Physicians across the country will see some key issues play out in their home states over the next year, as outlined by about 200 medical association leaders who last week came together to discuss strategy around these legislative and regulatory priorities. Four issues came out at the top of the list.
Ensuring physician-led team-based care
Nearly every state plans to take team-based care issues to their legislatures, advocating for an environment that encourages flexible, innovative health care teams under a framework of physician leadership. “Physicians drive a tremendous amount of positive economic benefit to the states,” AMA Executive Vice President and CEO James L. Madara, MD, told attendees at the AMA’s State Legislative Strategy Conference. “You are drivers of change, and we continue to work for policies that support that positive impact.”
Reforming Medicaid under the Affordable Care Act
Since October 2013, 9.7 million new enrollees joined Medicaid and Children’s Health Insurance Programs. Expect considerable activity around Medicaid as many states look to constrain growing budgets and seek new care and payment delivery models that can cut costs, improve quality and improve access to care. Implementation of the Affordable Care Act (ACA) brought to light a variety of issues, including health insurance exchanges, network adequacy and quality initiatives. “There is a lot going on, and it can be confusing, yet there are multiple places for physicians to be at the table,” said Sarah Somers, a managing attorney for the National Health Law Program.
Protecting the patient-physician relationship
In recent years, states have been introducing legislation that attempts to place limits on the information exchanged between physicians and their patients. Increasingly, physicians are seeing restrictions on conversations about firearms, interactions with gay patients, end of life care and other subjects, said R. Alta Charo, the Warren P. Knowles professor of law and bioethics at the University of Wisconsin.
These hot topics are the ones that motivate legislatures across the country to actually introduce bills, Charo said. She pointed to the idea of legislation that would ensure medical care doesn’t become politicized. “The key thing here is to proactively try to focus on the more principled, global concerns… if it’s introduced and discussed before you have controversy on something, you have the opportunity to take over the conversation.” Physicians in many states will be working toward protecting this relationship and ensuring no legislation infringes on the matter or breadth of information a doctor can share with a patient.
Reducing prescription drug abuse and overdose
In 2015, physicians will see more activity around pharmaceutical and prescribing issues, including new emphasis on drug abuse treatment and prevention and regulations restricting the prescribing of opioids. Watch for more movement on prescription drug monitoring programs (PDMP) and increased access to naloxone, as well as providing Good Samaritan protections for those who try to help an overdose victim. AMA has extensive resources to help medical societies address these and other related areas for state legislative advocacy. “We, as the leaders of medicine in our states and in our nation, must take an active role in acknowledging that we can always do better,” said Michael Botticelli, acting director of national drug control policy for the Office of National Drug Control Policy. “We have to be involved in developing evidence-based guidelines. We have to ensure PDMPs have the resources we need to be effective. If we do not lead, others will fill that vacuum.”
Among other issues physicians can expect to face this year include medical liability reform, managed care and contracting issues, administrative simplification and network adequacy. The AMA is working in conjunction with state and specialty medical associations to advance these priorities through model bills and state-specific activity. Watch for coverage on these important issues at AMA Wire®.
