Navigation Links
Internists express 'very substantial concerns' over MedPAC physician pay proposal
Date:9/23/2011

(Washington) "While ACP (the American College of Physicians) appreciates that MedPAC (Medicare Payment Advisory Commission) has put forward a comprehensive proposal to eliminate the SGR (sustainable growth rate) with the intent of protecting access to primary care for Medicare beneficiaries, we have very substantial concerns that preclude us from supporting it," Virginia L. Hood, MPPS, MPH, FACP, president of ACP, said today in a letter responding to a MedPAC proposal made last week. She noted that the comments provided in the letter are a constructive effort to develop a framework that would have ACP's full support.

Written on behalf of the 132,00 internal medical physicians and medical student members of ACP, the letter says that ACP is specifically concerned that the proposal will not adequately protect and ensure access to primary care, while also reducing access to other essential physician services. The proposal also will work against MedPAC's goal - which ACP shares - of transitioning to new delivery and payment models aligned with value.

"Although elimination of the SGR is an essential step toward new payment and delivery models, it is only a step and one that should be designed carefully so as not to result in having unintended consequences," Dr. Hood pointed out in the letter. "The College is concerned that the payment freezes and cuts outlined in the MedPAC recommendations will have a significant adverse effect on beneficiary access to care, and actually impede timely and effective implementation of new physician payment models."

Dr. Hood noted that primary care physicians would actually experience a net loss under MedPAC's plan, because their payment updates would not keep pace with inflation, and ancillary services and possibly hospital visits by primary care physicians would be subject to a nearly 17 percent cut over the next three years. "We anticipate that with such reductions, more primary care physicians delivering primary care will leave practice," said Dr. Hood.

She also expressed concern that the nearly 17 percent cut for non-primary care physicians "could create significant access problems, without any evidence to justify that such a cut is merited, appropriate, or serves important policy goals. Such physicians would be cut no matter how efficient or inefficient they were, whether their specialty is facing a projected shortage, or whether they practice in a high or low cost area of the country."

"The MedPAC proposal will also unintentionally undermine the goal of transitioning to new payment models by denying primary care physicians the resources to redesign their practices and making it more difficult for subspecialists to invest in new models like the Patient-Centered Medical Home Neighborhood," she said.

In her letter, Dr. Hood said, "ACP recommends that MedPAC consider ACP's recommendations to the Energy and Commerce Committee regarding the stabilization of the SGR, including repealing the SGR and setting the annual update for primary care services at no less than 2 percent and no less than zero for other services over the next five years.

  • Like MedPAC's proposal, ACP would provide a higher update for primary care services, but it would be set at a level that would keep pace with inflation rather than freezing payments for the rest of the decade.

  • By setting the update for all other physician services at no less than zero, the severe access problems and unintended adverse consequences - such as discouraging participation in new delivery models - which we believe would occur under the MedPAC proposal, would be reduced.

  • During this time, new payment and delivery models aligned with value would be developed, pilot-tested and evaluated, and the most effective modes would be selected for broad implementation.

"ACP also urges MedPAC to consider the proposals we submitted to the Joint Select Committee on Deficit Reduction to finance repeal of the SGR and other critical priorities," the letter said. "For instance, a multi-stakeholder effort to encourage high value care and reduce low value care could yield tens of billions in savings each year out of the estimated $700 billion spent annually on marginal, ineffective and wasteful care, which could be used at least in part to fund SGR repeal."

"Finally, ACP recognizes that MedPAC believes that physicians should contribute to deficit reduction, while helping to fund repeal of the SGR. We agree that physicians must contribute to lower health care spending and deficit reduction, by addressing the real cost-drivers. The medical profession must make a firm commitment to reduce marginal and ineffective care and to transition to new payment models aligned with value. Such an approach will address the real cost-drivers in medicine and make a significant and effective contribution to lowering overall health care spending," Dr. Hood concluded.


'/>"/>

Contact: David Kinsman
dkinsman@acponline.org
202-261-4554
American College of Physicians
Source:Eurekalert

Related medicine news :

1. Internists remind physicians about universal ethical principles
2. Internists issue heartfelt plea for Congress to help patients by stopping Medicare SGR cuts
3. Updated resource guide for internists released by ACP
4. Resource guide for internists released by ACP
5. Internists outline comprehensive federal strategy to control tobacco use
6. Academic internists release principles for Medicare GME reform
7. Physician assistants and internists reaffirm need for team-based primary care
8. Survey finds general internists leave practice sooner than subspecialists
9. Novel technique reveals both gene number and protein expression simultaneously
10. High EGFR expression a predictor for improved survival with cetuximab plus chemotherapy
11. Supportive of intent of ACO proposed rule, ACP expresses concern
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... 2016 , ... The temporary closing of Bruton Memorial Library on June 21 due to a ... new, often overlooked aspect of head lice: the parasite’s ability to live away from a ... occurrence, but a necessary one in the event that lice have simply gotten out of ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van ... Wellness at Work award to iHire in recognition of their exemplary accomplishments in worksite ... 7th annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum ...
(Date:6/24/2016)... ... ... was in a crisis. Her son James, eight, was out of control. Prone to extreme ... “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there was ... other children and say he was going to kill them. If we were driving ...
(Date:6/24/2016)... Rhinebeck, NY (PRWEB) , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of ... of companies that call for a minimum wage raise to $12 an hour by 2020 ... wage. This will restore the lost value of the minimum wage, assure the wage floor ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... actively feeding the Frederick area economy by obtaining investment capital for emerging technology ... past 2½ years that have already resulted in more than a million dollars ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016   Pulmatrix, Inc ., ... developing innovative inhaled drugs, announced today that it was ... Investments reconstituted its comprehensive set of U.S. and ... "This is an important milestone for Pulmatrix," said Chief ... shareholder awareness of our progress in developing drugs for ...
(Date:6/23/2016)... 23, 2016 Research and Markets has ... - Forecast to 2022" report to their offering. ... for the patients with kidney failure, it replaces the function ... the patient,s blood and thus the treatment helps to keep ... in balance. Increasing number of ESRD patients ...
(Date:6/23/2016)... June 23, 2016 Roche (SIX: RO, ROG; ... for its Elecsys BRAHMS PCT (procalcitonin) assay as a ... septic shock. With this clearance, Roche is the first ... integrated solution for sepsis risk assessment and management. ... infection and PCT levels in blood can aid clinicians ...
Breaking Medicine Technology: