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AMA president, Jesse Ehrenfeld, MD, MPH, joins to discuss the AMA’s key accomplishments in 2023 and the organization’s priorities for 2024. Dr. Ehrenfeld breaks down the key wins this year on reforming Medicare payment, reducing burnout and fixing prior-authorization, and why these priorities are only more urgent in 2024. AMA Chief Experience Officer Todd Unger hosts.
- Take action now! Contact your representatives about H.R.6683 - Preserving Seniors’ Access to Physicians Act of 2023.
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- 2024 Medicare physician fee schedule and more Medicare explained updates.
- Get all your Medicare fee schedule questions answered.
- Get involved! Patients and physicians can share prior authorization stories.
- What is the AMA Joy in Medicine Health System Recognition Program? Find out more.
- Learn more about the AMA Health System Program.
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Speaker
- Jesse Ehrenfeld, MD, MPH, president, AMA
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're discussing the progress that the AMA has made throughout 2023 and our priorities for the year ahead with Dr. Jesse Ehrenfeld, president of the AMA. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Ehrenfeld, it is great to have you here today.
Dr. Ehrenfeld: Great to see you, Todd. Thanks for having me.
Unger: It's been a busy year, and we saw some significant wins and progress on the AMA's top priorities. We're going to walk through those. I want to start with Medicare payment reform, some big news over the past week on that, a lot of action. Take us through what we were able to accomplish this year.
Dr. Ehrenfeld: Well, Todd, we accomplished so much. There are just a few of our wins. We mobilized the physician community with our grassroots Fix Medicare Now campaign.
We also raised an unprecedented level of awareness in the media and among policymakers about this problem and all of that advocacy has started to yield results. We've shifted the conversation on Capitol Hill about the MIPS program, and policymakers are starting to recognize its problems. We've also shaped a proposal to reform budget-neutrality policies that affect Medicare physician payment, and most importantly, we've continued to secure bipartisan support for a bill that would provide annual inflationary updates to the Medicare physician payment.
And we're still fighting against the payment cuts for 2024, but there's some good news there. A group of representatives recently introduced a bill called the Preserving Seniors' Access to Physicians Act of 2023, which would completely eliminate these cuts. The AMA strongly supports this legislation and is encouraging everybody to reach out to their representatives to get them to support this important bill.
Unger: Well, that is huge news and an incredible amount of progress. I just want to say thank you for what you've personally done to move that critical issue forward, and again, to emphasize what you said before, which is it's so important that physicians reach out to their representatives and urge them to support this bill.
Dr. Ehrenfeld, another top priority in the AMA Recovery Plan for America's Physicians is reducing physician burnout. Talk to us a little bit about the key accomplishments in this arena.
Dr. Ehrenfeld: Well, we've had a lot of well-being wins this year. We've gotten rid of stigmatizing questions from credentialing applications and advocated for new laws in over a dozen states, but one of the most important significant wins is the growth of the AMA Joy in Medicine Recognition Program. We recognized 72 health systems and practices for their well-being efforts this year, which is more than double the year before.
Now, we created that program just four years ago, and in that short amount of time, it has become a national standard of care in physician well-being. This growth has an incredible impact on burnout. Those 72 organizations we recognized support more than 120,000 physicians. The Joy in Medicine Program gives organizations a clear guide, steps to improve their well-being efforts and we expect even more will apply for recognition next year. By bringing together all of these organizations around this well-being roadmap, we can truly tackle a problem as big and systemic as burnout.
Unger: If you want to find out more information about the Joy in Medicine Program, the standard of care in physician well-being, please take a look at the AMA site, and as Dr. Ehrenfeld said, make sure to take action to apply for next year.
Dr. Ehrenfeld, there is so much to discuss, and we don't have time to cover everything. But before we go ahead, I want to ask you one more AMA recovery plan priority. What wins did we see this year on one of the top things physicians want to see stamped out? And that is prior authorization.
Dr. Ehrenfeld: Well, prior authorization continues to be one of the biggest burdens on physician practices, but we've made some progress towards fixing it this year at the national and the local level in the public and the private sector. Because of our advocacy, we convinced CMS to rightsize prior authorization in the Medicare Advantage plans, and we also continued our work with state and specialty societies to advocate for change.
Just this year, over 30 bills to reform prior authorization were introduced. And policymakers are feeling the pressure, and so are insurance companies. Two of the nation's largest insurers recently announced that they are going to take steps, voluntary steps, to reduce prior authorization burden. Now, while those changes remain to be seen, the impact, the momentum is clearly building for reform and relief.
Unger: When you hear all of the things that you've laid out in terms of the accomplishments over the past year, it's really hard to imagine where we would be without all of this work. It's so important to physicians and to patients, and it kind of begs the question, where would medicine be without this kind of work from the AMA this year?
Dr. Ehrenfeld: Well, Todd, look, I can't imagine practicing medicine in a world without the AMA. I think about the impact of the science published in JAMA this past year that has changed practice for hundreds of thousands of physicians across the globe.
I think about the impact our work has on inspiring the next generation of physicians, our residents, our medical students who are on a path to touch the lives of so many patients, and I think about the thousands of high school and college applicants that we have touched this past year who are inspired by what is possible in medicine today. And we saw a record number of applications to medical school in 2023. Just shy of a million applications went in.
And finally, I think about the hundreds of thousands of patients across America, including my own sons, who have benefited directly from the work of the AMA to preserve and expand access to care, to life-saving vaccines and to medicines that are critical to keeping our nation healthy.
Unger: Well, thankfully, this isn't a world without the AMA, because we have a lot of work to do in the year ahead. Dr. Ehrenfeld, tell us about the top priorities for 2024.
Dr. Ehrenfeld: Well, when you look at the issues we've talked about today, these are long-term problems in need of long-term solutions and commitment. And yes, we made a lot of progress this year, but our work is far from done. So our priorities for 2024 are going to look similar to 2023. As long as issues like a broken Medicare payment system, prior authorization and burnout remain a problem, our work only becomes more urgent.
Now is not the time to lose focus. The consequences are too great, and look no further than the physician shortage, which is just growing worse with each passing year. That's why one of the priorities next year will be urging Congress to pass three bipartisan bills that can start to address this issue. These bills seek to expand residency training options, provide greater student loan support and create a smoother pathway for foreign-trained physicians to practice in America. None of this can wait, and that's why we're working each and every day to make sure that it doesn't.
Unger: Those are incredibly important issues, absolutely shaping up to be another busy year. As you look ahead to the second half of your presidency, what has you most excited?
Dr. Ehrenfeld: Well, I am most excited to build on the momentum that we are gaining each and every day. The conversation has changed. The conversation on Capitol Hill in legislatures is different than it was six months ago. Our elected representatives feel the urgency to act on so many of our key issues, and I am so humbled to be the AMA president this year to drive this forward.
Unger: Well, Dr. Ehrenfeld, thank you so much for your leadership on all of these issues. It is exciting. There is a lot of momentum, and there's a lot to do in 2024. It's a pleasure to have you today. Thank you for sharing your perspective.
If you enjoyed this discussion and you want to support these important AMA initiatives, become an AMA member at ama-assn.org/join. That wraps up today's episode and we'll be back soon with another AMA Update. In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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