Policy and Health Issues in the News
Am Fam Physician. 2007 Jan 15;75(2):153-154.
Congress Passes Legislation That Prevents Medicare Payment Cut
Immediately before recessing in December, the U.S. Congress passed legislation to prevent a scheduled 5 percent pay cut for primary care physicians and to institute a 1.5 percent incentive payment, beginning in July, for physicians who report on quality measures. Lawmakers avoided adding any provision that would change new evaluation and management (E/M) codes, which are scheduled to increase the value of current procedural terminology (CPT) codes 99213 and 99214 (both dealing with office or other outpatient visits by established patients). The end result will be a slight increase in Medicare payments for the two most commonly billed primary care codes: payment for CPT code 99213 will increase by $6.83 (13 percent) and CPT code 99214 payment will rise by $7.58 (9 percent). Accounting for the increases in E/M services and the decreases in non-E/M services provided by family physicians, there would be a 5 percent increase overall on Medicare-allowed charges to family physicians in 2007. For more information, go to http://www.aafp.org/news-now/government-medicine/20061211nomedicarecut.html.
Congress Approves Extension of Physicians for Underserved Areas Act
The U.S. Congress has approved a bill backed by the American Hospital Association that extends the State30/J-1 Visa Waiver program for two years. The program allows state health agencies to hire up to 30 non-U.S. physicians each year to practice in rural and inner-city communities, and allows international medical graduates to remain in the United States for three years after graduation to practice in medically underserved areas. Without the waiver, graduates would be required to return to their home countries for at least two years before applying to reenter the United States. The program had expired on June 1, 2006. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20061218j-1visawaiver.printerview.html.
HHS Unveils Four Cornerstones of Value-Driven Health Care System
During his address at the National Summit for Employers on Health Care Transparency in November, U.S. Department of Health and Human Services (HHS) Secretary Michael Leavitt called on employers to commit to health care quality and cost reporting for employees. Leavitt discussed the four cornerstones of a value-drive health care system that will focus on health care competition based on value. In this proposed system, patients will receive cost and quality comparisons on physicians and hospitals according to developed standards, resulting in increased quality and lower costs. The four cornerstones are: supporting health information technology, including electronic health records; providing patients with independent assessments of the quality of care from physicians and hospitals; providing pricing information; and creating incentives for consumers, physicians, and hospitals to choose higher quality and lower costs. Leavitt called on all stakeholders, including physicians, health insurance plans, and third-party administrators, to support these action items. For more information, visit http://www.hhs.gov/transparency or http://www.aafp.org/news-now/inside-aafp/20061128advocacyawards.html.
Study Finds Many Patients Misunderstand Prescription Drug Labels
Research in the December issue of Annals of Internal Medicine shows that even the most compliant patients may misunderstand—and thus fail to follow—instructions printed on their medication bottles. According to the article, “Literacy and Misunderstanding Prescription Drug Labels,” as many as 48 percent of patients may not understand how to take their prescription medications, even if they can read the words on the label. Researchers asked 395 patients to read and interpret the prescription labels for five commonly prescribed medications—amoxicillin, trimethoprim, guaifenesin, felodipine, and furosemide. Of the 1,975 responses obtained for the five labels, 374 were incorrect, and 46.3 percent of patients misunderstood one or more of the prescription label instructions. For more information, visit http://www.annals.org/cgi/content/full/0000605-200612190-00144v1 or http://www.aafp.org/news-now/clinical-care-research/20061206labelliteracy.html.
AAFP Releases Online Tool to Calculate 2007 Medicare Income Changes
The American Academy of Family Physicians (AAFP) has updated an interactive online tool to help members calculate changes in their Medicare income based on E/M code payment changes recently published in the Centers for Medicare and Medicaid Services (CMS) final rule. The E/M Impact Tool allows users to see payment allowances and calculate revenue changes between 2006 and 2007. To access the tool, visit http://www.aafp.org/online/etc/medialib/aafp_org/documents/prac_mgt/codingresources/emimpacttool.Par.0001.File.tmp/emimpacttool.xls.
United States Accepts New International Health Regulations
The United States has officially accepted the revised International Health Regulations governing how the World Health Organization and member countries identify, respond to, and share information about public health emergencies of global concern, the HHS announced in December. The updated rules are designed to prevent the international spread of diseases while avoiding, as far as possible, disruptions to world travel and trade. Whereas the previous regulations applied only to cholera, yellow fever, and plague, the new rules ask countries to take broader responsibility for detecting and responding to emergencies, including taking public health actions at ports and airports and immediately reporting occurrences of smallpox, polio, severe acute respiratory syndrome, and new strains of human influenza. The United States accepted the rules with the reservation that they will be implemented according to U.S. principles of federalism. The revised regulations officially take effect in June 2007, but the HHS will begin implementation immediately. For more information, go to http://www.who.int/csr/ihr/en.
Health Insurers Propose Plan to Cover Uninsured Patients
A proposal set forth in November by America's Health Insurance Plans (AHIP), which represents private health insurance companies, would expand the Medicaid program and create federal tax incentives to encourage the purchase of private health insurance. The plan would cover all low-income children within three years and all low-income adults within 10 years. In the proposal, AHIP calls for an expansion of the State Children's Health Insurance Program to include all uninsured children from families living at or below 200 percent of the federal poverty level; expansion of Medicaid to cover uninsured adults, including single adults, living at or below the federal poverty level; establishment of a Universal Health Account to allow the purchase of insurance and payment for health coverage with pretax dollars; creation of a health tax credit of up to $500 for low-income families who buy insurance for their children; and creation of a $50 billion federal performance grant program to help states expand access to coverage. For more information, visit http://www.ahipbelieves.com/AVisionforReform/tabid/57/Default.aspx or http://www.aafp.org/news-now/professional-issues/20051129ahipplan.html.
Medical Resident Duty-Hour Limits Affect Training Programs
According to research in the December issue of Academic Medicine, rules implemented in 2003 restricting the number of hours medical residents can work have had an impact on family medicine residency programs. Residency program directors reported an increase in faculty patient care duties, a decrease in formal resident educational activities, a decrease in specialty clinic rotations for residents, and a decrease in residents caring for their patients in continuity clinics. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20061205dutyhours.html.
Employers Invest in Personal Health Records for Employees and Families
Several of America's largest corporations have come together to fund development of a Web-based framework called “Dossia” that will allow patients to build and maintain their own personal health records. Five companies—Applied Materials Inc., BP America Inc., Pitney Bowes, Wal-Mart Stores Inc., and Intel Corp.—will make Dossia available to more than 2.5 million employees, dependents, and retirees beginning in 2007. The companies are funding the initial development, which is estimated to be in the seven-figure range. For more information, visit http://www.dossia.org or http://www.aafp.org/news-now/professional-issues/20061208dossia.html.
Environmental Scan Shows Rise of Consumerism in Health Care
The AAFP's 2007 Environmental Scan, which provides a third-party view of the medical-practice environment, shows that patients and those who pay for their health care want convenience, access, price transparency, and demonstration of quality. Rising cost is the biggest factor driving the shift to consumerism in health care, according to the scan. For more information, visit http://www.aafp.org/news-now/professional-issues/20061213environscan.html.
—AFP and AAFP NEWS NOW STAFF
For more news, visit AAFP News Now at http://www.aafp.org/news-now.
Copyright © 2007 by the American Academy of Family Physicians.
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