Family Medicine Disappointed HHS Doesn't Specify Role of Primary Care Services in Essential Health Benefit "Guidance"

Federal officials instead to allow states to develop benefit packages based on existing plans

Monday, December 19, 2011

Leslie Champlin
Senior Public Relations Strategist
American Academy of Family Physicians
(800) 274-2237 Ext. 5224

LEAWOOD, Kan. — Family medicine physicians today expressed concern that the U.S. Department of Health & Human Services chose not to guarantee primary care and preventive services be included as essential health benefits for state-based exchanges in 2014. Rather than establish a robust national standard, HHS instead issued a bulletin( recently that allows states to choose one of several existing state plan types.

“The AAFP hopes that HHS follows up this bulletin quickly with an actual proposed regulation and that HHS specifies that primary care services performed by family physicians are essential,” said Glen Stream, MD, MBI, president of the AAFP. “Studies show that health systems that incorporate the elements of the patient-centered medical home reduce medical fragmentation and duplication and ultimately are found to better control costs. Primary care physicians form the foundation of the team and therefore patients receive the right preventive and chronic care management services at the right time from the right professional. As a result, illnesses are prevented, complications of chronic conditions are avoided, unnecessary hospitalizations are reduced, patients have better outcomes and costs are constrained.

“Clearly much more work is needed and the AAFP is committed to working with HHS, the states, and prospective exchange entities to continue developing their benefit packages so that the state-based exchanges offer a reliable and comprehensive range of services in 2014.”

# # #

Founded in 1947, the AAFP represents 129,000 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website,