AAFP Leaders Stress Importance of Family Medicine, Physician Payment During Capitol Hill Meetings

AAFP leaders delivered a strong message about the importance of adequate physician payment and the need for more primary care physicians to create a higher functioning health care system during a series of Capitol Hill meetings with House members and staff on Feb. 8.

"We focused on the House side and met with some of the new members of the House to let them know about our concerns and our issues and to stress that the Academy is here to advocate on behalf of family physicians," said AAFP President Roland Goertz, M.D., M.B.A., of Waco, Texas.

Goertz, along with AAFP Board Chair Lori Heim, M.D., of Vass, N.C.; AAFP President-elect Glen Stream, M.D., M.B.I., of Spokane, Wash.; and AAFP EVP Douglas Henley, M.D., visited several House offices, often dividing into groups of two to cover as many offices as possible. All four leaders, however, met as a group with Rep. Wally Herger, R-Calif., chair of the House Ways and Means Subcommittee on Health, who "voiced agreement and understanding of the issues that family physicians are facing," according to Goertz.

"We didn't get any knowledge that there would be commitments," said Goertz. "But (Herger) voiced understanding of our issues, and that is a positive step."

For the most part, the AAFP leaders focused on physician payment and primary care physician workforce issues and explained how physician payment affects workforce issues, said Goertz. The patient-centered medical home served as an underlying theme of conversations on the changes needed to achieve higher quality care, better patient outcomes and cost control.

"This was perfect timing for us to engage members of Congress and their staffs, particularly those who are new to leadership or new to the process, about how we view the issues and what we see as solutions that are in the best interests of primary care and family physicians," said Stream.

For example, Goertz and Henley met with Rep. Nan Hayworth, M.D., R-N.Y., a newly elected member of Congress, and her legislative director. They also met with Rep. Bill Flores, R-Texas, another freshman congressman who represents Goertz's district in Texas.

Meanwhile, Heim and Stream met with a health policy adviser for House Speaker John Boehner, R-Ohio, as well as with the legislative director for Rep. Kevin Yoder, R-Kan., a member of the House Committee on Appropriations. Yoder represents the area that includes the AAFP headquarters in Leawood, Kan.

Heim and Stream also met with the legislative assistant for Rep. Peter Roskam, R-Ill., a member of the House Ways and Means Subcommittee on Health, and they met with the legislative assistant for Rep. Dave Reichert, R-Wash., also a member of the health subcommittee. In addition, they lunched with Rep. Jim McDermott, D-Wash., another member of the health subcommittee.

During their meetings, AAFP leaders found that they needed to tailor their messages to the political realities of growing budget deficits and tight budgetary constraints. For example, it is likely that Congress will find it difficult to approve a permanent fix for the Medicare payment formula in the near future because of the cost attached to such a measure.

So, AAFP leaders discussed obtaining at least a three-to-five-year fix, along with a positive payment differential for primary care. And they insisted that a payment differential has to be part of any permanent fix that eventually emerges.

The AAFP delegation also focused on provisions in the Patient Protection and Affordable Care Act that are designed to boost the pay of primary care physicians. These provisions are steps in the right direction, according to Stream, but more resources need to be focused on community training programs instead of teaching hospitals to solve the shortage of primary care physicians.

The leaders also called for adequate funding of Title VII of the Public Health Service Act, a federal program that provides funds specifically to academic departments and programs to increase the number of family physicians.