Here are seven key notes:
1. Wanda Filer, MD, AAFP board chair, wrote the letter to CMS Acting Administrator Andy Slavitt based on CMS’ proposed rule for health insurance companies offering plans on the exchanges in 2018.
2. In her letter, Dr. Filer noted reduced competition in the payer marketplace could impede patient access, and therefore may result in poor patient outcomes.
3. CMS proposed rules would mandate payers to offer both silver and gold plans in each market in which they participate. Previously, various payers offered fewer choices on the federal exchanges than the commercial marketplace.
4. In the letter, AAFP calls for the government to expand plans that offer customers more preventive services with no cost sharing for those patients who see in-network physicians, whether or not the patients have met the deductibles. Dr. Filer writes,
“Fully covering preventive services makes health insurance more attractive to young and healthy people and makes it easy for them to understand what services are and are not covered.”
5. Additionally, AAFP is asking CMS to utilize copayments, rather than coinsurance, as the cost sharing standard for patients suffering from chronic conditions that take medication continually.
6. Dr. Filer encouraged CMS to utilize prescription data coupled with patient diagnosis information when identifying risk.
7. She concluded the letter stating, “Ultimately, the AAFP wants more choices available for patients, who too often raise concerns to their family physician about plans, premiums, benefits and seeing the doctor they want to.”
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