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Family medicine advocates for
patient-centered medical home to U.S. Capitol
With the threat of a 10.6% decrease in Medicare
payments to physicians looming if Congress doesn’t act by June 30,
IAFP leaders and members carried the message “Fix Medicare
payment, and implement medical home” to the The good news is there was agreement among
Republicans and Democrats that Medicare payment needs to be fixed.
The bad news is they don’t agree on how to fix it.
AAFP, along with many other organizations, proposes an
18-month update to the Medicare payment formula.
“That type of temporary fix will help to stabilize
expectations for family physicians on their business operations, so
we can continue to focus on serving our patients,” says Steven
Knight, M.D., IAFP president. However, if the Medicare physician payment cuts
take effect on July 1, the result will be bad for patients and
family physicians. “Family
medicine is a profession and a business,” says Dr. Knight.
“Family physicians cannot run their practices at status quo
if the possibility of a nearly 16 percent Medicare payment decrease
becomes reality. That
sharp of a decrease will mean that practices will have to cut back.
These cuts could mean health care access problems for seniors
covered by Medicare.” Talks with staff from Senator Durbin’s and
Senator Obama’s offices seem to indicate that the issue will not
likely be solved until late June.
“We urged our senators to move more aggressively to fix it
and fix it soon. Having
just gone through this panic drill six months ago, the continued
uncertainty and instability has worried patients and family
physicians.” The process of replacing the broken Medicare
payment formula is part of AAFP’s plan for implementing the
patient centered medical home. “Providing
a three-pronged payment needs to be our future for health care
delivery,” says Javette Orgain, M.D., IAFP president-elect.
“First we start with having payments based on evaluation
and management (E&M) for urgent care visits.
Then there is a monthly payment to provide continuity of care
in the form of preventive services and disease management for all
patients. Finally, a
quality measurement payment rewards practices that meet or exceed
evidence-based quality measures.
The three-pronged payment honors the cognitive services that
family physicians provide with preventive services, disease
management and comprehensive care for their patients.” Workforce issues Medicare payment reform is the first step towards
making sure that patients have access to family physicians now and
in the future. “With
the aging Baby Boomer generation, the need for health care services
will only increase greatly,” described Dr. Knight.
The AAFP reports that “Implementing the patient-centered medical home
will increase that need for family physicians.
The medical home focuses more medical care where it belongs,
in the offices of family physicians, rather than unnecessary visits
to emergency room or hospitalizations,” says Dr. Knight. “Reforming graduate medical education funding to
link it to outcomes and primary care workforce needs is a long-term
goal of AAFP and Academic Family Medicine Organizations,” says
Jerry Kruse, M.D., of Quincy, who is the chair of government
relations for the Society of Teachers of Family Medicine.
“However, we still need to address some current issues in
family medicine training.” In what has become an unpleasant annual ritual,
the President has zeroed out funding for family medicine training
under Title Unfortunately, more actions by the President have
attacked other training program revenue sources, such as Medicaid
graduate medical education (GME) support, and Medicare medical
education grants. Reform possibilities linger in the air “You could sense hopefulness among the Illinois delegation staff that with a new presidential administration in 2009, whether Republican or Democrat, there is a significant opportunity to reform our broken health care system,” says Kathleen Miller, M.D., IAFP board chair. “While in our visits, we did push to fix the current woes, such as the Medicare payment formula and graduate medical education revenue sources. We also discussed how a patient-centered medical home can provide the base for longer-lasting change.” Seven Illinois Steven Knight, M.D., IAFP president The IAFP team met with staff from both Illinois Senators’ offices, Dick Durbin and Barack Obama; and with seven Illinois Representatives. Rep. Judy Biggert (R-Hinsdale)
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