Health Care Reform Legislation Draws Praise, Criticism from AAFP Leadership

American Academy of Family Physicians (AAFP) Board Chair Jim King, MD, of Selmer, Tenn., recently submitted a letter to three House committees expressing the AAFP's support of America's Affordable Health Choices Act of 2009. In the letter, King said the AAFP believes the bill would make progress toward payment and delivery system reforms, and help build the primary care work-force for the future. According to King, the AAFP supports sliding scale tax credits, coverage of evidence-based preventive services with no cost-sharing, and expansion of Medicaid to cover the poor. The AAFP also endorses the elimination of Medicare payment cuts under the sustainable growth rate formula. However, King voiced concern about the bill's definition of primary care services, as well as its expanded definition of primary care providers. The new definitions could affect which physicians are eligible to receive bonus payments from Medicare for designated services. In response to a proposed public insurance plan option, the AAFP has reiterated its support, provided the plan meets criteria established by the New American Foundation. For example, the plan must promote primary care and adoption of the patient-centered medical home; it must make physician participation optional; and it must be subject to the same rules and regulations as those governing private plans. For more information, visit https://www.aafp.org/news-now/government-medicine/20090722house-bill-ltr.html or https://www.aafp.org/news-now/government-medicine/20090722publ-plan-king.html.

CDC Anticipates H1N1 Vaccine Availability, Issues Seasonal Flu Shot Recommendations

The Centers for Disease Control and Prevention (CDC) has announced plans for a voluntary novel influenza A (H1N1) vaccination program beginning in mid-October 2009. Five manufacturers are in the process of producing H1N1 vaccines under contracts with the U.S. Department of Health and Human Services (HHS). If approved by the U.S. Food and Drug Administration, the CDC will distribute the vaccine to states based on relative population figures. States will then distribute the vaccine to public health agencies and private practices. Vaccines for the H1N1 virus will be provided to physicians at no charge, and America's Health Insurance Plans has indicated that insurance companies will provide reimbursement for administration of the vaccine. Meanwhile, the CDC's Advisory Committee on Immunization Practices has recommended seasonal influenza vaccination for all persons six months to 18 years of age. According to the CDC, children typically have the highest attack rates during influenza outbreaks and are a major source of transmission. CDC officials expect the seasonal influenza vaccine to be available in August or September to make way for the H1N1 vaccine in October. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20090722cdc-h1n1-ask.html or https://www.aafp.org/news-now/clinical-care-research/20090724mmwr-ann-flu.html.

Obama Selects Family Physician from Alabama as Next U.S. Surgeon General

President Obama has chosen family physician Regina Benjamin, MD, MBA, of Bayou La Batre, Ala., as the next U.S. surgeon general. Benjamin, an AAFP member, has spent the past 20 years caring for patients in the Bayou La Batre Rural Health Clinic, a practice she founded on the Alabama Gulf Coast. During his formal introduction, Obama praised Benjamin's commitment to caring for patients regardless of their ability to pay for their care. Additionally, he lauded her perseverance in rebuilding her clinic after it was destroyed by Hurricane Georges in 1998 and by Hurricane Katrina in 2005, and again when it burned down on the eve of its reopening. Benjamin said she welcomes the opportunity to help create a better health care system that serves all Americans. For more information, visit https://www.aafp.org/news-now/government-medicine/20090713reg-benjamin.html.

AAFP Reminds Payers to Comply with Performance Measurement Principles

The AAFP recently sent letters to dozens of health insurance companies requesting their compliance with principles outlined in the Patient Charter for Physician Performance Measurement, Reporting, and Tiering Programs. Many of these companies agreed last year to adhere to these principles for collecting physician performance measurement results and reporting them to consumers. In the letter, AAFP Board Chair Jim King, MD, reiterated several aspects of the patient charter, including the need to focus on quality improvement; the need for transparent, timely, and valid measurement processes; and the importance of using meaningful data derived from evidence-based consensus standards. The AAFP also insisted that payers give physicians ample time to review the reports and that they include a process through which physicians can ask for a review. For more information, visit https://www.aafp.org/news-now/professional-issues/20090715perfmeas-remind.html.

Data Show Uninsured Patients Account for One Fifth of Emergency Department Visits

Uninsured patients accounted for nearly one fifth of the 120 million hospital-based emergency department visits in 2006, according to data released by HHS. The data are based on the Nationwide Emergency Department Sample, which gathers information about emergent care from approximately 1,000 community hospitals nationwide. The database generates national estimates on the number of emergency department visits in community hospitals, as well as by region, urban and rural location, teaching status, ownership, and trauma designation. It also provides information such as why patients were seen, what treatments they received, how much their care cost, and who was billed. According to HHS Secretary Kathleen Sebelius, the current health care system has forced uninsured, rural, and low-income patients to rely on the emergency department for care. For more information, visit the HHS Web site at http://www.hhs.gov/news/press/2009pres/07/20090715b.html.

Course Helps Physicians Transform Practices into Patient-Centered Medical Homes

A new online continuing medical education (CME) course can help physicians transform their practices into patient-centered medical homes. The nine-module course, “Practice Leaders in Medical Homes,” was designed by the Roger C. Lipitz Center for Integrated Health Care at Johns Hopkins University in cooperation with the AAFP, TransforMED, the American Board of Internal Medicine, the American College of Physicians, and the American Geriatrics Society. Each module contains self-assessment questions, a short reading, a narrated presentation, a case study, a video vignette, and a list of additional resources. After completing the module, physicians answer multiple-choice questions related to course objectives. Family physicians may receive one Prescribed AAFP credit for each completed module. For more information, visit https://www.aafp.org/news-now/cme-lifelong-learning/20090723lipitz-pcmh.html.

Health Plans Make Slight Progress in Improving Claims Processing Systems

For the second consecutive year, the American Medical Association (AMA) has assessed the strengths and weaknesses of the health care industry's claims processing systems. According to the AMA's “2009 National Health Insurer Report Card,” insurers have made progress in the past year, but there is still room for improvement. The report examined Medicare and seven of the nation's largest private health insurance companies in the areas of timeliness, accuracy, denials, and transparency related to claims processing. Key findings of the report include a continued variance in claims denial processes, which indicates a lack of standardization among payers; a slight improvement in timeliness responding to physicians' claims; and an improvement in accurately reporting contracted payment rates to physicians. For more information, visit https://www.aafp.org/news-now/practice-management/20090724ama-insurer-rptcrd.html.

IOM Updates Guidelines for Appropriate Weight Gain During Pregnancy

The Institute of Medicine (IOM) has updated its guidelines for weight gain during pregnancy for the first time in nearly 20 years. The new guidelines differ slightly from the 1990 guidelines in that the ranges for weight gain are now based on body mass index measures, rather than on the Metropolitan Life Insurance tables used previously. The new guidelines also include specific ranges of recommended weight gain for women who are obese, overweight, underweight, or normal weight. Unlike the older guidelines, the updated guidelines do not recommend modifying weight-gain ranges for women who are short, minorities, or teenagers. Counseling all pregnant women on diet and exercise may result in reduced obstetric risk, normal infant birth weights, improved long-term health, reduced postpartum weight retention, and reduced childhood obesity. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20090602iom-weight-gdnc.html.

AAFP Online CME Program Offers Four-Part Series on Type 2 Diabetes

The AAFP's online classroom, LearningLink, has launched the first activity in a four-part CME series titled “Type 2 Diabetes 2009.” The series reviews and applies evidence-based diabetes management guidelines for family physicians. The initial activity, “Highlights of Current Evidence and Clinical Recommendations,” offers three webcasts, a slide-driven lecture, an expert panel discussion, and video case dramatizations. Downloadable resources provide evidence-based recommendations, practice tools, and point-of-care applications. For more information, visit https://www.aafp.org/news-now/cme-lifelong-learning/20090715diab-learnlink.html.

— AFP and AAFP NEWS NOW staff