The American College of Physicians (ACP), the largest medical specialty group in the U.S. and second-largest physicians group (whose members include 133,000 internal medicine physicians and related subspecialists), has issued its annual “State of the Nation’s Health Care” report for 2013.
The report praises the Patient Protection & Affordable Care Act (which some call “Obamacare”); warns of a “threat to public health and access” from the across-the-board “sequestration” budget cuts in Washington, and calls for additional reforms to improve the U.S. Health Care system.
In issuing the report and proposal at the ACP’s annual State of the Nation’s Health Care briefing on February 21, the ACP’s President, David L. Bronson, MD, FACP, said, “Continued improvement in the health care system to expand coverage and reduce unnecessary costs is imperative.” “Such efforts will not succeed in ensuring patient access to high quality medical care if the current assault on the patient-physician relationship continues unabated,” he said.
Healthcare Problems Identified
In a news release issued along with its report, the ACP said its report noted that “In some ways it is the best of times for U.S. health care, because the Affordable Care Act [which some call "Obamacare"] will soon make affordable coverage available to nearly all legal U.S. residents—for the first time in history—accompanied by a record slowdown in health care cost increases.”
But, the ACP’s report “also warned of vulnerable patients being left behind in states that refuse to cover their poor under Medicaid; [and] the threat to public health and access if an across-the-board budget cut (sequestration) is allowed to occur.”
“It simply is unacceptable that the political divisions in Washington have caused a recurring series of wholly unnecessary budget impasses that imperil the health and safety of the American people,” the ACP’s Senior Vice President of Governmental Affairs and Public Policy, Bob Doherty, said in the release.
Other problems noted in the ACP report included, “the continued obstacles to high quality care created by Medicare’s flawed SGR formula; and the unacceptable toll of deaths and injuries from firearms.”
In addition, “A growing shortage of primary care physicians for adults will increase costs and reduce access,” the ACP warned. “And, many physicians report that it is the worst of times when it comes to intrusions on the hallowed patient-physician relationship,” the ACP said.
Among the proposals advanced by the ACP, were the following (as summarized in its news release):
“ACP’s recommendations to make the health system more effective:
- ACP calls for a renewed commitment at both the national and state levels to effectively implement the coverage expansions and related policies under the ACA [the Affordable Care Act - a/k/a/ "Obamacare"], with particular attention to ensuring the poorest and most vulnerable patients have access to affordable coverage.
- ACP urges Congress and the administration to reach agreement on a plan to replace across-the-board sequestration cuts and future potential future disruptions in funding for critical health care and instead enact fiscally- and socially-responsible alternatives to reduce unnecessary health care spending.
- Congress must enact legislation to eliminate Medicare’s SGR formula and support the medical profession’s commitment to transition to new payment models.
- ACP calls for policies to recruit and retain primary care physicians.
- A reduction of firearms-related injuries and deaths must result by improving access to mental health services, supporting research on the causes and prevention of violence, and enacting reasonable controls over access to firearms that do not infringe on constitutionally protected rights.”
“ACP’s recommendations to reduce intrusions on the patient-physician relationship:
- Public and private policymakers and payers must ensure that any payment reforms have, as an explicit goal, allowing physicians to spend more appropriate clinical time with their patients.
- Payment and delivery reforms that hold physicians accountable for the outcomes of care (measurable performance on quality, cost, satisfaction and experience with care) should concurrently eliminate the layers of review and second-guessing of the clinical decisions made by physicians.
- CMS should harmonize (and reduce to the extent possible) the measures used in the different reporting programs, work toward overall composite outcomes measures rather than a laundry list of process measures.
- CMS should provide more clinically relevant ways to satisfy the requirement that physicians must transition to using ICD-10 codes for billing and reporting purposes.
- Congress and CMS should consider working with physicians to encourage participation in quality reporting programs by reducing administrative barriers, improving bonuses to incentivize ongoing quality improvements for all physicians, and broadening hardship exemptions. If necessary, Congress and CMS should consider delaying the penalties for not successfully participating in quality reporting programs, if it appears that the vast majority of physicians will be subject to penalties due to limitations in the programs themselves.
- The government, the medical profession, and standard-setting organizations should work with EHR vendors to improve the functional capabilities of their systems, to improve the ability of those systems to report on quality measures and to ensure that those systems improve rather than adding to workflow inefficiency.
- Medicare and private insurers should move toward standardizing claims administration requirements, pre-authorization, and other administrative simplification requirements even in advance of, and in addition to, the simplification rules included in the ACA.
- Congress should enact meaningful medical liability reforms including health courts, early disclosure errors, and caps on non-economic damages.
- State and federal authorities should avoid enactment of mandates that interfere with physician free speech and the patient-physician relationship.”
“System-wide efforts to improve the health care system won’t succeed on their own in improving access and quality if the physicians that the system is counting on to deliver are over-hassled, over-stressed, harried, hushed and rushed,” Dr Bronson, the ACP’s President, noted.
“ACP views necessary strategic health reform improvements and results not from a partisan or ideological perspective, but from the standpoint of what the evidence tells us will be the most effective course of action,” Dr Bronson, said.
The American College of Physicians’ full State of the Nation’s Health Care 2013 report and recommendations is found on the ACP’s website.
For more news and information about the Patient Protection & Affordable Care Act, the Obama Administration’s signature Health Care Law, and about health care reform, see the HelpingYouCare® resource pages on VoicesForCare™, including:
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- Editorials: What Needs Improvement, With Your Comments;
- Advocacy: Proposals for Reform, With Your Comments;
- Legislation: Pending & Recently Adopted; and
- National & International Health Care Compare: Compare Health Care & Long-Term Care Statistics and Solutions in the 50 U.S. States and in Other Countries.
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