"This congress is very familiar with family medicine’s frustration with the RUC," said Dr. Glen Stream, whose term as AAFP president ended at the meeting. But he said that for the moment, "remaining in the RUC allows the opportunity to advocate and press for [the] changes" that the AAFP has requested.
Among those: creating primary care–specific E&M codes, valuing the codes to reflect the intensity and complexity of primary care, and paying for certain non-face-to-face services.
The AAFP has also hired Avalere Health to come up with data to support higher valuations, which the academy will take to the Centers for Medicare and Medicaid Services to use as a basis for the 2014 Medicare Physician Fee Schedule, said Dr. Stream, who now serves as AAFP board chair.
In Other Issues
The Congress of Delegates also approved a controversial resolution to end age restrictions on over-the-counter emergency contraception (EC). Under current law, women under age 16 must get a prescription to get EC. Supporters said that there is no scientific basis to prohibit younger women from getting the drug over the counter, and that it could help avert many abortions. Opponents, however, said that OTC availability would lead to fewer counseling opportunities with those young patients, and might lead to even greater sexual activity.
Among other resolutions, a proposal to oppose telemedicine when it is provided in the absence of a preexisting physician-patient relationship, was referred to the board of directors for study.
The board will also report back to the congress next year on developing model legislation that would exempt primary physicians from antitrust laws so they can collectively negotiate with health insurers. The goal is to help independent practices survive in the changing health delivery system.
Much discussion also centered on how to advance the patient-centered medical home model of care, including which, or how many organizations should certify the entities.
Dr. Douglas Henley, AAFP executive vice president, said that the medical home is the perfect environment to help control health costs and improve quality of care. The family physician can help prevent patients from becoming victims of unnecessary care, he said. Dr. Henley coined a new acronym to describe those patients: VOMIT, or "victims of multiple interventional technologies."
Finally, the AAFP leadership said that the board had given approval to generate a new report on what family medicine should look like over the next decade. The AAFP developed just such a blueprint 8 years ago; however, the research supporting that paper has become dated, said Dr. Henley.
"Now is a critical time to begin a discussion and perhaps revisit research or even initiate new research about what comprehensive primary care means in 2012 and into the future," said Dr. Henley.
That process has begun, he said, adding that AAFP members should expect to hear more in January.
*Correction, 11/06/12: A previous version of this story misstated the number of delegates and alternates at the meeting and misstated Dr. Erica Swegler's last name. The photo caption also misstated the name of the governing body.
**Correction, 12/10/12: A previous version of this story misstated Dr. Van Winkle's relation to Christopher.