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Physician Payment Reform, P4P, AHRQ

The Hospitalist. 2007 June;2007(06):

In March, SHM and 50 other members of the coalition sent a letter to the chairs and ranking members of the House and Senate Appropriations committees recommending that AHRQ receive $350 million in FY 2008, an increase of $31 million over FY 2007. The groups pointed out that while AHRQ is charged with supporting research to improve healthcare quality, reduce costs, advance patient safety, decrease medical errors, eliminate healthcare disparities, and broaden access to essential services, “precarious funding levels threaten the agency’s ability to achieve this important mission, at a time when healthcare costs are at an all-time high.”

Funding for NIH and Other Agencies

SHM also routinely joins with other organizations in urging Congress to increase funding for the National Institutes of Health (NIH) and other public health programs.

A Feb. 26 letter, signed by SHM and 405 other health organizations, urged Congress to increase FY 2008 funding for public health programs by an additional $4 billion, or 7.8%, above the FY 2007 level. The letter states that this increase in the FY 2008 budget for Function 550 discretionary health programs such as NIH, AHRQ, and CDC will “reverse the erosion of support for the continuum of biomedical, behavioral and health services research, community-based disease prevention and health promotion, basic and targeted services for the medically uninsured and those with disabilities, health professions education, and robust regulation of the nation’s food and drug supply.”

Access to Care

Recognizing SHM member interest—and that of the 110th Congress—in initiatives to expand healthcare coverage to the nation’s 47 million uninsured, the PPC is reviewing legislative proposals being considered in this area.

At the committee’s recommendation, SHM sent a letter of support for the Health Partnership Act (S. 325/H.R. 506), which would establish a grant program to promote the development of innovative health coverage initiatives at the state level. In the letter, then-SHM President Mary Jo Gorman, MD, MBA, commended the sponsors for “giving state and local governments the flexibility to test a variety of options for improving access so they can address the unique needs of their uninsured populations.”

She noted that many hospitalist programs exist to manage the burgeoning population of uninsured and underinsured patients who require hospitalization, and offered SHM’s help in moving the bill through Congress.

Grass-roots Advocacy

Politically active members are an organization’s best resource when it comes to influencing healthcare policy on Capitol Hill. Building on the relationships established during SHM’s first Advocacy Day held during the 2006 annual meeting, PPC members traveled to Washington D.C., in February to brief members of Congress and their staffs on SHM’s 2007 legislative priorities, including support for initiatives designed to improve the quality, safety, and cost effectiveness of inpatient medical care.

More than 30 appointments were scheduled with lawmakers and their staffs, many of whom sit on the key congressional committees with jurisdiction over the Medicare and Medicaid programs. Each PPC member had from five to eight visits. They continued the process of educating Congress about the specialty of hospital medicine that began during Advocacy Day and the role of hospitalists in improving the quality of care provided in our nation’s hospitals. It was time well spent. Lawmakers and their staffs were eager to learn about hospital medicine and our support for increased funding for AHRQ, pay-for-reporting, and legislation like the Health Partnership Act.

Allendorf is senior adviser, advocacy and government relations, for SHM.

Hospital Medicine Fast Facts

Staffing by the Numbers

  • On average, a hospital medicine group employs 8.0 FTE physicians.
  • 16% of hospital medicine groups employ physician assistants (PAs); these groups employ an average of 2.0 FTE PAs.
  • 20% of hospital medicine groups employ nurse practitioners. (NPs); these groups employ an average of 1.9 FTE NPs.
  • 9% of hospital medicine groups employ other clinical staff; these groups employ an average of 3.1 FTE other clinical staff.
  • 51% of hospital medicine groups employ non-clinical staff; these groups employ an average of 1.7 FTE non-clinical staff.
  • Between 2004 and 2005, the average growth in staff was 29%

To order a copy of the “SHM Bi-Annual Survey on the State of the Hospital Medicine Movement,” visit www.hospitalmedicine.org/shmstore or call toll free: (800) 843-3360.