“The state of America’s healthcare is poor,” according to Jeffrey P. Harris, MD., President of the American College of Physicians (ACP) as reported at the ACP State of the Nation’s Health Care briefing held on February 2, 2009 at the National Press Club in Washington D.C. “There are too many uninsured and underinsured people, we have too few primary care physicians, and we under recognize the true value of patient-centered care that can be delivered by primary care physicians.”
Bob Doherty, Senior Vice President, Governmental Affairs and Public Policy for ACP, said “ACP wants help from Congress to expand the Patient-Centered Medical Home model to more states, more practices, and more patients. This innovative model of primary care delivery offers enormous potential to improve quality and lower the costs of care especially for patients with chronic illnesses.”
The ACP on February 2nd released the report “Assuring Universal Access to Health Coverage and Primary Care:” that addresses the state of the nation’s health Care in 2009 and provides recommendations needed for reform. The report addresses the urgent need for primary care physicians and how the need for physicians will only increase with the growing number of patients with chronic illnesses.
The report notes that in order to succeed, it is important to transition to a new payment model for primary care. The suggestion is that practices that are organized to deliver patient-centered care using the Patient Centered Medical Home (PCMH) model should be paid a monthly, risk adjusted care management fees for each eligible patient, plus fee-for-service payment for face-to-face encounters with patients. In addition, there should be performance-based payments for reporting on quality, patient satisfaction, efficiency metrics, plus a shared savings component might also be included.
The total payments for PCMHs should be high enough to fully cover the costs including physician and other clinical staff work and the cost for health information systems needed to provide care management. There needs to be an overall and substantial gain in net revenue to go to primary care physicians in such practices.
ACP wants to see the CMS Medicare Demonstration a three year project providing a variety of practice settings in up to eight states, provide reimbursement in the form of a care management fee to physician practices for the services of a personal physician. ACP would like to see CMS set a timeline for transitioning to a new payment model for all practices nationwide that have voluntarily sought and received recognition as Patient-Centered Medical Homes following completion of the Medicare demonstration.