HHS 2013 Budget Requests Needed to Ensure Family Medicine Thrives, AAFP Testifies

The AAFP is urging the House Committee on Appropriations to provide adequate funding for various HHS programs essential to sustaining and strengthening the nation's primary care physician workforce in the fiscal year 2013 (FY13) budget.

"There is ample evidence that primary care physicians serve as a strong foundation for a more efficient and effective health care system," the AAFP said in written testimony (5-page PDF; About PDFs) submitted to the House Appropriations Committee, which funds the Health Resources and Services Administration (HRSA), the Agency for Healthcare Research and Quality (AHRQ), and other health-related agencies. "Federal investment not only would help to guide health system change to achieve optimal, cost-efficient health for everyone, but also would support primary care medicine training in what the January 2012 Bureau of Labor Statistics projections recognized as 'the most rapidly growing sector in terms of employment through 2020.'"

The March 29 testimony calls on the committee to provide at least $7 billion for HRSA in the FY13 appropriations bill and to allocate specific funding levels, including

In its written testimony, the AAFP provided a brief description of each program, explaining its respective role in supporting the primary care physician workforce. For example, Section 747 of Title VII is the only federal program that provides funds specifically to academic departments and programs to increase the number of primary care health professionals. The AAFP said it is "gravely concerned that failure to provide adequate funding for Title VII, Section 747, of the Primary Care Training and Enhancement program will destabilize education and training support for family physicians."

"Between 1998 and 2008, in spite of persistent primary care physician shortages, family medicine lost 46 training programs and 390 residency positions, and general medicine lost nearly 900 positions."

Primary care training grants are "vital" to family medicine, general internal medicine and general pediatrics training, said the AAFP. The grants strengthen curricula and offer incentives for training in underserved areas.

"In the coming years, medical services utilization is likely to rise, given the increasing and aging population, as well as the insured status of more people," said the AAFP. "These demographic trends will worsen family physician shortages."

The Academy also called on the committee to support reforms to graduate medical education programs. The AAFP has long advocated that primary care residents be trained in nonhospital settings, which is where most primary care is delivered, and teaching health centers development grants help in this process.

"Federal financing of graduate medical education has led to training that occurs mainly in hospital inpatient settings, even though most patient care is delivered outside of hospitals in ambulatory settings," said the AAFP in its testimony. The teaching health centers program, on the other hand, provides resources to qualified community-based ambulatory care settings that operate a primary care residency, the Academy said, calling on the committee to invest $10 million in program grants.

The AAFP also reiterated its support for AHRQ and the National Health Care Workforce Commission, asking for at least $400 million for AHRQ and $3 million for the workforce commission.