Patients Are Paramount, AAFP Tells FTC

Academy Shares Concerns About Rising Anticompetitive Behavior in Health Care

May 14, 2014 03:28 pm News Staff

The AAFP recently urged the Federal Trade Commission (FTC) to be mindful of patient safety issues when considering policy recommendations related to increasing competition in health care. That was the overarching message conveyed in an April 28 letter to the agency.

Recent increases in hospital and health system mergers are cause for concern, says the AAFP in a letter to the Federal Trade Commission.

The commission, which is an independent regulatory agency, has sought comments(www.gpo.gov) in recent months on issues related to competition in various segments of the health care sector. In March, the commission hosted a public workshop to examine competition in this sector, with an eye toward exploring whether increased competition would pay off in lower costs to consumers.

One of numerous questions the FTC put forward for comment concerned professional regulation of health care professionals, "particularly with respect to accreditation, credentialing, licensure and supervision/cooperation requirements." The agency further sought to explore whether such professional regulations might "unnecessarily restrict" the scope of practice of nonphysician providers.

The AAFP also wrote a letter to the commission in March, noting that "professional regulations at the state and federal level are designed to assure the competency of those individuals providing health care services to patients and to protect the safety of individuals seeking health care services."

Story highlights
  • The AAFP urged the Federal Trade Commission (FTC) in a recent letter to be mindful of patient safety issues when considering policy recommendations that could increase competition in health care.
  • The FTC has sought comments in recent months on issues related to competition in various parts of the health care sector.
  • The Academy urged the FTC to focus on a disturbing increase in hospital and health system mergers, as well as other activities that limit patient choice and raise costs.

"While competition is important and serves as a tool to increase the availability and affordability of services, we do not think access to health care services that may be unsafe or potentially harmful should be expanded to achieve greater competition," the letter stated.

In its most recent letter to FTC Chairwoman Edith Ramirez, the AAFP reiterated its concerns about potential changes to medical professional regulations and how such changes might affect patient safety.

"We continue to assert that applicable professional state and federal regulations already exist and they continue to assure the clinical competency of physicians and, thereby, protect the safety of patients receiving health care services," read the April letter, which detailed the lengthy process of educating and training physicians and referenced their commitment to continuing professional development. "Not all allied health professionals are required to complete equally vigorous training and education requirements to obtain health care-related degrees."

Physicians' extensive training and longitudinal relationships with patients uniquely position them to lead patient care teams that include other health care professionals practicing in their respective roles, said the AAFP.

Therefore, even taking into account the costs associated with training, accrediting, credentialing and licensing physicians, as well as the current and future shortage of primary care providers, "We do not support policy changes at the federal or state level that potentially promote access to health care services that may be unsafe or potentially harmful," the letter stated.

Rather, the role of allied health professionals in patient care should be defined more clearly, said the Academy, and they should be fully integrated into patient care teams "that allow each practitioner to provide care that is safe and appropriate based on the professional's education and training."

"All health professionals, physicians and nonphysicians alike, must work to improve the effectiveness of team-based care models, and jettison fragmented models of care that impede medical professionals from working together for the betterment of the patient," the AAFP noted.

In its letter, the Academy also encouraged the FTC to focus on other pressing issues that influence quality of care, such as "exposing the troubling increase in mergers between hospitals and health systems that increase costs, decrease competition, and fuel an uncoordinated race to provide expensive advanced medical technology and high-cost procedures."

Large insurers are expanding their reach in several markets, and their influence is increasing with their growing involvement in the insurance exchanges established by the Patient Protection and Affordable Care Act, the letter pointed out. "Our principal concern is with the consolidation and expansion of plans offered, which allow insurers to narrow their networks by contracting only with those physicians who are willing to accept the lowest levels of payments for their services." Such actions threaten quality of care and restrict choice for many patients, according to the AAFP.

Beyond consolidation of insurance companies and health system mergers, the AAFP also expressed concern about anticompetitive practices in the health information technology industry. The lack of interoperability among software products provided by different vendors, for example, "makes it practically infeasible for a physician practice to switch electronic health records should the vendor or health care community use anticompetitive methods to limit a practice's access to needed health information on their patients."

"This hoarding of data negatively impacts care and distorts market forces trying to decrease health care costs and improve quality," the Academy stated. "It is critical that health data flow to where patients wish to be treated."


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