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Society of General Internal Medicine Endorses National Commission on Physician Payment Reform Report Calling for an End to Fee-For-Service Payment

 , March 15, 2013

Alexandria, VA—

The Society of General Internal Medicine (SGIM) is delighted to announce its endorsement of the recently released report of the National Commission on Physician Payment Reform.  The report details a series of sweeping recommendations aimed at reining in health spending and improving quality of care by fundamentally changing the way doctors are paid. The Commission, chaired by former Robert Wood Johnson Foundation president Steven A. Schroeder, M.D., with former Senator Majority leader Bill Frist, M.D., as Honorary Chair, calls for eliminating stand-alone fee-for-service payment by the end of the decade. The group urges a transition over five years to a blended payment system that will yield better results for both public and private payers, as well as patients.  

The Commission’s recommendations provide a blueprint for phasing out fee-for-service and transitioning to a more value-based, mixed payment model over a five-year period. Initial steps include fast-tracking new models of care, such as accountable care organizations and patient-centered medical homes that reimburse doctors through fixed payments and shared savings, and adopting bundled payments for patients with multiple chronic conditions and in-hospital procedures and their follow-up.

The Commission pointedly noted that fee-for-service will remain an important mode of payment into the future, and that bundled payments and other fixed payment models are not a panacea; many of these models still pay individual physicians on a fee-for-service basis. As such, the Commission put forth several recommendations for recalibrating fee-for-service payment to fix payment inequities and reward care that improves patients’ health.

The Commission was convened by the Society of General Internal Medicine but operated as an independent body during its year of deliberations.  “We are extremely pleased with the work of the Commission,” said SGIM president Ann Nattinger, MD, MPH.  “The twelve recommendations of the Commission each stand on their own in importance but together create a strong framework from which we can begin to repair physician payment structure.  This report doesn’t just serve the interest of general internal medicine physicians but instead represents the broad range of payment issues related to evaluation and management services.

SGIM Executive Director, David Karlson, PhD., agrees.  “This report is the first step in a larger journey to improve primary care for both physicians and ultimately patients.  SGIM will now building on the work of the Commission as we broaden our outreach and try to see some of these recommendations enacted, hopefully with the help of our sister organizations.” 

SGIM members converged on Capitol Hill on March 13 to advocate on a number of issues important to general internal medicine and to distribute copies of the report to legislators.  Members made almost 100 legislative visits to representatives on both sides of the aisle in a variety of states.  The report will be broadly distributed to SGIM members and a special session on the report will be included at the Society’s annual meeting in Denver in late April.

Additionally, SGIM leadership has already convened a small leadership group to determine next steps in moving the excellent work of the commission further, perhaps through a collective effort of organizations.  “We hope to be able to extend the reach and operationalize parts of the Commission’s report over the next year,” said Ann Natttinger.  


SGIM is a member-based international association of over 3,300 of the world’s leading academic general internists, who are dedicated to improving access to care for vulnerable populations, eliminating health care disparities and enhancing medical education. The members of the Society advance the practice of medicine through their commitment to providing comprehensive, coordinated, and cost-effective care to adults, educating the next generation of outstanding physicians, and conducting cutting-edge research to improve quality of care and clinical outcomes of all patients.  For more information, visit

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