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Tuesday Dec 06, 2016

AAFP to Congress: Hands Off USPSTF

Last week, AAFP President John Meigs, M.D., testified before the House Energy and Commerce Committee Subcommittee on Health in defense of the U.S. Preventive Services Task Force(www.uspreventiveservicestaskforce.org) (USPSTF). 

The hearing was scheduled to examine the task force and discuss the USPSTF Transparency and Accountability Act (HR 1151), legislation that would alter the composition and scope of work of the task force. Meigs was invited to share the AAFP's views on the USPSTF and the important role it plays in assisting family physicians in their daily interactions with patients. 

The AAFP is a strong supporter of the task force and is an active participant in its work. The Academy actively engages with the task force to identify and evaluate clinical guidelines to ensure that family physicians have the most timely and relevant information to assist them in the care of their patients. The AAFP's clinical recommendations typically align with recommendations made by the task force.

In his testimony, Meigs outlined our strong support for the USPSTF and its existing composition.

"My work and that of hundreds of thousands of primary care physicians relies on the integrity of the U.S. Preventive Services Task Force (USPSTF or the task force)," he said. "The task force was designed to be, and has been, a non-partisan, independent body of physicians and other health professionals who make valuable recommendations for primary care. Many recommendations within H.R. 1151, the USPSTF Transparency and Accountability Act, in our opinion, would undermine the work and progress that has been achieved since the task force was established in the early 1980s."

In recent years, the task force and its recommendations have faced increased political scrutiny. Although some of this scrutiny was in response to recommendations made by the task force (specifically related to mammography and prostate cancer screening), the more significant attention came about as a result of Section 1302(www.cms.gov) of the Patient Protection and Affordable Care Act(www.hhs.gov). Section 1302 of the ACA requires all insurers (public and private) to provide preventive services that receive an A or B grade from the USPSTF and vaccination recommendations from the CDC's Advisory Committee on Immunization Practices independent of patient cost-sharing (co-pay and deductible).

The AAFP has policy supporting this provision, but recognizes that the inclusion of the coverage provisions in the ACA changed the impact of the work for the task force and elevated its significance in the eyes of many in the health care industry.

HR 1151 would make four significant changes:

  • alter the composition of the task force to include subspecialists;
  • allow representation and participation by the broader health care industry, including pharmaceutical and medical device companies;
  • require that the task force to assess how its grades would impact access to a health care service or device; and
  • require that the task force publish its research plan, including the analytic framework, key questions and literature search strategy.

Although HR 1151 will not advance in the current Congress, it likely will be re-introduced in the 115th Congress. The AAFP will continue to support the task force, its work and its recommendations. We also will aggressively oppose efforts to diminish the task force's work. 

The USPSTF, created in 1984, is a panel of national experts in prevention, epidemiology and evidence-based medicine. These experts include family physicians and other primary care physicians. The task force is charged with making evidence-based recommendations about clinical preventive services such as screening exams and preventive medications. The task force gives each recommendation a grade of A, B, C, or D or an I Statement based on the strength of the evidence considered during the rigorous review of evidence.  The recommendations are applicable to individuals who do not demonstrate signs or symptoms of the specific disease or condition under evaluation and only apply to services provided by primary care physicians. The recommendations are not designed to prohibit or restrict patient access to any preventive service.

Presidential Transition Update
In recent days, President-elect Trump has begun announcing nominees for key post in his administration. These nominations have spurred a flurry of reactions -- positive and negative -- from individuals across the nation, including family physicians. In my previous post, I discussed the impact of the elections and the AAFP's approach to working with the Trump Administration and the incoming 115th Congress. I would like to build on my previous post and offer some additional perspective on how the AAFP can best represent our members and advocate on behalf of our patients.

The AAFP is a professional organization that has the tremendous honor and obligation of representing the nation's family physicians and, more importantly, being an advocate for patients. The AAFP has been and remains a bi-partisan organization. We are an organization grounded in a set of core beliefs that each individual, regardless of their personal or economic situation, deserves access to affordable and quality health care. We are guided by our strategic plan and policies adopted by our Congress of Delegates. Although elections and politicians come and go, the AAFP's steadfast commitment to these fundamental objectives remains constant. 

Elections, by design, create disruption. This disruption contributes to a sense of uncertainty about what is to come and what is to be expected of new leaders. This is why it is important to be grounded as an organization. The AAFPs inclusive and comprehensive set of policies allow us to advance our mission and advocate for our members with any individual, regardless of their party affiliation or ideology. These same policies also allow the AAFP to hold elected officials accountable for their decisions and actions.

It would be a disservice to our members and their patients to not engage with an individual or political party simply because they hold or have advanced a point of view contrary to ours. Our job is to advocate on behalf of family medicine and patients, to the best of our ability, with all elected officials. We are a professional organization that feeds on the passion and commitment of our current and future members, while looking to our Board of Directors and professional staff to harness that passion and advance our goals and mission. 

There is a professional standard that guides how an organization such as the AAFP should conduct itself. This includes an effort to adhere to respectful dialogue on issues and representing our organization and members in a reputable manner at all times.

Although we all have our personal opinions on the various individuals who serve in government, it is important to remind ourselves that we all share a set of common goals for family medicine and patients. Now is the time to rally around those goals and objectives that unite us.  To this end, I urge you to engage with the AAFP to advocate for our profession and our patients. The best way to do this is by joining the Family Physician Action Network.  

Posted at 07:00AM Dec 06, 2016 by Shawn Martin

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ABOUT THE AUTHOR



Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.