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Policy and Health Issues in the News



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Am Fam Physician. 2008 Jan 1;77(1):23-24.

AHIC Provides Recommendations for Implementing Mandatory E-prescribing

The American Health Information Community (AHIC), a federal health information technology advisory body, recently sent a letter to the Department of Health and Human Services (HHS) Secretary Michael Levitt detailing the AHIC's recommendations for mandatory electronic prescribing (e-prescribing). E-prescribing is the electronic transmission of prescriptions or prescription-related information among the prescriber, dispenser, pharmacy benefit manager, and health plan. Although the AHIC supports moving forward with mandatory e-prescribing, it contends that certain steps must be taken before it is implemented. The American Academy of Family Physicians' (AAFP's) Executive Vice President and AHIC representative Douglas Henley, MD, Leawood, Kan., says that e-prescribing technology has the potential to improve patient safety and should be implemented in the future, after the appropriate prerequisites are in place. Preliminary steps to implementation recommended by the AHIC include mandatory participation by all pharmacies, inclusion of prescriptions for controlled substances, adoption of Centers for Medicare and Medicaid Services incentive programs to encourage physician and pharmacy participation, and development of an e-prescribing technology certification process overseen by the Certification Commission for Healthcare Information Technology. For more information, visit http://www.aafp.org/news-now/practice-management/20071206ahic-eprescribe.html or http://www.hhs.gov/healthit/documents/m20071128/rev_letter.html.

AAFP Suggests Changes to Patient-Centered Medical Home Legislation

Although AAFP leaders have some praise for proposed legislation that would provide a medical home for some patients, AAFP Board Chair Rick Kellerman, MD, Wichita, Kan., says changes are needed. Under the Medical Homes Act (S.B. 2376), Medicaid and the State Children's Health Insurance Program recipients who do not have a regular source of medical care would be assigned to primary care physicians who would manage and coordinate their care. Local medical management committees would establish the standards for the medical home, and participating physicians would receive a minimum payment per member. In a letter to the senators who recently introduced the bill, Dr. Kellerman praised the measure for emphasizing primary care practices as the principal site of medical homes and for helping reduce physician costs; however, he raised concerns about localizing the decision-making process and about setting the minimum physician payment amount. Dr. Kellerman suggested that the medical management committees be required to define patient-centered medical homes based on national standards and that the minimum payments be set with guidance from state-based primary care organizations. For more information, visit http://www.aafp.org/news-now/government-medicine/20071205medhomebill.html.

FCC Initiative to Bring Broadband Telehealth Networks to Rural Physicians

The Federal Communications Commission (FCC) has allocated $417 million under the Rural Health Care Pilot Program (RHCPP) for the creation of 69 statewide or regional broadband telehealth networks. The initiative will connect more than 6,000 health care professionals across the country. FCC Chairman Kevin Martin says that the broadband rollout will bring health information technology to rural America, reducing patient costs and travel time, increasing patient access to subspecialists, decreasing medical errors, and enabling physicians to quickly share critical patient-care information. Physician participants, including those affiliated with hospitals, clinics, universities, and community health centers, will be eligible to receive three-year universal support funding to help offset the costs associated with implementing telehealth networks. According to the FCC, the RHCPP will pay for 85 percent of the contracted work, and participants will be responsible for the remaining 15 percent. To ensure quality and efficiency, participants will be required to meet HHS health information technology standards, where possible. For more information, visit http://www.aafp.org/news-now/government-medicine/20071128fcctelemedicine.html or the RHCPP Web site at http://www.fcc.gov/cgb/rural/rhcp.html.

Organizations Join Campaign Aimed at Making Health Care More Affordable

The AAFP and several other organizations, including the National Federation of Independent Business, have recently joined the Divided We Fail campaign. The campaign is focused on making access to affordable health care and long-term financial security for patients key issues in the 2008 elections. The AARP in conjunction with the Business Roundtable and Service Employees International Union launched the campaign in early 2007. AAFP President Jim King, MD, Selmer, Tenn., says that the health care system needs to change, and the Academy will work with any organization that shares the goal of making sure all Americans have access to adequate health care. The campaign will promote affordable health care through paid advertisements running in radio, television, and print outlets. Presidential candidates will also be encouraged to form a coalition to create a plan for resolving issues related to health care affordability and long-term financial security. For more information, visit http://www.aafp.org/news-now/government-medicine/20071127aarpdwf.html or the Divided We Fail Web site at http://www.aarp.org/issues/dividedwefail.

Speaker Says Primary Care is an Important Component in Reducing Cancer Mortality

During his keynote address at AAFP's 2007 State Legislative Conference in November, past American Cancer Society (ACS) president Richard Wender, MD, cited access to primary care as one of three factors that has contributed to a reduction in cancer mortality. According to an ACS report, cancer deaths declined by about 1 percent per year from 1990 to 2002, and the decline accelerated to 2.1 percent per year by 2006. Citing a report by The Commonwealth Fund that showed that a regular source of primary care improves care at a lower cost, Wender emphasized that access to primary care in combination with prevention and early detection is important in achieving ACS cancer goals. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20071204wenderstateleg.html or http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=506814.

FDA Public Forum on Behind-the-Counter Drug Access Receives High Level of Interest

The Federal Food and Drug Administration's (FDA's) call for comments about the possibility of dispensing some prescription medications from behind pharmacy counters with the supervision of the pharmacist has been met with high interest. Because of the level of interest on the issue, the FDA extended the original November deadline to submit comments to mid-December. The American Pharmacists Association, along with more than 30 other pharmacy groups, spoke out in support of behind-the-counter access during a public meeting in November. However, the AAFP and the American Medical Association (AMA) argue that it would create safety concerns and interfere with the physician-patient relationship. The FDA public forum is aimed at soliciting views on specific issues associated with behind-the-counter availability, including its impact on patient access to safe and effective medications and products. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20071203fdabtcextended.html or the FDA Web site at http://www.fda.gov/oc/op/btc.

Organization Urges State Governments to Adopt Medical Home Pilot Projects

The Council of State Governments (CSG) has approved a resolution that encourages its members to support the Joint Principles of the Patient-Centered Medical Home (www.acponline.org/hpp/approve_jp.pdf) and to implement pilot programs to demonstrate the value of the new model of care. The resolution is based on principles developed by the AAFP, American Academy of Pediatrics, American College of Physicians, and the American Osteopathic Association, and on the work of the Patient-Centered Primary Care Collaborative. Materials outlining the resolution will be sent to governors and state legislative leaders, creating an opportunity for health care reform at the state level. The CSG represents all branches of state government, giving the resolution added weight. Supporting documents that will accompany the resolution sent to state leaders emphasizes the importance of the family physician in patient-centered medical homes. For more information, visit http://www.aafp.org/news-now/government-medicine/20071128csgresolution.html or the CSG Web site at http://www.csg.org.

AMA to Explore Barriers to Residents Choosing the Primary Care Specialty

In a recently adopted substitute resolution, AMA delegates call on the AMA to study barriers to primary care medicine as a career choice and how these barriers impact the medical profession and access to health care. This resolution replaces the original resolution, which addressed how inadequate primary care reimbursement impacts medical students' career choices. The new resolution includes the examination of all barriers, not just inadequate payment. The new wording was approved after the original resolution prompted debate among subspecialty delegates. The study findings and a plan of action will be presented at the 2008 AMA interim meeting. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20071205ama-primcare.html.

AFP and AAFP NEWS NOW staff

For more news, visit AAFP News Now at http://www.aafp.org/news-now.



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