AAFP News Now: AFP Edition
Policy and Health Issues in the News
Am Fam Physician. 2009 Mar 15;79(6):443-444.
Economic Stimulus Package Provides Funding for Primary Care and HIT
A $789.5 billion stimulus package designed to boost the U.S. economy was recently signed into effect by President Obama. The American Recovery and Reinvestment Act of 2009 includes substantial investments in an array of health-related programs and provisions, such as health information technology (HIT), education and training for primary care physicians, and comparative effectiveness research. The measure allocates $19 billion for HIT, which is divided into $17 billion in incentives for Medicare and Medicaid providers to adopt HIT, and $2 billion in immediate funding for the country’s HIT infrastructure. The stimulus package also allocates $500 million in funding for health care workforce programs, including primary care training grants, which have historically been underfunded. Additionally, the measure provides $1.1 billion for clinical research to be divided among the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services (HHS), and the National Institutes of Health. American Academy of Family Physicians (AAFP) President Ted Epperly, MD, Boise, Idaho, said the stimulus package represents an acknowledgement by Congress and the Obama administration that sustained economic growth depends on a well-functioning health care system. For more information, visit http://www.aafp.org/news-now/government-medicine/20090213stimulus-passes.html.
U.S. Federal Claims Court Finds No Link Between Vaccines and Autism
Three federal judges have ruled in three separate cases that there is no association between vaccines and autism. Although the February 12, 2009, rulings were decided in favor of immunization proponents, lawyers for the plaintiffs have indicated they will appeal. More than 5,500 cases alleging that vaccines cause autism have been filed with the National Vaccine Injury Compensation Program. Immunization opponents argue that the measles, mumps, and rubella (MMR) vaccine and thimerosal-containing vaccines can combine to cause autism. They also argue that thimerosal-containing vaccines alone can cause autism and that the MMR vaccine without thimerosal can cause autism. In his ruling, one of the three judges wrote that the respondent’s expert witnesses were far more qualified, experienced, and persuasive than the petitioners’ experts. Family physician Jonathan Temte, MD, PhD, who serves as a member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, hopes the rulings will ease people’s minds at a time when more parents are choosing to withhold or delay childhood vaccinations. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20090218vacc-cases.html or the U.S. Court of Federal Claims Web site at http://www.uscfc.uscourts.gov/node/5026.
Proposed FDA Bill Aims to Generate Revenue, Strengthen Regulatory Authority
Rep. John Dingell, D-Mich., has reintroduced the U.S. Food and Drug Administration (FDA) Globalization Act of 2009. The legislation, which is pending in the House Energy and Commerce Committee, would require domestic and foreign pharmaceutical and device companies that ship products into the United States to register with the FDA. The legislation would also require companies to pay a registration fee to cover the cost of drug and device inspections, and to provide country-of-origin labeling on their products. The fees would generate additional revenue to help the FDA hire more personnel and increase the number of inspections. Dingell believes the FDA lacks the resources to adequately protect the public against contaminated food and pharmaceutical products, as demonstrated by the recent outbreak of salmonellosis from contaminated peanut products. For more information, visit http://www.aafp.org/news-now/government-medicine/20090217fda-bill.html.
AAFP Expresses Concerns About Revised Physician Payments Sunshine Act
The AAFP is calling for changes to a revised version of the Physician Payments Sunshine Act of 2009, which addresses gifts to physicians from pharmaceutical companies and device manufacturers. The current version of the bill would require pharmaceutical companies and device manufacturers to report any gifts made to physicians of more than $100. The previous version of the bill called for reporting gifts of more than $500. In the revised bill, every payment made to physicians must be included in the aggregate calculation of reportable events. All gifts and reportable items would be posted online and available to the public. The revised bill also classifies dozens of items as gifts, including consulting fees, honoraria, entertainment, education, research, and compensation for serving as a faculty member or speaker for continuing medical education programs. Although AAFP President Ted Epperly, MD, agrees with the overall intent of the bill, he believes that lowering the threshold to $100 could discourage physicians from participating in continuing medical education activities and would create an inordinate amount of paperwork. For more information, visit http://www.aafp.org/news-now/professional-issues/20090209sunshine-act.html.
Study Reveals Shortage of Emergency Physicians in U.S. Emergency Departments
The number of board-certified emergency physicians is unlikely to meet the future staffing needs of U.S. emergency departments, according to a study in the December 2008 issue of Academic Emergency Medicine. The study analyzed data from the 2005 National Emergency Department Inventory-USA on 4,828 emergency departments in the United States. In 2005, there were approximately 22,000 board-certified emergency physicians with another 1,250 expected to enter the workforce the next year. The authors concluded that this number would meet only 55 percent of the current emergency physician demand. Perry Pugno, MD, MPH, director of the AAFP division of medical education and a physician workforce expert, is confident that family physicians are well-prepared to practice in the emergency department and fill these shortages. Although they may need more training in critical care procedures and new diagnostic tools, Pugno said family physicians are already working well in suburban and rural emergency departments. For more information, visit http://www.aafp.org/news-now/professional-issues/20090211emerg-report.html or the Academic Emergency Medicine study at http://www.emnet-usa.org/articles/Camargo_AcadEM_2008.pdf.
AAFP News Now Features Special Report on the Patient-Centered Medical Home
AAFP News Now recently unveiled a special report on the patient-centered medical home. The online resource includes a collection of feature articles, audio and video presentations, and profiles of physicians who share their experiences with the medical home model. The feature articles address a variety of issues related to the medical home, including how the model can improve clinical care, and how residency programs are incorporating the model into their curriculum. For more information, visit http://www.aafp.org/online/en/home/publications/news/news-now/pcmh.html.
New Jersey Pilot Program Helps Practices Become Patient-Centered Medical Homes
The New Jersey Academy of Family Physicians and Horizon Blue Cross Blue Shield of New Jersey have launched a one-year pilot project for physicians who want to transform their practices into patient-centered medical homes. Participating practices will take part in a three-month course to walk them through elements of the medical home model, and to receive recognition as a level one or level two medical home from the National Committee for Quality Assurance recognition program. Each practice will be required to use an electronic health record system to manage patient care and track outcomes. Horizon will pay practices a per-member, per-month fee for managing the care of patients with diabetes. For more information, visit http://www.aafp.org/news-now/practice-management/20090211njafp-transform.html.
New Guide Assists AAFP Members with Insurers’ Physician Assessment Programs
The AAFP has developed a free resource for members who are struggling with a health insurer’s tired network, report card, or quality and efficiency ratings. The “AAFP Members’ Guide to Physician Assessment Programs” is presented in a question-and-answer format to help physicians understand how measurement and reporting programs work. Some of the questions address why health plans do not use a single set of standards; who endorses the performance measures; and which data sources health plans use to measure physician performance. The 29-question guide also instructs physicians on how to validate their data and appeal their assessment reports. For more information, visit http://www.aafp.org/news-now/inside-aafp/20090218phys-assess-guide.html.
Online Library Provides Up-to-Date Health Care Workforce Information
A new centralized online library can help physicians stay abreast of health care workforce changes and health personnel shortages. The Health Workforce Information Center (HWIC) aims to assist health professionals in developing strategies to meet future workforce demands. The online center provides up-to-date information on workforce programs and funding sources; workforce data, research, and policy; educational opportunities and models; and workforce-related news and events. HWIC is funded by the Bureau of Health Professionals in the HHS Health Resources and Services Administration, and is operated by the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences in Grand Forks. For more information, visit http://www.aafp.org/news-now/professional-issues/20090220hrsa-wrkfrc-lib.html or the HWIC Web site at http://www.healthworkforceinfo.org/.
— AFP and AAFP NEWS NOW staff
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