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Tuesday Jul 19, 2016

No Summer Break for AAFP Advocacy Efforts

"Summer, summer, summertime. Time to sit back and unwind."
-- The Fresh Prince, aka Will Smith


Summer is officially in full swing. The United States recently celebrated its 240th birthday. A new class of family medicine residents started their training, Major League Baseball held its All-Star Game, and last week Congress wrapped up its work for the first half of 2016 before adjourning for a seven-week summer recess.  

I know that each of you do not get a seven-week summer vacation, but I do hope your summer is off to a good start. I thought this would be a good time to provide an update on a variety of issues, so let’s get to it.

First, some important updates from the sports world. The Washington Nationals are leading the National League East, the Kansas City Royals are a mere seven games back in the American League Central, we are 40 days from the opening weekend of college football, and the Summer Olympics kick-off in less than 20 days. 

Now, on to some more substantive issues.

Kevin J. Burke
I want to start this post by congratulating Mr. Kevin Burke on his upcoming retirement. For the past 15 years, Kevin has served as the AAFP’s Director of Government Relations. During his tenure, he has led the AAFP’s advocacy work with professionalism and distinction. His accomplishments are many, but his leadership on health care reform and tobacco regulations are two that are especially worth recognizing. I also would note that Kevin guided the AAFP through the tumultuous years of the sustainable growth rate and was a key figure in the successful effort to repeal the SGR last year. Kevin will be missed, but his contributions to the AAFP and family medicine will live on. 

2016 Presidential Elections
We are 112 days from Election Day. On Nov. 8, we will elect a new president. This week the Republican National Committee has convened in Cleveland to nominate Donald Trump(www.donaldjtrump.com), and the Democratic National Committee will convene next week in Philadelphia to nominate Secretary Hillary Clinton(www.hillaryclinton.com). The presidential race is officially underway and, regardless of your political persuasion, this is going to be an interesting campaign to watch. The first presidential debate(www.debates.org) will take place on Monday, Sept. 26 at Wright State University (home court of our friend and AAFP Board member Gary LeRoy, M.D.). Subsequent debates will be held Oct. 4 (Vice Presidential candidates), Oct. 9, and Oct. 19.  

MACRA and the Comprehensive Primary Care Plus Program
Most of you are familiar with our work on the Medicare Access and CHIP Reauthorization Act (MACRA) and the comprehensive set of comments and recommendations we sent to CMS on its proposed regulation.

I hope you are also aware of the forthcoming Comprehensive Primary Care Plus(innovation.cms.gov) program, which not only provides new and improved payments to primary care physicians, but it also is recognized as an Advanced Alternative Payment Model (Advanced APM) under MACRA. We anticipate that the CPC+ states and regions will be announced soon, and we are aggressively recruiting family physicians to participate.

To assist you in the preparation and applications process, we have partnered with Caravan Health. The resources available from Caravan Health are a member benefit, and I strongly urge you to take advantage of this opportunity. Even if you do not participate in the CPC+ program, these resources will greatly assist your practice as you prepare for MACRA. I know that I am starting to resemble a carnival barker, but I encourage each of you to take advantage of these resources by engaging with the AAFP at cpcplus@aafp.org.

Prescription Drug Abuse
The issue of prescription drug abuse and diversion has dominated the national health policy debate for the past six months, and the AAFP has been front and center. On Oct. 21, AAFP President Wanda Filer, M.D., M.B.A., joined President Obama and HHS Secretary Sylvia Burwell at a meeting in Charleston, W.Va., where the President called on the nation to address the opioid and prescription drug abuse epidemic stating, "This crisis is taking lives. It's destroying families. It's shattering communities all across the country."

Prior to the West Virginia meeting the AAFP laid out a set of steps we would take to work with our members to address the epidemic. Part of our pledge to the White House was our commitment to creating new and more advanced education and practice resource tools, which we have done through free-to-members CME offerings and the AAFP’s new opioid toolkit

On May 20, Filer issued a call to action to all family physicians.  She outlined the important role family physicians play in treating pain, but also treating addiction. She also called on family physicians to do more, stating that "We all need to do our part to end this epidemic."

Filer also took this message to policy-makers and the public through a similar posting in The Hill(thehill.com).

Both the House and Senate have approved the Comprehensive Addiction and Recovery Act(www.govtrack.us) (CARA) (S. 524) and the legislation is pending the President's signature. CARA, while not as comprehensive as the AAFP would have liked, does include numerous important provisions. The AAFP will be working aggressively during the appropriations process to ensure that the programs established by CARA receive funding. Much more to come on this issue, but the passage of CARA is a good step.

For more information on available resources and tools, please visit the AAFP’s pain management and opioid abuse resources page.

Mental Health
The issue of mental health continues to occupy a prominent position in the national health care debate, but it appears that momentum for federal legislation may be slipping. The House of Representatives did pass the Helping Families In Mental Health Crisis Act(www.govtrack.us) (H.R. 2646) on July 6 in an overwhelming bipartisan vote of 422-2. Despite this strong showing in the House, Senate politics seem to have the upper hand at the present time. It remains possible for the issue to remerge in the fall, but I predict mental health will slip until the 115th Congress convenes in 2017.

Posted at 07:00AM Jul 19, 2016 by Shawn Martin

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

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