services-- be allowed to expire, primary care physicians would be facing significant cuts at a time when there is already a primary care shortage, and when primary care physicians are being asked to invest resources in new high value payment models.
  • And while this agreement raises discretionary spending caps, Congress still must pass appropriations bills that ensure sufficient funding for AHRQ, NIH, Title VII Primary Care Training Programs, and other essential programs.

The College looks forward to working with Congress and the administration to support enactment of this budget agreement and to ensure that Congress addresses these other critical healthcare issues before it adjourns.


The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 143,000 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.

Contact: David Kinsman, (202) 261-4554