National Advocacy Conference Highlights, Feb. 15, 2012

Roe: Medicare payment problem is issue of access to care

During remarks Wednesday morning, Rep. Phil Roe, MD, R-Tenn., encouraged physicians to continue spreading the message that the real issue with Medicare physician payment is patients’ access to care. He believes patients and many members of Congress are only beginning to understand what’s really at stake with Medicare’s sustainable growth rate (SGR) formula.

Dr. Roe pointed to the fact that payments tied to the SGR haven’t covered the costs of providing care for years, which has meant that many physicians cannot afford to see large numbers of Medicare patients. At the same time, Dr. Roe said, 10,000 patients are being added to Medicare each day.

“When I look at SGR, it’s not the doctors’ and patients’ fault. It was the government’s fault,” he said. “We’re missing a golden opportunity to get rid of a bad system.”

In addition to advocating for elimination of the SGR, Dr. Roe introduced a bipartisan bill last year to repeal the Independent Payment Advisory Board (IPAB), a committee established by the Affordable Care Act that could unilaterally cut Medicare payments. The bill has more than 224 signatures and continues to gain support.

Dr. Roe encouraged physicians to make sure their Medicare patients understand these issues and to continue telling their members of Congress about the importance of repealing the SGR and the IPAB.

Garrett: Despite congressional inaction and uncertainty, possibility for change

From a Congress with historically low approval ratings to a Republican presidential primary contest that at one time had an unprecedented six frontrunners, the political climate in the United States is marked by inaction, division and uncertainty. That’s according to Major Garrett, a congressional correspondent for National Journal who spoke Wednesday during the conference’s final session.

Garrett attempted to make sense of the situation, pointed to conditions that could lead to positive changes and commented on what he sees as an abysmal state of Congress largely caused by divisions along party lines.

“Many in Congress have lost sight of rational decision-making and the fundamentals of government,” he said. “Now if we avoid a government shutdown, people think there’s cause for celebration; they have a sense of achievement.”

Garrett noted that inaction by Congress has led to its historically low approval ratings of around 10 percent. Meanwhile, he predicted that Congress would delay addressing such weighty issues as the debt ceiling, Bush-era tax cuts, unemployment and the Medicare physician payment issue until the end of the year.

But Garrett sees potential for positive change. After three highly partisan congressional elections, Garrett suggests that Americans might be so dissatisfied that both parties could see significant losses in the upcoming election. This kind of message from disapproving voters, coupled with the difficult decisions that will need to be made in December, could lead to a change in lawmakers’ behavior.

Joining Forces initiative helps physicians treat veterans with special needs

Many of the more than 2.3 million service members who have been deployed to Afghanistan or Iraq are returning to their communities with special health care needs. A Wednesday presentation described how a national initiative can equip physicians to provide the best possible care for these patients and their families.

Navy Capt. Paul S. Hammer, MD, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, explained how the Joining Forces initiative could help physicians diagnose and treat three specific conditions:

• Post-traumatic stress disorder, which affects as many as 17 percent of military members who served in the wars.
• Traumatic brain injuries.
• Post-combat depression.

According to Hammer, more than 40 percent of veterans of these wars are part of the National Guard or the reserves and will receive treatment in the private sector rather than from the Department of Defense (DOD) or Veterans Affairs (VA). Under this initiative, doctors in the private sector can learn from military and federal physicians’ experiences and protocol for these special conditions.

“There’s a huge advantage in having the DOD, the VA and the private sector join together,”  Hammer said. “It’s vital that we join forces in order to provide the best possible care for these young men and women who have given their lives … and deserve the best possible care we can give them.”

Discuss the conference in AMA online forum

Share your thoughts about this year’s National Advocacy Conference in the AMA’s Advocacy Forum (login required). Open to AMA members only, the forum provides a secure environment where AMA physician and medical student members can discuss issues addressed during the conference, such as repeal of Medicare’s flawed sustainable growth rate formula.

In the forum you’ll also find AMA Advocacy News, which contains links to news topics of interest to physicians.

To access the forum, AMA members must use their AMA login account. AMA members who do not have a login account can create one.