Fam Pract Manag. 1998 Oct;5(9):20.
- AAFP launches research initiative
- Don't expect many Medicare choices soon
- New HEDIS measures focus on care family physicians provide
AAFP launches research initiative
On Sept. 8, the American Academy of Family Physicians launched a nearly $8 million research initiative designed to improve primary care and to further validate a primary-care approach to health care. The research initiative is expected to tremendously increase evidence-based, outcomes-oriented primary care research within primary care.
“As family physicians, we are committed to providing the best possible care to treat our patients,” says the AAFP's then-president Neil Brooks, MD. “I am pleased to announce that the research supported by this project will help improve the quality of care people receive when they go to the doctor.”
Three grant recipients have been chosen from among 65 applicants. The first research group will explore the doctor-patient relationship and how patient care is delivered in the context of common family settings. A second group will explore best practices for helping family physicians to get health information at the point of care, incorporating patient needs and values into the process. The third group will create a virtual network of practicing physicians and family practice researchers to encourage information sharing. Ultimately, the group plans to serve as a national resource to enhance and expand family practice research.
Don't expect many Medicare choices soon
Although the government has said it will offer Medicare recipients a number of new coverage options in 1999 through its Medicare+Choice program, HCFA has received only a handful of applications from organizations seeking to set up these new types of Medicare plans.
The Medicare+Choice legislation, approved last year, opened the door to private fee-for-service plans, PPOs, provider-sponsored organizations (PSOs) and medical savings accounts for Medicare beneficiaries. But by early Sep-tember, the government had received a total of one PPO application and two applications from doctor-hospital groups seeking to form PSOs.
Robert Berenson, MD, director of HCFA's Center for Health Plans and Providers, says he expects some new plans will be available in 1999, although he declined to predict how many.
Berenson attributes the low response to the time required for groups to ensure they meet the government's requirements, develop business plans and develop provider networks. The Medicare+Choice regulations were released in June, and Beren-son says the process of developing an application for a new plan could take a year or longer.
Jeffrey NA. Medicare gets weak reply to request for new types of health programs. The Wall Street Journal. Sept 8, 1998:B-8.
New HEDIS measures focus on care family physicians provide
The National Committee for Quality Assurance (NCQA) has released the final specifications for HEDIS 1999 (Health Plan Employer Data and Information Set), the performance measurement tool now used by more than 90 percent of the nation's health plans. HEDIS 1999 includes several new clinical care measures that will lead to heightened scrutiny of primary care physicians by health plans seeking HEDIS compliance and NCQA accreditation:
A cardiac care measure that assesses whether patients with heart problems or illnesses have had their LDL level screened and whether it is controlled;
A behavioral health care measure that assesses the frequency of follow-up visits for patients being treated for depression with antidepressant medication and that evaluates how many patients remain on their medications after 12 weeks and after six months;
A diabetes care measure that assesses whether diabetic patients' glycohemoglobin was tested within the past year, HbA1c level is controlled, a lipid profile was performed, lipid levels are controlled, a dilated eye exam was performed within the past year, and whether kidney disease is appropriately monitored. This comprehensive measure, which will become mandatory in the year 2000, was developed jointly by NCQA, HCFA, the American Diabetes Association and the Foundation for Accountability.
For more information about HEDIS 1999, visit the NCQA Web site at http://www.ncqa.org/.
Copyright © 1998 by the American Academy of Family Physicians.
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