AAFP urges Congress to avert Medicare payment cuts, fights expanded scope of practice for nonphysicians, and more

By AAFP’s Federal Advocacy Team

This month, the AAFP advocacy team has fought for family medicine on several important fronts, including a major effort to call for congressional action to avert impending Medicare payment cuts for physician services. AAFP president, Dr. Tochi Iroku-Malize, Dr. Patricia L. Turner, executive director/CEO of the American College of Surgeons, and Dr. Ryan Mire, president of the American College of Physicians, outlined the risks of not address looming Medicare cuts for physicians in an opinion piece for Modern Healthcare.

“Continued financial challenges, administrative burdens and staff shortages, coupled with outdated Medicare payment policies, make it more difficult for physicians to maintain their practices and operate in their communities…. Congress must take action to protect patients’ access to care by halting the payment cuts that will take effect Jan. 1.,” they wrote.

Why it matters:

The Centers for Medicare and Medicaid Services’ 2023 Medicare physician fee schedule final rule confirms unsustainable Medicare payment cuts for family physicians are set to go into effect on January 1, putting patients’ timely access to essential primary care at risk. The AAFP strongly urges Congress to protect patients and support physicians by averting these cuts, increasing the conversion factor and investing in a more sustainable Medicare physician payment system.

What we’re working on:

AAFP submits comments supporting CMS proposals to improve access to continuous Medicaid and CHIP coverage

Why it matters:

Medicaid and the Children’s Health Insurance Program are essential to providing affordable health coverage to almost 90 million individuals and facilitating equitable access to comprehensive, person-centered primary care. CMS has proposed several policies to streamline application, eligibility determination, enrollment, and renewal processes for Medicaid, CHIP, and Basic Health Plan programs. These proposals would promote continuous, coverage, which translates to improved access to preventive care, fewer disruptions in care, strengthened physician-patient relationships built on trust and continuity, and fewer costly emergency department visits.

What we’re working on:

  • We’re urging CMS to simplify these processes to help reduce enrollment churn, which in turn would reduce administrative burdens on state Medicaid and CHIP agencies and beneficiaries and help physicians maintain continuity and trust in their relationships with patients. Increasing access to continuous coverage in these programs would help improve access to comprehensive, affordable health coverage and high-quality, longitudinal primary care for all.

AAFP calls for extension of pandemic telehealth flexibilities

Why it matters:

The AAFP is advocating for Congress to extend Medicare telehealth flexibilities through at least the end of 2023 to give physicians and patients certainty regarding coverage and reimbursement.

What we’re working on:

  • AAFP is urging Congress to extend Medicare waivers of geographic and originating site restrictions through the end of 2023 to avoid disruptions in access to care and ensure physicians’ ability to continue offering telehealth services. Physicians need adequate and stable telehealth reimbursement to continue providing virtual care to their patients.
  • We’re advocating to ensure that federal policies enable patients and trusted physicians to choose the most appropriate modality of care, whether in-person, audio/video, or audio-only.
  • AAFP has repeatedly called for additional studies of telehealth utilization to assess how policy changes during the COVID pandemic have impacted access, patient outcomes, and care continuity across different demographic groups to assess disparities and inform policy solutions to advance health equity.

AAFP opposes legislation to expand scope of practice for nonphysicians

Why it matters:

Physician-led team-based care ensures patients receive safe, cost-effective, and efficient care. Without physician direction and supervision, medical care will become even more uncoordinated and fractured, leading to less effective and duplicative services, higher costs, and lower-quality patient care.

What we’re working on:

  • AAFP signed a joint letter, along with more than 80 health organizations, opposing the I CAN Act (H.R. 8812), which would expand the scope of practice for non-physician practitioners and endanger the quality of care Medicare and Medicaid patients receive.

Robert Graham Center report reveals state of integrated primary care and behavioral health in the U.S.

Access to behavioral health services in the United States is becoming increasingly difficult and, at the same time, the need for these services is growing. Fifteen to 20% of adults in the United States report having been diagnosed with depression or mental illness, and 10% to 15% report suffering severe psychological distress in the past year. Fewer than 50% of those with a mental illness report receiving care in past year.

A new report from the Robert Graham Center explores the state of integrated behavioral health in primary care and its role in providing equitable access to and delivery of behavioral health services.

New report highlights need for investment in primary care

Why it matters:

A recent report from Definitive Healthcare emphasized the severe burnout primary care physicians faced in 2021. The report showed that family medicine is one of the most stressed specialties, with an estimated 13,000 family physicians leaving the workforce last year. Of note, family physicians spend on average 17 hours a week on paperwork.

That’s why AAFP advocates for targeted investments in primary care to address workforce shortages, burnout, administrative burden, and meaningful policies to improve health outcomes. Primary care is the only health care component in which an increased supply is associated with better population health and more equitable outcomes.

For the latest policy updates impacting family medicine, follow us at @aafp_advocacy.

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