National Advocacy Conference Highlights, Feb. 13, 2012

At the capital: Physicians hear from policy experts, speak out on SGR

During a critical time for medicine, physicians from around the country are gathered in Washington, D.C., to discuss key health care issues, hear from political experts and voice their concerns in face-to-face meetings with their members of Congress during the AMA’s National Advocacy Conference (NAC).

The conference’s most pressing issue is repealing Medicare’s flawed sustainable growth rate (SGR) formula. As AMA advocacy staff explained during a session on Monday, the congressional conference committee charged with addressing the SGR is expected to make a decision this week, making this year’s NAC the ideal time for physicians to demand a permanent solution.

“It’s a crucial opportunity for us to gather together to advocate for our profession, our patients and our employees,” Pennsylvania Medical Society President Marilyn Heine, MD, said. “If we’re able to gather en masse, it helps us give a much stronger message to communicate the importance of repealing the flawed Medicare physician payment formula.”

Other priority issues physicians are hearing about during the NAC—and are raising to their members of Congress—include stopping implementation of the ICD-10 code set, promoting the Medicare Patient Empowerment Act, and making sure that physicians can choose new health care payment and delivery models that work best for them.

Andrew Paul Lazar, MD, a dermatologist from Modesto, Calif., explained that the NAC communicates what’s important to physicians of all specialties.

“I’m very excited to hear what’s going on in Washington and what’s important to not just specialties but a broader physician spectrum,” Dr. Lazar said. “Hearing from the speakers and AMA staff today helped put together a picture of where things are going and what role we can play as active participants in the political process.”

Before meeting with their members of Congress, physicians will learn the most effective communication tactics for influencing them as well as how to establish and leverage long-term relationships. AMA members can watch a recently archived webinar on this topic presented by Brad Fitch, CEO of the Congressional Management Foundation and one of Tuesday’s scheduled presenters.

Gergen: Bipartisan efforts needed to build a brighter future

What is the current political landscape? According to David Gergen, senior policy analyst for CNN and adviser to four U.S. presidents, it’s one paralyzed by political partisanship, even as the nation faces such difficult problems as unemployment, rising debt and spiraling health care costs.

“The critical thing is that we need a politics that works,” Gergen said. “And right now, it’s a dysfunctional politics.”

Gergen explained that while American government was created to be contentious, it has worked historically because its elected officials were willing to compromise for the good of the country. While he predicted that the Affordable Care Act (ACA) will be upheld by the Supreme Court, he noted that the law is unstable and will continue to face opposition because its support was not bipartisan.

Citing the establishment of the Medicare program and civil rights legislation, Gergen attributed the success of all “milestone legislation” to having been passed in a bipartisan way. He also suggested that President Obama might need to consent to some kind of medical liability reform to assuage opposition to the ACA by conservative politicians.

“A lot of this can sound fairly bleak,” Gergen said, stating that he believes the next 35 years will be difficult ones for the United States. “There is still a possibility for good times. But it requires us to pull together.”

Influence of physician advocacy especially evident this year

From the disastrous Medicare physician payment formula to new payment and delivery models, AMA leaders reported Monday that medicine is making significant strides with federal lawmakers on various issues of importance to the nation’s physicians.

In the face of a 27 percent cut to Medicare physician payments scheduled for March 1, AMA Board Chair Robert M. Wah, MD, explained that the AMA has gained support among members of Congress for repealing the sustainable growth rate (SGR) formula.

“More and more members of Congress are echoing our call for SGR repeal,” Dr. Wah said. “Legislators on both sides of the aisle” are considering the AMA’s proposal to direct the unused funds for the wars in Afghanistan and Iraq to offset the cost of eliminating the SGR.

AMA President Peter W. Carmel, MD, noted that while Congress has accomplished little this year, the AMA has made “substantial progress” by working with the administrative arm of the federal government. Examples of AMA victories include securing additional exemptions to Medicare’s ePrescribing program, a streamlined process for rectifying physician identity theft, and a 90-day grace period for using Health Insurance Portability and Accountability Act version 5010 electronic transactions.

Looking forward, AMA President-elect Jeremy A. Lazarus, MD, described the AMA’s influence in shaping new payment and delivery models. In addition to making major revisions to the final rule on Medicare accountable care organizations, CMS also has been receptive to ensuring that physicians have a wide variety of payment and delivery models to choose from.

“It’s not enough to make sure these opportunities are available,” Dr. Lazarus said. “The AMA is helping physicians with the tools they need to participate.”