Burke aafp federal affairs

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Burke aafp federal affairs

  1. 1. AAFP Federal Affairs Update State Legislative Conference Salt Lake City, Utah November 5, 2011
  2. 2. AAFP Federal Priorities <ul><li>Medicare Physician Payment Reforms </li></ul><ul><li>Access to Health Care, especially Primary Care </li></ul><ul><li>Graduate Medical Education Funding </li></ul><ul><li>Support for the education and training of family physicians (Title VII) </li></ul>
  3. 3. Payment <ul><li>Supercommittee </li></ul><ul><ul><li>AAFP Ask : </li></ul></ul><ul><ul><ul><li>Recommend repeal of SGR </li></ul></ul></ul><ul><ul><ul><li>Specify a positive payment rate for 3-5 years </li></ul></ul></ul><ul><ul><ul><li>Include a higher rater (3% or better) for primary care physicians </li></ul></ul></ul>
  4. 4. Payment <ul><li>Reason for Supercommittee action: </li></ul><ul><ul><li>Broader reach for budget offsets </li></ul></ul><ul><ul><li>Streamlined procedures </li></ul></ul><ul><ul><li>Probably the last opportunity in several years </li></ul></ul>
  5. 5. Payment <ul><li>Supercommittee must report to Congress by November 23 </li></ul><ul><li>Both House and Senate must vote on the recommendations by December 23 </li></ul><ul><li>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 </li></ul>
  6. 6. Payment <ul><li>Regular Committees </li></ul><ul><ul><li>House Ways and Means </li></ul></ul><ul><ul><li>House Energy and Commerce </li></ul></ul><ul><ul><li>Senate Finance </li></ul></ul><ul><ul><li>If Congress doesn’t act by December 31, there will be a 29.5 percent reduction in Medicare physician payments. </li></ul></ul>
  7. 7. Access <ul><li>Comprehensive Primary Care Initiative </li></ul><ul><ul><li>Similar to PCMH </li></ul></ul><ul><ul><ul><li>Risk adjusted monthly per-patient care coordination fee </li></ul></ul></ul><ul><ul><ul><li>The Medicare fee would range from $4 to $40, with a $20 average. </li></ul></ul></ul><ul><ul><ul><li>Shared savings amount calculated retrospectively </li></ul></ul></ul><ul><ul><li>Multi-payor </li></ul></ul><ul><ul><li>Definition of primary care </li></ul></ul>
  8. 8. Access <ul><li>ACO Rule </li></ul><ul><ul><li>Most of AAFP’s recommendations were accepted, including </li></ul></ul><ul><ul><ul><li>Providing an option to avoid risk </li></ul></ul></ul><ul><ul><ul><li>Reducing the number of quality measures </li></ul></ul></ul><ul><ul><ul><li>Requiring only “pay for reporting” for year 1 </li></ul></ul></ul><ul><ul><ul><li>Giving physicians advance payments </li></ul></ul></ul><ul><ul><ul><li>Dropping requirement for anti-trust review </li></ul></ul></ul>
  9. 9. GME <ul><li>An annual $9 billion to teaching hospitals </li></ul><ul><li>No accountability for how it is used. </li></ul><ul><li>Supercommittee may find reductions in IME to be acceptable </li></ul><ul><li>Disproportionate affect of across-the-board reductions on primary care </li></ul><ul><li>ASK: Require GME funds at least maintain current primary care funding. </li></ul>
  10. 10. GME <ul><li>AAFP’s proposal to test funding directly to primary care residency, which will contract with the hospital for some of the training. </li></ul><ul><li>Congressional interest and possible introduction of a bill. </li></ul>
  11. 11. Title VII <ul><li>Funding, especially on the House side is strongly threatened. </li></ul><ul><li>ASK: maintain current funding ($39 million) and aim for $140 million. </li></ul><ul><li>Senate appropriations is current funding, which the House committee has no proposal. </li></ul>
  12. 12. AAFP Federal Priorities <ul><li>Questions? </li></ul><ul><li>Kevin J. Burke, Director </li></ul><ul><li>AAFP Government Relations </li></ul><ul><li>Washington, DC </li></ul><ul><li>[email_address] </li></ul>

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