TAFP responds to CMS regarding possible E&M increases for Medicare

CMS has proposed to increase Medicare payments for the common services physicians provide, based on recommendations from the American Medical Association’s Relative-Value Committee. Boosting the payment for evaluation and management services will better reflect the work of primary care physicians to manage chronic illnesses and perform other preventative health care measures.

Recognizing the importance of this proposal as an acknowledgement of the value of primary care, TAFP leadership acted quickly to voice its support and to make suggestions to parts of the proposal that could be detrimental to primary care providers.

“Investing in increased reimbursement for E&M services will begin to correct the payment inequities in health care and will benefit the whole U.S. health care system,” TAFP President Douglas Curran, M.D., stated in a letter to CMS Administrator Mark McClellan, M.D., Ph.D., about the new measures. “ We appreciate CMS’s validation of our effort, and we strongly encourage CMS to finalize its proposal in the final rule this fall.” The letter was also sent to the Texas congressional delegation and other key contacts.

The proposal, “Medicare Program: Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule and Proposed Changes to the Practice Expense Methodology,” appeared in the June 29, 2006 Federal Register. Essentially, it redistributes $4 billion for allowed charges among specialties, with family medicine seeing a 5-percent increase. CMS’ complete proposal, detailing these changes and others, can be found on the CMS Web site. CMS will accept comments from physicians until August 21, complying with the 60-day comment period, before the final rule is made on November 1. The changes would take affect in January 2007.

Read TAFP’s letter to CMS for more information. TAFP encourages members to personalize the response letter and alert CMS to the needs of family medicine.

TAFP asks TMA to join forces on Medicare E&M payment

The Academy has requested that the Texas Medical Association join the effort to encourage CMS to adopt and finalize the proposed changes to the Medicare payment system. Some of the changes significantly boost physician payment for evaluation and management services, which will help correct payment inequities in the health care system.

“The proposed changes to the Medicare physician fee schedule for the evaluation and management of patients are positive indicators that medical reimbursement is headed in the right direction,” TAFP President Douglas Curran, M.D., stated in a letter to TMA President Ladon Homer, M.D. “These changes reflect recent studies that have conclusively shown the effectiveness of primary care in lowering health care costs and improving the overall quality of care.”

Read TAFP’s letter to TMA President Ladon Homer, M.D.

TAFP tells Senate committee that health care transparency should include smart card technology

On July 26, the Senate Committee on State Affairs heard testimony from health plans, hospitals, provider groups and business groups on the latest fad in health care cost containment schemes – transparency, a term that seems to have a different meaning for each party involved. Business groups and insurers define transparency as public disclosure of provider health care prices plus performance ratings on certain quality indicators in hopes that patients will shop for the best value. Physician groups would like transparency to mean that the patient’s insurance information is available at the point of service, making clear what will and what will not be covered. Throw into the mix the issues of hospital chargemasters, billed charges versus negotiated rates, how quality is measured and who does the measuring, and the transparency debate becomes quite opaque.

Concerns over soaring health care costs have put the issue high on the priority list as the next legislative session draws near. TAFP provided testimony to the committee to describe the economic anomalies that cause the health care marketplace to be immune from the usual legislative market remedies, concepts like price inelasticity, which holds that when you’re in desperate need, price ceases to matter. Committee chairman Robert Duncan (R-Lubbock) put it this way: “If I’m going to have heart surgery, I’m not going to shop. I’m going to call my doctor and say ‘Who’s the best surgeon in town?’ and I’m going to go to him.”

In its testimony, TAFP suggested that insurance “smart cards” are a path to transparency, reducing the confusion about what’s covered by health plans. By implementing smart card technology, patients and physicians could have the insurance information they need to make the right decisions about care before medical services are provided.

“Being on the front lines of primary care gives family physicians a unique perspective that too often is lost in the health care economics debate,” TAFP said in its testimony. “Patients need high-quality, well-integrated and coordinated care. To ensure that they receive this care, we must shore up and streamline our health care system so that ever-increasing cost and inefficiency doesn’t continue to cripple it. We believe that properly defined and implemented ‘transparency’ tools like insurance smart cards can help patients, providers and health care payers do just that.”

Read TAFP’s testimony presented to the Senate Committee on State Affairs on July 26, 2006.

Your Academy awards excellence and installs new officers at the 57th Annual Session

After a whirlwind conference containing 28 hours of CME, a couple dozen TAFP Committee and Commission meetings, over a hundred informative products and services in the Exhibit Hall and all of the special events, attendees of TAFP’s 57 th Annual Session and Scientific Assembly left Frisco re-energized about the specialty.

CME lectures, presented by some of the top experts in the country, ranged from discussions on vaccines and epidemics to robotic prostate surgery and surgical management of obesity. Keynote speakers David Sherman, M.D., and AAFP President Larry Fields, M.D., presented engaging lectures on stroke management and the value of family medicine, respectively. Thursday’s three-hour workshops provided a closer look at geriatric medicine, preceptoring, new medications for office-based maintenance and detoxification, and risk management. TAFP plans to repeat the popular Procedures Workshop at the 2007 Annual Session. This year’s workshop examined dermatology and joint aspiration and injection and next year’s will focus on gynecological procedures and hemorrhoids.

Meet the newly installed 2006-07 officers. From left to right: President-elect Linda Siy, M.D., Vice-president K. Ashok Kumar, M.D., Treasurer Robert Youens, M.D., Parliamentarian Melissa Gerdes, M.D., and President Douglas Curran, M.D.

At the luau- themed President’s Gala, Saturday, July 22, Dr. Fields officiated the installation of TAFP’s 2006-2007 officers. For the next year, President Douglas Curran, M.D.; President-elect Linda Siy, M.D.; Vice President K. Ashok Kumar, M.D.; Treasurer Robert Youens, M.D.; and Parliamentarian Melissa Gerdes, M.D., will serve as the Academy’s official leadership.

Over 100 members participated in TAFP’s Committee and Commission meetings, where Academy members formed policy on pressing issues to the medical community. Some topics discussed included private sector advocacy, pay for performance, scope of practice and increasing research opportunities for family physicians. Look for future action on these topics as the Academy works to champion family medicine. The town hall meeting about retail health clinics held Friday night allowed members to bounce their concerns off of an expert panel comprised of Dr. Fields, Dr. Melissa Gerdes and Dr. Roland Goertz. The debate aired important points of view that will help shape the Academy’s plan of action toward our goal of maintaining a high quality of care for patients.

In the middle of the business, the Awards Lunch allowed the Academy to recognize a few of its outstanding members and friends. TAFP President Samuel T. Coleridge, D.O., presided over the ceremony.

The 2007 Physician of the Year Award went to Erica Swegler, M.D., of Keller, Texas, a partner in North Hills Family Medicine, P.A. She is recognized for her work in preventative medicine, specifically promoting immunizations and screening tests for cancer and diabetes-related complications in her patients. Dr. Swegler has served the Academy as president, vice-president and treasurer as well as the chair of several committees and commissions. Within her community, Dr. Sweger serves as the team physician for the Keller High School football team and is active in her church.

Erica Swegler, M.D., accepts the 2006-07 Physician of the Year Award from TAFP President Samuel T. Coleridge, D.O.

Two extraordinary physicians share the honor of being named this year’s Physicians Emeriti. Husband and wife Robert Chapman, M.D., and Martha Chapman, M.D., of Fort Worth, Texas, have practiced family medicine for more than 50 years. The Chapmans’ patients praise them for outstanding dedication to their community’s health needs while their colleagues call them role models for all family physicians.

Dr. Coleridge presented three special awards, the Unsung Hero awards and the Presidential Award of Merit. He recognized his wife, Maryann, and assistant, Carol Knisley, for providing support and guidance to him during his presidency. Eduardo Sanchez, M.D., received the Presidential Award of Merit for his important role as the commissioner of the Texas Department of State Health Services. Dr. Sanchez has provided the leadership needed in Texas to make immunizations, obesity and emergency preparedness top priorities in the state.

Other awardees included Thomas F. Gavagan, M.D., the Public Health Award; K. Ashok Kumar, M.D., the Exemplary Teaching Award; Glen Johnson, M.D., Philanthropist of the Year; Charles Bell, M.D., the Patient Advocacy Award; Henry Boehm, M.D., the TAFP Political Action Committee Award; and the University of North Texas Health Science Center at Fort Worth, for the Medical School Award of Achievement. TAFP Foundation scholarship recipients include Daniel Clearfield, Travis Brown, Peter Ruiz, M.D., Maribel Sanchez, Reshma Lakhiani, Linda Jo Saenz, M.D., Josephine Watson, Ashley Gallagher, Kristen S. Walkinshaw, Jeremiah Seely, and Regina K. Lee, M.D.

TAFP looks forward to making the CME, committee and commission meetings, exhibit hall and special events of the 2007 Annual Session and Scientific Assembly in Corpus Christi even better. We’ll see you there.

Get tools to help patients quit smoking

Smoking cigarettes can damage nearly every organ in the human body, it is linked to at least 10 different cancers including lung cancer--the most preventable form of cancer in our society--and it accounts for 30 percent of all cancer deaths in the United States. All family physicians have heard these warnings about smoking, but they often neglect to address the issue in the exam room. Primary care physicians have a unique ability to counsel patients on whole-body health and influence their tobacco use, and simply asking patients about smoking can make the difference.

AAFP’s project Ask and Act gives physicians the tools to identify patients who smoke and help them quit. Through the support of the Smoking Cessation Leadership Center at the University of California, San Francisco and the Robert Wood Johnson Foundation, the national Academy has produced CME and an online toolkit containing lapel pins, prescription pads, wall posters, quitline referral cards, other patient education materials and information on physician payment for tobacco cessation counseling.

To request an Ask and Act toolkit and for more information, visit the Ask and Act Web site or contact AAFP’s Mary Theobald.

Free fitness CME course available

Earn two Prescribed CME credits by viewing a free, live webcast provided by AAFP. “AIM to Change: Encouraging Fitness for All,” will be shown Wednesday, Aug. 16 at noon. Presented by Michelle May, M.D., F.A.A.F.P., the founder and medical director of a multidimensional weight management program, the course will provide physicians with information to pass on to patients and help them get fit. The webcast specifically encourages health care providers to:

• Make system and culture changes to promote the three components of fitness,
• Approach every patient encounter as an opportunity to engage in a fitness conversation,
• Utilize behavioral counseling techniques to open a dialogue,
• Reinforce a long-term commitment to improving health and making lasting changes,
• Use the AIM to change resources to move patients toward better health, and
• Maximize reimbursement for treatment and management of conditions related to overweight and obesity.

Although the webcast is free, advance registration is required and must be completed by August 14. Visit https://americansinmotion.webex.com/ and click on “enroll.” Questions can be directed to AAFP’s Mary Theobald.

Register online for TAFP's Primary Care Summit

Online registration for the 2006 Primary Care Summit is now available on the TAFP Web site. Join TAFP at the Westin Oaks in Houston October 13-15, 2006 for one of the Academy’s most anticipated CME conferences. Attendees can earn up to 24.75 AMA PRA Category 1 Credits™ , including a required ethics hour, with only one day out of the office. The early bird registration discount is only available until September 12, so register today to reserve your spot.

Copyright 2006, Texas Academy of Family Physicians