See What the American Academy of Family Physicians (AAFP) Federal Advocacy Team Has Been Working On.
Family Physicians Kick Off 2024 on Capitol Hill
Last week, AAFP President Steven Furr, MD, FAAFP; AAFP Board Chair Tochi Iroku-Malize, MD, MPH, FAAFP; and AAFP President-Elect Jen Brull, MD, FAAFP, spent time on Capitol Hill engaging with lawmakers about three key issues for family physicians:
- Reauthorizing the Teaching Health Center Graduate Medical Education (THCGME) program, which helps train the next generation of primary care physicians—61% of whom are family physicians—and address the physician shortage.
- Enacting Medicare physician payment reform. Family physicians deeply appreciate, and are already using, the G2211 add-on code, which more appropriately values primary care services. However, a Medicare payment reduction of 3.4% still threatens all physicians with untenable cuts.
- Ensuring that family physicians can continue to provide necessary substance use disorder care via support for the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Reauthorization Act.
Family Physicians to Build on Advocacy Wins
Family physicians spent a lot of time in 2023 advocating for policies and regulations that would improve patient care. The AAFP applauds Congress and health care agencies for implementing changes to strengthen access to care and ensure that physicians have the tools and resources they need to continue providing high-quality, longitudinal primary care to patients.
A few of the changes that are making a positive difference include:
- The implementation of the G2211 Medicare add-on code that began on January 1, 2024, which more appropriately values the complex, continuous services primary care clinicians provide.
- New Medicare codes in 2024 that will better assess patients’ unmet social needs and integrate community-based services to address those needs.
- The requirement for states to provide one year of continuous coverage for children enrolled in Medicaid/Children’s Health Insurance Program (CHIP), which began January 1, 2024. The AAFP supported this provision and continues to advocate in favor of expanding continuous coverage requirements to other beneficiaries.
- Provisions enacted in the Inflation Reduction Act that will make prescription drugs more affordable for Medicare patients.
- New guardrails and transparency requirements on Medicare Advantage plans’ use of prior authorization, reducing care delays and inappropriate coverage denials.
New Regulations Streamline Prior Authorization
The Centers for Medicare and Medicaid Services (CMS) announced a final rule to automate prior authorizations and require several payers to respond to prior authorization requests within 72 hours for urgent requests and seven days for non-urgent requests.
WHAT WE’RE WORKING ON:
The AAFP has long advocated for policies to alleviate administrative burden, avert care delays and allow physicians to spend more time treating their patients.
Comprehensive reform is needed to reduce the volume of prior authorizations and ensure patients’ timely access to care. The AAFP continues to advocate for Congress to swiftly pass the Improving Seniors’ Timely Access to Care Act, which will streamline and standardize prior authorization under the Medicare Advantage program and protect beneficiaries from unnecessary delays in care.
Proposed Information Blocking Disincentives
A new Office of the National Coordinator (ONC) for Health IT, CMS and U.S. Department of Health and Human Services (HHS) proposed rule could unfairly penalize and disproportionately impact small and independent primary care physician practices. The AAFP has long supported efforts to advance interoperability of health IT.
Interoperability allows the timely and secure access, exchange and use of electronic health information so that data can be leveraged to optimize patient and population outcomes. Interoperability is essential for ensuring family physicians have access to meaningful, actionable data at the point of care.
WHAT WE’RE WORKING ON:
- The AAFP submitted comments urging HHS to work with physicians to correct information-blocking issues before issuing penalties.
- Family physicians encourage ONC, CMS and HHS to ensure that the final rule effectively promotes information sharing and does not negatively impact patients’ access to high-quality primary care.
Advancing & Safeguarding Primary Care
Historic underinvestment in primary care jeopardizes the nation’s health. The only way to address this threat is to overhaul our system for financing primary care and move toward a system that is designed to support high-quality primary care, write AAFP Executive Vice President and Chief Executive Officer R. Shawn Martin and Aledade CEO Farzad Mostashari in Health Affairs.
Over the past decade, we’ve seen more primary care practices move into alternative payment models that help them care for their patients. The best part is that it’s working: Primary care practices in these new models are improving quality, producing savings and investing in new care delivery strategies that improve patient outcomes and physician satisfaction.
We attribute much of this progress to the combination of the Center for Medicare and Medicaid Innovation and the permanent Medicare Shared Savings Program.
For the latest policy updates impacting family medicine, follow AAFP Advocacy at @aafp_advocacy.
Post author: American Academy of Family Physicians (AAFP)
