Internists support broad goals of House 'tri-committee' proposed health-reform legislation

June 25, 2009

Washington, June 25, 2009 - Agreeing with the broad goals and most of the underlying policies contained in a comprehensive draft bill on health care reform legislation, the American College of Physicians (ACP) today praised the House "tri-committee." Made up of the House Ways and Means, Energy and Commerce, and Education and Labor Committees, the "tri-committee" unveiled its proposed legislation on June 19.

"We are pleased that the bill takes a comprehensive approach to reforming health care," said Joseph W. Stubbs, MD, FACP, president of ACP. He added that ACP believes it is critical to have legislation "providing all Americans with access to affordable coverage without regard to their health status and pre-existing conditions, giving them access to a wide variety of health plans similar to those available to federal employees, enacting policies to begin to address a critical shortage of internists and other primary care physicians, realigning payment and delivery systems with the value of care rendered and with patient-centered primary care, promoting prevention and wellness, and simplifying--and thereby reducing the enormous cost of--health plan administration."

ACP offered specific comments on reform for coverage, workforce and payment and delivery.


ACP supports the overall approach to providing affordable coverage to all Americans including: ACP told the Energy and Commerce subcommittee that it also believes that a public plan could appropriately be among the options made available to individuals and employers, but that it is concerned that building such a plan on Medicare rates, even though limited to the first three years from inception, would have a negative impact on physician participation and could particularly have an adverse impact on primary care physicians, since Medicare pays primary care physicians far less than other payers in many markets.

ACP told the subcommittee that it will provide recommendations to help ensure that payment rates under a public plan are sufficient to support primary care and to ensure adequate participation by physicians by specialty and by their locations of practice.

ACP said it supports making physician participation in the public plan voluntary (not linked to an agreement to participate in Medicare). It also supports giving the public plan wide latitude to implement innovative payment models, and it especially appreciates identification of the Patient-Centered Medical Home (PCMH) as being among such innovative models.

ACP supports requiring that the public plan provide essential core benefits including prevention. And it supports funding the public plan out of premiums, instead of taxpayer dollars, and administering it outside of the exchange to reduce potential conflicts of interest.


ACP strongly supports and appreciates the recognition of the need for the U.S. to have a national workforce policy to support primary care physicians and other health professions facing critical shortages. Specifically, ACP supports:

ACP believes that the workforce policies need to be combined with Medicare restructuring of payment policies to recognize and support the value of patient-centered primary care.

Payment and Delivery System Reform

ACP is pleased that the draft bill takes major steps forward to realign payment and delivery systems with the value of care provided, and especially the strong emphasis on the Patient-Centered Medical Home. Specifically, ACP: "ACP looks forward to continuing to provide suggestions on making sure that these policies are as effective as possible," Dr. Stubbs said. "A better health care system must result in everyone having health insurance coverage, and everyone having access to a primary care doctor. Anything less than that will fail to provide Americans with access to affordable, comprehensive and personal care they need and deserve."
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 128,000 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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