Conferees Support Senate's SCHIP Bill: Physician Payment to Be Tackled Later

House and Senate conferees in September agreed not to include a Medicare physician payment increase as part of a bill to reauthorize the State Children's Health Insurance Program (SCHIP). In August, the House and Senate passed bills to reauthorize SCHIP for the next five years. Although the House bill contained several provisions, including a measure to provide a 0.5 percent increase in physician payments in 2008 and 2009, the Senate approved an SCHIP bill that contains no provisions other than reauthorization of the program. Unlike the House bill, the Senate legislation passed by a veto-proof margin, giving the bill an edge as conferees worked to reconcile the two measures. Seeing the SCHIP legislation as the most expedient way of addressing the Medicare payment issue, the American Academy of Family Physicians (AAFP) had targeted the Senate with its advocacy efforts. AAFP president Rick Kellerman, MD, of Wichita, Kan., met with staff members from the offices of three senators on the Senate Finance Committee and urged them to support a two-year physician payment increase. For more information, visithttps://www.aafp.org/news-now/government-medicine/20070911stopcuts.html andhttps://www.aafp.org/news-now/government-medicine/20070921schipnopay.html.

Study Finds Medicare Part D Reduced Numbers of Seniors Without Coverage

According to a study published on the Health Affairs Web site, Medicare's prescription drug benefit has dramatically reduced the number of seniors without prescription drug coverage, although coverage is not as comprehensive as that provided by private insurance plans or the Veterans Administration (VA). The Kaiser Family Foundation study, “Medicare Prescription Drug Benefit Report,” was based on a 2006 survey of more than 16,000 persons. It found that the proportion of persons 65 years and older without drug coverage dropped from one third in 2005 to 20 percent in 2006 after enactment of the Medicare Prescription Drug Improvement and Modernization Act. In 2006, one half of persons 65 years and older received benefits through a new Medicare Part D plan; nearly 31 percent had prescription drug coverage through their employers, and an additional 3 percent were covered by the VA. Of those covered under Medicare Part D, 8 percent spent $300 or more a month on out-of-pocket drug costs, compared with 5 percent of those with private insurance or VA coverage. In addition, 20 percent of those with a Medicare drug plan did not fill or delayed filling a prescription because of costs, compared with 8 percent of those enrolled in private plans and 12 percent in VA plans. For more information, go tohttps://www.aafp.org/news-now/government-medicine/20070905partdfillsgaps.html.

Match Analysis Supports Increasing Funding for Public Medical Schools

An analysis of National Resident Matching Program data in the September issue of Family Medicine shows that more U.S. graduates from public university medical schools, particularly those with departments of family medicine, choose the specialty of family medicine than do students from private schools without family medicine departments. The analysis reviews data describing medical students who entered family medicine residencies in 2006. More than 10 percent of graduates from 77 publicly funded medical schools chose family medicine, compared with 6 percent from 48 privately funded medical schools. Schools with family medicine departments matched 9.1 percent of their graduates in the specialty, compared with 1.2 percent from schools without family medicine departments. According to article author Perry Pugno, MD, MPH, director of the AAFP Division of Education, and his colleagues, improved funding for public medical schools and more support for family medicine departments are likely to increase the number of medical school graduates who become family physicians. For more information, visithttps://www.aafp.org/news-now/resident-student-focus/20070911matchanalysis.html.

MinuteClinic Waiver Request Prompts Proposed Regulation Revisions

The Massachusetts Department of Public Health conducted its second public hearing in September regarding a revised set of regulations that would cover the operation of limited-scope medical clinics, such as retail health clinics. The revisions were prompted by an application submitted by CVS Caremark Corp. earlier this year to open Massachusetts' first retail health clinic—a CVS Minute-Clinic—in Weymouth. If the regulations are approved, clinics licensed to provide limited services in Massachusetts would operate under less stringent restrictions than full-service clinics and physician offices. For example, a retail health clinic operating in a retail store would not be required to provide facilities and services such as a functioning sink and toilet, a clean supply storage room, a separate room for soiled linen, and phone service for answering patient calls when the clinic is closed. For more information, go tohttps://www.aafp.org/news-now/professional-issues/20070919minuteclinic.html.

AAFP, ACOG Collaboration Leads to Action on Maternity Care Issues

Ongoing collaboration between the AAFP and the American College of Obstetricians and Gynecologists (ACOG) led to several developments over the summer. AAFP and ACOG drafted a joint letter to a managed care organization affiliated with Arizona's Medicaid program voicing opposition to the insurer's decision to pay only obstetricians for the provision of maternity care services in urban Arizona. ACOG has invited the AAFP to provide representation on its Committee on Obstetric Practice and its Committee on Practice Bulletins, and there has been a change on the ACOG antepartum record, form A, from “Newborn's Pediatrician” to “Newborn's Physician.” It is hoped that the new wording will encourage obstetricians and labor and delivery nurses to consider the names of family physicians along with those of pediatricians when assigning a newborn's physician. For more information, visithttps://www.aafp.org/news-now/professional-issues/20070907acogcollaborate.html.

NACHC Uses Reports to Advocate for Community Health Center Funding

The National Association of Community Health Centers (NACHC) is using two reports as an advocacy tool to obtain increased funding for community health centers (CHCs). A report by the NACHC and the AAFP's Robert Graham Center, “Access Denied: A Look at America's Disenfranchised,” released in March, found that 56 million Americans have inadequate or no access to primary care physicians. A second report, “Access Granted: The Primary Care Payoff,” released in August by the NACHC, the Robert Graham Center, and Capital Link, documents the savings created by CHCs and the economic benefits the centers provide for local communities. The reports are now at the forefront of the NACHC's efforts to increase funding for the centers and to expand the number of people covered by the entities. For more information, go tohttps://www.aafp.org/news-now/health-of-the-public/20070912chcadvocacy.html.

AAFP President Explains Importance of Title VII in Improving Patient Care

Speaking before the Health Resources and Services Administration Advisory Committee on Training in Primary Care Medicine and Dentistry, AAFP president Rick Kellerman, MD, said that Title VII funding could serve as a major catalyst in promoting and implementing the patient-centered medical home for the next several years. The United States needs to place a greater emphasis on primary care in general and the patient-centered medical home in particular to improve care, enhance health care access, and save costs, Kellerman said. He noted that section 747 of Title VII in the Public Health Service Act provides the only federal grants for training family physicians and should be used to teach students, residents, and faculty about practice improvements and innovations in primary care and the patient-centered medical home. In this way, Title VII could have a profound effect on the nation's health care system, transforming the system of care from an acute-care model to a preventive and patient-centered model. For more information, go tohttps://www.aafp.org/news-now/government-medicine/20070914hrsatitlevii.html.

AHRQ Releases Antidepressant Guides for Physicians and Patients

The Agency for Healthcare Research and Quality (AHRQ) has released two new resources for physicians and patients with the latest scientific evidence on anti-depressants. “Antidepressant Medicines: A Guide for Adults with Depression” offers patient-friendly information on depression, as well as facts about the potential benefits of antidepressants, pricing information, and a summary of the drugs' potential side effects. “Choosing Antidepressants for Adults” covers these topics from the health professional's perspective and provides confidence ratings for evidence on antidepressant use. For more information and to download the guides, go tohttps://www.aafp.org/news-now/health-of-the-public/20070919ahrqguides.html orhttp://effectivehealthcare.ahrq.gov.

NAHQ Celebrates National Healthcare Quality Week October 21–27

October 21–27 is National Healthcare Quality Week, designed to celebrate the work of quality professionals in health care. The National Association for Healthcare Quality (NAHQ) is inviting institutions to join in observing this week through special events that increase exposure and heighten awareness of the contributions that quality professionals make. Promotional materials are available on their Web site along with suggestions for hosting recognition and celebratory activities. For more information and to download materials, go tohttp://www.nahq.org/calendar/healthcareqw.htm.

— AFP and AAFP NEWS NOW staff

For more news, visit AAFP News Now athttps://www.aafp.org/news-now.