Medicare payment cuts will accelerate primary care collapse

February 05, 2007

Washington -- By not including funds to offset a pending cut in Medicare payments to physicians, the president's FY 2008 budget will accelerate the collapse of primary care, create access problems, and manufacture obstacles to fundamental reform of physician payment policies, the American College of Physicians (ACP) said today. The organization of 120,000 internists and medical students noted that the budget assumes at least an 8 percent cut in Medicare payments to doctors -- which is not sustainable -- and is certain to have a multitude of adverse effects.

"This Medicare payment cut will cause severe access problems and will stand in the way of achieving long-standing and fundamental reforms in physician payment policy to support quality improvement and patient-centered primary and principal care," ACP President Lynne M. Kirk, MD, FACP emphasized. "It is essential that lawmakers agree on a longer-term fix that will provide positive and stable updates, create sustained incentives for quality improvement, and support patient-centered care coordinated by a personal physician."

The administration's budget seeks to squeeze some $101.5 billion of savings from Medicare and Medicaid over the next five years. The two plans cover more than one in four Americans.

The FY 2008 budget proposes changes in the State Children's Health Insurance Program (S-CHIP) to focus more on low-income families. The changes would reduce S-CHIP spending by $223 million, or 4 percent, from this year's level.

ACP instead proposes that Congress provide increased funding to sustain and expand the S-CHIP program to more low-income children and their parents. The College also recommends that Congress take steps to expand Medicaid to all individuals with incomes below the federal poverty level.

ACP applauds the almost $11 million increase proposed in the budget for the Agency for Healthcare Research and Quality (AHRQ). The nation's leading Federal agency for research on health care quality, costs, outcomes, and patient safety provides critical information for the improvement of health care.

The College expresses concern, however, that the Department of Veterans Affairs' medical budget request has been reduced from $27.5 billion a year ago to $27.2 billion for FY 2008.

In addition, ACP urges Congress to provide at least $300 million for Title VII health professions programs in the FY 2008 budget. Elimination or serious under-funding of these programs will undermine the nation's ability to educate and train primary care physicians. The program is essential to address impending shortages of primary care physicians and to deliver care to the nation's most vulnerable communities.

"Congress should review the President's budget requests and assure adequate funding for programs that are critical to the health care of low-income children and adults, the elderly and veterans," continued Dr. Kirk. "Congress should also move forward on comprehensive reforms to expand health insurance to the nearly 47 million Americans who now lack coverage."
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The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 120,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.

American College of Physicians

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