Help is on the way for family physicians in the hot-button areas of physician payment and medical liability. That help comes from initiatives approved by the AAFP Board of Directors at its meeting Aug. 2 - 6 in Banff, Canada.
The initiatives were proposed by two "strike forces" established by the Board in March to look at current AAFP activities in physician payment and medical liability, identify gaps and recommend short-term ways to plug those gaps.
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AAFP Board OKs Payment, Liability Recommendations from 'Strike Forces'
By Paula Binder
Moving quickly, the strike forces researched the issues and fired off recommendations to the Board in four months. You can review the recommendations and resulting Board actions (Members Only) online. They are listed as "Board Report H -- Reimbursement" and "Board Report I -- Medical Liability" in the "AAFP Congress of Delegates Handbook" section of the Congress Web page. The AAFP Congress of Delegates will consider the Board reports during its Sept. 26 - 28 meeting in San Francisco.
Among the approved recommendations from the Reimbursement Strike Force:
- Ramp up the Academy's advocacy efforts with private insurers, pushing for actions that will help FPs improve their bottom lines. The Academy will look for ways to exert more influence with major health insurers and employers and their trade associations. Specifically, AAFP will push for health plan compliance with CPT coding standards and conventions; hold health plans accountable for the integrity of their data analysis methodologies; work with insurers to support a patient-centered, physician-led approach to chronic disease management; insist that insurers use standardized, evidence-based performance measures; and collaborate with other organizations to address "administrative simplification."
- Develop additional resources to help members with their health plan interactions. One of these resources, a private sector advocacy e-mail discussion list (Members only), is already available online. To be developed: an online health plan complaint form and an AAFP advisory committee composed of FPs who are health plan executives.
- Investigate other activities that could enhance member practice financial viability. Appropriate AAFP commissions will consider the activities and report to the Board no later than March 2006.
"Practicing family physicians cannot continue to function with the degree of financial duress they are experiencing. The doors of many personal medical homes will be closing to the patients who need them," said AAFP President Mary Frank, M.D., of Mill Valley, Calif, who chaired the Reimbursement Strike Force. "These recommendations are designed to bring financial relief to FPs in their day-to-day practice. We need to be aggressive with the private sector and enhance our activities in the public sector to bring about major changes in payment to family physicians and the financing of health care in this country."
Among the approved recommendations from the Medical Liability Strike Force:
Among the approved recommendations from the Medical Liability Strike Force:
- Actively support specific federal legislation. The AAFP will back legislation that caps noneconomic damages at a specified amount (not more than $500,000) without exceptions. It also will support the Fair and Reliable Medical Justice Act, S. 1337, which would fund studies of alternative judicial and extra-judicial systems.
- Advocate eliminating contingency fees in medical liability cases.
- Support constituent chapters that are advocating liability reform. For example, the AAFP could provide model legislation and research data.
- Continue monitoring potential system reforms that have not yet shown conclusive evidence of controlling medical liability insurance premiums. These reforms include requiring expert witnesses to be from the defendant's specialty, limiting the time allowed to bring suit, and restructuring malpractice claims involving Medicare and Medicaid to use the current system of administrative adjudication.
The Medical Liability Strike Force examined the evidence before making its recommendations, said President-Elect Larry Fields, M.D., of Ashland, Ky., who chaired the liability strike force.
"We now know, based on real evidence, what works and, just as importantly, what has not been shown to work in controlling medical liability premiums," he said. "In addition, we now know, also based on evidence, what the root cause of the liability crisis is and what factors are not causing the problem -- but rather are myths trotted out by plaintiffs' attorneys to cloud the issue and protect the attorneys' income.
"We now know, based on real evidence, what works and, just as importantly, what has not been shown to work in controlling medical liability premiums," he said. "In addition, we now know, also based on evidence, what the root cause of the liability crisis is and what factors are not causing the problem -- but rather are myths trotted out by plaintiffs' attorneys to cloud the issue and protect the attorneys' income.
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