AAFP Legislative Priorities Include Patient-Centered Medical Home, Payment Reform

The American Academy of Family Physicians (AAFP) plans to address several key health care issues during 2009, according to AAFP Division of Government Relations director Kevin Burke, Washington, DC. Some of the priorities on the AAFP's legislative agenda include Medicare payment reform, nationwide adoption of the patient-centered medical home, and health information technology for small- and medium-sized practices. The AAFP plans to work with the new Congress to revise the sustainable growth rate (SGR) formula, which dictates payments for physician services. Although the AAFP and other health care organizations have called for an out-right repeal of the SGR, eliminating the formula could cost as much as $300 billion. Congress may pass a Medicare bill that addresses long-term payment reform, which would allow the AAFP to advocate for the inclusion of primary care and the patient-centered medical home in the long-term plan. The AAFP will also push for financial incentives for physicians who adopt health information technology. One bill currently under consideration by Congress would provide more than $4,000 for each physician in a practice that adopts health information technology. For more information, visit https://www.aafp.org/news-now/government-medicine/2008122congress-issues.html.

Survey Shows Growing Dissatisfaction Among Primary Care Physicians

A recent survey from the Boston-based Physicians' Foundation reveals primary care physicians' growing dissatisfaction with the current practice environment. About 12,000 physicians responded to the survey, and almost one half of respondents said that they planned to reduce their patient panels or stop practicing entirely within the next three years. More than 60 percent of respondents said they are spending less time with patients because of the increase in nonclinical paperwork. Additionally, 60 percent of respondents would not recommend medicine as a career to young persons. The AAFP and the American College of Physicians are hopeful that the implementation of the patient-centered medical home will ease some of physicians' frustrations with the current practice environment. Under the medical home model, physicians would receive a care-management fee to help them obtain better payment for non–face-to-face service time. For more information, visit https://www.aafp.org/news-now/professional-issues/20081126phys-fdtn.html or the Physicians' Foundation survey at http://www.physiciansfoundations.org/news/news_show.htm?doc_id=728872.

House Committee Pushes for Delayed Implementation of ICD-10-CM Codes

The U.S. House of Representatives Small Business Committee has asked the U.S. Department of Health and Human Services (HHS) to delay conversion to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). The chair of the committee, Rep. Nydia Velazquez, D-NY, submitted a letter to HHS Secretary Michael Leavitt urging an extension to the pro-posed October 1, 2011, deadline for switching to the new set of outpatient diagnostic codes. Velazquez referred to the economic impact that switching to the new coding system over the next two years would have on small medical practices. The letter also noted that 50 percent of U.S. physician practices have fewer than five physicians, but account for 80 percent of outpatient visits. The National Committee on Vital and Health Statistics has recommended an October 2013 deadline for conversion to ICD-10-CM, whereas the AAFP has requested that the Centers for Medicare and Medicaid Services delay the adoption indefinitely. For more information, visit https://www.aafp.org/news-now/practice-management/20081126icd-10-house-cmte.html.

Senate Finance Chair Unveils Plan to Promote Primary Care Services

The chair of the Senate Finance Committee, Sen. Max Baucus, D-Mont., has introduced a blueprint for reforming health care that focuses on primary care and preventive services. Baucus unveiled the plan for improving quality and reducing costs during a Capitol Hill press briefing on November 12, 2008. The 98-page blueprint calls for an increase in Medicare payments for primary care health professionals, an expansion of Medicare's role in testing the patient-centered medical home model, and a replacement of the SGR. In a letter to Baucus, AAFP Board Chair Jim King, MD, Selmer, Tenn., acknowledged the importance of the proposal. King praised the blueprint's thorough review of the health care system's flaws and emphasized the need for physicians, patients, government, insurers, and hospitals to work together to create solutions. Instead of introducing the plan as a bill, Baucus hopes his proposal will move the debate about health care reform forward in the new Congress. For more information, visit https://www.aafp.org/news-now/government-medicine/20081118baucus-plan.html; https://www.aafp.org/news-now/government-medicine/20081203baucus-ltr.html; or the proposal at http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf.

Online Influenza-Tracking Tool Allows Physicians to Monitor Local Virus Activity

A new Web-based tool from Google could help physicians track influenza activity in their area. The Google Flu Trends tool, created in collaboration with the Centers for Disease Control and Prevention (CDC), examines data from online searches about influenza-related topics. The tool provides estimates based on searches from Internet users in a specific area. It is an average of one week to 10 days faster than the CDC in identifying influenza activity. Using Google Flu Trends, patients can see where influenza activity is spreading and get vaccinated before it spikes. Physicians can use the tool to increase the amount of testing they do for influenza when they see a high level of activity in their area. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20081203flu-trends.html or http://www.google.org/flutrends/.

New METRIC Module on Depression Helps Physicians Measure Patient Outcomes

The AAFP has released a new module in its METRIC performance improvement program titled Depression: Improving Patient Care. The METRIC program, which stands for Measuring, Evaluating, and Translating Research Into Care, provides a systematic approach to measuring disease outcomes. The conditions covered in the modules are chosen in part based on how prevalent they are in primary care. To complete the METRIC module on depression, physicians must assess their practice's performance by answering a series of questions; review 10 patient charts using evidence-based measures; create an action plan for making improvements; implement the plan; reexamine the same 10 charts; and evaluate whether the plan improved the care of patients with depression. Physicians who complete the module will earn 20 prescribed credits toward AAFP continuing medical education. For more information, visit https://www.aafp.org/news-now/cme-lifelong-learning/20081121metric-depress.html or https://www.aafp.org/online/en/home/cme/selfstudy/metric.html.

Primary Care Physician Shortage Forces Patients to Use Emergency Departments

The shortage of primary care physicians is creating an increase in emergency department use, according to a study in the October 22, 2008, issue of the Journal of the American Medical Association (JAMA). The study, “Uninsured Adults Presenting to U.S. Emergency Departments,” found that emergency department use is increasing, even among insured patients. During the past 10 years, emergency department use has more than doubled among insured and uninsured patients. Visits from insured patients increased from 35 visits per 100 persons per year to 39 visits per 100 persons. Although most insured patients have access to primary care, many are forced to seek care from emergency departments because there are fewer primary care physicians. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20081125jama-er-use.html or the JAMA Web site at http://jama.ama-assn.org/cgi/content/abstract/300/16/1914.

Medicare Beneficiaries in Arizona, Utah to Participate in PHR Pilot Program

Beginning this month, Medicare beneficiaries in Arizona and Utah will have the opportunity to participate in a personal health record (PHR) pilot program. Through PHRs, patients will be able to track health care visits and health conditions online by downloading their files from secure Web sites. A unique feature of this program is that participants will be able to choose which PHR works best for them. An estimated one million fee-for-service Medicare beneficiaries will be eligible to participate in the program. For more information, visit https://www.aafp.org/news-now/practice-management/20081119cms-phr-pilot.html.

AMA Delegates Discuss Resolution to Support Tobacco Control Content in EHRs

The American Medical Association (AMA) House of Delegates recently debated on a resolution to include tobacco control content in electronic health records (EHRs). The AAFP and the American Academy of Pediatrics cosponsored the resolution, which recommends that all EHR systems include a template that prompts physicians to address tobacco use with patients. The template would remind physicians to encourage patients who use tobacco to quit, and to stress the importance of a smoke-free environment. The automatic prompts would also remind physicians to direct patients and their families to tobacco cessation resources. AMA delegates have referred the resolution to the AMA Board of Trustees. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20081119ama-tobacco.html.

— AFPandAAFP NEWS NOWstaff