State Advocacy Initiatives Gain Recognition, Reap Awards

Illinois family physicians will no longer wait as long as 200 days for Medicaid payment, thanks to the Illinois AFP's Medicaid initiative. The initiative was one of three recently singled out for honors by the AAFP.

The Illinois initiative brought relief to family physicians in the state who were grappling with backlogs in their Medicaid accounts receivable that stretched back as many as 200 days. Its success won the Illinois AFP national recognition when the AAFP presented the chapter with one of three Leadership in State Government Advocacy Awards during the State Legislative Conference here Nov. 10-11.

Also recognized were the Ohio AFP for its C. David Paragas Leadership and Advocacy Training Seminar, a one-day event that trained 51 OAFP members to advocate on private sector issues, and the New York State AFP for its collaboration with the Medical Society of the State of New York Lobby Day, which brought family medicine issues to the fore in both the statehouse and the medical community.

2006 is the first year in which these advocacy leadership awards have been presented.

"The (awards') inaugural year recipients represent three very important facets of engagement in the legislative and public policy field: preparing family physicians on issues and becoming involved, addressing a specific public policy issue, and direct physician lobbying," said Diana Ewert, AAFP senior manager for state legislative affairs.

The Illinois Medicaid initiative evolved as Vincent Keenan, C.A.E., executive vice president of the Illinois AFP, began hearing -- and collecting -- reports about extraordinarily long Medicaid payment cycles from increasing numbers of family physicians, according to Ginnie Flynn, Illinois AFP director of public relations.

The IAFP asked several members in various practice locations and settings to track their Medicaid accounts receivable and to report the amount due, the number of days in arrears and the impact of the extended payment cycle on their practices. Illinois AFP President Fredric Leary, M.D., of Oak Park and FP Matthew Johnson, M.D., of Park Forest took that information to meetings with the state's comptroller and treasurer and staff members in the Department of Public Aid.

Within days of those meetings, Comptroller Daniel Hynes proposed a short-term borrowing plan dedicated to reducing the backlog. In November 2005, Illinois Gov. Rod Blagojevich and the state's treasurer agreed to the plan, which made $1 billion in short-term funds available to begin paying the backlog of Medicaid bills.

Although the borrowed money brought some temporary relief, the delays began to stretch out again in 2006. Illinois providers wanted a policy change to recognize that payment delays to Medicaid providers could not continue year after year, said Flynn.

In August 2006, Blagojevich announced that

Ohio family physicians have a better understanding and comfort level about advocating in the private sector as a result of the Ohio AFP's C. David Paragas Leadership and Advocacy Training Seminar. Launched in 2004, the biennial seminar first focused on legislative advocacy, according to Ann Spicer, the Ohio AFP's executive vice president.

"We have done well improving our legislative advocacy efforts, and we now have a good group of people I can call on for legislative testimony and contacting legislators," Spicer said. "This year, we thought, 'Why can't we do the same in the private sector and have the same success?'"

By bringing expertise from the AAFP, private sector health plans, the medical community and state government together, the seminar provided a comprehensive review of pay-for-performance, Medicaid managed care plans, health savings accounts and progress in implementing health information technology statewide.

"People loved it," said Spicer. "We had a really good response."

Not only did the seminar attract practicing family physicians, it also set the stage for the future by offering scholarships to 15 medical students and residents.

"They were very interested and asked very astute questions," said Spicer.

The New York State AFP bolstered its visibility in both the medical community and the statehouse as a result of its participation as a featured medical specialty organization in the Medical Society of the State of New York, or MSSNY, Lobby Day.

The event, which supplemented the New York State AFP's own legislative day, featured Marianne LaBarbera, M.D., then-president of the New York State AFP, of Staten Island. During her presentation, LaBarbera highlighted family medicine's legislative priorities in the state: covering the uninsured, reforming Medicaid, and promoting area health education centers and their value to the health care system.

The event "reinforced our relationship with MSSNY," said Vito Grasso, M.P.A., C.A.E., executive vice president of the New York State AFP. "The day gave us a podium and we took advantage of it to participate in a more formal way with MSSNY. We could highlight family medicine, and it gave family physicians an opportunity to participate with their colleagues" in other specialties.