Federal investment in health care is necessary to "transform health care to achieve optimal, cost-efficient health for everyone," said the AAFP in recent written testimony(4 page PDF) to the House Appropriations Committee. That is why the Academy is urging the committee to make a robust investment in the nation's primary care physician workforce by financially supporting programs critical to building and strengthening the nation's primary care physician pipeline.
"We recognize the difficult decisions (that) our nation's budgetary pressures present," said the AAFP. However, the Academy urged the House Appropriations Subcommittee on Labor, Health and Human Services, and Education "to make a robust fiscal year 2012 investment in our nation's primary care physician workforce ... to ensure that it is adequate to provide efficient, effective health care delivery addressing access, quality and value."
Specifically, the Academy called on the committee to provide at least $449.5 million for training programs covered by Title VII of the Public Health Service Act and administered by the Health Resources and Services Administration, including at least
- $140 million for primary care training and enhancement as authorized by Title VII, Section 747, of the Public Health Service Act;
- $10 million for development grants for teaching health centers; and
- $4 million for rural physician training grants.
Failure to provide adequate funding for Title VII programs "would destabilize ongoing efforts to increase education and training support for family physicians, exacerbating primary care shortages and further straining the nation's health care system," said the AAFP.
"We urge the committee to increase the level of federal funding for primary care training to reinvigorate medical education (and) residency programs, as well as academic and faculty development in primary care to prepare physicians to support the patient-centered medical home."
The AAFP called for other funding increases, as well, including President Obama's requested funding of $418.5 million for the National Health Services Corps and at least $405 million for the Agency for Healthcare Research and Quality, or AHRQ.
"AHRQ's investment in patient-centered outcomes research will help Americans make the informed decisions we must make to focus on paying for quality rather than quantity," said the AAFP. "By determining what has limited efficacy or does not work, this important research can spare patients from tests and treatments of little value."
Among other programs that are critical to the primary care physician pipeline, according to the AAFP, is the teaching health center program, which provides resources to qualified, community-based, ambulatory care settings that operate as primary care residency programs. These settings include federally qualified health centers, rural health clinics, community mental health centers, health centers operated by the Indian Health Service and centers that receive Title X grants.
In addition, the Academy continues to call for reforms to graduate medical education programs that encourage training of primary care residents in nonhospital settings, which is where most primary care is delivered.
"We were pleased that the Patient Protection and Affordable Care Act authorized a mandatory appropriations trust fund of $230 million over five years to fund the operations of teaching health centers," the AAFP said. "However, if this program is to be effective, there must be funds for the planning grants to establish newly accredited or expanded primary care residency programs."
The Academy also addressed rural health needs in its testimony. For example, the Rural Physician Training Grants Program helps medical schools recruit students who are more likely to practice medicine in rural communities. "This modest program ... will help provide rural-focused training and experience and increase the number of recent medical school graduates who practice in underserved rural communities," the AAFP said.