Physicans Group Says Healthcare Reform is All About the Money

The American College of Physicians last week released its “Two-pronged Strategy to Improve American Health Care,” and the focus of both prongs can be summarized into one sentence: Reforming healthcare means you have to change how physicians are paid.

Each year the organization examines the state of U.S. healthcare, and in this year’s report, the group found that most of the major challenges facing providers are about money–from changing the formulas that determine how much physicians get paid to eliminating bureaucratic hoops physicians must jump through to justify that payment.

What follows are the highlights of the major reforms sought by the American College of Physicians to fix the American healthcare system:

Recommendations to Make the Health System More Effective: 

• Renew commitment at both national and state levels to effectively implement the coverage expansion under ACA, particularly ensuring the poorest and most vulnerable have access to affordable coverage.
• Reach agreement in Congress and in the Administration on a plan to replace sequestration cuts and prevent future disruptions in funding for critical health care, by enacting fiscally–and socially–responsible alternatives to reduce unnecessary health care spending.
• Eliminate Medicare’s Sustainable Growth Rate (SGR) formula and support a transition to new payment models.
• Implement policies to recruit and retain primary-care physicians.
• Reduce firearms-related injuries and deaths 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.

Recommendations to Reduce Intrusions on the Patient-Physician Relationship:

• Payment reforms must allow physicians to spend more appropriate clinical time with their patients.
• Payment and delivery reforms that hold physicians accountable for the outcomes of care should eliminate the layers of review and second-guessing of clinical decisions made by physicians.
• CMS should harmonize the measures used in different reporting program.
• 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 encourage participation in quality reporting programs by reducing administrative barriers, improving bonuses, and broadening hardship exemptions.
• The government, the medical profession, and standard-setting organizations should work with EHR vendors to improve the functional capabilities of their systems.
• Medicare and private insurers should move toward standardizing claims administration requirements, pre-authorization, and other administrative simplification requirements.
• Congress should enact meaningful medical liability reforms including health courts, early disclosure of errors, and caps on non-economic damages.
• State and federal authorities should avoid enactment of mandates that interfere with physicians’ free speech and the patient-physician relationship.