March 2003 • Volume 9 • Number 3 |
BY JANE STOEVER
The four-months-late federal budget for 2003 contains three major victories for family practice and the Academy -- a Medicare physician fee increase (instead of decrease), funding for family practice training at about the 2002 level (instead of no funds), and a moderate increase for the Agency for Healthcare Research and Quality.
| James Martin, M.D. "The good news from Congress and the White House proves this: Political activism rather than local complaining can help us achieve our goals." |
Medicare payments for this year are up 1.6 percent (compared with the expected 4.4 percent cut), a change provided in the omnibus budget bill Congress adopted Feb. 13 and the president signed soon thereafter. The Academy and other medical groups had vigorously lobbied for fairer reimbursement.
"The AAFP commends the U.S. Congress for helping patients and physicians by passing provisions addressing the cuts in Medicare reimbursements for health care services for seniors," said AAFP President James Martin, M.D., of San Antonio in a news statement Feb. 14.
"We appreciate that our elected officials listened to the many family physicians and patients across the country who visited and called congressional offices to discuss this key health care problem," he said.
In addition to visits and calls, family physicians inundated lawmakers with e-mails. Medicare payments in 2002 plummeted 5.4 percent, a drop announced in fall 2001. Between Nov. 1, 2001, and Feb. 3, 2003, family physicians, patients and chapter executives sent Congress 15,103 e-mails on the topic via AAFP's Speak Out: Legislative Action Center.
"Having many thousands of family physicians respond to Congress on this issue shows the power and influence we can have as our lawmakers' constituents," said Martin.
Congress addressed the Medicare fee slippage for 2003 by giving the Centers for Medicare & Medicaid Services authority to correct projection errors made in 1998 and 1999. Effective March 1, 2003, this expected correction by CMS should yield a 1.6 percent increase in Medicare payments.
Title VII, AHRQ
The exact funding amount for family practice training programs in 2003 -- provided through the Public Health Service Act, Title VII, Section 747 -- was not known at press time, but the section as a whole received funding at about the 2002 level of $93 million.
Section 747 covers the primary care cluster, including training for family physicians, dentists and physician assistants. The administration's proposed budget for 2003 had called for zero funds for Section 747 (as does the 2004 proposed budget -- see the rest of this story).
The 2003 budget allows an increase of about 1.6 percent in funding for the Agency for Healthcare Research and Quality, the only federal agency charged with promoting research in primary care. The budget amount for AHRQ this year is about $302 million.
2004 budget proposal
Switch gears to the 2004 budget proposal from the White House. As did the 2003 budget plan, the 2004 proposal slates no funds for Section 747. However, it calls for strengthening community health centers and the National Health Service Corps and for diversifying the health care workforce.
Half of the physicians in community health centers are family physicians, said Martin in a news release last month. "We need to get the administration to recognize the role family doctors play in working in those centers." He added that Section 747 funding has helped create diversity in the workforce.
On the up side, however, the president's 2004 budget plan addresses the need for fair Medicare reimbursement. The document notes, "This budget proposes to adjust the formula to use actual data instead of estimates in current and previous updates. This would result in higher updates for the next several years."
According to staff in the AAFP Division of Government Relations, physicians and their medical societies put pressure on Congress, the Centers for Medicare & Medicaid Services, and HHS. Then the White House agreed to seek a solution.
"The good news from Congress and the White House proves this: Political activism rather than local complaining can help us achieve our goals," said Martin in an interview last month. "This is what it takes to continue serving our Medicare patients and to improve the practice environment for family doctors."
To reach writer Jane Stoever, e-mail jstoever@aafp.org.
FP Report is published by the
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Copyright © 2003 by
American Academy of Family Physicians.