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Am Fam Physician. 2006;73(8):1319-1320

Medicaid Cost Sharing and Premiums May Reduce Physician Revenues

Policy changes in the Deficit Reduction Act (signed by President Bush on February 8, 2006) that allow states to increase cost sharing and premiums for Medicaid beneficiaries may result in a loss of revenue for health care providers, according to a report by the Center on Budget and Policy Priorities. Premiums can lead to a loss of coverage for patients with low incomes, and higher co-payments can cause patients to avoid seeking medical care. Physicians who care for Medicaid beneficiaries therefore may see a reduction in the use of their services or a greater number of patients who cannot afford their co-payments. The Deficit Reduction Act is projected to reduce federal Medicaid spending by about $10 billion over the next 10 years, according to a Kaiser Commission report. An expected 80 percent of these savings would come from decreased use of services and 20 percent would be a result of lower payments to providers. The reports are available online at and For more information, visit the American Academy of Family Physicians (AAFP) News Now Web site at

AMA Supports Amendment on Cuts to Medicare Physician Payments

The American Medical Association (AMA) applauded an amendment in the Senate version of the 2007 budget bill that will help to prevent Medicare payment cuts. The 2007 payment cut may be around 5 percent, and the Centers for Medicare and Medicaid Services (CMS) have projected nine years of cuts totalling 34 percent. Combined with greater practice costs, these cuts will force many physicians to stop seeing new Medicare patients, an AMA survey found. In March, AMA physicians urged Congress to set Medicare payments that reflect the needs of older patients and the costs of providing care. The amendment should make it easier for Congress to do so. For more information, visit the AMA Web site Newsroom at

Increase in Candidates Matched into Family Medicine Residencies

The 2006 national fill rate for family medicine residency programs through the National Resident Matching Program was 85 percent, with 2,318 of 2,727 positions being filled. This is the highest fill rate for family medicine since 1998. Although the number of family medicine positions offered has steadily decreased in the past nine years, the number of candidates who have filled these positions has been increasing since 2004, and 26 more candidates were placed by the Match this year than in 2005. The process for third-year students is still underway. To view the complete match summary and analysis, visit A free guide for Match applicants is available at

HHS Issues Checklist to Help Clinics Prepare for Influenza Pandemic

Because medical offices and ambulatory clinics are the first place many influenza patients will seek care, the U.S. Department of Health and Human Services (HHS) has produced a checklist for these organizations to assess their readiness for a pandemic and to plan their response. The Medical Offices and Clinics Pandemic Influenza Planning Checklist, which was modeled after a similar checklist for hospitals, will be distributed at pandemic planning summits throughout the United States. Although the checklist was designed to aid with pandemic influenza, it also could be used in other emergency situations and can be adapted to the needs of each clinic. The HHS hopes that the tool will be used by medical offices and clinics to help them identify the strengths and weaknesses of their planning efforts. The checklist can be downloaded from

Programs Test Treatments Used in Cardiac Arrest and Severe Trauma

A research program funded in part by the National Institutes of Health (NIH) and the Canadian Institutes of Health Research may help scientists find ways to improve survival after cardiac arrest and severe trauma. The Resuscitation Outcomes Consortium (ROC) will conduct clinical trials to evaluate the effectiveness of new treatments in terms of cognitive outcomes and to provide the large-scale proof of effectiveness that will be necessary for widespread adoption of these techniques. Health care institutions and public safety agencies in 11 regions of the United States and Canada will take part in the trials, incorporating an estimated 15,000 patients over three years. All treatments to be tested have already been proven safe and potentially lifesaving in single-center trials. Some of the first treatments to be tested will be a high-concentration saline solution designed to compensate more effectively for blood loss, reduce inflammatory response, and prevent brain swelling, and a one-way valve to enhance blood flow during cardiopulmonary resuscitation. Future studies may evaluate new drug approaches to aid resuscitation and new strategies to control hemorrhage. For more information and a list of participants, visit

CMS Projects Seek to Improve Cancer Care Among Minorities

Demonstration projects launched by the CMS will evaluate ways to reduce health care disparities and improve the early detection and treatment of cancer among Medicare beneficiaries. The projects will last four years and will focus on breast, cervical, colorectal, and prostate cancers. Six sites have been selected for participation, with target populations including American Indians, Asian Americans, blacks, and Hispanics. At these sites, more than 13,000 Medicare beneficiaries will receive help in navigating the health care system more quickly and effectively. Screening, diagnostic, and treatment services will be provided, as well as scheduling and transportation assistance, adherence support, translation or interpretation services, and care coordination. For more information, visit the CMS Web site at

NHMA and HHS Partner to Address Health Disparities Among Hispanics

The National Hispanic Medical Association (NHMA) and the HHS’s Office of Minority Health have created an initiative to address health disparities and increasing rates of obesity and diabetes among Hispanics. In the United States, the risk for diabetes is 1.5 times higher in Hispanics than in non-Hispanic whites, and Hispanics have a 40 percent higher rate of diabetes-related death. The two-year initiative will develop a national leadership training program for Hispanic health care professionals and launch a national education campaign and outreach programs aimed at improving the health of Hispanics. Organizers hope to work with physicians, schools, and elected officials in New York, Texas, and California to foster cultural competency and responsiveness to issues impacting Hispanic health. For more information about the initiative, visit Spanish-language health fact sheets and other resources are available from the National Institute on Aging at and the National Kidney Disease Education Program at

AAFP Task Force Expands Scope to Include Health Care System Reform

Initially created to tackle universal health care coverage, the AAFP Task Force on Health Care Coverage for All will expand its scope to address reform of the health care system as a whole. According to the Task Force’s Chair and AAFP Board Chair, Mary Frank, M.D., Mill Valley, Calif., the problems behind health coverage gaps are symptomatic of wider issues that include payment concerns, use of technology, delivery of evidence-based care, and the provision of a family medicine workforce. The task force now will take a two-step approach, first concentrating on insuring the uninsured in the current environment, and second evaluating the overall health care system. The AAFP Board of Directors agreed to these principles at its March meeting in Washington, D.C. For more information, visit

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Copyright © 2006 by the American Academy of Family Physicians.

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