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Internists express strong support for ACA's programs to support coordinated care

(Washington) "Our current Fee-for-Service payment system rewards physicians for increasing the volume of visits and procedures rather than on the quality of care delivered and health outcomes," the American College of Physicians (ACP) today told the Senate Committee on Health, Education, Labor and Pensions (HELP) in a hearing on Improving Quality, Lowering Cost: The Role of Health Care Delivery Reform. "It does not provide incentives for physicians to coordinate care; and it provides no incentive for physicians to transform their care delivery to better meet the needs of a growing, older population characterized by multiple chronic illnesses. In addition, our current system undervalues the importance of primary care; the type of care that research clearly indicates is the foundation of a high performing healthcare system -- higher quality at lower cost."

In submitting its statement for the record, ACP pointed out that there are already a number of significant initiatives being implemented and/or tested throughout the country to address the need for improvements within our healthcare payment and delivery system. ACP aggressively backs the Patient-Centered Medical Home (PCMH) model as a means of promoting higher quality, better coordinated, less costly care. This model promotes the delivery of comprehensive primary care characterized by increased care access, improved care coordination and integration, and increased care quality and safety. PCMH has received the support of multiple other physician organizations. In addition, its programs are currently being implemented within both the public and private sectors in almost every state. ACP strongly supports continued efforts to expand this model throughout the healthcare system.

Further, in its four-page statement, ACP notes provisions in the Affordable Care Act, such as the Medicare Shared Saving Program and the establishment of the Center for Medicare and Medicaid Innovation (CMMI), that help provide a solid foundation for payment and delivery reform. ACP indicated that it was particularly pleased with the initial activities of the CMMI. "In a relatively short period of time, this Center has implemented programs that have the potential to significantly change the healthcare system," the testimony said. ACP urged Congress to continue to ensure that the Innovation Center be funded out of mandatory dollars as it is now, rather than through the unpredictability of subjecting it to annual appropriations.

ACP also referenced a strong connection between being able to promote value-oriented delivery reform and the current, adverse effects of the Sustainable Growth Rate (SGR) methodology currently employed under Medicare, and calls for the elimination of this ineffective approach to control healthcare expenditure.

"What is needed to promote effectively higher quality, lower cost care throughout the healthcare system is a transition away from the current volume-driven FFS payment model to models better aligned with value-oriented care," ACP concluded in its testimony. ACP provided the Committee with a framework to eliminate the SGR update methodology, while stabilizing physician payments and transitioning to broader payment models aligned with value.


Contact: David Kinsman
American College of Physicians

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