AAFP President Praises Provisions in Senate Finance Committee Bill

A health care bill put forth by Sen. Max Baucus, D-Mont., chair of the Senate Finance Committee, makes progress toward the twin goals of expanding access to affordable health care and strengthening the nation's primary care infrastructure, according to AAFP President Ted Epperly, M.D., of Boise, Idaho.

The $774 billion, 10-year proposal would provide a 10 percent bonus for primary care services during the next five years to help "rebalance a system that has seen the number of subspecialists skyrocket and the compensation for primary medical care fall precipitously," said Epperly in a prepared statement.

"This bonus is a down payment on the nation's commitment to rebuilding the primary medical care foundation on which all high quality health care rests," Epperly said.

The America's Healthy Future Act, (223-page PDF; About PDFs) as originally introduced, also would begin to change the Medicare payment system by compensating providers for outcomes instead of procedures, a shift Epperly endorsed.

"We must move to an outcomes-oriented system that values quality over quantity -- coordination instead of fragmentation," said Epperly in an interview with AAFP News Now.

"We have to begin to change the way we compensate providers in Medicare and Medicaid," said Baucus during a Sept. 16 Capitol Hill press conference at which he unveiled the legislation.

Baucus identified this type of payment reform as the key to reducing costs and improving quality. "Regrettably, this has been lost in most of the debate over health care reform," he said.

Epperly said the bill is a step in the right direction, but that it does not go far enough. For example, the bill does not provide a long-term solution for the sustainable growth rate, or SGR, formula. It would provide only a one-year SGR "patch" rather than replace the formula. A one-year patch "only kicks the can down the road," said Epperly.

According to Baucus, the Senate will address the SGR issue before scheduled cuts of 20 percent take effect in January, but he didn't know if they would attempt a long-term SGR fix. "Personally, I would like to see the SGR permanently fixed and reformed," he said.

Epperly applauded other provisions in the bill, including measures to increase the number of primary care health care professionals and promote preventive health care and wellness. For example, the bill would increase graduate medical education training positions via a redistribution program for currently unused training slots. It also would give priority to increasing primary care and general surgery training programs.

"These provisions are long overdue and much needed," Epperly said. "We need to take steps to fortify the diminishing pipeline for the primary care workforce."

Other provisions in the bill include