AAFP Congress of Delegates Townhall – My first.

By Saphu Pradhan, MD

An evening of speeches from the executives of the AAFP was quite informative and held my attention throughout.

The AAFP Board Chair, Dr. John Cullen, began by recognizing the negative impacts of COVID on family medicine practices, residents, and physicians. He spoke about the measures AAFP took to assist members by providing education on COVID, offering free CME webinars, assisting with purchase of personal protective equipment. In Washington, the AAFP advocated for pay parity for virtual visits and phone visits to improve access for patients while helping to keep practices afloat during these tumultuous times. The AAFP lobbied for financial relief and paycheck protection measures for struggling providers. In addition, the AAFP did not increase dues for membership and extended due dates for both CME credits and dues payments.

Dr. Saphu Pradhan’s first time serving as an AAFP Alternate Delegate.

AAFP President, Dr. Gary Leroy, spoke regarding the important role family physicians have played in our healthcare system which was exemplified by the COVID pandemic. He and other AAFP executives have met with CMS leaders to address the priorities of the AAFP membership, primarily, decreasing administrative burden. In response, CMS will be revising documentation and coding guidelines January 1, 2021 to take into account the cognitive component of our jobs rather than just paying for procedures. This will allow us to spend additional time with our patients. The reimbursement rate for primary care visits will increase by approximately 13% with the addition of a G code that accounts for complexity, the level of medical decision making and work outside of face to face visits. History and physical exam will not be as big a component in coding and reimbursement. The AAFP provides education on the new coding guidelines via AAFP.org/emcoding to update EMR vendors on the new guidelines as well as Practice Hack Videos for both employed and private physicians as well as their staff. The AAFP also offers vignettes showing appropriate coding in various situations and will offer quick reference coding cards among other educational materials to assist us with the transition.

President-elect, Dr. Ada Stewart, talked about the AAFP’s role in improving health equity including safe housing, clean air, access to food amongst other needs patients may have as being essential social determinants of health. In addition, the AAFP has spoken out against racism and has provided tools and resources through the 2017 development of the Center for Diversity and Health Equity to address multiple inequities in healthcare including maternal and infant mortality, implicit bias training and institutional racism. The Utah chapter is among 12 states that has been granted access to the 2 year AAFP Implicit Bias Training Guide. The Everyone project will provide resources to identify and address social determinants of health. Health equity fellowship programs are being offered to produce leaders with subject matter expertise in these areas. The AAFP has also encouraged the US dept of Health and Human Services to collect and provide to the public race and ethnicity data of COVID patients including testing status, hospitalizations and mortality rates. The AAFP has written letters in support for a task force to address race and ethnic disparities and to condemn all forms of racism. The AAFP strives to educate members on these issues by providing virtual town halls and other resources.

The Executive VP and CEO, Shawn Martin, spoke about the rapid interventions made by the AAFP to encourage growth of telehealth and payment parity from the beginning of the COVID outbreak and worked with CMS and commercial insurances to remove geographic limitations on telehealth and will continue to work on this. The AAFP has also worked to monitor and limit the use of telehealth by vendors who employ random providers and disincentivize continuity of care. The AAFP has also advocated for advancing broadband connectivity to rural and underserved communities to improve access to telehealth.

A Q&A session was held after the speeches where we learned that the AAFP is encouraging CMS to use evidence-based information to determine which outcome measures really matter and measure outcomes differently in the management of chronic disease.

First Official Day of the Congress of Delegates: Lots of speeches, little debate.

The day started with speeches by the EVP/CEO, then the candidates for president and board of directors followed by a speech by Dr. Stewart and Dr. Leroy, the President elect and current president, respectively. Mostly a reiteration of the speeches given at the Townhall.

The Recommendations from the Organization and Finance Committee were presented by the Reference Committee.

Of note, after some debate, the COD voted against adopting the AMA Code of Ethics, the main argument against was that as an independent organization speaking for its membership of family physicians and family medicine, the AAFP maintains an independent voice.

Tomorrow is the final day of Congress and is sure to be exciting, as the final reference committee reports are debated and new officers are elected. It is a fascinating and well-polished process to participate in.