American College of Physicians: Internal Medicine — Doctors for Adults ®

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Policy brief

From the April ACP Observer, copyright © 2006 by the American College of Physicians.

ACP President urges Congress to pass key payment reforms

ACP's President has warned members of a Congressional subcommittee that the nation's primary care system would collapse if fundamental payment reforms aren't passed. Among the reforms he recommended in his testimony were correcting inequities in setting relative value unit reimbursement and changing care models for patients with chronic diseases.


Immediate Past President C. Anderson Hedberg, MACP, testifies before Congress on the crisis in primary care.



ACP was the only physician group asked to testify before the House Ways and Means subcommittee on health. The hearing was called to consider the latest report from the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare.

In his testimony, Past President C. Anderson Hedberg, MACP, said that ACP endorsed MedPAC recommendations to reconfigure relative value work unit reimbursement to shift payment from some overpriced medical services to primary care. Those reimbursement disparities, Dr. Hedberg said, are contributing to a looming collapse of primary care, at a time when the number of Americans age 85 and older—many of whom have multiple chronic diseases—is expected to increase 50% between 2000 and 2010.

He also noted that MedPAC is exploring ways to improve chronic care, and he urged Congress to move to pilot test ACP's "advanced medical home" model, which would substantially change chronic care delivery and reimbursement. Subcommittee chair Rep. Nancy Johnson (R-Conn.) praised the advanced medical home model and ACP's work in developing it, and pledged to work with the College on the concept.

The complete testimony is online.

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