Mary Ellen Schneider

Associate Editor Denise Napoli contributed to this story.

Early signals from the incoming Obama administration have many physician groups thinking about the prospects for comprehensive health care reform.

“There are a lot of unknowns,” said Dr. Jonathan Leffert, chair of the American Association of Clinical Endocrinologists' (AACE) legislative and regulatory committee. “Anyone knows that with these reforms come a lot of potential changes. But we're going to be involved … and hopefully there at the table,” he said. “I am optimistic about what we can do.”

For the AACE, most of its legislative goals for 2009 are similar to those of 2008, including repealing the sustainable growth rate (SGR), which ties Medicare physician payments to the gross domestic product, and ensuring fair reimbursement for in-office DXA scans.

But now that a health care overhaul looks likely, Dr. Leffert said that having a voice in the shape that reform takes also is crucial.

“As endocrinologists, we want to be able to be there with our ideas related to chronic diseases like diabetes,” said Dr. Leffert. “We want to be able to put forward our thoughts and ideas as to what might be the best way to take care of a chronic disease and make that a model for chronic diseases in the reform package.”

Endocrinologists also have a thing or two to say about preventive medicine, continued Dr. Leffert. “[President Barack] Obama has discussed the issue of prevention and how important that is, and we are always trying to [convince] people to make lifestyle changes, to decrease our country's big problem with obesity. So we as an organization are going to be in the forefront of trying to give guidance to the federal government about what the priorities should be.”

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary, who Dr. Leffert called “a very energetic and enthusiastic individual.”

Sen. Daschle's experience as Senate majority leader will no doubt be an asset in his new post, added Dr. Leffert. “That [experience] in and of itself will be very useful in trying to move something as big and unwieldy as health care reform through the halls of Congress.”

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position has to be confirmed by the Senate; however, the health care czar position does not.

In another example of the focus on health care reform, Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the SGR. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians.

Associate Editor Denise Napoli contributed to this story.

Early signals from the incoming Obama administration have many physician groups thinking about the prospects for comprehensive health care reform.

“There are a lot of unknowns,” said Dr. Jonathan Leffert, chair of the American Association of Clinical Endocrinologists' (AACE) legislative and regulatory committee. “Anyone knows that with these reforms come a lot of potential changes. But we're going to be involved … and hopefully there at the table,” he said. “I am optimistic about what we can do.”

For the AACE, most of its legislative goals for 2009 are similar to those of 2008, including repealing the sustainable growth rate (SGR), which ties Medicare physician payments to the gross domestic product, and ensuring fair reimbursement for in-office DXA scans.

But now that a health care overhaul looks likely, Dr. Leffert said that having a voice in the shape that reform takes also is crucial.

“As endocrinologists, we want to be able to be there with our ideas related to chronic diseases like diabetes,” said Dr. Leffert. “We want to be able to put forward our thoughts and ideas as to what might be the best way to take care of a chronic disease and make that a model for chronic diseases in the reform package.”

Endocrinologists also have a thing or two to say about preventive medicine, continued Dr. Leffert. “[President Barack] Obama has discussed the issue of prevention and how important that is, and we are always trying to [convince] people to make lifestyle changes, to decrease our country's big problem with obesity. So we as an organization are going to be in the forefront of trying to give guidance to the federal government about what the priorities should be.”

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary, who Dr. Leffert called “a very energetic and enthusiastic individual.”

Sen. Daschle's experience as Senate majority leader will no doubt be an asset in his new post, added Dr. Leffert. “That [experience] in and of itself will be very useful in trying to move something as big and unwieldy as health care reform through the halls of Congress.”

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position has to be confirmed by the Senate; however, the health care czar position does not.

In another example of the focus on health care reform, Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the SGR. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians.

Associate Editor Denise Napoli contributed to this story.

Early signals from the incoming Obama administration have many physician groups thinking about the prospects for comprehensive health care reform.

“There are a lot of unknowns,” said Dr. Jonathan Leffert, chair of the American Association of Clinical Endocrinologists' (AACE) legislative and regulatory committee. “Anyone knows that with these reforms come a lot of potential changes. But we're going to be involved … and hopefully there at the table,” he said. “I am optimistic about what we can do.”

For the AACE, most of its legislative goals for 2009 are similar to those of 2008, including repealing the sustainable growth rate (SGR), which ties Medicare physician payments to the gross domestic product, and ensuring fair reimbursement for in-office DXA scans.

But now that a health care overhaul looks likely, Dr. Leffert said that having a voice in the shape that reform takes also is crucial.

“As endocrinologists, we want to be able to be there with our ideas related to chronic diseases like diabetes,” said Dr. Leffert. “We want to be able to put forward our thoughts and ideas as to what might be the best way to take care of a chronic disease and make that a model for chronic diseases in the reform package.”

Endocrinologists also have a thing or two to say about preventive medicine, continued Dr. Leffert. “[President Barack] Obama has discussed the issue of prevention and how important that is, and we are always trying to [convince] people to make lifestyle changes, to decrease our country's big problem with obesity. So we as an organization are going to be in the forefront of trying to give guidance to the federal government about what the priorities should be.”

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary, who Dr. Leffert called “a very energetic and enthusiastic individual.”

Sen. Daschle's experience as Senate majority leader will no doubt be an asset in his new post, added Dr. Leffert. “That [experience] in and of itself will be very useful in trying to move something as big and unwieldy as health care reform through the halls of Congress.”

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position has to be confirmed by the Senate; however, the health care czar position does not.

In another example of the focus on health care reform, Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the SGR. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians.

The national rollout of Medicare's Recovery Audit Contractor program is on hold because of protests filed by two contractors who bid unsuccessfully to be part of the program.

The dispute will be reviewed by the Government Accountability Office (GAO) and a decision is expected next month. In the interim, officials at the Centers for Medicare and Medicaid Services imposed an automatic stay on any work by the four regional recovery audit contractors (RACs) recently selected by the agency.

The stay means that the agency has postponed most of its provider outreach efforts. However, the delay is temporary and not expected to result in any substantive changes to the program, according to CMS.

The RAC program is aimed at identifying and correcting improper payments—both over and under—made through the Medicare fee-for-service program. But the program has been unpopular with physicians, who say it adds administrative hassles and puts the burden on physicians to prove that payments they received were correct.

The RAC program was mandated by Congress as part of the Medicare Modernization Act.

The national rollout of Medicare's Recovery Audit Contractor program is on hold because of protests filed by two contractors who bid unsuccessfully to be part of the program.

The dispute will be reviewed by the Government Accountability Office (GAO) and a decision is expected next month. In the interim, officials at the Centers for Medicare and Medicaid Services imposed an automatic stay on any work by the four regional recovery audit contractors (RACs) recently selected by the agency.

The stay means that the agency has postponed most of its provider outreach efforts. However, the delay is temporary and not expected to result in any substantive changes to the program, according to CMS.

The RAC program is aimed at identifying and correcting improper payments—both over and under—made through the Medicare fee-for-service program. But the program has been unpopular with physicians, who say it adds administrative hassles and puts the burden on physicians to prove that payments they received were correct.

The RAC program was mandated by Congress as part of the Medicare Modernization Act.

The national rollout of Medicare's Recovery Audit Contractor program is on hold because of protests filed by two contractors who bid unsuccessfully to be part of the program.

The dispute will be reviewed by the Government Accountability Office (GAO) and a decision is expected next month. In the interim, officials at the Centers for Medicare and Medicaid Services imposed an automatic stay on any work by the four regional recovery audit contractors (RACs) recently selected by the agency.

The stay means that the agency has postponed most of its provider outreach efforts. However, the delay is temporary and not expected to result in any substantive changes to the program, according to CMS.

The RAC program is aimed at identifying and correcting improper payments—both over and under—made through the Medicare fee-for-service program. But the program has been unpopular with physicians, who say it adds administrative hassles and puts the burden on physicians to prove that payments they received were correct.

The RAC program was mandated by Congress as part of the Medicare Modernization Act.

Fate of Frozen Embryos Explored

Couples undergoing fertility treatment would rather store their cryopreserved embryos for future pregnancy attempts or donate them for research than discard them or give them to another couple, according to a survey of more than 1,000 individuals whose embryos had been preserved. However, not all couples are able to take advantage of the option of donating their embryos for research. Restrictions on the use of federal funding in the destruction of embryos and some state laws banning embryo research have limited the availability of this option, according to the study authors. Slightly more than half of respondents said they would be very likely to store the embryos so they could have another child, and 21% said they would be very likely to donate the embryos for research; only 7% of survey respondents said they would be very likely to donate their unused embryos to others trying to have a baby, and only 6% said they would be very likely to thaw and dispose of the excess embryos.

Give the Gift of Women's Health

Planned Parenthood of Indiana has stirred up controversy by offering holiday gift certificates for services at its centers. The gift certificates can be purchased online in $25 increments. The idea is to help the 800,000 uninsured residents of the state who struggle to afford basic health services, according to Betty Cockrum, president and CEO of the state group. However, the gift certificates can also be used by people with insurance to help offset the cost of copayments or uncovered medications. “The gift certificates are also a wonderful idea for that person in your life who puts everyone else first and has been putting off taking care of her or his own health,” Ms. Cockrum said in a statement announcing the program. The program has raised the ire of antiabortion groups, as the certificates can be used for any service offered at the health centers, including abortion.

Defensive Medicine $1.4B in Mass.

Defensive medicine—physicians ordering tests, procedures, referrals, hospitalizations, or prescriptions because of fear of being sued—is widespread and adds a minimum of $1.4 billion per year to the cost of health care in Massachusetts, according to a physician survey conducted by the Massachusetts Medical Society. The physicians' group said that defensive practices also reduce access to care and may be unsafe for patients. The survey queried nearly 900 physicians in eight specialties between November 2007 and April 2008 about their use of seven tests and procedures. Of the respondents, 83% said they practice defensive medicine. The survey also found that 13% of hospitalizations and 18%–28% of various tests, procedures, referrals, and consultations were ordered for defensive reasons. The society said that patients are unnecessarily exposed to radiation and possible severe allergic reactions when subjected to tests ordered for defensive purposes.

Group Calls for Cancer Action

A coalition of cancer organizations has put together a six-item to-do list for the incoming Obama administration. The tasks include increasing the availability of vaccines shown to prevent cancer-causing infections, promoting culturally sensitive risk reduction and education campaigns, and investing in cancer research and access to prevention and early detection. In addition, the coalition urged the new president to commit to a comprehensive tobacco control program within the United States, ratify an international tobacco-control treaty, and support efforts by nongovernmental organizations to assist cancer survivors. The aim of the plan is to reverse the growing global cancer burden, according to the coalition. Although cancer incidence and deaths are declining in the United States, the global rate of cancer is projected to rise about 1% each year.

Workers Have Uninsured Children

Approximately 8.6 million children in the United States are uninsured, and most of these are in working families, according to a report from the advocacy group Families USA. In fact, almost 90% of uninsured children are in families where one parent works, and more than two-thirds live in households where at least one family member works full-time, year-round. The report, based on new Census Bureau data from 2005 through 2007, does not reflect the worsening economic situation in 2008, Families USA Executive Director Ron Pollack said at a press briefing. Mr. Pollack said the report points out the need for Congress to move quickly to pass legislation to reauthorize and expand the State Children's Health Insurance Program, now scheduled to expire on March 31.

Fate of Frozen Embryos Explored

Couples undergoing fertility treatment would rather store their cryopreserved embryos for future pregnancy attempts or donate them for research than discard them or give them to another couple, according to a survey of more than 1,000 individuals whose embryos had been preserved. However, not all couples are able to take advantage of the option of donating their embryos for research. Restrictions on the use of federal funding in the destruction of embryos and some state laws banning embryo research have limited the availability of this option, according to the study authors. Slightly more than half of respondents said they would be very likely to store the embryos so they could have another child, and 21% said they would be very likely to donate the embryos for research; only 7% of survey respondents said they would be very likely to donate their unused embryos to others trying to have a baby, and only 6% said they would be very likely to thaw and dispose of the excess embryos.

Give the Gift of Women's Health

Planned Parenthood of Indiana has stirred up controversy by offering holiday gift certificates for services at its centers. The gift certificates can be purchased online in $25 increments. The idea is to help the 800,000 uninsured residents of the state who struggle to afford basic health services, according to Betty Cockrum, president and CEO of the state group. However, the gift certificates can also be used by people with insurance to help offset the cost of copayments or uncovered medications. “The gift certificates are also a wonderful idea for that person in your life who puts everyone else first and has been putting off taking care of her or his own health,” Ms. Cockrum said in a statement announcing the program. The program has raised the ire of antiabortion groups, as the certificates can be used for any service offered at the health centers, including abortion.

Defensive Medicine $1.4B in Mass.

Defensive medicine—physicians ordering tests, procedures, referrals, hospitalizations, or prescriptions because of fear of being sued—is widespread and adds a minimum of $1.4 billion per year to the cost of health care in Massachusetts, according to a physician survey conducted by the Massachusetts Medical Society. The physicians' group said that defensive practices also reduce access to care and may be unsafe for patients. The survey queried nearly 900 physicians in eight specialties between November 2007 and April 2008 about their use of seven tests and procedures. Of the respondents, 83% said they practice defensive medicine. The survey also found that 13% of hospitalizations and 18%–28% of various tests, procedures, referrals, and consultations were ordered for defensive reasons. The society said that patients are unnecessarily exposed to radiation and possible severe allergic reactions when subjected to tests ordered for defensive purposes.

Group Calls for Cancer Action

A coalition of cancer organizations has put together a six-item to-do list for the incoming Obama administration. The tasks include increasing the availability of vaccines shown to prevent cancer-causing infections, promoting culturally sensitive risk reduction and education campaigns, and investing in cancer research and access to prevention and early detection. In addition, the coalition urged the new president to commit to a comprehensive tobacco control program within the United States, ratify an international tobacco-control treaty, and support efforts by nongovernmental organizations to assist cancer survivors. The aim of the plan is to reverse the growing global cancer burden, according to the coalition. Although cancer incidence and deaths are declining in the United States, the global rate of cancer is projected to rise about 1% each year.

Workers Have Uninsured Children

Approximately 8.6 million children in the United States are uninsured, and most of these are in working families, according to a report from the advocacy group Families USA. In fact, almost 90% of uninsured children are in families where one parent works, and more than two-thirds live in households where at least one family member works full-time, year-round. The report, based on new Census Bureau data from 2005 through 2007, does not reflect the worsening economic situation in 2008, Families USA Executive Director Ron Pollack said at a press briefing. Mr. Pollack said the report points out the need for Congress to move quickly to pass legislation to reauthorize and expand the State Children's Health Insurance Program, now scheduled to expire on March 31.

Fate of Frozen Embryos Explored

Couples undergoing fertility treatment would rather store their cryopreserved embryos for future pregnancy attempts or donate them for research than discard them or give them to another couple, according to a survey of more than 1,000 individuals whose embryos had been preserved. However, not all couples are able to take advantage of the option of donating their embryos for research. Restrictions on the use of federal funding in the destruction of embryos and some state laws banning embryo research have limited the availability of this option, according to the study authors. Slightly more than half of respondents said they would be very likely to store the embryos so they could have another child, and 21% said they would be very likely to donate the embryos for research; only 7% of survey respondents said they would be very likely to donate their unused embryos to others trying to have a baby, and only 6% said they would be very likely to thaw and dispose of the excess embryos.

Give the Gift of Women's Health

Planned Parenthood of Indiana has stirred up controversy by offering holiday gift certificates for services at its centers. The gift certificates can be purchased online in $25 increments. The idea is to help the 800,000 uninsured residents of the state who struggle to afford basic health services, according to Betty Cockrum, president and CEO of the state group. However, the gift certificates can also be used by people with insurance to help offset the cost of copayments or uncovered medications. “The gift certificates are also a wonderful idea for that person in your life who puts everyone else first and has been putting off taking care of her or his own health,” Ms. Cockrum said in a statement announcing the program. The program has raised the ire of antiabortion groups, as the certificates can be used for any service offered at the health centers, including abortion.

Defensive Medicine $1.4B in Mass.

Defensive medicine—physicians ordering tests, procedures, referrals, hospitalizations, or prescriptions because of fear of being sued—is widespread and adds a minimum of $1.4 billion per year to the cost of health care in Massachusetts, according to a physician survey conducted by the Massachusetts Medical Society. The physicians' group said that defensive practices also reduce access to care and may be unsafe for patients. The survey queried nearly 900 physicians in eight specialties between November 2007 and April 2008 about their use of seven tests and procedures. Of the respondents, 83% said they practice defensive medicine. The survey also found that 13% of hospitalizations and 18%–28% of various tests, procedures, referrals, and consultations were ordered for defensive reasons. The society said that patients are unnecessarily exposed to radiation and possible severe allergic reactions when subjected to tests ordered for defensive purposes.

Group Calls for Cancer Action

A coalition of cancer organizations has put together a six-item to-do list for the incoming Obama administration. The tasks include increasing the availability of vaccines shown to prevent cancer-causing infections, promoting culturally sensitive risk reduction and education campaigns, and investing in cancer research and access to prevention and early detection. In addition, the coalition urged the new president to commit to a comprehensive tobacco control program within the United States, ratify an international tobacco-control treaty, and support efforts by nongovernmental organizations to assist cancer survivors. The aim of the plan is to reverse the growing global cancer burden, according to the coalition. Although cancer incidence and deaths are declining in the United States, the global rate of cancer is projected to rise about 1% each year.

Workers Have Uninsured Children

Approximately 8.6 million children in the United States are uninsured, and most of these are in working families, according to a report from the advocacy group Families USA. In fact, almost 90% of uninsured children are in families where one parent works, and more than two-thirds live in households where at least one family member works full-time, year-round. The report, based on new Census Bureau data from 2005 through 2007, does not reflect the worsening economic situation in 2008, Families USA Executive Director Ron Pollack said at a press briefing. Mr. Pollack said the report points out the need for Congress to move quickly to pass legislation to reauthorize and expand the State Children's Health Insurance Program, now scheduled to expire on March 31.

Call Made for Memory Screening

Congress should develop a national dementia screening policy, the Alzheimer's Foundation of America said in a report. “Our nation must elevate age-related health issues to a high priority, and memory screenings need to be a critical part of that discussion,” Dr. Richard E. Powers, chairman of the foundation's medical advisors, said in a statement. He coauthored the report, which supports memory screening while acknowledging ethical, pragmatic, and theoretical issues surrounding such testing. The report said that 5- to 10-minute screening tests don't in themselves establish a diagnosis and so shouldn't have adverse consequences. The national policy could create a panel of experts and consumers tasked with recommending when physicians should do screening. The report also called for more medical school training in dementia. “This is a real world problem of escalating proportions,” said Dr. Powers.

MS Research Made Strides in 2008

Researchers made a number of significant advances in both clinical and laboratory studies last year that could boost the understanding and treatment of multiple sclerosis, said the National Multiple Sclerosis Society. There are currently more than 130 clinical trials in MS underway around the world, including at least a dozen late-phase clinical trials for new therapies, the society said. For example, Acorda Therapeutics Inc. is expected to soon seek approval of the drug Fampridine-SR (4-aminopyridine) to treat mobility issues in MS. The drug was helped improve walking speed in a clinical trial of 240 patients with all types of MS. Also in 2008, at least three phase II trials showed drugs' capacity to treat relapsing-remitting MS, said the society. It also began discussions with several pharmaceutical companies about fast-tracking novel therapies and testing existing drugs against MS.

Obama Picks Science Team

President Obama has begun assembling his team of key science and technology advisers. Last month, he tapped three well-known scientists for top jobs in the administration, including Dr. Harold Varmus as cochair of the President's Council of Advisors on Science and Technology. He is a Nobel Prize winner who headed the National Institutes of Health under President Bill Clinton. Cochairing the council will be Eric Lander, Ph.D., one of the leaders of the Human Genome Project and a professor of biology at the Massachusetts Institute of Technology and Harvard Medical School in Boston. The final cochair of the council will be John Holdren, Ph.D., who will also serve as director of the White House Office of Science and Technology Policy. Dr. Holdren is director of the Program on Science, Technology, and Public Policy at Harvard's Kennedy School of Government.

Coalition Describes Ideal FDA Pick

The next commissioner of the Food and Drug Administration should be a proven manager who can rise above politics, according to a coalition of a patient advocacy groups. The group of more than 30 organizations, including the ALS Association and the Parkinson's Action Network, wrote a letter to Health and Human Services secretary-designate Tom Daschle calling for the Obama administration to fill the FDA post quickly. Candidates for the job shouldn't be excluded because of ties to the pharmaceutical or device industries, the coalition advised. “Diverse experience, including that with an FDA-regulated industry, should be viewed as a positive qualification,” the letter said.

RAC Program Heavily Criticized

Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the Practicing Physicians Advisory Council. The program is currently on hold while the Government Accountability Office studies whether CMS has properly implemented it. During a demonstration project, however, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those determinations were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested from practices of various sizes. Even with those plans, PPAC panelists recommended further limits and suggested that the CMS require auditors to reimburse providers for fulfilling records requests. PPACmembers said more information should be available on the appeals process.

Call Made for Memory Screening

Congress should develop a national dementia screening policy, the Alzheimer's Foundation of America said in a report. “Our nation must elevate age-related health issues to a high priority, and memory screenings need to be a critical part of that discussion,” Dr. Richard E. Powers, chairman of the foundation's medical advisors, said in a statement. He coauthored the report, which supports memory screening while acknowledging ethical, pragmatic, and theoretical issues surrounding such testing. The report said that 5- to 10-minute screening tests don't in themselves establish a diagnosis and so shouldn't have adverse consequences. The national policy could create a panel of experts and consumers tasked with recommending when physicians should do screening. The report also called for more medical school training in dementia. “This is a real world problem of escalating proportions,” said Dr. Powers.

MS Research Made Strides in 2008

Researchers made a number of significant advances in both clinical and laboratory studies last year that could boost the understanding and treatment of multiple sclerosis, said the National Multiple Sclerosis Society. There are currently more than 130 clinical trials in MS underway around the world, including at least a dozen late-phase clinical trials for new therapies, the society said. For example, Acorda Therapeutics Inc. is expected to soon seek approval of the drug Fampridine-SR (4-aminopyridine) to treat mobility issues in MS. The drug was helped improve walking speed in a clinical trial of 240 patients with all types of MS. Also in 2008, at least three phase II trials showed drugs' capacity to treat relapsing-remitting MS, said the society. It also began discussions with several pharmaceutical companies about fast-tracking novel therapies and testing existing drugs against MS.

Obama Picks Science Team

President Obama has begun assembling his team of key science and technology advisers. Last month, he tapped three well-known scientists for top jobs in the administration, including Dr. Harold Varmus as cochair of the President's Council of Advisors on Science and Technology. He is a Nobel Prize winner who headed the National Institutes of Health under President Bill Clinton. Cochairing the council will be Eric Lander, Ph.D., one of the leaders of the Human Genome Project and a professor of biology at the Massachusetts Institute of Technology and Harvard Medical School in Boston. The final cochair of the council will be John Holdren, Ph.D., who will also serve as director of the White House Office of Science and Technology Policy. Dr. Holdren is director of the Program on Science, Technology, and Public Policy at Harvard's Kennedy School of Government.

Coalition Describes Ideal FDA Pick

The next commissioner of the Food and Drug Administration should be a proven manager who can rise above politics, according to a coalition of a patient advocacy groups. The group of more than 30 organizations, including the ALS Association and the Parkinson's Action Network, wrote a letter to Health and Human Services secretary-designate Tom Daschle calling for the Obama administration to fill the FDA post quickly. Candidates for the job shouldn't be excluded because of ties to the pharmaceutical or device industries, the coalition advised. “Diverse experience, including that with an FDA-regulated industry, should be viewed as a positive qualification,” the letter said.

RAC Program Heavily Criticized

Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the Practicing Physicians Advisory Council. The program is currently on hold while the Government Accountability Office studies whether CMS has properly implemented it. During a demonstration project, however, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those determinations were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested from practices of various sizes. Even with those plans, PPAC panelists recommended further limits and suggested that the CMS require auditors to reimburse providers for fulfilling records requests. PPACmembers said more information should be available on the appeals process.

Call Made for Memory Screening

Congress should develop a national dementia screening policy, the Alzheimer's Foundation of America said in a report. “Our nation must elevate age-related health issues to a high priority, and memory screenings need to be a critical part of that discussion,” Dr. Richard E. Powers, chairman of the foundation's medical advisors, said in a statement. He coauthored the report, which supports memory screening while acknowledging ethical, pragmatic, and theoretical issues surrounding such testing. The report said that 5- to 10-minute screening tests don't in themselves establish a diagnosis and so shouldn't have adverse consequences. The national policy could create a panel of experts and consumers tasked with recommending when physicians should do screening. The report also called for more medical school training in dementia. “This is a real world problem of escalating proportions,” said Dr. Powers.

MS Research Made Strides in 2008

Researchers made a number of significant advances in both clinical and laboratory studies last year that could boost the understanding and treatment of multiple sclerosis, said the National Multiple Sclerosis Society. There are currently more than 130 clinical trials in MS underway around the world, including at least a dozen late-phase clinical trials for new therapies, the society said. For example, Acorda Therapeutics Inc. is expected to soon seek approval of the drug Fampridine-SR (4-aminopyridine) to treat mobility issues in MS. The drug was helped improve walking speed in a clinical trial of 240 patients with all types of MS. Also in 2008, at least three phase II trials showed drugs' capacity to treat relapsing-remitting MS, said the society. It also began discussions with several pharmaceutical companies about fast-tracking novel therapies and testing existing drugs against MS.

Obama Picks Science Team

President Obama has begun assembling his team of key science and technology advisers. Last month, he tapped three well-known scientists for top jobs in the administration, including Dr. Harold Varmus as cochair of the President's Council of Advisors on Science and Technology. He is a Nobel Prize winner who headed the National Institutes of Health under President Bill Clinton. Cochairing the council will be Eric Lander, Ph.D., one of the leaders of the Human Genome Project and a professor of biology at the Massachusetts Institute of Technology and Harvard Medical School in Boston. The final cochair of the council will be John Holdren, Ph.D., who will also serve as director of the White House Office of Science and Technology Policy. Dr. Holdren is director of the Program on Science, Technology, and Public Policy at Harvard's Kennedy School of Government.

Coalition Describes Ideal FDA Pick

The next commissioner of the Food and Drug Administration should be a proven manager who can rise above politics, according to a coalition of a patient advocacy groups. The group of more than 30 organizations, including the ALS Association and the Parkinson's Action Network, wrote a letter to Health and Human Services secretary-designate Tom Daschle calling for the Obama administration to fill the FDA post quickly. Candidates for the job shouldn't be excluded because of ties to the pharmaceutical or device industries, the coalition advised. “Diverse experience, including that with an FDA-regulated industry, should be viewed as a positive qualification,” the letter said.

RAC Program Heavily Criticized

Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the Practicing Physicians Advisory Council. The program is currently on hold while the Government Accountability Office studies whether CMS has properly implemented it. During a demonstration project, however, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those determinations were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested from practices of various sizes. Even with those plans, PPAC panelists recommended further limits and suggested that the CMS require auditors to reimburse providers for fulfilling records requests. PPACmembers said more information should be available on the appeals process.

NIAMS Rewards Collaboration

The National Institute of Arthritis and Musculoskeletal and Skin Disease has completed its first year of making grants to foster collaboration across disciplines. In 2008, the Building Interdisciplinary Research Teams (BIRT) Awards program made 1-year grants to support researchers who are already receiving NIAMS grants but who wish to work with scientists outside their normal circle. Grants were given to researchers who combined developmental biology with systems biology, soft tissue biology with imaging technologies, tissue engineering with immunology, and tissue engineering with developmental biology. In one project, researchers at the University of Pittsburgh are using elevated magnet field strengths to make magnetic resonance images of cartilage closer in resolution to optical coherence tomography images.

FDA Cracks Down on False Claims

The Food and Drug Administration and the owners of Wilderness Family Naturals have signed a consent decree that prohibits the company from making unapproved claims that its products prevent or cure diseases. Directly or through the Web sites it controlled, the company has claimed product benefits related to arthritis; chronic fatigue syndrome; HIV infection and AIDS; heart disease; hyperthyroidism; diabetes; and cancer. None of the company's products—ranging from coconut oil to spices and vitamin supplements—had been approved by the FDA for disease treatment.

COX-2s May Have Cut Bleeding

The increased use of cyclooxygenase-2 inhibitors (COX-2) instead of older NSAIDs may have contributed to a decline in hospitalizations for upper gastrointestinal bleeding, according to the Agency for Healthcare Research and Quality. From 1998 to 2006, the number of hospitalizations for upper GI bleeding per 100,000 people decreased 14%. Other medical advances—such as the 1994 recommendation by the National Institutes of Health to aggressively treat of Heliobacter pylori and more widespread use of proton pump inhibitors to control gastroesophageal reflux disease—also may have helped, said the AHRQ. However, hospitalizations for lower GI bleeding increased 8% from 1998 to 2006. The findings are based on data from the Healthcare Cost and Utilization Project 1998 and the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays.

The Ideal FDA Commissioner?

The next commissioner of the FDA should be a proven manager who can rise above politics, according to a coalition of a patient advocacy groups. The group of more than 30 organizations wrote a letter to Health and Human Services secretary-designate Tom Daschle calling for the Obama administration to fill the FDA post quickly. Candidates for the job shouldn't be excluded because of ties to the pharmaceutical or device industries, the coalition advised.

CMS Looks at Incentive Sharing

Under current federal rules governing patient referrals, physicians can't share incentive payments for quality improvement. But that might change, a Centers for Medicare and Medicaid Services official told the Practicing Physicians Advisory Council (PPAC) last month. The CMS proposed an exception under rules governing physician payment for 2009, but opposition—mainly from medical device manufacturers—killed it, said Lisa Ohrin, acting director of the Division of Technical Payment Policy at the Center for Medicare Management. She said, however, that allowing incentive payments is a priority for the CMS, so the agency will again propose allowing physicians to share the payments.

RAC Program Heavily Criticized

Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the PPAC. The program is on hold while the Government Accountability Office studies whether the CMS has properly implemented it. During a demonstration, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested.

NIAMS Rewards Collaboration

The National Institute of Arthritis and Musculoskeletal and Skin Disease has completed its first year of making grants to foster collaboration across disciplines. In 2008, the Building Interdisciplinary Research Teams (BIRT) Awards program made 1-year grants to support researchers who are already receiving NIAMS grants but who wish to work with scientists outside their normal circle. Grants were given to researchers who combined developmental biology with systems biology, soft tissue biology with imaging technologies, tissue engineering with immunology, and tissue engineering with developmental biology. In one project, researchers at the University of Pittsburgh are using elevated magnet field strengths to make magnetic resonance images of cartilage closer in resolution to optical coherence tomography images.

FDA Cracks Down on False Claims

The Food and Drug Administration and the owners of Wilderness Family Naturals have signed a consent decree that prohibits the company from making unapproved claims that its products prevent or cure diseases. Directly or through the Web sites it controlled, the company has claimed product benefits related to arthritis; chronic fatigue syndrome; HIV infection and AIDS; heart disease; hyperthyroidism; diabetes; and cancer. None of the company's products—ranging from coconut oil to spices and vitamin supplements—had been approved by the FDA for disease treatment.

COX-2s May Have Cut Bleeding

The increased use of cyclooxygenase-2 inhibitors (COX-2) instead of older NSAIDs may have contributed to a decline in hospitalizations for upper gastrointestinal bleeding, according to the Agency for Healthcare Research and Quality. From 1998 to 2006, the number of hospitalizations for upper GI bleeding per 100,000 people decreased 14%. Other medical advances—such as the 1994 recommendation by the National Institutes of Health to aggressively treat of Heliobacter pylori and more widespread use of proton pump inhibitors to control gastroesophageal reflux disease—also may have helped, said the AHRQ. However, hospitalizations for lower GI bleeding increased 8% from 1998 to 2006. The findings are based on data from the Healthcare Cost and Utilization Project 1998 and the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays.

The Ideal FDA Commissioner?

The next commissioner of the FDA should be a proven manager who can rise above politics, according to a coalition of a patient advocacy groups. The group of more than 30 organizations wrote a letter to Health and Human Services secretary-designate Tom Daschle calling for the Obama administration to fill the FDA post quickly. Candidates for the job shouldn't be excluded because of ties to the pharmaceutical or device industries, the coalition advised.

CMS Looks at Incentive Sharing

Under current federal rules governing patient referrals, physicians can't share incentive payments for quality improvement. But that might change, a Centers for Medicare and Medicaid Services official told the Practicing Physicians Advisory Council (PPAC) last month. The CMS proposed an exception under rules governing physician payment for 2009, but opposition—mainly from medical device manufacturers—killed it, said Lisa Ohrin, acting director of the Division of Technical Payment Policy at the Center for Medicare Management. She said, however, that allowing incentive payments is a priority for the CMS, so the agency will again propose allowing physicians to share the payments.

RAC Program Heavily Criticized

Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the PPAC. The program is on hold while the Government Accountability Office studies whether the CMS has properly implemented it. During a demonstration, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested.

NIAMS Rewards Collaboration

The National Institute of Arthritis and Musculoskeletal and Skin Disease has completed its first year of making grants to foster collaboration across disciplines. In 2008, the Building Interdisciplinary Research Teams (BIRT) Awards program made 1-year grants to support researchers who are already receiving NIAMS grants but who wish to work with scientists outside their normal circle. Grants were given to researchers who combined developmental biology with systems biology, soft tissue biology with imaging technologies, tissue engineering with immunology, and tissue engineering with developmental biology. In one project, researchers at the University of Pittsburgh are using elevated magnet field strengths to make magnetic resonance images of cartilage closer in resolution to optical coherence tomography images.

FDA Cracks Down on False Claims

The Food and Drug Administration and the owners of Wilderness Family Naturals have signed a consent decree that prohibits the company from making unapproved claims that its products prevent or cure diseases. Directly or through the Web sites it controlled, the company has claimed product benefits related to arthritis; chronic fatigue syndrome; HIV infection and AIDS; heart disease; hyperthyroidism; diabetes; and cancer. None of the company's products—ranging from coconut oil to spices and vitamin supplements—had been approved by the FDA for disease treatment.

COX-2s May Have Cut Bleeding

The increased use of cyclooxygenase-2 inhibitors (COX-2) instead of older NSAIDs may have contributed to a decline in hospitalizations for upper gastrointestinal bleeding, according to the Agency for Healthcare Research and Quality. From 1998 to 2006, the number of hospitalizations for upper GI bleeding per 100,000 people decreased 14%. Other medical advances—such as the 1994 recommendation by the National Institutes of Health to aggressively treat of Heliobacter pylori and more widespread use of proton pump inhibitors to control gastroesophageal reflux disease—also may have helped, said the AHRQ. However, hospitalizations for lower GI bleeding increased 8% from 1998 to 2006. The findings are based on data from the Healthcare Cost and Utilization Project 1998 and the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays.

The Ideal FDA Commissioner?

The next commissioner of the FDA should be a proven manager who can rise above politics, according to a coalition of a patient advocacy groups. The group of more than 30 organizations wrote a letter to Health and Human Services secretary-designate Tom Daschle calling for the Obama administration to fill the FDA post quickly. Candidates for the job shouldn't be excluded because of ties to the pharmaceutical or device industries, the coalition advised.

CMS Looks at Incentive Sharing

Under current federal rules governing patient referrals, physicians can't share incentive payments for quality improvement. But that might change, a Centers for Medicare and Medicaid Services official told the Practicing Physicians Advisory Council (PPAC) last month. The CMS proposed an exception under rules governing physician payment for 2009, but opposition—mainly from medical device manufacturers—killed it, said Lisa Ohrin, acting director of the Division of Technical Payment Policy at the Center for Medicare Management. She said, however, that allowing incentive payments is a priority for the CMS, so the agency will again propose allowing physicians to share the payments.

RAC Program Heavily Criticized

Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the PPAC. The program is on hold while the Government Accountability Office studies whether the CMS has properly implemented it. During a demonstration, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested.

With Barack Obama's inauguration this month, observers expect that one of his early moves may be to stop action on a controversial federal abortion regulation.

The regulation, issued during the final weeks of the Bush administration, withholds federal payment and funding from providers who do not certify that they do not discriminate against physicians and midlevel providers who refuse to perform abortion or sterilization procedures.

The regulation has been stirring controversy among abortion rights advocates since it was first proposed in August 2008. They contend that the regulation is overly broad and as a result would decrease access to reproductive health services, including contraception.

Meanwhile, supporters, such as the Christian Medical Association, say the Bush administration's approach is balanced and helps clear up misconceptions about the conscience protections already in place under existing law.

Democrats in Congress have already indicated their willingness to act to reverse the regulation. At the end of the last session of Congress, Sen. Patty Murray (D-Wash.) and then-Sen. Hillary Clinton (D-N.Y.), introduced a bill that would stop all action on the regulation.

Aside from addressing the conscience refusal issue, reproductive health advocates expect that the Obama administration's health care agenda may include changes to expand access to emergency contraception, increase funding for family planning, and take a more comprehensive approach to sex education.

“We certainly have a pent up agenda,” said Susan Cohen, director of government affairs at the Guttmacher Institute, a nonprofit research and education organization focused on sexual and reproductive health.

One area in which Ms. Cohen and her colleagues hope to see some action early in the Obama administration is increasing funding for Title X, which provides federal funds for family planning and preventive screening services. The National Family Planning and Reproductive Health Association estimates that if Title X funding had kept pace with medical inflation since 1980, it would be funded at $759 million today, instead of its current $283 million budget.

Sex education is another area ripe for a change in course under a Democratic president and Congress. During the Bush administration, the federal government invested millions in abstinence-only education. However, many reproductive rights advocates say policy makers should look at evidence favoring a comprehensive sex education approach, which includes teaching teens about contraception as well as abstinence. President Obama should eliminate funding for abstinence-only sex education and shift those funds to comprehensive sex education, said Dr. Suzanne T. Poppema, chairwoman of the board of Physicians for Reproductive Choice and Health.

Reproductive rights advocates also are hopeful that the new president will eliminate the Mexico City policy or “global gag rule,” which bars nongovernmental organizations that receive U.S. funds from performing abortions or providing referrals for abortion overseas.

Dr. Poppema also said that the Obama administration should take action to expand access to emergency contraception. The president-elect could significantly expand the number of women who could obtain emergency contraception by directing the Department of Defense to add the medication to its formulary and instructing the Justice Department to mandate that emergency contraception be made available to all victims of sexual assault.

Aside from the list of possible policies that could be quickly changed, abortion rights advocates said they are relieved to be able to stop constantly fighting the federal government. “We have been having to constantly fight what we consider to be bad policy,” said Ms. Crepps.

Though the new Congress will be controlled by Democrats, the majority are not uniformly in favor of abortion rights, she said. However, a solid majority favor family planning and she predicted that they can make some headway in expanding access to contraceptives as one way to prevent abortions.

With Barack Obama's inauguration this month, observers expect that one of his early moves may be to stop action on a controversial federal abortion regulation.

The regulation, issued during the final weeks of the Bush administration, withholds federal payment and funding from providers who do not certify that they do not discriminate against physicians and midlevel providers who refuse to perform abortion or sterilization procedures.

The regulation has been stirring controversy among abortion rights advocates since it was first proposed in August 2008. They contend that the regulation is overly broad and as a result would decrease access to reproductive health services, including contraception.

Meanwhile, supporters, such as the Christian Medical Association, say the Bush administration's approach is balanced and helps clear up misconceptions about the conscience protections already in place under existing law.

Democrats in Congress have already indicated their willingness to act to reverse the regulation. At the end of the last session of Congress, Sen. Patty Murray (D-Wash.) and then-Sen. Hillary Clinton (D-N.Y.), introduced a bill that would stop all action on the regulation.

Aside from addressing the conscience refusal issue, reproductive health advocates expect that the Obama administration's health care agenda may include changes to expand access to emergency contraception, increase funding for family planning, and take a more comprehensive approach to sex education.

“We certainly have a pent up agenda,” said Susan Cohen, director of government affairs at the Guttmacher Institute, a nonprofit research and education organization focused on sexual and reproductive health.

One area in which Ms. Cohen and her colleagues hope to see some action early in the Obama administration is increasing funding for Title X, which provides federal funds for family planning and preventive screening services. The National Family Planning and Reproductive Health Association estimates that if Title X funding had kept pace with medical inflation since 1980, it would be funded at $759 million today, instead of its current $283 million budget.

Sex education is another area ripe for a change in course under a Democratic president and Congress. During the Bush administration, the federal government invested millions in abstinence-only education. However, many reproductive rights advocates say policy makers should look at evidence favoring a comprehensive sex education approach, which includes teaching teens about contraception as well as abstinence. President Obama should eliminate funding for abstinence-only sex education and shift those funds to comprehensive sex education, said Dr. Suzanne T. Poppema, chairwoman of the board of Physicians for Reproductive Choice and Health.

Reproductive rights advocates also are hopeful that the new president will eliminate the Mexico City policy or “global gag rule,” which bars nongovernmental organizations that receive U.S. funds from performing abortions or providing referrals for abortion overseas.

Dr. Poppema also said that the Obama administration should take action to expand access to emergency contraception. The president-elect could significantly expand the number of women who could obtain emergency contraception by directing the Department of Defense to add the medication to its formulary and instructing the Justice Department to mandate that emergency contraception be made available to all victims of sexual assault.

Aside from the list of possible policies that could be quickly changed, abortion rights advocates said they are relieved to be able to stop constantly fighting the federal government. “We have been having to constantly fight what we consider to be bad policy,” said Ms. Crepps.

Though the new Congress will be controlled by Democrats, the majority are not uniformly in favor of abortion rights, she said. However, a solid majority favor family planning and she predicted that they can make some headway in expanding access to contraceptives as one way to prevent abortions.

With Barack Obama's inauguration this month, observers expect that one of his early moves may be to stop action on a controversial federal abortion regulation.

The regulation, issued during the final weeks of the Bush administration, withholds federal payment and funding from providers who do not certify that they do not discriminate against physicians and midlevel providers who refuse to perform abortion or sterilization procedures.

The regulation has been stirring controversy among abortion rights advocates since it was first proposed in August 2008. They contend that the regulation is overly broad and as a result would decrease access to reproductive health services, including contraception.

Meanwhile, supporters, such as the Christian Medical Association, say the Bush administration's approach is balanced and helps clear up misconceptions about the conscience protections already in place under existing law.

Democrats in Congress have already indicated their willingness to act to reverse the regulation. At the end of the last session of Congress, Sen. Patty Murray (D-Wash.) and then-Sen. Hillary Clinton (D-N.Y.), introduced a bill that would stop all action on the regulation.

Aside from addressing the conscience refusal issue, reproductive health advocates expect that the Obama administration's health care agenda may include changes to expand access to emergency contraception, increase funding for family planning, and take a more comprehensive approach to sex education.

“We certainly have a pent up agenda,” said Susan Cohen, director of government affairs at the Guttmacher Institute, a nonprofit research and education organization focused on sexual and reproductive health.

One area in which Ms. Cohen and her colleagues hope to see some action early in the Obama administration is increasing funding for Title X, which provides federal funds for family planning and preventive screening services. The National Family Planning and Reproductive Health Association estimates that if Title X funding had kept pace with medical inflation since 1980, it would be funded at $759 million today, instead of its current $283 million budget.

Sex education is another area ripe for a change in course under a Democratic president and Congress. During the Bush administration, the federal government invested millions in abstinence-only education. However, many reproductive rights advocates say policy makers should look at evidence favoring a comprehensive sex education approach, which includes teaching teens about contraception as well as abstinence. President Obama should eliminate funding for abstinence-only sex education and shift those funds to comprehensive sex education, said Dr. Suzanne T. Poppema, chairwoman of the board of Physicians for Reproductive Choice and Health.

Reproductive rights advocates also are hopeful that the new president will eliminate the Mexico City policy or “global gag rule,” which bars nongovernmental organizations that receive U.S. funds from performing abortions or providing referrals for abortion overseas.

Dr. Poppema also said that the Obama administration should take action to expand access to emergency contraception. The president-elect could significantly expand the number of women who could obtain emergency contraception by directing the Department of Defense to add the medication to its formulary and instructing the Justice Department to mandate that emergency contraception be made available to all victims of sexual assault.

Aside from the list of possible policies that could be quickly changed, abortion rights advocates said they are relieved to be able to stop constantly fighting the federal government. “We have been having to constantly fight what we consider to be bad policy,” said Ms. Crepps.

Though the new Congress will be controlled by Democrats, the majority are not uniformly in favor of abortion rights, she said. However, a solid majority favor family planning and she predicted that they can make some headway in expanding access to contraceptives as one way to prevent abortions.

As a new administration prepares to tackle health care reform, the health insurance industry is offering a few suggestions.

America's Health Insurance Plans (AHIP), which represents about 1,300 companies covering more than 200 million Americans, says its members would be willing to guarantee coverage for individuals with preexisting medical conditions in exchange for a government mandate that all individuals purchase health insurance.

AHIP's board of directors issued the proposal after conducting a nationwide “listening tour” on health care during which many Americans raised concerns about the lack of coverage for preexisting conditions in the individual insurance market.

But to make guaranteed coverage a reality, the federal government will need to require that individuals purchase coverage and use mechanisms such as an insurance coverage verification system, an automatic enrollment process, and some type of enforcement, the group said.

When coverage is guaranteed and there is no mandate to have insurance, individuals tend not to purchase insurance until they get sick, which drives up costs, said Robert Zirkelbach, a spokesman for AHIP.

For example, a study conducted on behalf of AHIP by Milliman Inc. found that in many states that implemented guarantee issue or community rating policies in the 1990s, there had been a rise in insurance premiums and a reduction in individual insurance enrollment.

In addition, some health plans had left the individual insurance marketplace.

Another aspect of the AHIP proposal aims to increase the affordability of health insurance plans on the individual market.

The group suggests lowering costs for consumers through refundable tax credits.

In addition, it proposes tackling the overall cost of medical services by expanding the use of preventative services, conducting comparative effectiveness trials for medications and devices, and reforming the medical liability system.

The AHIP proposal also supports expanding eligibility for Medicaid and the Children's Health Insurance Program.

“No one should fall through the cracks of our health care system,” Karen Ignagni, AHIP president and CEO, said in a statement. “Universal coverage is within reach and can be achieved by building on the current system.”

Affordability will be critical to the success of any proposal, said Ron Pollack, executive director and vice president of Families USA, a nonprofit, nonpartisan organization focused on health care affordability.

“It's the ball game,” he said. “How can you require someone to do something they simply can't achieve?”

Families USA supports the idea of a mandate for health insurance coverage, Mr. Pollack said, but only if it includes adequate subsidies and help for those who can't afford to purchase coverage on their own.

The AHIP proposal is a “helpful step,” but some work is still needed in determining what steps can be taken to guarantee coverage if a mandate for coverage is not politically feasible, he said.

As a new administration prepares to tackle health care reform, the health insurance industry is offering a few suggestions.

America's Health Insurance Plans (AHIP), which represents about 1,300 companies covering more than 200 million Americans, says its members would be willing to guarantee coverage for individuals with preexisting medical conditions in exchange for a government mandate that all individuals purchase health insurance.

AHIP's board of directors issued the proposal after conducting a nationwide “listening tour” on health care during which many Americans raised concerns about the lack of coverage for preexisting conditions in the individual insurance market.

But to make guaranteed coverage a reality, the federal government will need to require that individuals purchase coverage and use mechanisms such as an insurance coverage verification system, an automatic enrollment process, and some type of enforcement, the group said.

When coverage is guaranteed and there is no mandate to have insurance, individuals tend not to purchase insurance until they get sick, which drives up costs, said Robert Zirkelbach, a spokesman for AHIP.

For example, a study conducted on behalf of AHIP by Milliman Inc. found that in many states that implemented guarantee issue or community rating policies in the 1990s, there had been a rise in insurance premiums and a reduction in individual insurance enrollment.

In addition, some health plans had left the individual insurance marketplace.

Another aspect of the AHIP proposal aims to increase the affordability of health insurance plans on the individual market.

The group suggests lowering costs for consumers through refundable tax credits.

In addition, it proposes tackling the overall cost of medical services by expanding the use of preventative services, conducting comparative effectiveness trials for medications and devices, and reforming the medical liability system.

The AHIP proposal also supports expanding eligibility for Medicaid and the Children's Health Insurance Program.

“No one should fall through the cracks of our health care system,” Karen Ignagni, AHIP president and CEO, said in a statement. “Universal coverage is within reach and can be achieved by building on the current system.”

Affordability will be critical to the success of any proposal, said Ron Pollack, executive director and vice president of Families USA, a nonprofit, nonpartisan organization focused on health care affordability.

“It's the ball game,” he said. “How can you require someone to do something they simply can't achieve?”

Families USA supports the idea of a mandate for health insurance coverage, Mr. Pollack said, but only if it includes adequate subsidies and help for those who can't afford to purchase coverage on their own.

The AHIP proposal is a “helpful step,” but some work is still needed in determining what steps can be taken to guarantee coverage if a mandate for coverage is not politically feasible, he said.

As a new administration prepares to tackle health care reform, the health insurance industry is offering a few suggestions.

America's Health Insurance Plans (AHIP), which represents about 1,300 companies covering more than 200 million Americans, says its members would be willing to guarantee coverage for individuals with preexisting medical conditions in exchange for a government mandate that all individuals purchase health insurance.

AHIP's board of directors issued the proposal after conducting a nationwide “listening tour” on health care during which many Americans raised concerns about the lack of coverage for preexisting conditions in the individual insurance market.

But to make guaranteed coverage a reality, the federal government will need to require that individuals purchase coverage and use mechanisms such as an insurance coverage verification system, an automatic enrollment process, and some type of enforcement, the group said.

When coverage is guaranteed and there is no mandate to have insurance, individuals tend not to purchase insurance until they get sick, which drives up costs, said Robert Zirkelbach, a spokesman for AHIP.

For example, a study conducted on behalf of AHIP by Milliman Inc. found that in many states that implemented guarantee issue or community rating policies in the 1990s, there had been a rise in insurance premiums and a reduction in individual insurance enrollment.

In addition, some health plans had left the individual insurance marketplace.

Another aspect of the AHIP proposal aims to increase the affordability of health insurance plans on the individual market.

The group suggests lowering costs for consumers through refundable tax credits.

In addition, it proposes tackling the overall cost of medical services by expanding the use of preventative services, conducting comparative effectiveness trials for medications and devices, and reforming the medical liability system.

The AHIP proposal also supports expanding eligibility for Medicaid and the Children's Health Insurance Program.

“No one should fall through the cracks of our health care system,” Karen Ignagni, AHIP president and CEO, said in a statement. “Universal coverage is within reach and can be achieved by building on the current system.”

Affordability will be critical to the success of any proposal, said Ron Pollack, executive director and vice president of Families USA, a nonprofit, nonpartisan organization focused on health care affordability.

“It's the ball game,” he said. “How can you require someone to do something they simply can't achieve?”

Families USA supports the idea of a mandate for health insurance coverage, Mr. Pollack said, but only if it includes adequate subsidies and help for those who can't afford to purchase coverage on their own.

The AHIP proposal is a “helpful step,” but some work is still needed in determining what steps can be taken to guarantee coverage if a mandate for coverage is not politically feasible, he said.

Early signals from the incoming Obama administration have many physicians feeling optimistic about the chances for comprehensive health reform.

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President-elect Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary.

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President-elect Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position must be confirmed by the Senate; however, the health care czar position does not.

In another example of his focus on health care reform, Mr. Obama, along with congressional Democrats, have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the Sustainable Growth Rate formula, which ties physician payments to the gross domestic product. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians. The experience with the Massachusetts health reform law illustrates that expanding insurance coverage does not guarantee access to care if there are not enough primary care physicians to see all the new patients, Mr. Doherty said.

Shoring up the primary care workforce will require an increase in payments for primary care services, an emphasis on primary care in graduate medical education funding, and the creation of programs that would allow primary care physicians to eliminate their medical school debt, he said.

The American College of Cardiology did not respond to requests about its legislative goals for 2009.

Early signals from the incoming Obama administration have many physicians feeling optimistic about the chances for comprehensive health reform.

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President-elect Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary.

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President-elect Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position must be confirmed by the Senate; however, the health care czar position does not.

In another example of his focus on health care reform, Mr. Obama, along with congressional Democrats, have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the Sustainable Growth Rate formula, which ties physician payments to the gross domestic product. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians. The experience with the Massachusetts health reform law illustrates that expanding insurance coverage does not guarantee access to care if there are not enough primary care physicians to see all the new patients, Mr. Doherty said.

Shoring up the primary care workforce will require an increase in payments for primary care services, an emphasis on primary care in graduate medical education funding, and the creation of programs that would allow primary care physicians to eliminate their medical school debt, he said.

The American College of Cardiology did not respond to requests about its legislative goals for 2009.

Early signals from the incoming Obama administration have many physicians feeling optimistic about the chances for comprehensive health reform.

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President-elect Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary.

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President-elect Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position must be confirmed by the Senate; however, the health care czar position does not.

In another example of his focus on health care reform, Mr. Obama, along with congressional Democrats, have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the Sustainable Growth Rate formula, which ties physician payments to the gross domestic product. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians. The experience with the Massachusetts health reform law illustrates that expanding insurance coverage does not guarantee access to care if there are not enough primary care physicians to see all the new patients, Mr. Doherty said.

Shoring up the primary care workforce will require an increase in payments for primary care services, an emphasis on primary care in graduate medical education funding, and the creation of programs that would allow primary care physicians to eliminate their medical school debt, he said.

The American College of Cardiology did not respond to requests about its legislative goals for 2009.

As a new administration prepares to tackle health care reform, the health insurance industry is offering a few suggestions.

America's Health Insurance Plans (AHIP), which represents about 1,300 companies covering more than 200 million Americans, says its members would be willing to guarantee coverage for individuals with preexisting medical conditions in exchange for a government mandate that all individuals purchase health insurance.

AHIP's board of directors issued the proposal after conducting a nationwide “listening tour” on health care during which many Americans raised concerns about the lack of coverage for preexisting conditions in the individual insurance market.

But to make guaranteed coverage a reality, the federal government will need to require that individuals purchase coverage and use mechanisms such as an insurance coverage verification system, an automatic enrollment process, and some type of enforcement, the group said.

When coverage is guaranteed and there is no mandate to have insurance, individuals tend not to purchase insurance until they get sick, which drives up costs, said Robert Zirkelbach, a spokesman for AHIP.

Another aspect of the AHIP proposal aims to increase the affordability of health insurance plans on the individual market. The group suggests lowering costs for consumers through refundable tax credits. In addition, it proposes tackling the overall cost of medical services by expanding the use of preventative services, conducting comparative effectiveness trials for medications and devices, and reforming the medical liability system.

The AHIP proposal also supports expanding eligibility for Medicaid and the Children's Health Insurance Program. “No one should fall through the cracks of our health care system,” Karen Ignagni, AHIP president and CEO, said in a statement. “Universal coverage is within reach and can be achieved by building on the current system.”

Affordability will be critical to the success of any proposal, said Ron Pollack, executive director of Families USA, a nonprofit, nonpartisan organization focused on health care affordability.

Families USA supports the idea of a mandate for health insurance coverage, Mr. Pollack said, but only if it includes adequate subsidies and help for those who can't afford to purchase coverage on their own.

As a new administration prepares to tackle health care reform, the health insurance industry is offering a few suggestions.

America's Health Insurance Plans (AHIP), which represents about 1,300 companies covering more than 200 million Americans, says its members would be willing to guarantee coverage for individuals with preexisting medical conditions in exchange for a government mandate that all individuals purchase health insurance.

AHIP's board of directors issued the proposal after conducting a nationwide “listening tour” on health care during which many Americans raised concerns about the lack of coverage for preexisting conditions in the individual insurance market.

But to make guaranteed coverage a reality, the federal government will need to require that individuals purchase coverage and use mechanisms such as an insurance coverage verification system, an automatic enrollment process, and some type of enforcement, the group said.

When coverage is guaranteed and there is no mandate to have insurance, individuals tend not to purchase insurance until they get sick, which drives up costs, said Robert Zirkelbach, a spokesman for AHIP.

Another aspect of the AHIP proposal aims to increase the affordability of health insurance plans on the individual market. The group suggests lowering costs for consumers through refundable tax credits. In addition, it proposes tackling the overall cost of medical services by expanding the use of preventative services, conducting comparative effectiveness trials for medications and devices, and reforming the medical liability system.

The AHIP proposal also supports expanding eligibility for Medicaid and the Children's Health Insurance Program. “No one should fall through the cracks of our health care system,” Karen Ignagni, AHIP president and CEO, said in a statement. “Universal coverage is within reach and can be achieved by building on the current system.”

Affordability will be critical to the success of any proposal, said Ron Pollack, executive director of Families USA, a nonprofit, nonpartisan organization focused on health care affordability.

Families USA supports the idea of a mandate for health insurance coverage, Mr. Pollack said, but only if it includes adequate subsidies and help for those who can't afford to purchase coverage on their own.

As a new administration prepares to tackle health care reform, the health insurance industry is offering a few suggestions.

America's Health Insurance Plans (AHIP), which represents about 1,300 companies covering more than 200 million Americans, says its members would be willing to guarantee coverage for individuals with preexisting medical conditions in exchange for a government mandate that all individuals purchase health insurance.

AHIP's board of directors issued the proposal after conducting a nationwide “listening tour” on health care during which many Americans raised concerns about the lack of coverage for preexisting conditions in the individual insurance market.

But to make guaranteed coverage a reality, the federal government will need to require that individuals purchase coverage and use mechanisms such as an insurance coverage verification system, an automatic enrollment process, and some type of enforcement, the group said.

When coverage is guaranteed and there is no mandate to have insurance, individuals tend not to purchase insurance until they get sick, which drives up costs, said Robert Zirkelbach, a spokesman for AHIP.

Another aspect of the AHIP proposal aims to increase the affordability of health insurance plans on the individual market. The group suggests lowering costs for consumers through refundable tax credits. In addition, it proposes tackling the overall cost of medical services by expanding the use of preventative services, conducting comparative effectiveness trials for medications and devices, and reforming the medical liability system.

The AHIP proposal also supports expanding eligibility for Medicaid and the Children's Health Insurance Program. “No one should fall through the cracks of our health care system,” Karen Ignagni, AHIP president and CEO, said in a statement. “Universal coverage is within reach and can be achieved by building on the current system.”

Affordability will be critical to the success of any proposal, said Ron Pollack, executive director of Families USA, a nonprofit, nonpartisan organization focused on health care affordability.

Families USA supports the idea of a mandate for health insurance coverage, Mr. Pollack said, but only if it includes adequate subsidies and help for those who can't afford to purchase coverage on their own.

Early signals from the Obama administration have many physicians feeling optimistic about the chances for comprehensive health reform.

Officials at the American Academy of Pediatrics have been in contact with congressional staff members to make their priorities known, starting with the reauthorization of the State Children's Health Insurance Program.

Although many Democrats in Congress have supported the reauthorization of SCHIP in the past, there are still questions about whether this will be pursued as a stand-alone bill or as part of the new administration's economic stimulus package.

Another piece of the SCHIP reauthorization that has yet to be resolved is whether the bill will include immediate coverage for immigrant children, an issue that created controversy in the past.

AAP officials also are hopeful that Congress will use the Medikids Health Insurance Act legislation, which has stalled in previous sessions of Congress, as the children's portion of the larger health reform plan. The legislation would create Medikids, a health insurance program modeled after Medicare, that would act as a safety net to ensure coverage for all children. Under the legislation, children would be automatically enrolled in Medikids but transferred to other insurance or government programs if they are eligible. Children could regain coverage under Medikids at any time if they lose their other coverage for any reason.

The AAP also would like to see Congress continue to encourage investment in the concept of the medical home by expanding demonstration beyond the Medicare program into the Medicaid program, where pediatricians can get involved.

The AAP and other physician groups have a greater chance of getting some of their priorities addressed this time around because of the poor economic conditions, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary. The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious President Obama is about health reform, he tapped Sen. Daschle not only to serve as HHS secretary, but also to direct a new White House Office on Health Care Reform.

Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

In another example of his focus on health care reform, Mr. Obama, along with congressional Democrats, have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians. “I think the signals are positive.”

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

ACP officials are hoping that the Obama health care reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians. The experience with the Massachusetts health care reform law illustrates that expanding insurance coverage does not guarantee access to care if there are not enough primary care physicians to see all the new patients, Mr. Doherty said.

Shoring up the primary care workforce will require an increase in payments for primary care services, an emphasis on primary care in graduate medical education funding, and the creation of programs that would allow primary care physicians to eliminate their medical school debt, he said.

Officials at the American Academy of Family Physicians also are calling for increasing payments for primary care services, addressing the shortage of primary care physicians, and advancing the primary care model known as the patient-centered medical home.

Dr. Ted Epperly, AAFP president, said he is confident that the medical home concept will be part of the health reform proposal that will be considered by Congress. All of the major players in the new administration and in Congress have mentioned the medical home and primary care reform as part of the solution, he said. “The concepts are known to them.”

As part of payment reform, the AAFP is seeking a blended payment that would include increased payments for the evaluation and management codes associated with primary care, a care management fee to cover activities not associated with a face-to-face visit, and quality incentives for reporting on or achieving certain quality targets.

If we want to overcome our economic challenges, we must address our health care challenge. PRESIDENT OBAMA

Early signals from the Obama administration have many physicians feeling optimistic about the chances for comprehensive health reform.

Officials at the American Academy of Pediatrics have been in contact with congressional staff members to make their priorities known, starting with the reauthorization of the State Children's Health Insurance Program.

Although many Democrats in Congress have supported the reauthorization of SCHIP in the past, there are still questions about whether this will be pursued as a stand-alone bill or as part of the new administration's economic stimulus package.

Another piece of the SCHIP reauthorization that has yet to be resolved is whether the bill will include immediate coverage for immigrant children, an issue that created controversy in the past.

AAP officials also are hopeful that Congress will use the Medikids Health Insurance Act legislation, which has stalled in previous sessions of Congress, as the children's portion of the larger health reform plan. The legislation would create Medikids, a health insurance program modeled after Medicare, that would act as a safety net to ensure coverage for all children. Under the legislation, children would be automatically enrolled in Medikids but transferred to other insurance or government programs if they are eligible. Children could regain coverage under Medikids at any time if they lose their other coverage for any reason.

The AAP also would like to see Congress continue to encourage investment in the concept of the medical home by expanding demonstration beyond the Medicare program into the Medicaid program, where pediatricians can get involved.

The AAP and other physician groups have a greater chance of getting some of their priorities addressed this time around because of the poor economic conditions, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary. The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious President Obama is about health reform, he tapped Sen. Daschle not only to serve as HHS secretary, but also to direct a new White House Office on Health Care Reform.

Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

In another example of his focus on health care reform, Mr. Obama, along with congressional Democrats, have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians. “I think the signals are positive.”

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

ACP officials are hoping that the Obama health care reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians. The experience with the Massachusetts health care reform law illustrates that expanding insurance coverage does not guarantee access to care if there are not enough primary care physicians to see all the new patients, Mr. Doherty said.

Shoring up the primary care workforce will require an increase in payments for primary care services, an emphasis on primary care in graduate medical education funding, and the creation of programs that would allow primary care physicians to eliminate their medical school debt, he said.

Officials at the American Academy of Family Physicians also are calling for increasing payments for primary care services, addressing the shortage of primary care physicians, and advancing the primary care model known as the patient-centered medical home.

Dr. Ted Epperly, AAFP president, said he is confident that the medical home concept will be part of the health reform proposal that will be considered by Congress. All of the major players in the new administration and in Congress have mentioned the medical home and primary care reform as part of the solution, he said. “The concepts are known to them.”

As part of payment reform, the AAFP is seeking a blended payment that would include increased payments for the evaluation and management codes associated with primary care, a care management fee to cover activities not associated with a face-to-face visit, and quality incentives for reporting on or achieving certain quality targets.

If we want to overcome our economic challenges, we must address our health care challenge. PRESIDENT OBAMA

Early signals from the Obama administration have many physicians feeling optimistic about the chances for comprehensive health reform.

Officials at the American Academy of Pediatrics have been in contact with congressional staff members to make their priorities known, starting with the reauthorization of the State Children's Health Insurance Program.

Although many Democrats in Congress have supported the reauthorization of SCHIP in the past, there are still questions about whether this will be pursued as a stand-alone bill or as part of the new administration's economic stimulus package.

Another piece of the SCHIP reauthorization that has yet to be resolved is whether the bill will include immediate coverage for immigrant children, an issue that created controversy in the past.

AAP officials also are hopeful that Congress will use the Medikids Health Insurance Act legislation, which has stalled in previous sessions of Congress, as the children's portion of the larger health reform plan. The legislation would create Medikids, a health insurance program modeled after Medicare, that would act as a safety net to ensure coverage for all children. Under the legislation, children would be automatically enrolled in Medikids but transferred to other insurance or government programs if they are eligible. Children could regain coverage under Medikids at any time if they lose their other coverage for any reason.

The AAP also would like to see Congress continue to encourage investment in the concept of the medical home by expanding demonstration beyond the Medicare program into the Medicaid program, where pediatricians can get involved.

The AAP and other physician groups have a greater chance of getting some of their priorities addressed this time around because of the poor economic conditions, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary. The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious President Obama is about health reform, he tapped Sen. Daschle not only to serve as HHS secretary, but also to direct a new White House Office on Health Care Reform.

Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

In another example of his focus on health care reform, Mr. Obama, along with congressional Democrats, have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians. “I think the signals are positive.”

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

ACP officials are hoping that the Obama health care reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians. The experience with the Massachusetts health care reform law illustrates that expanding insurance coverage does not guarantee access to care if there are not enough primary care physicians to see all the new patients, Mr. Doherty said.

Shoring up the primary care workforce will require an increase in payments for primary care services, an emphasis on primary care in graduate medical education funding, and the creation of programs that would allow primary care physicians to eliminate their medical school debt, he said.

Officials at the American Academy of Family Physicians also are calling for increasing payments for primary care services, addressing the shortage of primary care physicians, and advancing the primary care model known as the patient-centered medical home.

Dr. Ted Epperly, AAFP president, said he is confident that the medical home concept will be part of the health reform proposal that will be considered by Congress. All of the major players in the new administration and in Congress have mentioned the medical home and primary care reform as part of the solution, he said. “The concepts are known to them.”

As part of payment reform, the AAFP is seeking a blended payment that would include increased payments for the evaluation and management codes associated with primary care, a care management fee to cover activities not associated with a face-to-face visit, and quality incentives for reporting on or achieving certain quality targets.

If we want to overcome our economic challenges, we must address our health care challenge. PRESIDENT OBAMA