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Internists review progress, challenges and opportunities
Date:2/11/2014

(Washington) "For the first time in the history of the United States, Americans are experiencing the benefits of health reforms designed to ensure that everyone has access to affordable coverage including a suite of essential benefits," Molly Cooke, MD, FACP, president of the American College of Physicians (ACP), said at today's annual State of the Nation's Health Care briefing. "In addition, Congress is on the verge of passing bipartisan, bicameral legislation to repeal the Sustainable Growth Rate formula. This flawed formula was put in place by Congress in 1997, and resulted in the first scheduled cut in physician payments in 2002. Now, 12 years later, we have the opportunity to permanently eliminate the SGR and accelerate that transition to value-based payment and delivery models."

In a 21-page report, ACP offers its assessment of where things stand with both the Affordable Care Act (ACA) and Medicare Physician Payment Reform and the next steps to be taken to build on the progress made.

While applauding the historic progress being made in expanding access to coverage, ACP noted two challenges that can create barriers to care. The trend to narrow provider networks and to restrictive formularies, which can make it difficult for patients to see the physicians they trust and get the medications they need. While such trends pre-date and are not limited to health plans offered through the ACA, ACP observed that the federal government has a particular responsibility to address such barriers to access in federally qualified plans. State regulatory agencies and the insurance industry itself also have important roles.

Dr. Cooke reported on letters sent today by ACP to HHS Secretary Kathleen Sebelius, the National Association of Insurance Commissioners, America's Health Insurance Plans, and the Blue Cross and Blue Shield Association of America, featuring specific and detailed recommendations from ACP to address concerns about the impact of
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Contact: David Kinsman
dkinsman@acponline.org
202-261-4552
American College of Physicians
Source:Eurekalert

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