American College of Physicians: Internal Medicine — Doctors for Adults ®


Regents approve health care worker flu vaccination policy

From the September ACP Observer, copyright 2007 by the American College of Physicians.

By Jessica Berthold

At its July 14-15 meeting, the Board of Regents approved a policy to require annual flu vaccinations for health care workers, as well as new clinical guidelines and a resolution to improve pay-for-performance programs. Following are highlights of items approved at the meeting.

Flu vaccine. Every health care worker with direct patient care activities should be required to receive an annual influenza vaccine, unless he or she has a medical contraindication or religious objection, or has signed an informed declination.

Clinical guidelines. Clinical practice guidelines on diagnosis and management of stable chronic obstructive pulmonary disease; diagnosis and treatment of lower back pain; and interventions to improve palliative care of pain, dyspnea and depression at the end of life were approved and will be published in future issues of the Annals of Internal Medicine.

Health disparities. The board approved a proposal from the African American Task Force that says, in part, that the College must develop a policy around improving care for underserved populations; encourage sessions about health disparities among African Americans at the College’s annual meeting; develop resources to assist private practice doctors who serve minority populations; and develop strategies to increase the number of African Americans who attain Fellowship.

Pay-for-performance (P4P). The College will work with other health care groups to develop specific ways (like including appropriate sample size and patient non-adherence issues) that P4P programs can better assess a doctor’s effort to improve patient care.

Patient-Centered Medical Home (PCMH). The Board approved measures to ensure that the model can be implemented and maintained by solo practices and smaller medical groups, including payment for start-up costs. The PCMH would modify the current fee-for-service reimbursement model and pay primary care doctors for coordinating all aspects of a patient care.

Tiered payments. The College will work with health plans on tiered measuring systems to ensure an appeal process for inaccurate claims data, as well as assure that doctors can review performance data for accuracy in advance of public release of tiered payment structures by insurers.

Associate membership. Resident physicians and fellows-in-training from countries without chapters, under certain conditions, will be approved for associate membership.

Health care reform. A white paper summarizing state efforts to reform health care, as well as recommendations on key elements that state plans should include in reform was approved. It included:

  • Work towards either achieving universal coverage, or substantially reducing the numbers of uninsured within five years;
  • Provide coverage for a core package of preventive and primary care services and for catastrophic expenses, at a minimum; and
  • Include reimbursement reforms to support the value of patient-centered care managed by a primary physician;

The Herbert S. Waxman Learning Center. The center will be renamed the Herbert S. Waxman Clinical Skills Center, to more accurately reflect its activities.


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