High-Need Physician Workforce Incentives Act Endorsed by American College of Physicians
by Barbara Kram, Editor
The American College of Physicians (ACP) gave its strong support to the bipartisan High-Need Physician Workforce Incentives Act of 2007. The six-part bill introduced today by Representative Michael C. Burgess, MD, and epresentative Henry Cuellar of Texas focuses on workforce issues of physicians.
“Rep. Burgess and Rep. Cuellar have recognized the critical importance of enacting legislation to reverse a rapid decline of physicians going into primary care and other generalist fields,” said David C. Dale, MD, FACP, president of the American College of Physicians. “We enthusiastically endorse their efforts to provide scholarships and debt relief for physicians who choose primary care and agree to practice in critical shortage
The first proposal of the High-Need Physician Workforce Incentives Act of 2007 suggests a “scholarship program for general physicians in high-need areas.” The proposal would empower the Health Resources and Services Administration (HRSA) to make grants to health facilities to alleviate shortages of internal medicine, family practice, pediatric, emergency medicine, general surgery and OB/GYN physicians.
Scholarship recipients will, after completing residency, serve as generalist physicians at high-need facilities for a year for each year they received a scholarship.
The bill’s second proposal provides for a “loan repayment program” to alleviate shortages of the same types of physicians. For each year of service at a high-need facility, HRSA will pay up to $35,000 of the principal and interest of an individual’s educational loans.
“These two parts of Rep. Burgess’s and Rep. Cuellar’s bill will create targeted incentives, as ACP previously has proposed, to encourage students to pursue careers as primary care physicians,” Dr. Dale noted. “The legislation also will provide grants to states to provide physicians with care coordination fees for managing and coordinating care, in partnership with patients, through a Patient-Centered Medical Home (PCMH).”
The bill creates a “primary care physician retention and medical home enhancement grants.” The proposal directs HRSA to make grants to the states to provide financial aid for care management to physicians in medically-underserved areas to support patient-centered care in a qualified medical home.
Based on the PCMH, the proposal’s medical home model includes:
— Physicians advocating for their patients to obtain optimal, patient-centered outcomes defined by partnership between the physician, the patient, and the patient’s family.
— Decision-making guided by evidence-based medicine and clinical decision support tools.
— Physician accountability for continuous quality improvement through voluntary participation in performance measurement.
— Active patient participation in decision-making, patient personal responsibility for diet and lifestyle, and collection of patient feedback.
— Utilization of health information technology to support optimal patient care.
— Patients and families participating in quality improvement at the practice level.
“ACP is delighted Rep. Burgess is continuing his interest and help in improving America’s healthcare system,” continued Dr. Dale. “He and Rep. Cuellar are to be commended for addressing the critical need to have a strong foundation of primary care and generalist physicians to meet the needs of an aging population with more chronic diseases and to support a new model of delivering care-the patient-centered medical home-that will result in better outcomes for patients and more efficient use of resources.”
Rep. Burgess today also introduced two other bills, one that would create a pathway to eliminating Medicare cuts from the Sustainable Growth Rate (SGR) Formula and another that would provide grants to new primary care residency programs. ACP looks forward to working with Rep. Burgess and other members of Congress on legislation that would lead to repeal of the SGR– while providing positive, predictable and stable payments during the transition years to repeal — and on the most effective approaches to support training programs in primary care.