Primary Care Groups Will Consider Public Option—with Caveats

ACP also 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. It also wants to support making physician participation in the public plan voluntary—or not linked to an agreement to participate in Medicare.

Larry Wickless, DO, president elect of the American Osteopathic Association, said, "Congress must make a concerted effort to restore the patient physician relationship." This should be done by making shifts in how healthcare is delivered: by moving from "the current episodic based payment system toward payment models that promote the patient physician relationship."

Physician payment is an area that all the groups representing primary care physicians found important. They called on Congress to enact a five part plan to reform physician payments that would:

• Provide a substantial increase in Medicare payments to primary care physicians, beginning in 2010.


• Eliminate the Medicare Sustained Growth Rate (SGR) and replace it with a system that provides "predictable and stable updates" to all physicians.


• Improve the accuracy of relative values for services paid under the Medicare physician fee schedule.


• Pilot test other new payment models to align incentives with the value of services provided by primary care physicians.

"Unless Congress takes action very soon to stop this precipitous drain on the numbers of primary care physicians in the United States, healthcare costs will continue to skyrocket while the quality of overall care will decrease," Epperly said.