California's Physician Groups Offer Congress Solutions for Key Components of National Health Reform
Wednesday, October 7, 2009
Leaders from California’s physicians groups recently met with key members of Congress to offer their experience at the forefront of two key health care reform elements – Medicare Advantage and Accountable Care Organizations (ACOs). You can read more about CAPG’s visit to Washington in an opinion editorial that ran in the Los Angeles Times.
Board members from the California Association of Physician Groups offered Congressional members their expertise on how policy makers can apply best practices from the coordinated care services that have shown a proven track record of reduced hospitalizations, better outcomes and healthier patients.
We believe this is particularly true within the Medicare system. While physician groups recognize the need to address economic imbalances between Medicare Advantage and traditional Medicare, they are urging Congress to follow the creed of all physicians: “First, Do No Harm.”
It’s incomprehensible that policy leaders would go to the unnecessary expense of disrupting continuity of care found in Medicare Advantage and send patients back into a self-directed fee-for-service system where the government will have to spend money to re-create medical homes that our medical groups are already providing.
More than any other population group in our country, Medicare patients need the personalized services that improve coordination and prevent complications from chronic diseases, which recent research from John Hopkins shows, reduces costly hospitalizations by up to 27 percent.
Also on the agenda for the physician groups was discussion about Accountable Care Organizations. Making ACOs a permanent part of health reform will help control costs by transcending the old model of fee-for-service charges by doctors, and accelerating “outcome based” medicine and adoption of health information technology.
Of concern to us is the latest proposal to limit use of ACOs to a pilot project. People are losing their jobs, their savings and their health care coverage, so when the Congressional Budget Office estimates the savings of an ACO “pilot program” at $2.3 billion, it seems short-sighted to not use the best practices that are out there and available to implement ACOs much more broadly within the Medicare and overall healthcare system.
Accountable Care Organizations have worked in California for several decades – from consumer protections to financial solvency standards. California’s physician groups have been working in an integrated, accountable system to create improved outcomes for patients and we can offer the road map for how to implement this as part of the national health reform package now being negotiated. We are the experts who can demonstrate how the coordinated care model can work for the rest of the nation and we are eager to get the process started.
Most importantly, we heard from many Congressional members who said that they are reading your letters and your stories are making an impact. We urge you to continue your advocacy efforts and send Congress your letter supporting Medicare Advantage and Accountable Care Organizations.
Thank you for your interest and continued advocacy.
Coordinated Care Facts
In 2007, Medicare Advantage saved seniors nearly $90 per month or $1000 per year in out of pocket costs. An estimated savings of approximately $7 billion annually. Additionally, compared to traditional Medicare, Medicare Advantage plans can reduce out-of-pocket costs by up to $4,000 annually for patients with the highest healthcare needs.
- Comprehensive Care: Patients receive integrated treatment plans, and expert case management and disease prevention strategies for the chronically ill.
- Cost-Effective Care: Integrated medical groups are able to support investments in advanced healthcare information technology, tracking patient follow-through on treatment plans and patient outcomes, and helping to uncover health problems before they become catastrophic.
- Accessible Care: Efficiencies within the coordinated care delivery model mean better healthcare for more seniors, including:
• lower out-of-pocket costs
• increased health services such as dental care, vision care and preventive care
• reduced hospitalizations
• increased prescription coverage
• higher overall satisfaction rates
• greater value for the premium dollar than any other healthcare delivery system
What’s At Risk
If Medicare reforms dismantle incentives for coordinated care, seniors will experience significant increases in out of pocket costs - at a time when many seniors have seen their retirement account’s decline by over 40 percent in value — and decreased quality of healthcare.
Downloadable Resources
Enter your name and email address to stay up-to-date on the progress we are making towards Coordinated Care reform.
Home The Facts Coordinated Care Profiles Latest News Coordinated Care Letters About Us Privacy Policy
Paid for by the California Association of Physician Groups
An advocate of patients rights and improved national healthcare.
