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The American College of Physicians Statement on National Commission on Physician Payment Reform
Statement attributable to:
Molly Cooke, MD, FACP
President of the American College of Physicians (ACP)
July 8, 2013
The American College of Physicians (ACP) urges Congress to consider the recommendations of the National Commission on Physician Payment Reform in their work to repeal the sustainable growth rate (SGR) formula used for calculating Medicare payments to physicians and replace it with a fair and stable system. ACP's Executive Vice President and CEO Steven Weinberger, MD, FACP, served as one of the Commissioners. The group was chaired by former Robert Wood Johnson Foundation President Steven A. Schroeder, MD, with former Senate Majority leader Bill Frist, MD, serving as honorary chair. The group's report, released on March 4, 2013, offers a number of recommendations aimed at reining in health spending and improving quality of care by fundamentally changing the way doctors are paid. Specifically, the Commission calls for:
- Abolishing the SGR.
- Eliminating fee-for-service (FFS) as a stand-alone payment and transitioning over five years to a blended payment system that will yield better results for both public and private payers, as well as patients.
- Increasing reimbursement for evaluation and management (E&M) services.
- Initially focusing payment reforms on areas where significant potential exists for cost savings and better quality.
- Ensuring that measures to be used in the new payment system will safeguard access to high quality care, are adequately risk-adjusted, and will promote strong physician commitment to patients.
- Recognizing that FFS will remain a mode of payment in this blended system, recalibrating FFS to encourage behavior that improves quality and cost-effectiveness and to allow small practices to form virtual relationships and thereby share resources to achieve higher quality care.
The Commission also stresses that "payment reform should reward patient-centered comprehensive care that manages transitions between sites of care and among providers of care" and "should be transparent to patients and the public"-points with which ACP also strongly agrees.
The College agrees with the overall approach proposed by the Commission, including the goal of moving away from stand-alone fee-for-service payments. In addition, ACP recommends that all physicians be provided stable, predictable and positive annual FFS payment updates after the SGR is repealed for at least five years, with higher baseline updates for undervalued evaluation and management services, during which new models of payment and delivery would be designed, evaluated and more broadly adopted throughout the health care system.
"The debate over reforming Medicare physician payments is now at a critical juncture," observed Dr. Weinberger, "with both the House and Senate working on bipartisan bills to repeal the SGR and transition to new approaches to paying for and delivering care, like Patient-Centered Medical Homes. The Commission's report offers a well-considered, evidence-based and consensus approach to reform that should be considered by Congress as it moves forward on such legislation."
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 137,000 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.