AAFP Campaign Unites Physicians, Patients to Reform Medicare Payment

The AAFP has launched a broad-based campaign to mobilize physicians and their patients to stop a 10.6 percent cut in the Medicare physician payment rate. Unless Congress acts to forestall it, that cut is scheduled to take effect on July 1.

The Medicare: Stop the Cut campaign, which launched on Feb. 7, brings together family physicians and their patients to warn lawmakers about the effect scheduled payment reductions will have on patient access and care. The campaign offers online tools and resources physicians and their patients can use to prevent the scheduled cut, including sample letters members and patients can send to Congress and model op-ed pieces FPs can send to their local newspapers. There also are model petitions patients can sign and send to federal lawmakers protesting the cut.

In addition, Academy members can print out a four-color poster urging Congress not to "shut the door on our patients," which can be displayed in members' offices or handed out to patients.

Members also can send letters supporting a positive update directly to Congress via the AAFP's Speak Out program. Also, family physicians interested in sharing their experiences with Medicare payment and in explaining the effect future cuts would have on their practices and patient access to care can e-mail their stories to the Academy.

"I strongly doubt family physicians would turn away Medicare patients they are taking care of right now," said AAFP President Jim King, M.D., of Selmer, Tenn., in an interview with AAFP News Now. "But we do know that many practices are closing their doors to new Medicare patients because they simply can't keep their practices open due to low payments."

"The Academy wants to make sure that all Medicare patients can see a family physician in a patient-centered medical home," added King.

The campaign is designed to be proactive, rather than reactive, accomplishing the dual goals of keeping physicians informed and engaged while enabling both physicians and their patients to take aggressive actions to stop the planned reduction in Medicare payment levels, said King.

"This campaign will raise the level of awareness of family physicians who are out there just trying to take care of their Medicare patients," he said. "Our patients also will learn about the challenges we face trying to keep our practices open."

But, he added, "This is going to take an effort. It is going to take phone calls. It is going take e-mails, and it is going to take getting patients involved."

Medicare payment rates are determined, to a large extent, by the sustainable growth rate, or SGR, formula -- an arcane calculation that tries to align spending rates with specified targets. During the past several years, spending has exceeded targeted rates, triggering steep reductions in physician payment levels that have been averted only by last-minute congressional action. In December, Congress passed a bill providing a 0.5 percent increase in the physician payment rate for the first six months of 2008, blocking a steep reduction that was scheduled to take place in January. The update will expire on July 1, and without congressional intervention, payments will be cut by 10.6 percent for the rest of 2008; an additional 5 percent cut is scheduled for 2009.

The Academy is urging Congress to provide an 18-month positive update in the Medicare physician payment level to give federal lawmakers enough time to develop an alternative to the SGR.