January 21, 2021, 3:54 pm News Staff — The AAFP recently shared its key policy priorities with a newly rebalanced Congress as lawmakers returned to work and COVID-19 infection and mortality numbers continued to tick upward.
"Family physicians play a key role in the fight against COVID-19 by diagnosing, testing, treating and counseling millions of patients and their families as the pandemic continues to impact our nation," said the Jan. 8 letter to the 117th Congress, signed by Academy President Ada Stewart, M.D., of Columbia, S.C.
Analysis suggests that most health care-related legislation will still be subject to partisan battles. But the Academy used the letter to signal its strong eagerness to put U.S. health and patient outcomes first.
"As Congress develops legislation to respond to and rebound from the COVID-19 pandemic, we urge you to think of us as partners," the letter said.
Echoing the AAFP's December message to President Joe Biden and his incoming administration, the Academy urged bipartisan support for five critical initiatives.
The letter reminded Congress what CMS data demonstrate: States that rely more on primary care "have lower Medicare spending, lower resource inputs (hospital beds, ICU beds, total physician labor), lower utilization rates and better quality of care."
To maximize primary care's benefit to overall American health, the AAFP conveyed its continued bullishness on leveraging, and improving on, the Patient Protection and Affordable Care Act. The law has "made important investments in improving coverage and access, including preventive services benefits and protections for patients with pre-existing conditions," the letter said. "We are committed to working with Congress to build on what works and redesign what does not. We call on Congress to prioritize the health of all Americans by expanding coverage for and eliminating barriers to comprehensive primary care services."
To head off a surge in deaths due to preventable causes, the U.S. "will need 52,000 more primary care physicians by 2025 in order to prevent shortages in the primary care workforce," the letter said. "We call on Congress to invest in strategies that strengthen the family physician pipeline — especially in rural and medically underserved areas."
"The COVID-19 pandemic has deepened the existing gaps in our nation’s health care system and the health impacts of systemic racism in our society, which must be corrected to ensure we improve the health of all Americans," the Academy wrote.
"Family physicians can mitigate health inequity, including systemic racism, by collaborating with community stakeholders to effect positive change for the populations they serve. We are working to develop strategies that promote health equity through identifying and incorporating social determinants of health in all health care delivery systems — with the goal of prioritizing preventive health and management of chronic conditions.
"We call on Congress to ensure that federal resources are used in a way that is equitable, effective, and advances the health, safety and well-being of all individuals without exception."
"The COVID-19 pandemic has brought a spotlight on how inflexible and unresponsive the fee-for-service payment system has become," the Academy said. "In contrast to the fee-for-service payment model, value-based payment reforms (e.g., accountable care organizations, patient-centered medical homes and other alternative payment models) can promote and finance comprehensive, continuous, coordinated primary care."
Citing the primary care payment compromises built into December's omnibus spending legislation as misguided in the long term, the letter urged lawmakers to look for ways to expand delivery of care while meaningfully reforming payment.
"We call on Congress to support payment models that increase investment in primary care to recognize its foundational role in the health care system and to strengthen incentives for physicians, especially those in independent and rural practices, to participate in value-based care models."
"The temporary expansion of telehealth during COVID-19 has enabled physicians to rapidly pivot to providing virtual care to their patients," the letter said. "A return to pre-COVID telehealth policies would mean that millions of Medicare beneficiaries lose access to telehealth and would squander the time and resources that physicians have invested integrating telehealth within their practices.
"We call on Congress to preserve access to telehealth benefits, including standardization of payment across payers, beyond COVID-19 in a way that increases access to care and promotes high-quality, comprehensive and continuous care."