House Approves Short-term SGR Formula Fix as Part of Legislation

The U.S. House of Representatives passed a bill that would provide slight increases in physician payments under Medicare in 2008 and 2009 as a substitute for the steep payment cuts that were called for under the sustainable growth rate (SGR) formula. A provision in the Children's Health and Medicare Protection (CHAMP) Act, a $50 billion bill to reauthorize the State Children's Health Insurance Program, would provide a 0.5 percent increase in Medicare physician payments in 2008 and 2009. If enacted, it would negate a 9.9 percent reduction in Medicare payment rates in 2008 and another 5 percent reduction in 2009. However, the bill stops short of repealing the SGR. Although the original CHAMP Act, which was introduced in July, would have eliminated the SGR in 2010, House members could not find enough offsets in the budget to pay for the SGR's repeal. As a result, House members passed a bill that does not contain a repeal, meaning physicians could face a 10 or 11 percent reduction in Medicare payments in 2011 and 2012. For more information, visit https://www.aafp.org/news-now/government-medicine/20070808houseschip.html.

North Carolina Seeks Expansion of Primary Care Program

North Carolina officials have asked the federal government to approve a plan to move the state's higher-cost Medicare patients into a primary care Medicaid management program that has saved the state millions of dollars during the past few years. Officials submitted a 646 waiver to the Centers for Medicare and Medicaid Services earlier this year, asking the agency to approve a five-year demonstration project that would put the state's high-risk Medicare patients and dual eligibles (i.e., patients qualifying for both Medicaid and Medicare) into a primary care program known as Community Care of North Carolina (CCNC). Currently, CCNC provides care to more than 750,000 Medicaid recipients in the state, making the program the largest payer in North Carolina. The program relies heavily on medical homes, population health management, community-based networks, and case-management services to deliver care—a combination that has produced millions in cost savings while improving quality of care, according to the assistant secretary for health policy and medical assistance at the North Carolina Department of Health and Human Services. For more information, visit https://www.aafp.org/news-now/government-medicine/20070808expandccnc.html.

Senate Committee Passes Landmark Tobacco Control Bill

The U.S. Food and Drug Administration (FDA) would gain authority to regulate tobacco products under a bipartisan bill passed by the Senate Health, Education, Labor and Pensions Committee. A similar bill is making its way through the U.S. House. In a 13-8 vote, the Senate committee passed the Family Smoking Prevention and Tobacco Control Act on August 1. The legislation proposes giving the FDA the authority to restrict tobacco marketing and sales to children and adolescents and requiring tobacco companies to disclose the contents of tobacco products. Under the Senate bill, the FDA would have the ability to stop illegal sales of tobacco products to children and adolescents and the authority to restrict advertising and promotions that appeal to children and adolescents. States would be granted the authority to regulate cigarette marketing for the first time in 40 years. The American Academy of Family Physicians (AAFP) strongly supports the legislation and has signed two congressional letters urging enactment of the measure. The full Senate is expected to vote on the measure this fall. For more information, visit https://www.aafp.org/news-now/government-medicine/20070808senatetobaccobill.html.

Residents, Students Debate Health System Reform, Other Issues

Tomorrow's family physicians want to see more progress toward health system reform, stronger language regarding retail health clinics, and a greater distance between the pharmaceutical industry and medicine, according to resolutions adopted in August during the resident and student congresses at the AAFP's National Conference of Family Medicine Residents and Medical Students. In one resolution, student members urged the AAFP to expand its advocacy on health insurance reform. Students and residents also called on the AAFP to incorporate stronger language regarding retail health clinics' potential for conflict of interest and fragmentation of medical care into the Academy's policy statement “Desired Attributes of Retail Health Clinics.” In addition, students and residents adopted resolutions asking the Academy to expand its efforts to gauge the potential influence that pharmaceutical companies may have on physician treatment decisions. For more information, visit https://www.aafp.org/news-now/resident-student-focus/20070810studentresidentcongress.html.

Report Finds Community Health Centers Save Billions in Health Costs

The nation's community health centers (CHCs) save billions of dollars each year in public and private health care expenditures by relying on a primary care system that employs a patient-centered medical home model, according to a new report by the National Association of Community Health Centers Inc., the Robert Graham Center, and Capital Link. The study calculated the savings generated by CHCs and the economic benefits provided by the centers to local communities. It found that patients who receive most of their care from CHCs have 41 percent lower costs than those who access care elsewhere, resulting in savings of $10 billion to $17 billion a year. For more information, visit https://www.aafp.org/news-now/professional-issues/20070809accessgranted.html.

UnitedHealth Group Pilot Project to Test Patient-Centered Medical Home

UnitedHealth Group is working with the AAFP, the American Academy of Pediatrics, and the American College of Physicians to undertake a pilot project that will test the impact of the patient-centered medical home on delivery of care, overall patient health, and total health care spending. The project is expected to launch in Florida with a small number of primary care practices. After the pilot project is operational, UnitedHealth Group will support the participating practices by helping them incorporate quality improvement and care management systems to increase access. The insurer will pay participating practices a monthly care-management fee based on projected savings for all patients who select a medical home. In addition, the company will share any excess savings that accrue from the pilot program with the practices and, through premium reductions, with employers. For more information, visit https://www.aafp.org/news-now/professional-issues/20070815unitedpilot.html.

New Collaboration Launches Center to Advance E-Prescribing Efforts

A coalition that includes the AAFP, BlueCross BlueShield Association, Humana Inc., Intel Corp., the Medical Group Management Association, and SureScripts has come together to launch the Center for Improving Medication Management. The center will focus on the adoption and use of health information technology—particularly e-prescribing technology. It will initiate programs to gather and disseminate best practices for deployment of technology that electronically links physicians, pharmacists, and patients. The center also will conduct research to find out how those groups can better use technology to improve medication management; patient compliance with medication orders; and communication among the physician, the patient, and the pharmacist. For more information, visit https://www.aafp.org/news-now/practice-management/20070816ctrmedmgmt.html.

NIH Senior Health Site Adds Topics on Skin Cancer, Communication

Two new topic areas added to the National Institutes of Health (NIH) Senior Health Web site (http://nihsenior-health.gov) offer older patients information about skin cancer and how to make the most of visits to their physicians' offices. The Web site is a joint effort of the National Institute on Aging and the National Library of Medicine. Visitors to the site can find information about the causes and risks of various types of skin cancer, as well as about symptoms, screening, and diagnosis. This section of the site also explains various treatment options and recaps the latest research on skin cancer. The other new area offers older patients guidance on how to communicate openly, comfortably, and assertively with their physicians, stressing that the most effective patient-physician relationships function as partnerships, with both sides taking responsibility for good communication. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20070815nihseniorhealth.html or https://nia.nih.gov/health.

AHRQ Releases Reports on Secure Exchange of Health Information

The U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) released a set of reports on ensuring the secure exchange of electronic health information. The reports, “Privacy and Security Solutions for Interoperable Health Information Exchange,” review 34 state health information exchange plans. They highlight variations in approaches and offer recommendations on ways to increase interoperability while maintaining privacy. According to the reports, more research and guidance is needed to identify different interpretations of the Health Insurance Portability and Accountability Act Privacy Rule among states, to evaluate available technologies, and to develop a standard set of definitions for terms such as medical emergency and current treatment. For more information and to access the reports, go to http://www.healthit.ahrq.gov.

—AFP and AAFP NEWS NOW staff