House Members Offer Support for Primary Care Issues

March 02, 2015 01:46 pm Michael Laff Washington, D.C. –

Members of Congress may be battling among themselves over health care policy, but lawmakers on both sides of the aisle continue to express strong support for primary care and expanded access for patients in need.

AAFP Board Chair Reid Blackwelder, M.D., introduces Rep. Diane Black, R-Tenn., during a meeting with AAFP leaders. Black spoke about Congress' latest payment patch to avoid pay cuts mandated by the sustainable growth rate. "I don't think we'll have a solution by March 31st," she said, referring to when the patch expires, "but I do believe it will happen this year."

AAFP Board members met with Reps. Diane Black, R-Tenn., and Gene Green, D-Texas, who discussed their current health policy initiatives.

Black, who is trained as a nurse, covered a range of issues, including electronic health records (EHRs), telemedicine, coordination of care, the state of accountable care organizations (ACOs) and prospects for repealing the Medicare sustainable growth rate (SGR) used to calculate physician payment.

For more than 10 years, the House and Senate have adopted temporary measures, often called "doc fixes," to avoid major cuts in Medicare payments called for by the SGR, but the law itself remains intact.

Black said House leaders, including Speaker John Boehner, R-Ohio, and Deputy Whip Kevin Brady, R-Texas, are committed to repealing the SGR. The one-year patch that Congress passed in 2014 to avert scheduled cuts to physician payment is set to expire on March 31.

"I don't think we'll have a solution by March 31st, but I do believe it will happen this year," Black said.

Story highlights
  • AAFP Board members were in the nation's capital to visit with lawmakers and discuss major primary care issues.
  • Two House lawmakers spoke about prospects for repealing the Medicare sustainable growth rate.
  • One legislator told AAFP she will introduce legislation to permit Medicare to pay for telemedicine visits.

She said bipartisan support for SGR repeal continues. The remaining hurdle is identifying a method to pay for it without asking seniors to shoulder the costs or health care institutions to accept reductions.

"A $151 billion hole is difficult to fill," Black said, referring to the estimated cost for SGR repeal. "We have to find another way to pay for it without hitting the health care industry with more cuts."

AAFP Board Chair Reid Blackwelder, M.D., of Kingsport, Tenn., told AAFP News he was encouraged by Black's comments. "Because of her background, she has shown long-standing support for primary care," he said.

Still, said Blackwelder, physicians need to continue to push for SGR repeal through visits to the Capitol and emails to their legislators' offices.

"This is the first time ever that we've had bipartisan support. The next step is payment," he said. "We have to continue to wave the flag. If we're not willing to step forward, then it will not be seen as the priority it needs to be."

Black covered other key issues during her remarks, saying, for example, that she plans to introduce legislation to change Medicare ACOs -- primarily, the administrative costs associated with their implementation.

"ACOs are showing some progress, and they have a future," Black said. "But they are too expensive to set up and the risk versus reward is really skewed."

From left, Rep. Gene Green, D-Texas, shares a comment with AAFP President Robert Wergin, M.D., and Board Chair Reid Blackwelder, M.D. In his comments, Green addressed problems his constituents have accessing primary care and the need to train the next generation of family physicians.

Black also said she will push for Medicare Advantage programs to pay for telemedicine visits, something they do not cover now. That failure to pay leaves many rural residents either facing a long drive to receive health care or having some other obstacle prevent them from reaching a physician or medical facility easily.

Finally, Black introduced legislation that would exempt ambulatory surgical centers from being penalized for any failure to meet EHR meaningful use requirements. Although the bill specifically targeted those medical institutions and does not apply to family physicians, it still demonstrates Black's familiarity with problems related to EHR use, said Blackwelder.

"We'd like to delay penalties for all physicians," he said. "There are interoperability issues, and vendors don't have skin in the game. There's an opportunity for us to have a discussion (with Black). She does recognize the issue of interoperability."

Green focused his comments primarily on access issues, saying that his district in Houston is composed of working-class residents, many of whom do not have insurance. The need for primary care physicians in the area is high. He noted that as many practicing physicians are getting older, there is great demand for CME and training programs that will develop the next generation of primary care physicians.

"Family physicians in my district are really important," said Green. "We don't have enough of them. The doctors who are there don't have enough time to see everyone. We need to train the next generation of family physicians in our community."

Green pledged to support funding teaching health centers to train more family physicians. He acknowledged that the salaries at these centers may not be as lucrative as other opportunities but noted their value to overall health in a community.

"You're not going to get rich working in a health center, but you can earn a living and raise a family," Green said.

He also reiterated his support for SGR repeal, stating that no congressional legislator supports the measure any longer.

AAFP President Robert Wergin, M.D., of Milford, Neb., said he was encouraged by Green's comments.

"He aligns well with our positions," Wergin said. "He made a strong statement about SGR. The cost to do short-term patches is costing more than a full repeal."

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