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Comprehensive Reforms to Move Toward Patient-Centered Care

ACP's proposals will fundamentally change the way that primary care is organized, delivered, financed, and valued. Sweeping policy proposals to advance patient-centered// primary care were released today by the American College of Physicians (ACP) in its annual report on The State of the Nation's Health Care.

The U.S. health care system is facing a collapse of primary care medicine, the ACP reported in its January 2006 State of the Nation's Health Care report. Very few new physicians are going into primary care and many of those currently in practice are leaving the field or are planning to retire in the near future. The result of this collapse of primary care will be higher costs, lower quality, diminished access, and decreased patient satisfaction.

ACP, today, proposed a bold solution to this looming collapse: a patient-centered health care system. This model of health care delivery has been proven to result in better quality, more efficient use of resources, reduced utilization, and higher patient satisfaction.

‘Many U.S. physicians already are providing some of the characteristics of patient-centered care, but few provide all of them,’ said Lynne M. Kirk, MD, FACP, president of ACP. ‘In comparison, many other industrialized countries have made a deliberate policy decision to build their health care systems around patient-centered care, and physicians in those countries are far more likely to report that they have all or most of the characteristics associated with patient-centered care.’

Patient-centered health care is a system that builds upon the relationship between patients and their primary and principal care physicians and supports the systems needed to achieve better results.

Patient-centered health care provides:

· Access to longitudinal and comprehensive care by a personal physician who is responsible and accountable for managing the care of the whole patient, in partnership with the pat ient;
· Use of health information and other system improvements to enhance access to care, to provide access to evidence-based guidelines at the point of care, to support the ability of physicians to follow up on recommended treatments and patient self-management plans, and to measure and report on the quality of care being provided.

Dr. Kirk went on to address the need for patient-centered care to be available to all Americans, not just all insured Americans. She emphasized ACP's belief that immediate steps must be taken to expand health insurance coverage, with the goal of providing coverage to all Americans.

‘By definition, a health care system that leaves out nearly 47 million Americans is NOT one that is centered on patients' needs,’ continued Dr. Kirk. ‘The nearly 47 million Americans who now lack health insurance coverage are much less likely to have a regular source of care, never mind having access to physician practices that are organized to provide patient-centered primary care.’

The College also released a companion position paper to the State of the Nation's Health Care report, ‘A System in Need of Change: Restructuring Payment Policies to Support Patient-Centered Care,’ which offers a series of nine recommendations to fundamentally reform current Medicare physician payment and delivery systems.

The recommendations include paying physicians on a risk-adjusted, bundled, and prospective basis for providing patient-centered care through a qualified medical home, instead of paying doctors solely on the volume of services billed. The College also proposes an alternative to Medicare's flawed sustainable growth rate formula that will stabilize payments and create powerful incentives for physician participation in programs that will result in quality improvements and cost savings.

ACP also released a legislative roadmap for implementing the College's recommendations, which will be the basis for di scussions on Capitol Hill.

‘In our visits to lawmakers, the College will point out that patient-centered primary care is not a theoretical model with unknown impact’ said Robert Doherty, ACP's Senior Vice President of Governmental Affairs and Public Policy. ‘It is a model that has been successfully implemented in other countries that have better outcomes at substantially lower cost. But we don't need to just look abroad for proof. Within the U.S., states that rely more on primary care physicians have lower Medicare expenditures, fewer hospital admissions, fewer deaths in the Intensive Care Unit, and better overall quality.’


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