Proposed SGR Repeal Contains Elements Long-Advocated by AAFP

Tuesday, Nov. 12, 2013

Statement attributable to:
Reid Blackwelder, MD,
American Academy of Family Physicians:

“The AAFP has long supported a reformed health care system based on primary care, the patient-centered medical home, support for chronic care management, and a payment system that appropriately values primary medical care that improves patient outcomes.

“The AAFP recognizes that this proposal is not final legislation. We will still be strongly advocating for aspects of the final bill that will support and grow the critical primary care workforce that will be our health care system’s foundation for success.

“The House Ways and Means/Senate Finance committees’ bipartisan SGR repeal proposal moves in this direction by constructing an infrastructure for future growth in quality-based patient care. By encouraging physicians to build on the patient-centered medical home model and other alternative payment models, the proposal shifts focus away from delivery and payment models that foster episodic care. Instead, it moves toward those that facilitate ongoing comprehensive care that reduces intensive medical and inpatient services. Moreover, the proposal would establish payment for complex chronic care management legislatively and would put in place mechanisms to better value the complexity of primary medical care in the physician fee schedule. 

“Taken together, the proposal moves toward patient-centered, comprehensive reforms that promise greater efficiency, more care coordination, and less duplication and fragmentation.

“The Ways and Means/Senate Finance committees’ proposal includes policies that will enable individual family physicians and primary care physician groups to move away from the current system.

“The AAFP looks forward to working with the House and Senate to refine this proposal to ensure patients have access to continuous, comprehensive, team-based and physician-led primary care. Among our recommendations:

  • Decrease the regulatory and administrative burden placed on physicians and physician practices to ensure that a majority of a physician’s time is spent on patient care.
  • Increase the level of financial assistance for individual physicians and small practices to ensure that these critical providers of care are able to prosper in new delivery systems.
  • Identify appropriate exemptions for those physicians and physician practices that would allow young physicians entering practice to establish financial security prior to facing the regulatory requirements of the proposal.
  • Create payment policies that appropriately value primary care services.
  • Extend current payment incentives that promote access to primary care physicians for Medicare and Medicaid beneficiaries.
  • Improve the methodology for determining the value of physician work in a manner that places less emphasis on time and greater emphasis on the services provided.”

Editor's Note: To arrange an interview with Dr. Blackwelder, contact Leslie Champlin, 800-274-2237, Ext. 5224, or

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Founded in 1947, the American Academy of Family Physicians represents 134,600 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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