Just as the future of America's health care depends on family medicine -- as outlined in the 2004 Future of Family Medicine report -- so does the future of family medicine depend on ensuring family physicians are able to practice successfully in every nook and cranny of the country.
That's one reason why private sector advocacy has become a hotbed of activity for the Academy. "What we're doing is giving our members a fair shot at working within a strangulated, fragmented environment," said Laura Schmidt, an AAFP private sector advocacy specialist. "We're focusing our efforts on resolving private insurer payment issues, minimizing administrative hassles and helping physicians navigate through managed care."
Advocating members' private-pay issues -- and addressing the hassle factors they face daily -- is one way to help keep FPs practicing medicine as the country begins to turn to primary care to help solve problems with the health care system. Those actions also are intended to make family medicine appealing to the country's best and brightest students, thereby helping ensure a pipeline bursting with aspiring family physicians for the future, said Schmidt.
To that end, the Academy has made strides in the past 18 months in conducting face-to-face meetings with some of the country's most influential private insurance plans to ask for policy changes.
Consider these examples of the power of a dialogue opened and pursued:
Private Sector Advocacy Efforts Reap Rewards for Present, Future
By Sheri Porter
11/14/2006
- January 2006. UnitedHealthcare says it won't support benefit tiering around primary care in its new UnitedHealth Premium Designation Program.
- February 2006. Aetna modifies its policy regarding payment for two evaluation and management codes on the same date of service, and for payment of an E/M code in conjunction with surgery.
- May 2006. Anthem Blue Cross Blue Shield of Ohio announces it will discontinue its controversial blended-rate policy in southern Ohio.
- June 2006. CIGNA agrees with the AAFP's concept of a personal medical home and about the ability of FPs to provide such a home.
- October 2006. Humana tells AAFP that it has set a higher patient copay for health care provided at retail clinics versus care provided by patients' primary care physicians.
An editorial written about AAFP's efforts in taking on big insurance that was posted June 23 to the "As We See It: Voices From the AAFP" (Members Only) section of AAFP News Now online put it this way: "When the Academy steps forward to speak on behalf of all 94,000 AAFP members, something magical happens. The Goliaths stop. They listen. And some of them actually change their behavior."
