Medicare must change the way that it values and reimburses physician services to prevent a collapse of primary care medicine in the U.S., the president of the American College of Physicians (ACP) told the House Ways and Means Subcommittee on Health today. ACP President C. Anderson Hedberg, MD, FACP, made his comments while sharing ACP's views on the 2006 report of the Medicare Payment Advisory Commission

"The collapse will occur at a time when we need more primary care physicians to care for an aging population," noted Dr. Hedberg. "By 2030, one fifth of Americans will be over 65, with an increasing proportion over 85. In fact, the 85 and over population which is most likely to require chronic care services for multiple conditions will increase by 50 percent from 2000 to 2010."

ACP supports the Commission's recommendations for improving the way that Medicare values services, Dr. Hedberg told the subcommittee. The improvements could begin correcting inequities in payments to primary care, and therefore begin the reversal necessary to save primary care medicine.

Overpriced medical services tend to be ordered more frequently and may contribute to an increase in the total volume of services. Because the Sustainable Growth Rate (SGR) limits aggregate physician spending increases, the combination of mispriced relative values and volume means certain types of services are capturing a larger share of Medicare spending, which works to the detriment of services provided by primary care physicians. Specialties that derive a substantial amount of income from misvalued services have higher lifetime earnings. This earnings gap is a major reason why medical students with high student debt do not choose careers in primary care.

"ACP appreciates Subcommittee Chairman Johnson's leadership in seeking repeal of the SGR," Dr. Hedberg said. "We call on Congress to enact an alternative to the SGR that separates physician fee updates from measure
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1-Mar-2006

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