AAFP Federal Affairs Update

State Legislative Conference

Salt Lake City, Utah

November 5, 2011

AAFP Federal Priorities

• Medicare Physician Payment Reforms

• Access to Health Care, especially Primary Care

• Graduate Medical Education Funding

• Support for the education and training of family physicians (Title VII)

Payment

• Supercommittee– AAFP Ask:

• Recommend repeal of SGR• Specify a positive payment rate for 3-5 years• Include a higher rater (3% or better) for primary

care physicians

Payment

• Reason for Supercommittee action:– Broader reach for budget offsets– Streamlined procedures– Probably the last opportunity in several years

Payment

• Supercommittee must report to Congress by November 23

• Both House and Senate must vote on the recommendations by December 23

• Failure to pass recommendations to reduce the deficit by $1.5 trillion over 10 years will produce across-the-board cuts of $1.2 trillion, beginning in 2013

Payment

• Regular Committees– House Ways and Means – House Energy and Commerce – Senate Finance

If Congress doesn’t act by December 31, there will be a 29.5 percent reduction in Medicare physician payments.

Access

• Comprehensive Primary Care Initiative– Similar to PCMH

• Risk adjusted monthly per-patient care coordination fee

• The Medicare fee would range from $4 to $40, with a $20 average.

• Shared savings amount calculated retrospectively

– Multi-payor– Definition of primary care

Access

• ACO Rule– Most of AAFP’s recommendations were

accepted, including• Providing an option to avoid risk• Reducing the number of quality measures• Requiring only “pay for reporting” for year 1• Giving physicians advance payments• Dropping requirement for anti-trust review

GME

• An annual $9 billion to teaching hospitals

• No accountability for how it is used.

• Supercommittee may find reductions in IME to be acceptable

• Disproportionate affect of across-the-board reductions on primary care

• ASK: Require GME funds at least maintain current primary care funding.

GME

• AAFP’s proposal to test funding directly to primary care residency, which will contract with the hospital for some of the training.

• Congressional interest and possible introduction of a bill.

Title VII

• Funding, especially on the House side is strongly threatened.

• ASK: maintain current funding ($39 million) and aim for $140 million.

• Senate appropriations is current funding, which the House committee has no proposal.

AAFP Federal Priorities

Questions?

Kevin J. Burke, Director

AAFP Government Relations

Washington, DC

kburke@aafp.org