AACOM PUBLIC POLICY AGENDA FOR 2013

This document represents AACOM’s government relations agenda for the 1^st session of the 113^th Congress.  It reflects AACOM’s priorities to raise awareness of and develop initiatives to promote osteopathic medical education as osteopathic medical schools continue to grow in number, size, and importance to the U.S. health care system and medical education system.  AACOM will actively pursue these goals notwithstanding the very challenging political fiscal environment. 

CLINICAL EDUCATION

AACOM strongly supports programs that promote medical education, particularly innovative programs that are designed to better prepare physicians for the realities of clinical practice.

CLINICAL CLERKSHIP EDUCATION:

• AACOM will work to prioritize clinical clerkship training overseen by U.S. colleges of osteopathic and allopathic medicine and to maintain an academic environment for students learning and training in clinical settings.

GME: 

• AACOM will continue to vigorously oppose cuts to GME funding.  The key element of this position is that cuts to GME will ultimately increase, not decrease, health care costs.  AACOM will act as a resource to federal lawmakers as they consider ways to reduce health care costs without cutting GME funding.
• AACOM believes that GME funding should be associated directly with health care workforce needs.  With rising projections of physician shortages to meet the health care needs of a growing and aging population, AACOM supports the sustainable expansion of the number of GME positions. 
• AACOM believes that the Institute of Medicine’s intent to study GME could address important issues facing the nation’s medical education system and should recognize the value of osteopathic medical education to the nation’s health care system.  We will continue to actively participate in this process and be ready to respond to their recommendations upon release.
• AACOM represents the nation’s colleges of osteopathic medicine (COMs), which train students in venues outside of large academic medical centers. We support GME programs that expand the participation of community-based institutions. This is particularly important at a time when the number of osteopathic medical school graduates is growing and is expected to continue to grow in response to physician workforce shortages that exist and/or are projected to continue over the next five to 15 years.
• The current number of GME positions funded by the Centers for Medicare & Medicaid Services (CMS) will not be sufficient to accommodate the number of medical school graduates seeking positions or the number of positions needed to offset projected physician workforce shortages caused by a growing and aging population and rapid physician retirement.  There is growing evidence that community-based medical education produces outcomes to better address the need for a primary care-based health care system to provide better access and value for all populations, those traditionally well-served, and historically underserved rural and urban populations.   AACOM supports lifting the statutory cap on GME slots and exploring additional methods of financing GME outside of CMS.
• In an effort to support innovative GME programs, AACOM supports the continuation of the Health Resources and Services Administration (HRSA) Teaching Health Center (THC) GME Program, as well as appropriations for the THC development grants, as authorized by the Affordable Care Act (ACA).
• AACOM supports the Council on Graduate Medical Education (COGME) recommendation for AACOM and the Association of American Medical Colleges (AAMC) to work with appropriate accrediting agencies, licensing boards, and other relevant organizations to review new approaches for medical education and training in the United States.

HEALTH PROFESSIONS TRAINING: 

• AACOM supports increased appropriations for HRSA Title VII health professions training program funding, specifically the primary care training program. Each of these programs has been vital to the growth of osteopathic medical education; the programs benefit the health care system far beyond their modest costs.
• AACOM supports increased appropriations for the National Health Service Corps (NHSC) and other scholarship and loan repayment programs as yet another means to bring necessary medical services to underserved areas of the country.
• AACOM recognizes the growth of interprofessional practice and team-based care and supports programs that prioritize resources for implementation and evaluation of interprofessional training models. 

HEALTH INFORMATION TECHNOLOGY: 

• AACOM supports the expansion of health information technology (HIT) in the medical education setting.
• AACOM supports the implementation of the HITECH Act grant program for demonstration projects to develop curricula that will integrate qualified HIT in the clinical education of health professionals. 

PREVENTION:

• AACOM supports programs throughout the U.S. Department of Health and Human Services, including at the Centers for Disease Control and Prevention (CDC) and CMS that focus on prevention as a method of improving health and controlling health care costs.

HEALTH CARE WORKFORCE

AACOM strongly supports federal health care workforce policies intended to ensure an adequately trained workforce that meets the needs of the 21^st Century.

• AACOM believes that addressing physician workforce shortages, especially primary care physician shortages, has become even more critical with the passage of the ACA, which is expected to increase the number of individuals covered by health insurance by approximately 32 million.
• AACOM believes that additional resources should be devoted to ongoing health care workforce data production, analysis, and oversight to assure that investments in the future of health care appropriately address areas of greatest need.
• AACOM supports enhanced funding for the NHSC and other scholarship and loan repayment programs to help recruit and retain an adequate health care workforce in the geographical areas in which they are most needed.

FEDERAL STUDENT FINANCIAL AID

AACOM recognizes the growing debt burden that many osteopathic medical school graduates face and supports programs designed to help students better manage that debt and/or provide payback mechanisms that are associated with national and local physician workforce needs and service.

• AACOM supports reevaluating how osteopathic medical students pay for their education, including exploration of programs that would defer payment.
• As students graduate with growing debt loads and the nation faces a critical physician workforce shortage, AACOM supports the expansion of programs that include a service component in loan repayment options.
• AACOM advocates for the creation of new programs and supporting current programs that directly fund students pursuing primary care and other needed specialties.
• AACOM will continue to oppose legislative and regulatory changes that increase the debt burden faced by osteopathic medical students to include continuing to advocate for lowering the interest rates on all federal student loans and opposing any increase in costs associated with these loans.
• AACOM supports statutes and regulations that reduce the administrative burden that interferes with the educational mission of member institutions.

RESEARCH

As osteopathic medical education continues to grow in this country, AACOM believes that more research must be devoted to analyzing this practice modality, and supports fully integrating osteopathic medicine into the nation’s research infrastructure.

• AACOM supports increased funding for the National Institutes of Health (NIH) overall, and particularly the National Center for Complementary and Alternative Medicine (NCCAM).  Many COMs need to develop infrastructure, and increased funding is one method of meeting this need.  
• AACOM supports funding to expand a full range of research on osteopathic manipulative medicine, from basic research into pathophysiologic mechanisms to assessment of efficacy.
• AACOM supports increased funding for the Agency for Healthcare Research and Quality (AHRQ) and the expansion of programs at AHRQ that evaluate the quality of care, promote knowledge transfer and fund patient-centered outcomes research (PCOR).
• AACOM supports PCOR as it is being implemented by the Patient-Centered Outcomes Research Institute (PCORI) and encourages the allocation of sufficient resources by PCORI to train osteopathic researchers in methods of PCOR.
• AACOM supports the expansion of medical education and interprofessional education research with the particular goal of improving resources for outcomes research in osteopathic medicine.
• AACOM supports research being funded by the Center for Medicare & Medicaid Innovation, AHRQ and other agencies to develop innovations in the methods of physician training and care delivery. 

OSTEOPATHIC REPRESENTATION

AACOM advocates for osteopathic medical education and osteopathic physician representation on standing and newly established federal committees, commissions, councils, advisory panels, and task forces.

AACOM will continue to work to educate Congress and federal agencies about the importance of this representation, as well as advocate for individual members of the osteopathic medical education and osteopathic medicine communities to serve on relevant federal panels.