AAFP Recognizes Congressman for Health Care Leadership

The AAFP recently recognized Rep. Pete Stark, D-Calif., for his leadership on health care issues by awarding him the AAFP National Leadership/Government Service Award during the Academy's Family Medicine Congressional Conference here on May 19.

Stark, who is chair of the House Ways and Means Subcommittee on Health, has been active in crafting legislation focusing on physician payment issues. During his comments after the award presentation, Stark addressed the current threatened cuts in Medicare payments. He called for an 18-month payment update to give Congress enough time to develop a more equitable Medicare payment system than the current sustainable growth rate, or SGR, formula used to calculate payments.

Stark acknowledged that Congress may not act soon enough to stop 10.6 percent reduction in Medicare physician payment rates scheduled to take effect on July 1, but he said that if the cut goes into effect, federal lawmakers will "correct it as soon as possible in 2009." He also said any correction would be retroactive to compensate physicians for the reduction.

According to Stark, the House currently is waiting for the Senate to act. The Senate Finance Committee is expected to bring a bill to the Senate floor in early June that provides a small Medicare payment update during the next 18 months. The bill calls for cuts to Medicare Advantage, Medicare's system of managed care plans, to pay for the update, but that provision has been opposed by the Bush administration and congressional Republicans. Their opposition could delay action on the measure, increasing the chances that Congress will not pass legislation blocking the impending cut before the July 1 deadline.

In his remarks, Stark also called for reform of the process that determines the relative values assigned to physician services by CMS. Based on the current system, the AMA's Relative Value Scale Update Committee, or RUC, makes recommendations to CMS about the value of individual health care services. Historically, the committee has undervalued primary care services, leading to lower payments, especially when compared with subspecialty services and procedures.

In addition, Stark said that physicians need to take responsibility for reforming the values set by the RUC. "You figure out how we are going to reform the RUC system so that it is fair," Stark told his audience. The goal, he added, is not to develop a more generous payment system but rather a more equitable one.

He also expressed his support for the patient-centered medical home, saying he hoped the medical home would "empower" primary care while leading to a more equitable payment system that recognizes and rewards primary care services.