Policy and Health Issues in the News
Am Fam Physician. 2007 Jul 15;76(2):179-180.
Supplemental Funding Legislation Eliminates Current SCHIP Shortfalls
President Bush has signed a $120 billion supplemental appropriations bill that will provide $650 million in emergency funding for 14 states struggling with shortfalls in their state children's health insurance programs (SCHIPs). The legislation (HR 2206) primarily will fund combat operations in Iraq and Afghanistan; however, the bill also contains funding for domestic programs, including SCHIPs in Alaska, Georgia, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, Rhode Island, and Wisconsin. Georgia officials had made a number of reductions to the state's SCHIP in mid-March, freezing enrollment in the program and changing financial eligibility requirements to make it tougher for applicants to qualify. Enrollment will remain frozen indefinitely, according to state officials. Although the $114 million Georgia will receive from the bill should cover the state's shortfall, it does not secure funding beyond September 30. Reauthorization is now a major issue for SCHIP, which insures about 6 million children and 600,000 adults nationwide. House and Senate members have vowed to complete reauthorization before the September 30 deadline, but some analysts are not convinced Congress will succeed. For more information, visit http://www.aafp.org/news-now/government-medicine/20070606schipfundingbill.html.
High-Deductible Plans May Increase Patients' Maternity Care Costs
A June 12 study conducted by the Georgetown University Health Policy Institute and the Kaiser Family Foundation found that couples with high-deductible, consumer-driven health plans (CDHPs) could be financially liable to their physicians for up to 82 percent of prenatal and delivery costs depending on their CDHP. The study compared out-of-pocket expenses for maternity care under traditional health plans and CDHPs. The results indicate that families with CDHPs pay more out-of-pocket expenses for maternity care in most scenarios, but planning for those expenses can be difficult given the complexity of the plans and the unpredictability of pregnancy. The results reflect the high deductibles, coinsurance requirements, and limited definitions for covered services of CDHPs, according to the study authors. The study's implications should raise caution flags to families and the physicians who care for them, the authors said. For more information, visit http://www.aafp.org/news-now/professional-issues/20070621cdhpmaternity.html.
Primary Care Collaborative Succeeds in Pushing Legislative Agenda
The Patient-Centered Primary Care Collaborative (PCPCC), a coalition that comprises the American Academy of Family Physicians (AAFP), other health groups, major employers, and a consumer group, has sent legislative proposals to Capitol Hill asking lawmakers to provide financial support for states wanting to make patient-centered medical homes a part of their Medicaid programs and SCHIPs. The legislative proposals would base the patient-centered medical home on a model set out by the National Committee for Quality Assurance and endorsed by the PCPCC. So far, language promoting the medical home has been included in at least four bills on Capitol Hill, one of which would provide incentives to support health information technology and care coordination in a patient-centered medical home. Another bill would provide state grants for management fees to physicians in medically underserved communities. For more information, visit http://www.aafp.org/news-now/government-medicine/20070620pcpcclegislative.html.
Report Recommends Cross-cultural Training for Residents
According to a May 2007 Commonwealth Fund report, family medicine educators do a better job of incorporating cultural competency into residency training curricula than do their peers in other medical specialties and subspecialties, but they still need to improve if future family physicians are to meet patients' needs. The report found that resident physicians received minimal formalized cultural competency training. As a result, residents did not think they were well prepared to care for patients from different cultural, ethnic, national, or religious backgrounds. The report calls for curricula that incorporate cultural issues through didactic and clinical experiences. According to the Institutes of Medicine (IOM), cultural competency is crucial to erasing health care disparities. Poor communication, patients' lack of English skills, and physicians' misunderstandings about their patients' religious or cultural belief systems hinder the quality of care given to minority groups, the IOM said. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20070606crossculture.html.
Health Groups Urge Increase in Tobacco Tax to Fund SCHIP
Sixty-seven health-related organizations, including the AAFP, are urging Congress to increase the federal tobacco tax to help pay for reauthorization of the SCHIP and to enable the program to expand to cover more children. In May, the organizations sent letters to the House Energy and Commerce Committee and the Senate Finance Committee asking for a minimum increase in the federal tobacco tax of at least 61 cents per pack to help provide $50 billion in financing for SCHIP during the next five years. This would enable the joint federal/state program to add 3 million children to its rolls. For more information, visit http://www.aafp.org/news-now/government-medicine/20070613schiptobaccotax.html.
CMS Announces National Provider Identifier Dissemination Plan
The Centers for Medicare and Medicaid Services (CMS) has announced a plan to disseminate National Provider Identifier (NPI) information, which is needed to submit Medicare health care claims transactions when other health care providers are involved in the care of a patient. The NPI information will be available via a query-only Internet database searchable by NPI number or provider name. Information will also be available in a downloadable Internet file that CMS will update monthly. Some data elements required on the NPI application are not disclosable to the public because of the Freedom of Information Act, so Social Security numbers, taxpayer identification numbers, and dates of birth will not appear in the database. For more information, visit http://www.aafp.org/news-now/practice-management/20070604npidisseminate.html, or http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/Data-DisseminationNPI.pdf.
AAFP Celebrates 60th Anniversary, Reflects on Achievements
The AAFP celebrated its 60th anniversary in June. Originally called the American Academy of General Practice, the organization was established by a group of about 200 general practitioners (GPs) in response to the increasing domination of medicine by limited specialists and the decreasing number of GPs. According to AAFP president Rick Kellerman, MD, Wichita, Kan., the organization's achievements over the years include bridging the gap between GPs and the new family medicine specialty; requiring CME as a condition of membership; helping GPs in practice become residency directors and department faculty, and lending staffing support to the Society of Teachers of Family Medicine; lobbying for state and federal government funding to support family medicine training, and fighting the annual payment cuts triggered by Medicare's sustainable growth rate formula; establishing the Future of Family Medicine project and the TransforMED initiative; and helping found the World Organization of Family Doctors.
AHRQ Releases “How To” Guide Analyzing Patient Registries
The Agency for Healthcare Research and Quality (AHRQ) has developed a 219-page publication that analyzes patient registries. “Registries for Evaluating Patient Outcomes: A User's Guide” identifies best practices for operating registries and includes information on registry design; data elements and sources; ethics and privacy concerns; data collection, analysis, and interpretation; adverse event detection, processing, and reporting; and quality measurement. The guide can be downloaded from the AHRQ Web site at no charge. Free print copies may be requested by calling (800) 358-9295 or by e-mailing the AHRQ at email@example.com. For more information, visit http://www.ahrq.gov, or http://www.aafp.org/news-now/practice-management/20070620registryhandbook.html.
AAFP Offers Online Board Preparation Resource
The AAFP has launched a new tool to help family physicians prepare for Part III of the American Board of Family Medicine's Maintenance of Certification Program for Family Physicians. The AAFP's Online Board Review is a collection of multiple-choice practice questions organized into short quizzes by topic areas that correspond to the categories included in the examination. Although most of the quizzes focus on topics pertaining to a single organ system, such as cardiovascular or respiratory topics, the collection also includes 10 mixed-review quizzes with questions from a variety of topic areas. Participants can check their answers after completing each quiz; an explanation of the answer and supporting references are provided for each question. For more information, visit http://www.aafp.org/news-now/cme-lifelong-learning/20070612boardprepquestions.html, or http://www.aafp.org/online/en/home/cme/boardreview/questions.html.
— AFP and AAFP NEWS NOW staff
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