On the 10-year anniversary of the Affordable Care Act, it has largely lived up to its potential while falling short in some respects, due in large part to court rulings, sustained political opposition from some quarters, and implementation problems.
ACP's vision for U.S. health care addresses insurance costs, excessive prices, and more support for primary care as a way of improving the system.
ACP's legislative wins include changing CMS reimbursement rules, boosting research into firearm injuries and deaths, and spurring development of generic drugs.
If the former, then only modest, incremental policies may be needed to expand coverage at the edges and to lower out-of-pocket costs. If the latter, then more ambitious policies to fundamentally change how health care is financed, delivered, and covered would be needed.
The American College of Physicians aims to offer health care reforms that will ensure that all Americans have access to coverage and care at a price that they, and the country, can afford.
New reimbursement models will begin the transition away from fee-for-service to risk-adjusted capitation payments, known as Primary Care First Model Options.
Congress passed bipartisan legislation to fund the Department of Health and Human Services (HHS) for a full fiscal year, the first time in over 20 years that a full year of funding became law.
ACP seeks to understand how internists perceive its advocacy and how to best show them more clearly its relevance to their daily lives.
Because the public trusts physicians on matters affecting their health, doctors can contribute so much to the fight for commonsense gun policy reforms. Learn how.
ACP's advocacy goals address improving payments to internists' services, reducing administrative tasks imposed on them, blocking insurance mergers, streamlining Medicare's Quality Payment Program, and much more.
Despite a treacherous political environment that posed a direct threat to ACP's efforts to preserve the historic gains in coverage from the Affordable Care Act (ACA), a group of six medical societies was able to preserve key components of the program.
There are five ways that lawmakers, Republicans and Democrats alike, and President Trump can work together on real solutions to the real problems in the American health care system.
For all of its known flaws, the Affordable Care Act has extended coverage to millions of Americans, and was saved in the U.S. Senate by a slim margin. It's time for Congress to put aside partisan differences and come together to strengthen and heal Obamacare instead of trying to bring it down.
While the country has surely made enormous progress in the past half-century in advancing equality and diversity, it's important to remember history when we consider the medical profession's obligation now to challenge discriminatory policies.
ACP's lobbying agenda includes working on a bipartisan basis to shore up health insurance markets, give people more choices of coverage, and protect coverage for the most vulnerable covered by Medicaid.
There is almost nothing that physicians and the larger health care system can do for patients that isn't affected by what comes down from Washington. ACP must become involved in the political process.
ACP advocacy is based on the premise that public policy positions that are well supported by facts and evidence will be more persuasive and have greater acceptance.
Republican congressional leaders are beginning the process of enacting legislation to repeal the Affordable Care Act (ACA) in stages, using a process that has been called repeal, delay, and replace.
The idea that the GOP can come up with a quick and easy plan to replace the ACA is just not realistic. It is going to be a hard slog, not a sprint.
Internists in small practices worry that the payment disruptions from the Medicare Access and CHIP Reauthorization Act (MACRA) will be the straw that breaks the camel's back for profitability. ACP is committed to ensuring that this doesn't happen.
There is a growing awareness among physicians that the Medicare Access and CHIP Reauthorization Act (MACRA) makes important changes in how Medicare will reimburse them, as well as confusion about what will be different and what they should do to be ready.
Medicare is transitioning to a new value-based payment system, and the agency has outlined specifics about how it intends to implement it.
Critical questions will arise about defining and measuring value in the patient encounter when the Medicare Access and CHIP Reauthorization Act goes into action.
The process by which advocacy organizations achieve results for their members can seem opaque to those who are not directly involved. How does advocacy really work?.
ACP will continue to press federal and state regulators to block recently proposed insurance mergers, which may decrease choice and increase costs for patients and employers, reduce access due to changing and narrowing networks of physicians and hospitals, or prevent physicians from negotiation over provision of health services.
Telemedicine will be highly disruptive to patients and physicians. Like other technological advances, such disruption can be a good thing, leading to improvements in patient care. It can also be disruptive in a bad way if it undermines that patient-physician relationship.
Despite grumblings on social media, physicians are upbeat on the topics of health information technology, value-based payments, and the Affordable Care Act.
Following the repeal of the sustainable growth rate, ACP seeks to secure its future through other legislative and regulatory goals, including physician payment reform, graduate medical education, and primary care workforce programs.
Removing the sustainable growth rate formula frees up physician advocacy organizations to talk to Congress about other important issues that otherwise would have been overshadowed, such as the Primary Care Incentive Payment Program.
Fee-for-service reimbursement is a half-century old, and despite its staying power is now facing demands that it be modernized, if not traded in altogether.
ACP outlines its legislative agenda for the year, including resisting changes to the Affordable Care Act, preserving the Medicare primary care bonus program, and repealing the Medicare sustainable growth rate.
Based on Obamacare's year 1 enrollment numbers, the law has been very successful in bringing down the numbers and percentages of people without health insurance. But these data also show why it struggles to win support among the broader public.
ACP has decided to once again take on the problem of excessive paperwork and other administrative burdens, including those imposed by the advent of electronic health records.
A host of issues highlight the dysfunctional approach that federal and state governments have taken toward issues with a direct impact on health care.
Medicaid is the largest provider of government-funded health coverage in the United States, based on number of people enrolled, yet it doesn't get as much attention as Medicare. That may soon change.
After reflection on the first year of health care reform, and the conclusion of the first enrollment period, 4 aspects could make the program work even better.
There are plenty of examples of wasteful government spending, but the sustainable growth rate formula is hard to top.
Access to health care can collide with controlling costs. Balance, transparency and real choice will help not only the success of the Affordable Care Act, but Medicare Advantage and employer-based health plans.
2014 is shaping up to be a critically important year in determining whether the country moves forward or backward on expanding health insurance to 30 million uninsured persons and providing better consumer protections for many millions more.
Breaking down the numbers offers insight into who stands to gain the most from the reforms provided by the Affordable Care Act. But the broader coverage offered under the law means that the country as a whole is better off.
As open enrollment begins under the Affordable Care Act, its success depends upon who signs up, how easy it is to do so, and whether the states help their residents do so. Physicians can help their patients sign up.
Health care reform has reached its implementation stage, and internists will now face new patients with new questions about how to access health care.
Health care reform, pricing transparency and the movement away from fee-for-service payments mean the times are changing for American medicine.
A recent week provides a great example of how ACP's Washington office supports College advocacy.
Washington, D.C., politics has become so dysfunctional that the federal government is no longer capable of solving great problems such as firearms-related injuries and deaths, the federal deficit and debt fueled by unsustainable health care spending.
As sequestration's impact on health care looms, physicians must tell members of Congress reach a bipartisan agreement with the president to reduce spending on less effective and lower-priority programs, increase funding for more important and more effective programs, and further trim health care spending by focusing on unnecessary care.
With fewer than 10 months left until the Affordable Care Act's coverage guarantees take effect, how prepared are federal agencies and state governments to make the law work?.
Physician silence on gun control puts children and adults at risk from a person using firearms to harm them, in their classrooms, in their own homes, in their workplaces and on their neighborhood streets.
Congress avoided big tax increases and across-the-board spending cuts—barely. ACP examines who won and who lost in health care.
As a direct result of ACP's advocacy efforts, internists will see higher Medicare and Medicaid payments and relief from intrusive administrative requirements.
Medicaid, Medicare, funding for medical education and guarantees of health insurance coverage for all Americans are on the line in the upcoming presidential election.
Now that health care reform is established at a national level, the battle moves to the states that choose to accept or reject establishment of health care exchanges and federal funding for Medicaid.
ACP's health care positions can't be neatly labeled as coming from one political perspective or another. A wide array of issues requires consideration.
The United States won't control health care costs until it addresses the excessive prices it pays for some health care services.
The Supreme Court is ruling on the constitutionality of health care reform, leaving states in the position of having to plan for any eventuality. Letting the states take the lead in health care reform remains a viable option.
Health care reform has made progress with internists already seeing bonus reimbursement in their offices. But the Affordable Care Act is about to run smack into the Supreme Court, and what happens there could result in any range of outcomes.
ACP's annual report on the state of health care cites proposed budget cuts as the biggest threat to recent advances made by health care reform. And more advances could be affected by the outcome of the presidential elections.
Congress' dysfunction has led to record-low approval ratings of 11%, and continued delays in resolving issues important to physicians, such as reimbursement and medical education.
An attempt at political compromise failed, even when the consequences were so sever as to guarantee some type of success. The pressure will only increase in an election year, threatening physician payments, cuts to critical health programs and services, and no end in sight for a solution.
ACP has proposed that Congress create a national, physician-led initiative to promote high-value care, promote research into comparative effectiveness, and reduce the needless expense of defensive medicine.
Under the new budget control agreement that President Obama and Congress reached in August to allow for an increase in the debt ceiling, federal health care spending could be subject to deep cuts.
Politicians often choose to wait until the absolute last minute to strike a deal on difficult decisions.
President Obama and House Republicans have issued starkly different proposals on the future of Medicare and Medicaid.
It's been a little over one year since the Affordable Care Act was signed into law by President Obama. How is it faring?.
An election is held. The political party that promised to change the direction of American politics wins a lopsided victory.
Critics have unfairly attacked health care reform. But proponents haven't been straightforward about its costs. The truth involves how resources get allocated.
One would have to go back more than 45 years to find a Congress that has had as big an impact on health care as the just-departed 111th Congress.
It is often said that people don't see the forest for the trees, obsessing on the details instead of the big picture.
A serious bi-partisan discussion is needed to make serious decisions about health care reform.
A new focus by health care reform advocates on the patient-centered medical home will forge a path toward financing and delivering primary care.
The “failure” to permanently reform the sustainable growth rate formula shouldn't jeopardize overall progress on health care reform.
The American College of Physicians begins an educational campaign to introduce health care reform to its members.
Health reform legislation represents a historic shift in the federal government's role in health care, but debate continues whether it will be good for America and for internal medicine.
Fee-for-service payments need to align incentives with value of services rendered.
Congress faces unpopular options as they consider how to stay solvent through this decade and the next.
Every Congress has made its mark on Medicare since the program's inception in 1965. Success or failure for health care reform isn't the end of the journey, but another milestone.
Even if health reform passes, the problem of rising costs will not go away. And politicians cannot confront the fundamental issue that Americans can't have all the health care they want.
The public would have more confidence in the cost-control measures that emerge from health care reform if physicians led the discussion.
Proposals that redistribute money pose a special challenge to physician membership organizations. Physicians expect their societies to represent their interests, but what happens when one subset of members stands to benefit at anotherâ€™s expense? ACP chooses a path thatâ€™s best for patients.
A snapshot of health care reform as Congress takes a mid-summer break. Multiple bills need to be reconciled, while members of Congress face increasing pressure from advertising and lobbying.
Politicians acknowledge needing more primary care physicians, but paying for it requires support from elected officials and from the College.
Politicians acknowledge needing more primary care physicians, but paying for it requires support from elected officials and from the College.
A large number of Americans favor health care reform, which could help the new President as he seeks to overcome mandates, taxes and pay cuts.
Stimulus legislation enacted in the first two months of President Obama's administration show that the White House is serious about health care reform.
Searching the first 100 days of President Barack Obama's administration for clues about health care reform.
President Barack Obama and Congress is a return to basics, a recognition that the relationship between patients and their primary care doctor is the basis of all good medical care. But reform will also require funding.
Four good reasons why President-elect Barack Obama may succeed in reforming health care.
Align physician reimbursement to compensate for the best possible patient care coordination.
None of the presidential candidates are discussing health care cost containment, setting up reform as an issue doomed to fail after the election.
The Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331) was a huge victory for ACP and its allies.
Internists often ask me what it will take to restore primary care in the U.S. Even more important than policies, strategies or tactics is having the passion to create great change.
Recent events show how much progress we are making, and the growing level of controversy that has resulted.
It's in deep trouble.
Achieving consensus on complicated policy issues to produce meaningful, evidence-based policy presents a significant challenge for large membership organizations like ACP.
For the first time in 15 years, health care reform is back as a major campaign issue.
The newly elected Democratic majority that took charge of Congress last January promised an ambitious health care agenda.
Washington, D.C. is once again playing its own version of the film â€œGroundhog Day.”.