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AMA State Advocacy Roundtable Conference

August 7-9, 2014
Conrad Chicago
Chicago, Illinois

Held each summer in August, this meeting allows state and specialty society lobbyists, general counsel and policy staff to exchange information and strategies on critical state health care issues, and participate in an informal format that supports open dialogue and idea-sharing. This conference also encourages networking among fellow medical association staff.

Meeting agenda and schedule  

The year ahead in health care: A forecasting model

Background:

2015 will continue to be shaped by not only the implementation of the Affordable Care Act (ACA), but also by issues - such as cost containment, health information technology and others - that began trending before the ACA was enacted into law.  There will be increasing pressure to deliver both higher quality and more cost effective care and develop new alliances and networks between diferent types of providers (physicians, hospitals, insurers, etc.) to accomplish these goals.  Will insurers be able to keep premiums down as more patients sign up for coverage thru private plans or expanded Medicaid programs?  Will accountable care organizations (ACOs) deliver on their promise of the Triple Aim?  As hopitals continue to experience a downward trend in terms of patient volume, what other ways will they find to increase revenue and maintain operating margins? And how will states manage to control their healthcare-related budgets with an increasing Medicaid population? Hear the answers to these questions and more.

Objectives:

  • Discuss issues that will dominate the healthcare conversation in the year ahead.
  • Hear differing perspectives from critical health care sector stakeholders.
  • Determine how these issues will affect your organization and its state advocacy agenda.

Moderator:

  • David Burda, MA, Editorial Director, Healthcare Strategies, MSP Communications

Panelists:

  • Julie Hamos, Director, Illinois Department of Healthcare and Family Services
  • Steve Hammen, Divisional Senior Vice President, Network Management, Blue Cross Blue Shield Association of Illinois
  • Casey Cesnovar, Director, State Government Relations, Walgreens
  • Meghan Wolthman, Vice President, Government & Community Relations, Advocate Health Care

Contact information:

For more information on issues raised in this session, please contact Kai Sternstein, Vice President, Advocacy Resource Center at michaela.sternstein@ama-assn.org or (312) 464-5929.

The growing demand for data transparency

Background:

The demand for health care data and transparency is greater than ever. Complete and accurate cost and quality information can empower consumers to make informed decisions about their care, advise benefit choices by employers and public payers, help insurers evaluate providers, inform important research, and allow physicians to make quality improvements and successfully participate in new payment and delivery models.

But is the data collected in the numerous initiatives across the country being translated into information from which all stakeholders can benefit? How do we ensure complete and accurate information? What information should be available and to who? What requirements should be placed on those reporting these data? And what types of advocacy can help ensure the most useful information is available?

Objectives:

  • Better understand the environment that is leading to the demand for transparency and what initiatives are underway.
  • Consider the interest of the employer, as a major driver behind the demand.
  • Identify how medical societies can address data transparency initiatives and how physicians should engage in order to benefit.

Keynote speaker

  • Leemore Dafny, PhD, Professor of Management and Strategy and Herman Smith Research Professor in Hospital and Health Services, Kellogg School of Management, Northwestern University

Panelists:

  • Larry S. Boress, President and CEO, Midwest Business Group on Health
  • Rich Deem, Senior Vice President, Advocacy, American Medical Association
  • Patricia Kolodzey, Associate Director, Legislative Affairs, Texas Medical Association

AMA resources:

Outside resources:

Contact information:

For more information on issues raised in this session, please contact Emily Carroll, Senior Legislative Attorney, Advocacy Resource Center at emily.carroll@ama-assn.org or (312) 464-4967.

Health insurance reforms and beyond

Background:

This year has been full of changes in the health insurance market, including the implementation of exchanges and a shift toward narrow provider networks. With these changes have come physicians concerns, and medical societies have responded with both legislative and regulatory advocacy. Some successes have been achieved, but much more work remains ahead. What are the most pressing issues? What are the best strategies for protecting patients and physicians? This session will detail state legislative strategy and identify key resources for legislative and regulatory progress.

Objectives:

  • Understand how medical societies have directed their advocacy agendas to address physician concerns related to exchange implemenation and provider network changes.
  • Identify what health reform priorities and related advocacy strategies might be important for your physicians in 2015.

Panelists - Part 1 - Addressing exchange issues and providing solutions

  • Kathryn Kolan, JD, Director, Legislative and Regulatory Affairs, Washington State Medical Association
  • Brett Johnson, JD, Associate Director, Center for Medical and Regulatory Policy, California Medical Association
  • Cory Meadows, Director for Advocacy and Legal Affairs, Kentucky Medical Association

Panelists - Part 2 - Networks-Rulemaking and legislating

  • Kathryn Kolan, JD, Director, Legislative and Regulatory Affairs, Washington State Medical Association
  • Brett Johnson, JD, Associate Director, Center for Medical and Regulatory Policy, California Medical Association
  • David Brewster, Assistant Director, Practice Advocacy, American Academy of Dermatology Association

AMA resources:

Outside resources:

Contact information:

For more information on issues raised in this session, please contact Daniel Blaney-Koen, Senior Legislative Attorney, Advocacy Resource Center at daniel.blaney-koen@ama-assn.org or (312) 464-4954 or Emily Carroll, Senior Legislative Attorney, Advocacy Resource Center at emily.carroll@ama-assn.org or (312) 464-4967.

Telemedicine

Background:

Telemedicine, a key innovation in support of health care delivery reform, is being used in initiatives to improve access to care, care coordination and quality, as well as reduce the rate of growth in health care spending. At the same time, pressure to facilitate greater adoption of telemedicine has legislators seeking to streamline medical licensure and regulation of telemedicine at both the state and federal level. In this session, we will hear about efforts to facilitate multistate medical licensure and regulate telemedicine. We will hear from state and national medical specialty societies, including one medical society that has entered the market as a telemedicine vendor. This panel will discuss how physician leadership can help support the safe adoption of these exciting new technologies.

Objectives:

  • Learn how to protect the interest of patients and the ability of states to enforce state licensure and medical practice laws while setting the stage for the adoption of these new medical technologies.
  • Identify opportunities for physicians to proactively address telemedicine licensure and policy.
  • Discuss what state-based efforts are needed to advance sound telemedicine policy.

Panelists:

  • Eric Fish, JD, Senior Director, Legal Services, Federation of State Medical Boards
  • Kristina Finney, MPH, Manager, Quality and Patient Safety Resources, American Academy of Dermatology Association
  • Troy Alexander, Associate Director, Legislative Affairs, Texas Medical Association

AMA resources:

Outside resources:

Contact Information:

For more information on issues raised in this session, please contact Kristin Schleiter, Senior Legislative Attorney, Advocacy Resource Center at kristin.schleiter@ama-assn.org or (312) 464-4783.

Friday Breakout Sessions

Breakout #1 - Protecting the patient physician relationship

Background:

As legislatures continue to reach into the patient-physician relationship through physician gag laws, mandated procedures as well as legalizing medical marijuana, this session will highlight strategies for medical society engagement on politically sensitive issues.

Objectives:

  • Brainstorm with colleagues on approaches to defend the patient physician relationship
  • Identify potential collaboration for legislative success

AMA resources:

Contact information:

For more information on issues raised in this session, please contact Carrie Armour, Senior Legislative Attorney, Advocacy Resource Center at carrie.armour@ama-assn.org or (312) 464-4039.

Breakout #2 - State alternatives to GME financing

Background:

In recent years, there has been a growing inability for medical school graduates to enter the training program of their choice. Proposals to change graduate medical education (GME) have focused on funding, governance, and prioritization of specialties. While many of these proposals come from national organizations offering national solutions, states are playing an increasingly important role in reforming GME. Individual states have pioneered methods and organizational structures to target GME positions toward state health workforce needs and offered creative mechanisms to support GME. There is thus an opportunity for medical associations to take significant action to support the future health care workforce.

Objectives:

  • Learn about state-level GME financing efforts to increase the physician workforce and influence physicians' specialty and distribution.
  • Discuss with your colleagues the opportunities and challenges inherent in new and innovative state-based approaches to GME financing.

Panelist:

  • Paul Rockey, MD, MPH, Scholar in Residence, Accreditation for Council for Graduate Medical Education

AMA resources:

Outside resources:

Contact information:

For more information on issues raised in this session, please contact Kristin Schleiter, Senior Legislative Attorney, Advocacy Resource Center at kristin.schleiter@ama-assn.org or (312) 464-4783.

Breakout #3 - The future of medical liability reform

Background:

What is the future medical liability reform in your state? Will your approach evolve with the times, or will you look to tried-and-true methods for success? Decide where your society stands after this debate-style discussion.

Objectives:

  • Challenge your thinking on the future of medical liability reform advocacy.
  • Refine your arguments in support of traditional and innovative medical liability reform efforts.

Panelists:

  • Gordon Smith, JD, Executive Vice President, Maine Medical Association
  • Donald Palmisano, Jr., JD, Executive Director/CEO, Medical Association of Georgia

AMA resources:

Contact information:

For more information on issues raised in this session, please contact Kristin Schleiter, Senior Legislative Attorney, Advocacy Resource Center at kristin.schleiter@ama-assn.org or (312) 464-4783.

Medicaid - Expanding your state's options

Background:

Medicaid programs across the country are in a period of fundamental and rapid change.  Enrollment is growing, even in those states that have not expanded Medicaid eligibility, and state Medicaid programs are facing intense fiscal pressure to contain costs.  As a result, states are increasingly looking for ways to lower costs and improve program administration.  The changes on the horizon will have a long-lasting impact on Medicaid patients and the physicians who care for them.

This session will explore ways physicians can lead the way toward meaningful payment and delivery system reform, and examine ways in which states that have not yet expanded Medicaid can design alternative models to address some of Medicaid's perceived shortfalls while also providig important coverage to residents and drawing down federal funds.

Objectives:

  • Better understand delivery and payment reforms designed to increase quality and reduce cost
  • Explore alternative approaches states are using to expand Medicaid eligibility
  • Identify opportunities for physician leadership to influence Medicaid programs

Keynote Speaker:

  • Matthew Heinz, MD, Director of Provider Outreach, Office of Intergovernmental and External Affairs, HHS

Reactor Panel:

  • Gene Ransom, Chief Executive Officer, MedChi, The Maryland State Medical Society
  • Scott Smith, JD, Director, Government Affairs, Arkansas Medical Society

AMA resources:

Outside resources:

Contact information:

For more information on issues raised in this session, please contact Annalia Michelman, Senior Legislative Attorney, Advocacy Resource Center at annalia.michelman@ama-assn.org or (312) 464-4788.

Rx drug abuse

Background:

Under pressure from legislators to do "something," many states faced challenging political situations asking them to compromise "or else."  What strategies did the states employ, and were they successful?  What are the short and long-term implications of the medical society actions, including how can we avoid the criminalization of patients suffering from substance abuse, and how can we turn the discussion to emphasize treatment and prevention?

Objectives:

  • Identify the policy and politics behind state legislative compromises concerning prescription drug abuse and diversion.
  • Learn now prescription drug abuse and diversion can be addressed outside the legislative arena.
  • Discuss how the national discussion of prescription drug abuse and diversion can shift to emphasize treatment and prevention.

Panelists:

  • Tim Maglione, JD, Senior Director, Government Relations Group, Ohio State Medical Association
  • Wes Glinsmann, Director, State Legislative and Political Affairs, Oklahoma State Medical Association
  • Scott Clark, Associate Director, Medical & Regulatory Policy, California Medical Association
  • Alexis Geier Horan, MPP, Senior Director, Government Relations and Clinical Practice, American Society of Addiction Medicine

AMA resources:

Outside resources:

Contact information:

For more information on issues raised in this session, please contact Daniel Blaney-Koen, Senior Legislative Attorney, Advocacy Resource Center at daniel.blaney-koen@ama-assn.org or (312) 464-4954.

Health workforce mapper demonstration

Background:

The AMA Geographic Mapping Initiative has undergone a transformation, with interactive mapping technology that will facilitate a truly evidence-based discussion on the health care workforce.  Come learn about this exciting new advocacy tool. The AM Geographic Mapping Initiative has undergone a transformation, with interactive mapping techology that will facilitate a truly evidence-based discussion on the health care workforce.  Come learn about this exciting new advocacy tool, the AMA Health Workforce Mapper.

Objectives:

  • Learn about the capabilities of the AMA Health Workforce Mapper.
  • Discuss how the AMA Health Workforce Mapper may impact your advocacy efforts on the health care workforce and other topics.

Panelist:

  • Sean Finnegan, MS, Research and GIS Data Manager, Robert Graham Center

Contact information:

For more information on issues raised in this session, please contact Kristin Schleiter, Senior Legislative Attorney, Advocacy Resource Center at kristin.schleiter@ama-assn.org or (312) 464-4783.

Physician-led teams

Background:

While messaging about team-based care continues to resonate, medical associations are leading discussions about potential proactive strategies that present strengthened education and training standards sufficient from medicine's perspective and to support a scope of practice expansion.

Objectives:

  • Discuss how to calibrate your messaging on physician leadership of health care teams.
  • Explore "pathways to yes" strategies that allow medicine to shape and control scope of practice debates.

Panelists:

  • Shawn Martin, Vice President, Advocacy & Practice Advancement, American Academy of Family Physicians
  • Erin O'Brien, Assistant Vice President, State Legislative Affairs, Illinois State Medical Society
  • Dave Renner, Director, State and Federal Legislation, Minnesota Medical Association

AMA resources:

Website: Physician-led team  
Physician-led team campaign booklet 
Physician-led team model bill 
Bill summary - IL SB 2187 (2014)
Bill summary - MD HB 402 (2014) 

Outside resources:

AAFP IPSOS Survey Infographic 
AAFP Presentation: Scope of practice messaging 
AAFP Primary Care for the 21st Century 
Minnesota SF 511 - APRN (2014) 
Connecticut Chapter 375 Podiatry 
West Virginia Legislative Auditor APRN report 

Contact information:

For more information on issues raised in this session, please contact Kristin Schleiter, Senior Legislative Attorney, Advocacy Resource Center at kristin.schleiter@ama-assn.org or (312) 464-4783.

Administrative simplification: The Colorado initative

Background:

The Colorado Clean Claims Initiative is an effort by the state of Colorado, strongly supported by Colorado Medical Society and the American Medical Association, to standardize health care claims edits and payment rules accross all private payers.  The Clean Claim Task Force, comprised of representatives from major private payers, claims software vendors, the Colorado Medical Society, the American Medical Association, the Colorado Medical Group Management Association, local physician billing personnel and the state of Colorado, plans to identify and develop a standardized set of health care claim edits and payment rules to process medical claims.  Current estimates place the savings of standardization of the millions of claims edits at $80 million to $100 million a year in Colorado alone.

Objectives:

  • Learn about the important work being done by the Colorado Clean Claims Task Force
  • Consider how your society might be able to benefit and capitalized on the Task Force's progress.

Keynote speaker:

  • Mark Painter, Co-chair, Colorado Clean Claims Task Force

Reactor panel:

  • Madeleine Mongan, JD, Deputy Executive Vice President, Vermont Medical Society
  • Heather McComas, PharmD, Director, Administrative Simplification Initiative, AMA

AMA resources:

Outside resources:

Contact information:

For more information on issues raised in this session, please contact Emily Carroll, Senior Legislative Attorney, Advocacy Resource Center at emily.carroll@ama-assn.org or (312) 464-4967.

Showing your value to physicians

Background:

The trend line is clear: physicians are opting at a startlingly fast rate to give up their autonomy, take down their shingle (or never hang it in the first place) in exchange for the perceived stability of a salaried position.  Further, young physicians are placing a great value on a better work-life balance - much more so than their more mature physician colleagues.  These younger physicians seem to be willing t trade away higher salaries for not only that balance, but also for the ability to avoid the administrative hassles that would come with owning their own place.  Given this evolving environment, how can organized medicine continue to ensure its relevance?  Do our respective state advocacy agendas need to change or do the issues remain the same regardless of how a physician is employed?  How seriously should we take the generational changes that are taking place?

Objectives:

  • Discuss how medical societies are maintaining relevance to hospital-based physicians, students and residents, independent physicians and those working in physician-led groups.
  • Identify advocacy issues that cut across all segments of physicians and those that are unique to each of the segments represented on this panel.
  • Determine if it possible to create an advocacy agenda that represents all physicians.

Panelists:

  • Dimitri Azar, MD, MBA, Dean, College of Medicine and Professor of Ophthalmology, Pharmacology and Bioengineering, University of Illinois at Chicago
  • Betty Chu, MD, MBA, Chief Medical Officer, Medical Affairs, Henry Form West Bloomfield Hospital and Henry Ford Detroit Main Campus
  • David G. Seaman, CEO, PRONGER SMITH Medical Care

Contact information:

For more information on issues raised  in this session, please contact Kai Sternstein, Vice President, Advocacy Resource Center, at michaela.sternstein@ama-assn.org or (312) 464-5929.