BILL ANALYSIS                                                                                                                                                                                                    Ó



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          Date of Hearing:  May 6, 2014

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
                 ACR 107 (Bloom) - As Introduced:  February 21, 2014
           
          SUBJECT  :  Year of the Family Physician.

           SUMMARY  :  Designates 2014 as the Year of the Family Physician.   
          Specifically,  this resolution  :

          1)Declares, among other things, all of the following:

             a)   Family physicians are trusted members of their  
               communities; are dedicated to keeping patients as healthy  
               as possible throughout their lives; advocate for the  
               patient in an increasingly complex health care system;  
               provide care that covers all ages, sexes, each organ  
               system, and every disease; and, their practices are a place  
               for patients and families to turn to for care and needed  
               advice;

             b)   Family physicians can provide patients with a  
               patient-centered medical home (PCMH), through which they  
               receive a full range of services and individuals who  
               regularly visit a family physician in a PCMH are more  
               likely to receive preventive services, better management of  
               chronic illnesses, and have a decreased chance of premature  
               death, thereby improving health outcomes and lowering  
               costs; 

             c)   Adults in the United States who have a family physician  
               or another type of primary care physician (PCP) have 33%  
               lower health care costs and 19% lower odds of dying than  
               those who see only a specialist; and, as a nation, we would  
               save $67 billion each year if everyone saw a family  
               physician or another type of primary care provider as their  
               usual source of care; and,

             d)   There is tremendous value to ensuring that all patients  
               have access to health insurance coverage and care,  
               especially as our communities face a dire shortage of PCPs,  
               including family physicians, a problem that will be  
               exacerbated by the entrance of millions of newly insured  
               into the health care market; and, the implementation of the  








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               Patient Protection and Affordable Care Act (ACA) will lead  
               to a significant demand for experienced and well-trained  
               health care professionals who can treat a wide variety of  
               health conditions.

          2)Asserts that meeting the "Triple Aim" of better health, better  
            care, and lower costs in our health care system means placing  
            a new emphasis on primary care as provided by family  
            physicians and every patient and every family deserves a  
            family physician.

          3)Resolves that the Legislature declares 2014 as the "Year of  
            the Family Physician" in recognition of the critically  
            important role family physicians will play for patients during  
            the implementation of the ACA and beyond; and, further  
            resolves that the Chief Clerk of the Assembly transmit copies  
            of this resolution to the author for appropriate distribution.


           EXISTING STATE LAW  :

          1)Defines "PCP" as a physician who has the responsibility for  
            providing initial and primary care to patients, for  
            maintaining the continuity of patient care, and for initiating  
            referral for specialist care.  Requires a PCP to be either a  
            physician who has limited his or her practice of medicine to  
            general practice or who is a board-certified or board-eligible  
            internist, pediatrician, obstetrician-gynecologist, or family  
            practitioner.

          2)Establishes the Medical Board of California which licenses and  
            regulates physician and surgeons.

           EXISTING FEDERAL LAW  :

          1)Defines "primary care provider," pursuant to the ACA Primary  
            Care Extension Program, as a clinician who provides  
            integrated, accessible health care services and who is  
            accountable for addressing a large majority of personal health  
            care needs, including providing preventive and health  
            promotion services for men, women, and children of all ages,  
            developing a sustained partnership with patients and  
            practicing in the context of family and community, as  
            recognized by a state licensing or regulatory authority,  
            unless otherwise specified.








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           2)Defines, under the ACA, a PCMH as a mode of care that includes  
            personal physicians; whole person orientation; coordinated and  
            integrated care; safe and high-quality care through  
            evidence-informed medicine, appropriate use of health  
            information technology, and continuous quality improvements;  
            expanded access to care; and, payment that recognizes added  
            value from additional components of patient-centered care.

           FISCAL EFFECT  :  None

           COMMENTS  :

           1)PURPOSE OF THIS RESOLUTION  .  According to the author, this  
            resolution would recognize family physicians for the work they  
            do in providing preventative and restorative care to patients  
            with emotional and physical conditions, especially as their  
            role increases as the result of implementation of the ACA.   
            The author asserts that family physicians provide a very  
            important role in providing comprehensive care to their  
            patients on a wide range of ailments and disorders; and, they  
            are often the first to screen and diagnose their patients.   
            Family physicians are able to cultivate long-term  
            relationships with their patients and develop an understanding  
            of their individual medical, physical, and psychological  
            needs.  Their dedication to their patients, practice, and  
            community is a testament to their skills as medical  
            professionals.

           2)BACKGROUND  .  According to the U.S. Department of Health and  
            Human Services' Agency for Health care Research and Quality,  
            primary care is the cornerstone of health care.  PCPs are a  
            foundational element of the U.S. health care system and are  
            required to meet our nation's triple aims of improving  
            quality, containing costs, and improving patient and family  
            experience.  Primary care is also critical to ensuring access  
            to health care for all Americans and reducing disparities.   
            Whether the focus is on the individual, a population, or the  
            health care system, good access to primary care is associated  
            with more timely care, better preventive care, avoiding  
            unnecessary care, improved costs, and lower mortality.   
            Primary care by some measures is the largest aspect of our  
            health care system.  In 2008, 490 million visits were made to  
            PCPs-a bit more than half of all visits to physicians'  
            offices.








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          According to the 2010 American Medical Association (AMA)  
            Physician Masterfile, there are slightly more than 246,000  
            PCPs in the U.S.  This number, however, overestimates how many  
            are currently practicing physicians and needs to be adjusted  
            because the AMA Physician Masterfile includes some retired  
            physicians and others who have left the workforce and a  
            substantial number of primary care trained physicians now  
            practice in non-primary care settings, including as  
            hospitalists and in emergency departments.  After adjusting  
            for these factors, the number of practicing PCPs in the U.S.  
            is estimated to be approximately 209,000.  Among physicians in  
            the U.S. who spend the majority of their time in direct  
            patient care, slightly less than one-third are specialists in  
            primary care.

           3)TRIPLE AIM  .  Originally developed by the Institute for Health  
            care Improvement (IHI), the "Triple Aim" is an approach to  
            optimizing health system performance.  Adopted by the Centers  
            for Medicare and Medicaid Services (CMS), the goals of the  
            Triple Aim are defined as:  a) improving the patient  
            experience of care (including quality and satisfaction); b)  
            improving the health of populations; and, c) reducing the per  
            capita cost of health care.  According to CMS, Office of the  
            Actuary, the U.S. health care system is the most costly in the  
            world, accounting for 17% of the gross domestic product with  
            estimates that percentage will grow to nearly 20% by 2020.   
            Aging populations and increased longevity, coupled with  
            chronic health problems, have become a challenge, putting new  
            demands on medical and social services.

          In most health care settings today, no one is accountable for  
            all three dimensions of the IHI Triple Aim, although access to  
            primary care is essential.  The role and impact of primary  
            care services must be substantially broadened and new models  
            of primary care, such as the PCMH must be utilized.   
            Organizations and communities that attain the Triple Aim will  
            have healthier populations.  Patients with better access to  
            and utilization of primary care can expect less complex and  
            much more coordinated care and the burden of illnesses will  
            decrease.  Importantly, stabilizing or reducing the per capita  
            cost of care for populations will give businesses the  
            opportunity to be more competitive, lessen the pressure on  
            publicly funded health care budgets, and provide communities  
            with more flexibility to invest in activities, such as schools  








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            and the lived environment, that increase the vitality and  
            economic wellbeing of their inhabitants.

           4)PCP SHORTAGE  .  According to a study by the Robert Graham  
            Center there is a shortage of PCPs in the U.S., and the study  
            points out that California, compared to all other states,  
            could be facing the most severe shortage in the next 17 years.  
             The study suggests the state might need 8,243 more PCPs by  
            2030-that's 32% of its current workforce.  The study finds  
            that the aging population, population growth, and more  
            patients due to the ACA are driving the increased need for  
            PCPs.  As of 2010, California has more than 25,000 PCPs.  The  
            state's current population to PCP ratio of 1483:1 is greater  
            than the national average of 1463:1.

           5)SUPPORT  .  The California Academy of Family Physicians (CAFP)  
            is the sponsor of this resolution.  CAFP writes that the  
            purpose of this resolution is to recognize the cost-reducing,  
            health-improving, and lifesaving work that California's family  
            physicians are doing every day, especially during this year of  
            health reform.  There is tremendous value to ensuring that all  
            Californians have health insurance coverage, but Californians  
            also need access to care.  CAFP states that there is an  
            extensive evidence base demonstrating that when patients have  
            access to good primary care, good things happen.  Health care  
            quality and health outcomes improve, problems are diagnosed  
            earlier, self-reported health and mental health improve,  
            disparities are reduced, hospital admission rates and  
            emergency department utilization are reduced, and costs go  
            down.  In short, the entire health care system becomes more  
            efficient and effective.

           6)RELATED LEGISLATION  .

             a)   AB 2458 (Bonilla) establishes the Graduate Medical  
               Education (GME) Fund to administer and fund grants to  
               graduate medical education residency programs.  The  
               author's stated intention of this bill is to increase the  
               number of primary care residency slots in California.  AB  
               2458 is currently on the Assembly Appropriations Suspense  
               File.

             b)   AB 1176 (Bocanegra and Bonta) would have established the  
               Medical Residency Training Program to fund GME residency  
               programs in California and would have required every health  








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               insurer or health plan that provides health care coverage  
               in this state to pay an annual GME assessment of $5.00 for  
               each covered life.  AB 1176 was held under submission in  
               the Assembly Appropriations Committee.

             c)   AB 565 (Salas), Chapter 378, Statutes of 2013, revises  
               the Steven M. Thompson Physician Corps Loan Repayment  
               Program to include certain practice settings providing  
               primary care in underserved areas, that an applicant have  
               three years providing care to underserved populations or in  
               an underserved area, and gives preference to applicants who  
               agree to practice in a federally designated health  
               professional shortage area or provide care in underserved  
               areas to underserved populations.

             d)   ACR 84 (Rodriguez) proclaims May 18, 2014, though May  
               24, 2014, as Emergency Medical Services Week.  ACR 84 is  
               pending on Assembly Third Reading.

           REGISTERED SUPPORT / OPPOSITION  :  

           Support 
           
          California Academy of Family Physicians

           Opposition 
           
          None on file.

           
          Analysis Prepared by  :    Patty Rodgers / HEALTH / (916) 319-2097