In comments to the U.S. House Ways and Means Committee, ACP highlights legislation that will improve payment system, address physician work shortages
Oct. 20, 2023 (ACP) -- The nation's supply of primary care physicians is insufficient, especially in rural and underserved areas, and the American College of Physicians is rolling up its collective sleeves to better address this and other pressing access-to-care issues.
ACP recently responded to a U.S. House of Representatives Ways and Means Committee request for information on how to equalize payment disparities between different geographic areas, improve the long-term financial health of clinicians and facilities, level payments for identical care provided in varying sites of service, bring new professionals into the health care workforce, and implement innovative care models and technology to improve patient outcomes.
“We need to try to fix the payment system, and we need more government programs and incentives to address physician workforce shortages,” said George Lyons, Jr., Esq., ACP director of legislative affairs.
In the letter, ACP outlined key legislation and policies that, if passed and fully funded, could help turn things around.
Medicare Payment Reform
ACP urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act. This legislation would provide annual Medicare physician payment updates tied to inflation. ACP also supports the passage of H.R. 5378, the Lower Costs, More Transparency Act, which aims to increase pricing transparency among health care organizations.
In addition, ACP called for passing a bill that extends payment parity for audio-only telehealth services, waives certain geographic restrictions on telehealth services and expands originating sites to include the home and other sites.
Moreover, ACP strongly supports full implementation of Medicare add-on code G2211 in 2024, Lyons said. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits and reflects the time, intensity and practice expense required to build longitudinal relationships with patients.
Reforming MACRA
In the letter, ACP also urged the committee to conduct hearings on reforming the Medicare Access and CHIP Reauthorization Act (MACRA). “Reform should focus on creating positive, consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models and meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients,” Lyons said. “There also need to be more Alternative Payment Models (APMs) for our physicians to join.”
MACRA paved the way for several payment models tied to physician performance. Programs such as Comprehensive Primary Care Plus, Primary Care First and the Accountable Care Organization Realizing Equity, Access and Community Health Model are some of the most well-known APMs. The newest APM is the Making Care Primary Model, which is structured to facilitate and promote care coordination between primary care and other specialists.
Addressing Physician Debt and Shortages
ACP stressed the need for Congress to fully fund federal programs such as Medicare-supported graduate medical education, the National Health Service Corps and Community Health Centers.
ACP also urged Congress to pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, and H.R. 4942/S. 665, the Conrad State 30 and Physician Access Reauthorization Act. The REDI Act allows borrowers in medical or dental internships or residency programs to defer student loan payments until the completion of their programs. The Conrad 30 program allows international doctors to remain in the United States after completing their residency if they practice in areas experiencing doctor shortages.
Reducing Administrative Burdens
Bolstering the nation's physician supply also calls for efforts that reduce the administrative burden on physicians and patients. ACP urges passage of the Safe Step Act, which would place reasonable limits on the use of step therapy. ACP also said that the passage of the Improving Seniors' Timely Access to Care Actis essential to reducing the administrative burden on patients and physicians. Part of the Health Care Price Transparency Act of 2023, this bill seeks to modernize the prior authorization process in Medicare Advantage, which often still requires faxing documents to insurance companies.
Now, the committee is weighing the input they received. Every member can do something to help move these bills forward, Lyons said. This starts by signing up for the ACP Advocates for Internal Medicine Network, which provides legislative updates on key policy issues and makes it easy for members to reach out to their lawmakers.
Back to the October 20, 2023 issue of ACP Advocate