burke.aafp slc 2013
DESCRIPTION
TRANSCRIPT
AAFP FEDERAL PRIORITIES
State Legislative ConferenceDenver, ColoradoNovember 1, 2013
Thank You
• SLC Organizers– Michelle Greenhalgh– Amber Melaney
• Additional GR Staff– Lorlita Alexander– Jessie Williams
• Headquarters Staff– Karin Reid
AAFP Federal Priorities – 2013• Implementation of Health Care
Marketplace
• Medicare Physician Payment Reform
• GME and Primary Care Workforce Assistance
Implementation of Health Care Marketplaces
Implementation of Health Care Marketplaces• The AAFP convened an ACA Work
Group with reps from 8 areas to develop educational resources for members and patients.
• The effort was headed by Amber Melaney, AAFP’s analyst in state government relations
Implementation of Health Care Marketplaces• The group created materials in four
components:– Member and Chapter Educational
Resources– Presentation for Family Medicine
Faculty– Webinar for Physician Small
Business Owners (November 6)– ACA Implementation Interactive Map
ACA Implementation Interactive Maphttp://www.healthlandscape.org/ACAMapper2013/index.html
Implementation of Health Care Marketplaces• The AAFP ACA landing page contains
AAFP-developed resources:– Understanding Health Insurance
Marketplaces– Health Care Reform: What It Means for Me– New Health Care Law and Medicare: What
to Expect– How Health Care Reform Will Affect Family
Physicians
Implementation of Health Care Marketplaces• The landing page also contains
information from healthcare.gov that details the costs and coverage of health insurance plans in Marketplaces.
• Congress of Delegates and Scientific Assembly
• Social Media• CMS Champion for Coverage
Designation• Blog by Dr. Blackwelder• aafp.org and FamilyDoctor.org
Carousels• CHEX and ANN Articles
Implementation of Health Care Marketplaces
SGR
• Fee Schedule Conversion Factor will decline 24.7% on January 1, 2014 unless Congress acts.
• Congressional Committees– House Energy & Commerce Com.– House Ways & Means Com.– Senate Finance Committee
SGR
• House Energy & Commerce Committee proposal– Medicare Patient Access and Quality
Improvement Act (HR 2810)– AAFP letters of April 15, June 10 and
July 16. – July 31, 2013 – approved by a vote
of 51 to 0.
SGR- HR 2810 Outline
• Cost: $175 billion over 10 years• SGR repealed• Update of conversion factor for
2014-2018 is 0.5% annually• Eligible Professional Organizations
will create “Peer Cohorts”• Peer Cohorts determine “core
measure sets”
SGR- HR 2810 Outline
• Core measure sets include quality measures and clinical practice improvement activities.
• Physicians will be paid (beginning in 2019) according to their performance in their peer cohort.
• Bonuses up to 1.5%; penalties of as much as 1.5%
SGR- HR 2810 Outline
• Alternative Payment Models– Emphasis on care coordination– Fast track for evaluated models (like
PCMH)– Encourages development of payment
codes for complex chronic diseases– Encourages adjustments for
misvalued physician payments
Finance/Ways and Means• Cost: $150 billion over 10 years• SGR repealed• No peer cohorts• 0% update for 10 years• Emphasis on value-based
purchasing and alternative payment model
Finance/Ways and Means• Care Coordination payments are
authorized in 2015 for all those in PCMH (or other approved APM)
• Appropriate use criteria, provider endorsed, for advanced imaging
• Fix misvalued payments (RUC)• Make Medicare data more
transparent
Finance/Ways and Means• Beginning in 2024, annual update
of -1% for FFS; +2% for APM• APMs are eligible for 5% bonus
and PCMH are qualified• APMs are excluded from value-
based payments and reporting requirements
Finance/Ways and Means• NPs & PAs will be eligible for care
coordination payment• Provides “assistance for smaller
practices” – undefined• Value based purchasing for FFS is
an aggressive one – beginning in 2017 – 8% (increasing to 10%) of Medicare payment at risk
Finance/Ways and Means• No conversations yet about budget
offsets• No clear path or process to get the
measure passed this year• Congress has some 15 legislative
days left this year• Prediction: short-term extension of
SGR, w/ final action in spring 2014
GME & Workforce Issues• Continue to promote the Primary
Care Workforce Access Improvement Act (HR 487)
• Advocate for primary care medical student support
• Title VII Health Professions Grants
AAFP Federal Priorities - 2013• Contact
Kevin J. Burke, Director
AAFP Government Relations
1133 Connecticut Ave., NW (#1100)
Washington, DC 20036
(888) 794-7481 (toll free)