Graham Center Policy One-Pagers

These reports offer succinct summaries of research and perspectives pertinent to family practice advocacy and are produced by the Robert Graham Center: Policy Studies in Family Medicine and Primary Care in Washington, DC.

Sep 15, 2015 Issue
Family Physicians Contribute Significantly to Emergency Care of Medicare Patients in Urban and Suburban Areas
Rural populations rely on physicians trained in primary care to provide emergency services. Less is known about primary care’s contribution to emergency services in urban and suburban settings. Two-thirds of family medicine and three-fourths of general internal medicine Medicare claims for emergency care are generated in urban settings, demonstrating primary care’s significant contribution to the emergency workforce in the most populated areas.

Aug 1, 2015 Issue
Primary Care Physicians Are More Likely to Participate in Medicare EHR Incentives than Other Eligible Physicians
Family medicine and general internal medicine physicians are more likely to participate in the Medicare electronic health record (EHR) incentive program compared with other subspecialties, after accounting for Medicare income and other factors. These findings support the continuation of incentive programs that assist physicians in the meaningful use of EHR technology.

Jun 1, 2015 Issue
Osteopathic Schools Are Producing More Graduates, But Fewer Are Practicing in Primary Care
The expansion of osteopathic medical schools was to be a boon for underserved areas in need of primary care service. However, the impact has thus far been diminished by the decrease in osteopathic graduates engaged in primary care practice. Policy makers and leaders should consider strategies for maintaining a proud tradition of primary care production in a time of looming primary care physician shortage.

Jun 1, 2015 Issue
Shifting Sources of U.S. Primary Care Physicians
Trends in the composition of the primary care physician workforce since 2000 show a declining proportion of U.S. allopathic physicians, and increasing proportions of U.S. osteopath physicians and both U.S.-born and foreign-born international graduates.

Apr 1, 2015 Issue
Smaller Practices Are Less Likely to Report PCMH Certification
Despite efforts to achieve broad transformation of primary care practices into patient-centered medical homes (PCMHs), certification rates have lagged in small and solo practices. The challenges these groups face with the transformation and certification processes should be addressed to continue national momentum toward reshaping the nation's primary care platform.

Feb 1, 2015 Issue
Teaching Health Center GME Funding Instability Threatens Program Viability
The Teaching Health Center Graduate Medical Education (THCGME) program, funded since 2011 and set to expire in 2015, has increased the numbers of primary care physicians and dentists training to care for under-served populations nationwide. Without continued federal funding, most of these THCs report that they would be unlikely to continue current residency recruitment and enrollment, threatening the initial program investments and even the viability of the program itself.

Jan 1, 2015 Issue
Opting Out of Medicaid Expansion May Cost States Additional Primary Care Physicians
States currently electing not to expand Medicaid possibly forego the opportunity to expand their primary care workforces by a total of 1,525 physicians. Increased demand from expansion states and a limited primary care physician pool may provide a pull across state lines to the disadvantage of nonexpansion states.

Dec 1, 2014 Issue
Accounting for Complexity: Aligning Current Payment Models with the Breadth of Care by Different Specialties
Family physicians provide care for a wider range of conditions than do most specialists, introducing a high level of complexity into their practice. Historic assumptions associating complexity with the intensity, skill, and training required to accommodate a single task fail to capture the complexity of identifying and managing many interacting conditions. Payers and policy makers should recognize this dimension of complexity in care and revisit payment criteria.

Aug 15, 2014 Issue
The Continued Importance of Small Practices in the Primary Care Landscape
In 2010, as many as 45% of active primary care physicians (PCPs) were practicing at sites with five or fewer physicians. This large cohort of practices faces unique challenges in meeting the increasing demands of practice transformation, payer reporting requirements, and integrated delivery that merit policy maker and payer attention.

Jul 15, 2014 Issue
Family Medicine Residents: Increasingly Diverse, but Lagging Behind Underrepresented Minority Population Trends
Increasing racial and ethnic diversity in the U.S. population has not been fully realized in the physician workforce. Family physicians, the most widely distributed of the physician specialties, are on the front line of a physician trend toward greater racial and ethnic diversity over the past two decades, but residents still lag behind national growth in the underrepresented minority population.

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