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Report warns of primary care system collapse

Physician Practice Advisor, February 1, 2006

The number of primary care physicians (PCP) who retire currently exceeds the number of new PCPs graduating from medical school, according to a report released Monday by the American College of Physicians (ACP). The "State of the Nation's Health Care" report, which the ACP releases annually, warns that primary care is at risk of collapsing, in part because of decreased physician income, increased medical costs, and more demands from health insurers.

The report recommends that Congress revise the formula Medicare uses to determine the value of physician services. The report also suggests financial incentives under a future Medicare pay-for-performance program be nonpunitive.

The ACP also proposes a new model for financing and delivering primary care called the "advanced medical home." According to the report, this model is based on the premise that quality healthcare is not episodic and illness-oriented but patient-centered and physician-guided. The ACP called for CMS to conduct a pilot program in 2007 to test the cost-effectiveness of changes in reimbursement, coding, and coverage policies based on the advanced medical home proposal.