AAFP Forging Solutions for Members, Patients, Says President

The iron is definitely hot when it comes to physician payment and medical liability. Family physicians want help in those areas -- and the sooner, the better. In response, the AAFP Board of Directors has established two "strike forces" that will explore ways to help members cope with these issues in the short term, AAFP President Mary Frank, M.D., of Mill Valley, Calif., said during her president's report at the Annual Leadership Forum and National Conference of Special Constituencies May 7.

"As your officers have gone out to chapter and Academy meetings, what we have consistently heard from members is, 'Everything you're planning for the long term sounds good -- but how do I keep going in the interim?'" said Frank.

To help in that interim, the strike forces will look at current AAFP activities regarding payment and liability, identify gaps and recommend short-term ways to plug those gaps. Frank chairs the payment strike force; AAFP President-Elect Larry Fields, M.D., of Ashland, Ky., chairs the liability strike force. The strike forces met May 3 to begin their work; their reports will go to the Board in August and to the Congress of Delegates in September.

"We're listening to you," Frank said. "Your Board members are all practicing physicians, teaching physicians, so we're feeling the same economic hurt you are. We're working to make it better."

The Academy also is working on short- and long-term solutions to make pay-for-performance fulfill its potential. Some physicians grumble about P4P, Frank said, "but you know what? It's here, and many of us are going to see it as part of our lives in the next 12 months." The Academy supports the concept, she said -- as long as P4P programs are based on good, solid quality measures, and as long as they add funding for financial rewards for meeting quality measures instead of withholding payment dollars to fund those rewards.

The AAFP has played a key role in the Ambulatory care Quality Alliance, a coalition convened last fall that has just endorsed a "starter set" of 26 clinical performance measures for ambulatory care. "The beauty of this is that, by stepping forward as a coalition and working on this, we're meeting the needs of people in Congress who are pushing this agenda, and we're getting the payers off the hook," Frank said. Left to their own devices, payers might each develop a set of performance measures -- a potential nightmare for physicians, she said.

Frank noted she was giving her speech during Cover the Uninsured Week. "We've had a plan for health care coverage for all since 1991," she said. The AAFP Congress has directed the Academy to keep pushing on the issue, building coalitions and refining its approach.

Since last fall, the Academy has sponsored two "summits" on the issue with 12 other physician organizations. At the second summit, the groups agreed to develop a set of mutually supportable principles.

The Academy also has:

"These are only some of the groups we're working with," Frank said. "The Academy has made a commitment to be sure that every person in this country has coverage, and that the coverage is the right coverage to get them access."