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Family docs: Don't nix Medicaid pay boost


By Andis Robeznieks
Posted: December 7, 2012 - 12:30 pm ET
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(Updated with comment from AAFP President Dr. Jeffrey Cain at 5 p.m. ET.)

The American Academy of Family Physicians is mobilizing its 105,900 members to let Congress know it opposes a proposal to pay for suspending the scheduled 26.5% Medicare payment cuts by cutting Medicaid primary-care pay increases. The group also opposes allowing across-the-board sequestration-driven pay cuts to reduce funding for graduate medical education physician-training programs and sequestration-driven cuts to programs such as the National Health Services Corps, which encourages new doctors to practice in underserved areas.

The Leawood, Kan.-based group also was one of 41 national organizations to sign a letter to congressional leaders (PDF) stating opposition to eliminating the temporary Medicaid primary-care increase for which the Patient Protection and Affordable Care Act called.

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"As organizations representing the majority of the country's physicians, we write to express our strong opposition to proposals that would eliminate the Medicaid primary-care payment increase" that was finalized in a CMS rule scheduled to take effect Jan. 1, the letter stated.

In an interview, AAFP President Dr. Jeffrey Cain said it isn't fair for the federal government to expect physicians to invest in electronic health records or transforming their practices into patient-centered medical homes while facing a 26.5% Medicare pay cut. Cain said Congress needs to find a replacement for the sustainable growth-rate Medicare payment formula, and acknowledged that it could take another one- to two-year suspension to do so—but another source of funds needs to be found to pay for this suspension instead of the money allocated for a Medicaid pay increase.

“It's not even like robbing Peter to pay Paul, it's like robbing Peter to make a loan to Paul,” Cain said. “It seems like a bad investment.”

In addition to the 41 national organizations, the letter is signed by most state medical societies and most state chapters of the AAFP, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association.

"Elimination of this policy further burdens the already-challenged Medicaid system of today," the organizations argued in the letter. "Patients will face obstacles to connecting with a patient-centered medical home and will be forced to rely on episodic acute-care services provided in other settings, foregoing the more cost-effective coordinated and preventive-care services that primary-care physicians provide."

On a Web page devoted to the AAFP's three-pronged campaign, the organization stated, "We cannot afford for Congress to put family medicine at risk."


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