CAPG lauds passage of federal health care reform legislation

In response to today’s historic passage of federal health care reform legislation, Donald Crane, President and CEO of the California Association of Physician Groups (CAPG), issued the following statement in strong support of the Senate measure:

“This is the most sweeping health reform legislation since the enactment of Medicare. It will provide an extraordinary opportunity to make a very real difference in the lives of millions of people. This comprehensive bill package addresses major areas in need of change, including expanding coverage to nearly all Americans, eliminating various unfair insurance practices, and beginning to transform our dysfunctional delivery system.”

Both the House and Senate bills will begin to modernize an antiquated fee-for-service payment model -- one that has been entrenched for decades and now threatens to bankrupt our current health care system --into a higher quality, more accountable system of care. The existing fragmented structure makes it very difficult for patients to receive optimal care because the fee-for-service model pays physicians for treatment regardless of whether the care provided is appropriate, beneficial, or even warranted. Additionally, within the fee-for-service model, patients are obliged to self navigate through a maze of specialists who frequently have no connection to each other, creating a climate ripe for medical errors, duplicate treatments, waste, and sub-standard outcomes.

Healthcare reform offers us a unique opportunity to transition from this disorganized approach to one that is more affordable, comprehensive, and coordinated through the establishment of Accountable Care Organizations (ACO).

Making ACOs a permanent part of health care reform will help control costs by moving beyond the old model of fee-for-service, and instead advancing “outcome based” medicine, physician networks, and the adoption of health information technology. The implementation of an ACO system will improve care for patients by providing lower cost care, through a network of physicians, who will use the latest technology to provide evidence-based health care to their patients. The Congressional Budget Office estimates the savings of a national ACO “pilot program” at $2.3 billion.

California’s physician groups are among the few throughout the country that have been practicing within an ACO model for the past 20 years. The 150 multi-specialty groups that comprise CAPG represent the backbone of California’s delivery system and are in fact the very “Accountable Care Organizations” that the House and Senate bills have tasked the Center for Medicare and Medicaid Services (CMS) to spread across the country. We are the experts who can demonstrate how the accountable care model can work for the rest of the nation and we are eager to get the process started.