Health System Reform

Health Care Delivery Systems -- The AAFP supports universal access to basic health care services for all people. The AAFP believes this goal can be attained with a pluralistic approach to the financing, organization, and delivery of health care.

Principles for Reform of the U.S. Health Care System -- Ten of the nation’s leading physician associations have established principles to serve as a guide for Congress to improve both individual health and the collective health care system in the U.S.

Health Care for All: A Framework for Moving to a Primary Care-Based Health Care System in the United States -- Health care system reform will not succeed if policy makers focus only on financing public and private insurance coverage. The underlying flaws in the current system – fragmentation, duplication of services, inadequate quality and a growing number of people who have limited access because they are uninsured or underinsured – are not addressed only by tweaking the way people get insurance. The American Academy of Family Physicians policy, Health Care for All: A Framework for Moving to a Primary Care-Based Health Care System in the United States,” advocates for an overhaul in the way health care is delivered. That overhaul would base the health care system on primary care and the patient-centered medical home, which would ensure preventive and chronic care management, ensure access to and coordinate services provided by subspecialists, hospitals, long-term and home health care, and other health professionals.

AAFP Policy on Physician Payment -- It is the position of the AAFP that every reasonable effort should be made to devise a payment system (fee-for-service, capitation, or at-risk contracts) that emphasizes increased payment for cognitive skills relative to procedural skills; that acknowledges and pays for case management services as necessary to the provision of continuous, comprehensive patient care; and that encourages and pays for preventive care and appropriate health maintenance services.

Pay for Performance -- The AAFP encourages family physicians to improve continuously the quality of patient care through ongoing documentation and analysis of practice patient data and patient feedback.. Yet most commonly used physician payment options, notably visit-based fee for service, do not support, and at times inhibit, the accomplishment of these goals.