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Payment reform and solutions to challenges facing primary care addressed in policy papers
Date:4/24/2009

tter value for health care spending in the U.S. The recommendations address not only the need for new payment models to support primary care, but the need to design, test and then implement a variety of new models to align incentives for high quality, effective and efficient care for all physicians.

The first component is to develop, test and evaluate innovative payment models that align incentives with quality, effective and efficient care instead of paying on the basis of the volume of services. The second, concurrent and complementary component is to improve the current fee-for-service payment system, which is largely based on the resource-based relative value scale (RBRVS, a schema used to determine how much money medical providers should be paid).

The recommendations involve changes to reverse the declining interest in the practice of primary care that is on the verge of making particular specialties extinct and to provide a better environment for physicians to respond to patient needs. Refinement of the fee-for-service system is needed because it is likely to remain in effect until new, more effective payment models are identified and implemented and it may serve, at least in part, as the basis for determining payments under the new models.

In the "Solutions" paper, ACP's recommendations offer a comprehensive strategy to address the challenges facing primary care by providing:

  • Reforms in medical education
  • Relief from educational debt
  • Reduced regulatory and administrative burdens
  • A redesign of how primary care is financed and delivered
  • Payment reform (which is addressed more fully in the payment reform paper)

These efforts are designed to halt and reverse the decline in the number of physicians entering primary care.

"Efforts to expand coverage will fail to achieve improvements in access, quality and efficiency of care without enough primary care physicians,"
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Contact: David Kinsman
dkinsman@acponline.org
202-261-4554
American College of Physicians
Source:Eurekalert

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