AAFP Teams Up with Other Groups Calling to Eliminate SGR, MedPAC Weighs In

The American Academy of Family Physicians (AAFP) recently joined the American Medical Association (AMA) and 130 other medical groups in calling on Congress to eliminate the sustainable growth rate (SGR) formula. In a letter to Congress, the groups said physicians are committed to helping develop and test delivery reforms that can provide a foundation for replacing the SGR and improving the Medicare physician payment system. The Centers for Medicare and Medicaid Services estimates that physicians will face a 29.5 percent reduction—the largest physicians have faced to date—under the SGR on January 1, 2012, unless Congress acts to block the cut. Just a few days later, the Medicare Payment Advisory Commission (MedPAC) released its annual report to Congress with recommendations to prevent the cut and increase Medicare payment rates to physicians, suggesting a 1 percent pay increase in place of the scheduled reduction. The AAFP praised statements in the report about more accurate payments for primary care physicians. However, the AAFP is concerned that a small segment of the Medicare population continues to report problems finding primary care physicians. The MedPAC report states this is a “serious concern” for the health care system. MedPAC plans to draft SGR reform recommendations in the next few months and vote on proposals in October. For more information, visit https://www.aafp.org/news-now/government-medicine/20110316sgrletter.html, http://www.ama-assn.org/amednews/2011/03/21/gvl10321.htm, and http://www.medpac.gov/documents/mar11_entirereport.pdf.

2011 Resident Matching Program Results Again Show Gains for Family Medicine

The number of medical students choosing to enter family medicine has risen for the second year in a row, according to the results of the 2011 National Resident Matching Program (NRMP). Preliminary figures show residency programs for family medicine filled 2,576 positions of the 2,730 offered, for a record-high fill rate of 94.4 percent, which is 3 percent higher than last year's figure. Overall, the percentage of U.S. seniors who chose family medicine rose to 8.4 percent this year from 7.9 percent in 2010. According to an AAFP Division of Medical Education summary of the 2011 NRMP results, the increased percentage of medical students may reflect the impact of health care reform discussions about the importance of building a more primary care–based health care system for improving medical care access and cost-effectiveness. Although the family medicine match rate among U.S. medical school graduates has increased, most positions offered and filled in the NRMP continue to be in subspecialties outside of primary care, especially among U.S. graduates. For more information, visit https://www.aafp.org/news-now/resident-student-focus/20110317thematch.html.

Physician Reentry Programs Help Get Family Physicians Back into Practice

The AMA released new recommendations to improve the reentry process for physicians who have taken an extended absence from practicing medicine. For those physicians, the United States does not have a comprehensive physician reentry system, according to the AMA report. It lists several barriers to reentry, including lack of information on the process of and requirements for reentry, high costs of participating in reentry programs, lack of geographic access to the limited number of programs available, and lack of consistency in state laws and regulations. The report recommends developing policies that ensure the quality of reentry programs and the readiness of the programs' graduates to resume practice, as well as ensuring that a physician reentry system is financially feasible. The AMA also recommends creating an evidence base that can be used to inform policymakers, reentering physicians, and reentry program development. For more information, visit https://www.aafp.org/news-now/cme-lifelong-learning/20110323docreentry.html and http://www.ama-assn.org/ama1/pub/upload/mm/40/physician-reentry-recommendations.pdf.

IOM Report Focuses on Priorities from the Healthy People 2020 Initiatives

The Institute of Medicine (IOM) released a report identifying 12 leading health indicators and 24 objectives to be treated as high priorities in implementing the Healthy People 2020 initiatives. The report cited several measures of health-related concepts that reflect public health concerns, such as the proportion of the population having access to health care, receiving quality health care services, experiencing positive mental health, and being in healthy physical and social environments. It also reported on measures of injuries, responsible sexual behavior, healthy births, substance abuse, and chronic disease. Many of the objectives identified by the IOM are aligned with priorities of the AAFP, such as increasing the proportion of persons with a primary care physician, persons who receive evidence-based clinical preventive services, and adults who meet federal physical activity guidelines. Other AAFP-aligned objectives were those calling for reductions in the following measures: child and adolescent obesity; consumption of calories from solid fats and added sugars in children two years and younger; initiation of tobacco use by children, adolescents, and young adults; and tobacco use by adults. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110316wklynewsbrfs.html#NewsArticleParsys96686 and http://iom.edu/Reports/2011/Leading-Health-Indicators-for-Healthy-People-2020.aspx.

AAP Updates Recommendations for Child Car Seats, Booster Seats

The American Academy of Pediatrics (AAP) recently updated its recommendations for child car seats. The recommendations include putting toddlers in rear-facing car seats until two years of age or until they reach the maximum height and weight for their seat; keeping most children in a belt-positioning booster seat until they are 4 ft 9 in tall and are between eight and 12 years of age; and having children younger than 13 years ride in the rear of a vehicle. The AAP previously recommended that infants and toddlers ride in rear-facing car seats until they reach the limits of those car seats. However, a 2007 study in Injury Prevention showed that children younger than two years are 75 percent less likely to die or be severely injured in a car crash if they are riding in a rear-facing seat. A car seat guide for parents is available at http://www.healthychildren.org/carseatguide. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110323wklynewsbrfs.html#NewsArticleParsys65372 and http://www.aap.org/advocacy/releases/carseat2011.htm.

Insurance Survey Finds That Newly Unemployed Cannot Get Health Insurance

According to the Commonwealth Fund 2010 Biennial Health Insurance Survey, an estimated 52 million adults were uninsured at some point during 2010, up from 38 million in 2001. Adults in families with low and moderate incomes were the most likely to be uninsured. Approximately 9 million working-age adults became uninsured during the past two years, with 57 percent of them having had health insurance coverage through a job that was lost. Only 25 percent who lost employer health insurance were able to find another source of coverage. Of those who tried to buy individual coverage in the past three years, 71 percent (19 million persons) found it difficult or impossible to find a plan that fit their needs or that they could afford, and some were turned down or charged a higher price for coverage because of a preexisting condition. Survey results showed that 75 million adults did not get needed health care last year, skipping physician visits, prescriptions, and recommended tests or treatments because of costs. Uninsured adults were the most likely to forego care because they could not afford it, although 31 percent of adults who were insured all year also went without the health care they needed because of costs. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110323wklynewsbrfs.html#NewsArticleParsys98988 and http://www.commonwealthfund.org/Content/Surveys/2011/Mar/2010-Biennial-Health-Insurance-Survey.aspx.

U.S. Physicians Invited to Complete Pilot Survey on Best Specialty Fit

Medical school graduates interested in exploring which medical specialties would offer them the best fit may want to participate in a pilot survey project being conducted by the Educational Commission for Foreign Medical Graduates (ECFMG). The survey offers matches between participants and medical specialties based on responses to a questionnaire. Participants who complete the online survey will receive immediate and individualized feedback regarding the top 10 medical specialties in which they likely would be satisfied, as well as the 10 that probably would be their worst matches. Feedback also will include information about the typical characteristics of physicians in those specialties. To help ensure the survey instrument's validity, the ECFMG hopes to gather responses from large numbers of U.S. physicians who already are in different medical specialties. Family physicians interested in participating in the pilot project can learn more by sending an e-mail that includes their name and medical specialty to acculturation@ecfmg.org. For more information, visit https://www.aafp.org/news-now/professional-issues/20110315ecfmgsurvey.html.

AAFP Foundation Offers Opportunities to Help Survivors of Japan's Disasters

The earthquake and resulting tsunami that struck Japan in March 2011 left tens of thousands without adequate food, water, and electricity. More than 1.5 million persons evacuated severely damaged areas, including areas with the threat of radiation exposure from damaged nuclear power plants. AAFP members can offer help by donating to the AAFP Foundation, and those interested in volunteering in Japan may contact Alex Ivanov, the AAFP's international activities manager, by e-mailing aivanov@aafp.org. For more information, visit https://www.aafp.org/news-now/inside-aafp/20110316japan-aid.html.

—AFP and AAFP NEWS NOW staff