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Am Fam Physician. 2006;73(9):1501-1502

TransforMED Demonstration Project Will Test New Model of Care

In April, the American Academy of Family Physicians (AAFP) announced the launch of the TransforMED initiative—a demonstration project to implement and evaluate a new model of care. The initiative resulted from the 2004 Future of Family Medicine Report (, which projected a patient-centered health care system. Thirty-six family medicine practices of various sizes and locations will take part in the two-year project by implementing the model's concepts, including open access for patients; responsive and prospective evidence-based care; use of electronic health records and e-mail, Internet, and voice-mail communication; a multidisciplinary team as the source of care; and purposeful and organized management of chronic disease. Evaluation of the model will determine its workability in a variety of settings and its impact on patient satisfaction, quality of care, and practice efficiency and economics. The process of implementation itself also will be assessed to identify the most effective and efficient methods of changing physician practice. The final results of the project will be released in a report in 2009, but members of the project will make the research widely available throughout the demonstration. For more information, visit

California Adopts Policy Expanding Coverage to Unborn Children

The U.S. Department of Health and Human Services (HHS) has approved California's proposal to extend health care coverage to pregnant women and their unborn children when the family income is up to 300 percent of the federal poverty level ($20,000 for a family of four in 2006). This type of coverage was made possible by an HHS regulation from 2003 that defined a child as a person under the age of 19 including the period from conception to birth. Previously, California covered children from birth to age 19 with family incomes of up to 250 percent of the federal poverty level; the new coverage provides access to prenatal care. California is the eighth state to adopt this policy, following Arkansas, Illinois, Massachusetts, Michigan, Minnesota, Rhode Island, and Washington. An estimated 123,052 women who are pregnant and their unborn children in California will be eligible for coverage, and the Centers for Medicare and Medicaid Services (CMS) hope to work on similar programs in other states. For more information, visit the HHS Web site at

CMS Relaxes Financing Rule for Residents in Disrupted Programs

The CMS has issued a rule providing for continued Medicare financing of medical residents in training programs affected by natural disasters or public health emergencies. Under the new rule, restrictions that limited the locality of the host hospital are lifted, and hospitals will be able to create more flexible emergency affiliation agreements that may be retroactive to the date of the disaster and that may apply even when only part of the home training program is closed. In the past, a host hospital could count displaced residents for Medicare payment only if the original program was completely closed. The rule will apply retroactively to home and host hospitals affected by Hurricanes Katrina and Rita; host hospitals who accepted residents affected by these hurricanes also will receive full payment in the first year rather than as part of the rolling average. Because of the ruling, residents from hospitals affected by the hurricanes should find it easier to return to their home hospitals and to get Medicare support while with their hosts. The rule was published in the April 12 Federal Register and comments will be accepted until June 12. More information is available online at

AAFP Calls on Congress to Fund Training for Family Physicians

In a statement submitted for the record, the AAFP urged Congress to provide fiscal year 2007 funding for Section 747 of Title VII in the Public Health Service Act. Section 747 is the only federal program that funds training for family physicians. It aims to increase the numbers of primary care physicians and persons who provide care to the underserved, and it offers competitive grants for medical school and residency training programs. In 2005, the program received $88.8 million; this was cut to $41 million in 2006, and no funding has been proposed for 2007. Citing several studies that show the program's effectiveness in promoting family medicine and thereby improving the nation's health, the AAFP asked Congress to restore funding to 2005 levels. The statement also recommended $440 million in funding for the Agency for Health Care Research and Quality, which translates research findings into practical information, and urged Congress to support rural health programs. For more information and to access the full statement, visit

CDC Reports Slowing TB Decline and Increasing Drug Resistance

Although rates of tuberculosis (TB) were at an all-time low in 2005, progress to eliminate TB is slowing and the occurrence of drug-resistant disease is increasing, the Centers for Disease Control and Prevention (CDC) reports. According to national surveillance data, the number of reported cases of TB in the United States declined from 2004 to 2005—from 14,516 to 14,093; however, this was the smallest decline in the national TB case rate in more than 10 years. In addition, between 2003 and 2004, the number of persons in the United States with TB resistant to at least two first-line treatments increased 13.3 percent—the largest increase since 1993. Following trends in the occurrence of drug-resistant disease will be critical in order to understand the implications of this data, the CDC stated. For more information, visit For information on the CDC's TB elimination program, visit

Medicare Announces Funding for 2006 Health Insurance Counseling

State Health Insurance Assistance Programs (SHIPs) are to receive $30 million to help Medicare beneficiaries make decisions about their drug coverage, the CMS announced. The funding covers the period up to May 15, 2006, when enrollment for this year ends, and the next enrollment period, which begins in November. SHIPs host and participate in events nationwide, providing information and assistance to millions of beneficiaries. CMS funding to SHIPs has more than doubled since 2003 and will remain high after the initial enrollment period ends. Support for the SHIPs is part of CMS's commitment to local and proactive outreach, according to CMS administrator Mark B. McClellan, M.D., Ph.D. For more information, visit the CMS Web site at

Cancer Organizations Provide Online Asian-Language Resources

The Asian American Network for Cancer Awareness, Research and Training and the American Cancer Society have launched a searchable online database of cancer materials written in Asian languages. The Asian and Pacific Islander Cancer Education Materials (APICEM) Web tool was designed to help Asian-language speakers with limited English to find information on reducing their risk of malignancies such as breast and colon cancers. It provides a single point of access to patient education materials developed by various organizations and translated into more than 12 Asian and Pacific languages, including Chamorro, Chinese, Hawaiian, Hmong, Khmer, and Vietnamese. The material can be searched by language, type of cancer, topic, or organization, and all materials have been screened by experts for medical accuracy and linguistic and cultural relevance. APICEM is located on the American Cancer Society Web site at Questions and answers about the tool are available at

For more news, visit AAFP News Now at

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Copyright © 2006 by the American Academy of Family Physicians.

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