AFMO Launches Web Site for Family Medicine Research

The Academic Family Medicine Organizations (AFMO) has developed a Web site providing information about funding opportunities for research, projects by American Academy of Family Physician’s (AAFP) National Research Network, research meetings and conferences, training, and awards. The AFMO Research Subcommittee coordinates and monitors the site (http://www.fmresearch.org/). AFMO is a collaboration of the AAFP, the Society of Teachers of Family Medicine, the North American Primary Care Research Group, the Association of Departments of Family Medicine, and the Association of Family Medicine Residency Directors. The AFMO is led by a steering committee composed of volunteer member representatives plus the chief staff executive of each of the five organizations.

CMS Eliminates Grace Period for Expired Codes

The Centers for Medicare and Medicaid Services (CMS) has eliminated the 90-day grace period formerly allowed after new International Classification of Diseases (ICD-9), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) codes took effect. Beginning October 1, 2004, physicians must use the 2005 ICD-9 codes to avoid delayed or denied claims. To avoid similar billing problems, the 2005 CPT and HCPCS codes must be used beginning January 1, 2005. The 2005 ICD-9 codes are available online at http://www.cms.hhs.gov/medlearn/icd9code.asp. Revised HCPCS codes soon will be available online at http://www.cms.hhs.gov/medicare/hcpcs/update.asp. Physicians should contact their usual supplier for the 2005 CPT code book.

AAFP Publishes Resource for Starting a Medical Practice

AAFP has published a guide to help physicians who want to open their own practices. This resource, “On Your Own: Starting a Medical Practice from the Ground Up,” provides information on licensing regulations, insurance requirements, supplies, medical records, personnel issues, contracts, taxes, and office design. This publication (Item No. 749, $50) is available online at https://www.aafp.org/newpractice.xml. To order by telephone, call 800-944-0000. A table of contents that includes an abstract for each chapter is available at https://www.aafp.org/x19748.xml.

AAFP Board Approves Recommendation to Double EB CME Credit

At the August meeting, the AAFP Board of Directors approved a recommendation from the Commission on Continuing Medical Education that doubles the continuing medical education (CME) credit awarded for educational activities designated for AAFP evidence-based (EB) CME credit. Activities approved for partial EB CME credit would receive double credit only for the portion of the program that is evidence-based. For example, in a course worth 20 CME credits, of which 12 are evidence-based, the 12 credits will be doubled. The Board did not approve a recommendation that would have required AAFP members to complete a minimum number of EB CME credits per three-year membership cycle. Because the change will require a modification of the CME record-keeping system, no timeline for implementing the change in credits has been established.

CDC Releases State-Specific Breastfeeding Data

In August, the Centers for Disease Control and Prevention (CDC) released state-by-state data on the percentage of mothers who are breastfeeding their infants and for how long. The new data were gathered as part of the CDC’s 2003 National Immunization Survey, which queried mothers in 50 states, the District of Columbia, and selected geographic areas within the states. Part of the survey focused on the Healthy People 2010 objectives for breastfeeding: 75 percent of new mothers initiate breastfeeding, 50 percent continue to breastfeed for at least six months; and 25 percent continue to breastfeed for at least 12 months. Only six states met these criteria (Hawaii, Idaho, Oregon, Utah, Vermont, and Washington). The national average for mothers who exclusively breastfeed their infants for at least six months is low—14.2 percent. The survey also confirmed previous findings that lower income mothers and non-Hispanic black mothers consistently had lower breastfeeding rates. More information is available online at http://www.cdc.gov/breastfeeding/NIS_data/.

FDA Approves New Treatments for HIV Patients

In August, the U.S. Food and Drug Administration (FDA) approved two fixed-dose combination drug products for the treatment of human immunodeficiency virus (HIV) infection: Epzicom (abacavir/lamivudine) and Truvada (tenofovir disoproxil/emtricitabine). These drugs are indicated for use in combination with other antiretroviral drugs from different classes. Combining the drugs in a single medication should make treatment regimens less complicated for patients to follow. More information is available online at http://www.fda.gov/bbs/topics/news/2004/NEW01099.html. The FDA also has approved Sculptra, an injectable filler to correct facial fat loss in patients with HIV infection. It is the first approved treatment for lipoatrophy, or facial wasting, a sinking of the cheeks, eyes, and temples caused by the loss of fat tissue under the skin. For more information, go to http://www.fda.gov/bbs/topics/news/2004/NEW01100.html.

NACHC Report Confirms Uninsured Patients Are Using Emergency Departments for Routine Care

In a report, “Nation’s Health at Risk: Part II,” from the National Association of Community Health Centers, Inc. (NACHC), the data suggest that uninsured patients are using hospital emergency departments for routine care. According to the report, the number of visits to emergency departments increased from 89.8 million in 1998 to 110.2 million in 2002. Between $1.6 and $8 billion in annual health care costs could be saved if patients with nonurgent, avoidable conditions went to community health centers instead. The report attributed the recent trends to a decrease in the number of physicians who accept patients enrolled in Medicaid, as well as a “weakened economy and state budget cuts.” The full report is available online at http://www.nachc.com/press/nachcreport.asp.

Two Studies Focus on the Causes of Health Care Disparities

Results from two surveys reveal the nature of health care disparities in the United States. The study from the Memorial Sloan-Kettering Cancer Center in New York City and the Center for Studying Health System Change (CSHSC), Washington, D.C., concluded that black and white patients are treated by differently qualified physicians, which may cause disparities in the quality of care each group receives. The physicians treating black patients were more likely than those treating white patients to say they (the physicians) could not provide high-quality care for all of their patients. Published in the August 5 issue of New England Journal of Medicine, the report is based on telephone surveys of more than 4,000 primary care physicians who had about 150,000 routine visits from black and white Medicare patients. The CSHSC is a nonpartisan policy research organization. The abstract of the study is available online (requires registration) at http://content.nejm.org/cgi/content/full/351/6/575.

The second report, “Disparities in Cardiac Care: Rising to the Challenge of Healthy People 2010,” was published in the August 4 issue of the Journal of the American College of Cardiology. According to the report, race makes a difference in the health care system, but a majority of physicians surveyed did not view a patient’s race or ethnicity as a leading factor in obtaining care. Insurance coverage was more important. For the abstract of the study, go to http://www.cardiosource.com/library/journals/journal/article/abstract?acronym=JAC&uid=PIIS0735109704009994&kwhighligh=.