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Testimony to Ways and Means Health Subcommittee Recommends Key
Elements for Plan That Emphasizes Graduated Approach to Rewarding
Quality and Effectiveness
May 7, 2013
(Washington) "The American College of Physicians (ACP) strongly
supports a phased approach to repealing the Sustainable Growth Rate
(SGR) and progressing to better, value-based payment and delivery
models," Charles Cutler, MD, FACP, chair of the ACP Board of
Regents, today told the House Ways and Means Health subcommittee.
Dr. Cutler is a practicing primary care internist in a
multi-specialty group practice in Norristown, Penn.
Dr. Cutler said that a proposal developed by Ways and Means
Committee chairman Dave Camp (R-MI), and Energy and Commerce
Committee chair Fred Upton (R-MI), is a "bold plan for Medicare
payment reform that holds the promise of breaking a decade-long
impasse on repeal of the Medicare Sustainable Growth Rate." He
noted that the plan had four key elements to create a viable
Medicare payment system: it repeals the SGR, stabilizes payments,
and provides multiple pathways for physicians to participate in
efforts to improve quality and effectiveness of care.
He also praised the Medicare Physician Payment Innovation Act of
2013, H.R. 574, introduced by Representative Allyson Schwartz
(D-PA) and Joe Heck (R-NV). "This bill, which we support, has a
similar approach as the Camp-Upton proposal" he observed and
"merits strong consideration by the subcommittee."
He recommended that the Subcommittee on Health consider adding
the following policies to the Camp-Upton proposal:
ACP, Dr. Cutler noted, strongly believes that the
patient-centered medical home (PCMH) and PCMH-Neighbor models are
ready to be a part of this new, value-based health care payment and
delivery system-for practices that have made or are ready to make
the transition to these models. It is also critical, he said, that
robust and aligned performance measurement approaches and a stable
infrastructure be developed, tested, validated, and integrated into
performance measures for all physicians and practices in all of the
VBP programs. Additionally, all measures, whether developed by a
specialty society or other experts, should go through a
multi-stakeholder evaluation process, a role that is performed by
the National Quality Forum as a trusted evaluator of measures.
"In conclusion," Dr. Cutler's testimony said, "ACP's approach,
like the chairmen's proposal, recognizes that physicians are
starting out in different places on incorporating best practices to
achieve greater value for their patients, with some physicians
already being very far down the road in redesigning their practices
to achieve better value, while others are just getting started on
the entrance ramp to value-based models. Physicians at all points
on this journey need to have models available to them that are
appropriate and realistic for their particular stage but with the
opportunity for physicians to earn additional incentive payments
when they are doing more, and sooner, to improve outcomes and
effectiveness of care."
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.
David Kinsman, (202) firstname.lastname@example.org