AAFP Continues To Give Full Support For More Bureaucracy

I still hear that the American Academy of Family Physicians is all we have as family doctors in terms of support. There is some truth to that but that is only because no other group has stood up and taken the reigns from them.   A 15-page letter (yes, 15 pages) signed by AAFP Board Chair John Meigs, M.D., of Centreville, Ala., noted that the Academy’s recommendations are meant to “continue to strengthen primary care for Medicare beneficiaries, to enable more physicians to participate in Advanced Alternative Payment Models (AAPMs), and to further reduce the administrative and regulatory burdens family physicians face in the Merit-based Incentive Payment System (MIPS)”.

I am at the point in my career where I actually think I am reading another language when I see this crap.  I am told the AAFP is going to fix family medicine with the following:

The AAFP relayed its support for portions of the QPP and suggestions for improving other sections by:

  • expressing support for an opt-in pathway for family physicians and other MIPS-eligible clinicians who fall below the agency’s low-volume threshold;
  • suggesting it would be “both beneficial and logical” if physicians in similar practices who are part of a larger multispecialty group reported quality as a smaller subgroup;
  • asking CMS to ensure there is parity in quality reporting by insisting all eligible clinicians submit data on six measures using cross-cutting measures if necessary; 
  • opposing use of certain measures in the QPP — specifically, Medicare spending per beneficiary and total per capita cost — because those two measures were intended for use at the tax identification level and may not be valid at the solo/small practice level;
  • requesting that CMS hold physicians harmless in the cost category if they cannot be “reliably measured against at least one episode-based cost measure” and do so at least until CMS can create a “more even and meaningful playing field;”
  • reiterating concerns about complex scoring in the MIPS performance categories;
  • supporting CMS’ exemption of alternative payment model entities enrolled in round one of the Comprehensive Primary Care Plus program from the Medical Home Model-eligible clinician limit, and urging the agency to extend the exemption across the board;
  • agreeing with CMS’ suggested definition of “Other Payer Medical Home Model” and suggesting ways to strengthen the primary care emphasis;
  • calling on CMS to make payers responsible for submitting relevant information on payer arrangements;
  • giving full support to the Physician-Focused Payment Model Technical Advisory Committee’s role in evaluating physician-focused payment models;
  • and remaining in full support of CMS’ plan to establish a policy for extreme and uncontrollable circumstance policies for the MIPS performance categories without requiring clinicians to submit an application.

I am not the smartest guy in the world but I see a ton of words like “support”, “agreeing”, “remaining in full support”, etc.  They write this stuff as if they are a pre-teen scribbling a note to his/her crush and then worrying that it may come off wrong.

Why would any doctor want to give money to this organization so they can sit around and pay their lawyers to come up with this crap?

This healthcare system is a big, smelly turd and the AAFP continues to brag about how well they can polish it.  Direct Primary Care is Michelangelo’s David compared to this garbage and they ignore it like it is an eyesore. My hope is that someday family docs leave industrialized medicine and leave the AAFP because both are broken.

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