“Health insurers have initiated and perpetrated, with the assistance and acquiescence of the Affordable Care Act, a program of high deductible insurance plans that are designed to shift more cost of care to patients,” the New Jersey resolution stated. “Such costs will deter a large segment of middle-class and lower middle-class patients from seeking care and force primary-care physicians to be the agents of collections and cost administrators for insurers.”
The resolution goes on to state how high-deductible plans “will create a catastrophic effect on the delivery of care by driving small practices out of business” and leading patients to either postpone needed treatments or to seek care in hospital emergency departments.
Asked about the resolution, AAFP President Dr. Reid Blackwelder declined to take a stand but noted that the organization as a whole is concerned about the impact of high-deductible plans.
“We want all Americans to be covered with insurance, but we need coverage that meets their needs and is affordable,” said Blackwelder, whose term as president of the 115,900-member organization ends Oct. 22.
Blackwelder also noted that two provisions in the ACA that had positive implications for AAFP members are set to expire Dec. 31: the 10% Medicaid primary-care bonus and its Medicaid-parity provision, which put primary-care Medicaid payments on par with Medicare rates for 2013 and 2014.
Blackwelder said he was heartened by the results of Kaiser Family Foundation survey of state Medicaid directors that indicated how at least 15 states were going to continue reimbursing primary-care physicians at a higher rate for Medicaid patients, 14 states are still evaluating their position, and 22 states have indicated they would not be continuing the higher rates for Medicaid services, according to the survey, which also included the District of Columbia.
“We applaud and appreciate the wisdom of the states that will continue with the higher Medicaid payments,” Blackwelder said.
“These patients are already in the system, they're just in all the wrong places,” he added. “It's really a disincentive. You want me to take more Medicaid patients but, in two months, you'll go back to reimbursing with inadequate payments.”
Another focus of the meeting will be increasing the number of family medicine graduate medical education residency training positions, Blackwelder said.
The week's activities end with the Thursday kickoff of the Family Medicine for America's Health campaign, which Blackwelder said builds on the success of the Future of Family Medicine project. That initiative, launched in 2002, resulted in the development and dissemination of the patient-centered medical home practice model.
“The campaign is about how we will continue to reform how healthcare is delivered, how it's paid for and how we train the family physician workforce that the nation needs,” Blackwelder said.