A system in need of change -- restructuring payment policies to support patient-centered care

Washington, January 22, 2007 -- A policy paper with proposals to restructure conventional American health care fee-for-service payment policies was released today by The American College of Physicians (ACP) at its annual report on "The State of the Nation's Health Care."

"A System in Need of Change: Restructuring Payment Policies to Support Patient-Centered Care" offers a series of nine recommendations to address inadequacies in the current Medicare physician payment and delivery system. The combined recommendations would constitute some of the biggest changes in Medicare payment policies since the program was enacted in 1965.

"The guiding philosophy of these recommendations is that patient needs are best met through the delivery of patient-centered, longitudinal, coordinated care," explained Lynne M. Kirk, MD, FACP, president of ACP.

"This is the model of care that internists and other physicians who provide primary and principal care are trained and well-suited to deliver yet has been historically unrecognized or under-recognized by the payment system," Dr. Kirk emphasized.

The specific recommendations result from three major ACP goals:

- Instituting a multi-component, bundled payment structure that facilitates more effective and efficient care delivery for patients through the Advanced Medical Home (AMH). The AMH, also called the patient-centered medical home, offers the benefits of a personal physician with a whole-person orientation. The physician accepts overall responsibility for the care of the patient and leads a team that provides enhanced access to care, improved coordinated and integrated care, and increased efforts to ensure safety and quality.

- Eliminating Medicare's Sustainable Growth Rate (SGR) formula for annual physician fee updates. The College proposes a transitional pathway to accomplish this goal that culminates in a stable and predictable methodology for updating physician paymen

Contact: David Kinsman
American College of Physicians

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