FMCC 2016 Care Mgt Breakout by Matt Burke
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Coordination of care involves organizing patient care activities between multiple parties, including the patient, to appropriately deliver healthcare services. Studies found that care coordination programs sometimes resulted in cost savings or neutral costs, and quality of care improved in many programs through continued analysis, though savings are not strongly incentivized at the clinic level.
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FMCC 2016 Direct Primary Care Breakout by Jay Keese
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This document provides information about government relations resources and opportunities for members to get involved in advocacy from the American Academy of Family Physicians (AAFP). It outlines the AAFP Division of Government Relations staff and their roles. It encourages members to utilize state advocacy resources on the AAFP website and provides an overview of the Center for State Policy resources. The document also lists federal advocacy priorities, member advocacy tools including the Family Medicine Action Network and text alerts. It promotes the upcoming Family Medicine Advocacy Summit and gives an overview of the Political Action Committee. It closes by welcoming any questions.
Rural Health: A Chapter Focus
The NC Rural Health Leadership Alliance is a collaboration between organizations working to improve health outcomes in rural North Carolina. It began informally in the 1990s and was formalized in 2014. The Alliance focuses on priority areas like primary care/behavioral health integration and workforce recruitment through working groups. Key areas of focus for the workforce include preserving Medicaid GME funding, increasing loan repayment funding, and boosting health professional training in rural areas. The Alliance has had some successes but continues working towards goals like greater loan repayment funding and payment model changes for rural counties.
Rural Health: A Chapter Focus
This document summarizes two pieces of Georgia legislation related to rural health and primary care education. The first is the 2017 Preceptor Tax Incentive Program (PTIP) bill (HB 301) that aimed to provide tax credits for physicians, nurses and physician assistants who serve as preceptors for students. The second is the 2018 "Achieving Connectivity Everywhere (ACE) Act" (SB 402) that established a framework to expand broadband access across Georgia, especially in rural areas, by providing grants to public-private partnerships. The bill recognized broadband as essential for education, healthcare and more. It prioritized grants that would provide connectivity for hospitals and telehealth facilities.
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This document discusses health issues facing rural communities in the United States and the role of family physicians in addressing these issues. It notes that rural residents have higher rates of poverty, fewer physicians per capita, and worse health outcomes. Common challenges for rural physicians include workforce shortages, lack of specialty care access, and long work hours. The AAFP aims to establish itself as a leader on rural health issues through initiatives like advocacy, payment reform, practice support, and collaboration with other organizations to improve health in rural America.Prescription Drug Abuse: A Chapter Focus
The document discusses Florida's HB 21 legislation aimed at reducing opioid deaths and addiction. It establishes a 3-day limit for acute pain opioid prescriptions but allows exemptions. It requires PDMP checks and continuing education for prescribers. While intended to curb the opioid crisis, there was no input from medicine and it has led to unintended consequences for chronic pain patients. Amendments are being considered once elections are over.
Prescription Nation 2018: Facing America's Opioid Epidemic
The document is a report from the National Safety Council on prescription drug use in 2018. It discusses key actions states are taking to address the opioid crisis, such as prescriber education, integrating prescription drug monitoring programs into clinical settings, increasing access to naloxone to treat overdoses, establishing opioid prescribing guidelines, improving data collection and sharing, and increasing treatment availability for opioid use disorders. It also outlines new legislative trends on issues like emergency room interventions and education requirements.
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This document summarizes the recent changes to South Carolina's laws regarding the scope of practice for advanced practice registered nurses (APRNs). It outlines the history of legislative efforts over the past two decades to expand APRN scope, culminating in a compromise bill passed in 2018. Key aspects of the new law include replacing written protocols with practice agreements between APRNs and physicians, expanded prescriptive authority for APRNs, and specifying medical acts APRNs can perform. It also provides guidance for developing practice agreements and lessons learned from the advocacy process.
Scope of Practice Legislative Landscape
This document summarizes scope of practice trends for various healthcare providers. It discusses how 26 states and DC have granted independent practice to nurse practitioners. It also outlines proposals for physician assistants to establish independent regulatory boards and directly bill insurers. The document reviews passed legislation in 4 states creating a new provider category called assistant/associate physicians who have completed medical licensing exams but not a residency. It summarizes scope expansions under consideration for pharmacists, psychologists, and naturopathic providers.
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Work on Primary Care Spending Measures
This document summarizes the work of the Milbank Memorial Fund to develop and promote measures of primary care spending. It discusses a study finding that commercial health plans spend between 4-8% of total medical spending on primary care. It outlines Milbank's agenda to build evidence on primary care spending, collaborate with other organizations, and disseminate findings. Milbank plans further research, supporting state efforts to replicate measurement and regulation, and continued work to increase primary care investment.
Primary Care Spend: A Chapter Focus
This document summarizes Oregon's experience increasing primary care spending through legislative and collaborative efforts. It outlines how Oregon created a patient-centered medical home program, increased transparency of primary care spending across payers, and eventually mandated a minimum primary care spending threshold of 12% of total medical expenditures. Key lessons included starting with less controversial policies, using data to drive transparency and goals, and engaging a multi-stakeholder collaborative. The presentation recommends similar best practices for other states seeking to invest more in primary care.
State Efforts to Rein in Drug Costs
This document summarizes state legislative efforts to address rising prescription drug prices. It finds that in 2018, 28 states passed 45 new laws focused on drug costs, particularly related to pharmacy benefit managers and increasing transparency. It also discusses emerging policy approaches like price gouging laws, drug affordability boards empowered to set rates, and importation from Canada. The document predicts more state action on these issues in 2019 and provides resources for advocates and legislators working on drug pricing reforms.
Election Update: What's at Stake?
This document provides an overview of competitive US House races for the 2018 midterm elections that will indicate whether Democrats are having a good night in their goal of taking back the House majority. Key races to watch are listed for New York, Pennsylvania, Illinois, Minnesota, California and other states. Winning toss-up seats will be important for Democrats, while winning tilts and likely Republican districts would signal a strong Democratic wave. The document also promotes the work of the American Academy of Family Physicians in bringing its members together with legislators to advance its policy agenda.
Election Update: What's at Stake?
FiscalNote is a leading technology company providing policy data and tools to over 5,200 clients. It has 350+ employees across offices in Washington DC, New York, Baton Rouge, Brussels, and Seoul. Upcoming state elections may impact policy issues like healthcare, Medicaid expansion, and prescription drug prices. The document forecasts outcomes of gubernatorial and legislative races and reviews key ballot initiatives in states like Idaho, Maine, and Massachusetts. It concludes some Republican candidates are embracing Democratic healthcare policies and changing voter expectations may decrease Republican "trifectas" or party control of state government.
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This document discusses trends in Medicaid Section 1115 waivers. It provides an overview of the National Association of Medicaid Directors (NAMD), which supports state Medicaid directors. The rest of the document summarizes key topics discussed in a NAMD presentation on Section 1115 waivers, including why states use them, operational aspects like stakeholder engagement and budget neutrality, and trends in waiver policies around community engagement, pharmacy benefits, delivery system reform, and behavioral health integration. The document concludes by providing additional NAMD resources on these topics.Medicaid: A Chapter Focus
The document discusses Georgia's successful advocacy for increasing Medicaid payment rates for primary care physicians and OB-GYNs. It outlines the steps taken: 1) Forming a coalition of physician groups; 2) Building the case by highlighting Georgia's Medicaid payment rates had not increased in 15 years and physician shortages; 3) Presenting a unified ask that resulted in increasing 78 payment codes to Medicare parity levels. The coalition is now asking to open after-hours care codes for Medicaid. The document also discusses Arkansas implementing the first Medicaid work requirement and over 8,500 people losing coverage for not complying with reporting hours worked monthly online.
State Strategies for Administrative Simplification
This document summarizes efforts to advance prior authorization reforms. It shows that 86% of physicians report prior authorization burdens have increased, with an average of 14.6 hours spent per week on prior authorizations. 92% of physicians report care delays and treatment abandonment as a result. Principles for reform focus on clinical validity, continuity of care, transparency, timely access, and alternatives. Recent legislative activity and tools/resources to advance the conversation on reform are presented.
Administration Simplification: A Chapter Focus
This document summarizes the journey of prior authorization legislation in Ohio from 2015-2018. It discusses how the author testified in support of bills in 2015-2016 (SB 129) and 2017-2018 (SB 56/HB 72) regarding step therapy. The legislation went into effect in 2017 with additional provisions in 2018. It outlines the new rules for insurers related to prior authorization, including disclosure requirements, timelines for responses, and prohibitions on retroactive denials. Additional rules implemented in 2018 include requirements for web-based prior authorization systems and faster response times.
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The document discusses the opioid epidemic in the United States and the role of physicians in addressing it. It notes that opioid overdose deaths have significantly increased since 2012, with over 50,000 deaths in 2015. The American Medical Association (AMA) created an Opioid Task Force to provide recommendations. The AMA is working to increase prescription drug monitoring program usage, safe prescribing practices, and access to treatment for substance use disorders. While physician opioid prescriptions and education efforts have increased to address the epidemic, challenges remain regarding stigma, treatment capacity and access, guideline consistency, and insurance coverage of alternative treatment options.
Health Landscape
This document provides an overview of HealthLandscape, which is a tool created by the American Academy of Family Physicians to help with data-driven healthcare decision making through geographic information systems (GIS) mapping. The presentation discusses HealthLandscape's history and capabilities, provides a brief introduction to GIS, and outlines several free online HealthLandscape mapping tools that can be used to visualize health outcomes, social determinants of health, and healthcare workforce data. It also describes how HealthLandscape can work with organizations to create custom maps and analyses to support advocacy efforts and other projects.
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