Kevin Burke, American Academy of Family Physicians, presented on the AAFP Federal Affairs Update at the State Legislative Conference on November 6, 2015.

1. AAFP Federal Affairs Update
State Legislative Conference
Minneapolis, Minnesota
November 6, 2015

2. AAFP Federal Advocacy
Priorities
• Medicare Physician Payment Reforms
• Access to Health Care, esp. Primary Care
• Social Determinants of Health
• Graduate Medical Education Reform
• Support for the education and training of
family physicians (Teaching Health
Centers, Title VII)

3. Time Frame
• Congress has 3 more weeks
– Current federal funding expires on Dec. 11
– Budget agreement raised the spending cap
– Still to be determined: How the additional
funding will be allocated among many
competing agencies.
– Most important question: can Congress avoid
the pending shut-down of the whole federal
government.

4. Payment
• At least the SGR is not a hostage to this
end-of-session turmoil.
• We will see the end of the 10% Medicare
bonus payment for primary care on Dec.
31.
• 2016 Medicare Physician Fee Schedule
will be essentially flat for family physicians

5. Payment
• AAFP Response to RFI on MACRA
– Harmonize measures
– Define PCMH
– Evaluate the basis of payment for primary
care & reform primary care payment
– Create virtual groups of physician providers
– Attribute patients prospectively

6. GME
• An annual $9 billion to teaching hospitals from
Medicare (additional $ from Medicaid and VA)
• No accountability for how it is used
• Fellowship training is often profitable for
academic hospitals
• House Republicans asked GAO to evaluate how
the academic hospitals are using their GME
funding.

7. Title VII
• Title VII (Health Professions Grants for Primary
Care Training and Enhancement) is the only
direct federal investment in family medicine
education and training
• Funding remains strongly threatened
• May be included in final omnibus appropriations
or continuing resolution at current rate of $38
million for FY 2016

8. AHRQ
• Agency for Healthcare Research and
Quality - $364 million annual budget
– House bill would eliminate funding
– Senate has a reduction of $128 million
• AHRQ’s mission is to generate the
evidence necessary to build a high-quality,
high-value health care system. Very
primary care focused.

9. Congressional Primary Care
Caucus
• Rep. David Rouzer (R-NC) and Rep. Joe
Courtney (D-CT) announced formation of
the Primary Care Caucus on Oct. 8.
• Goal is to educate legislators and to
advocate on behalf of primary care
physicians, providers and their patients.
• Ask your Representative to join by using
Speak Out

10. AAFP Federal Advocacy
Priorities
Questions?
Kevin J. Burke, Director
AAFP Government Relations
Washington, DC
kburke@aafp.org