AGA Washington Insider

A policy blog for GIs

A GI Returns to Washington…and Will Continue Until GIs Are Heard

AllianceOnce again I returned to Washington, DC, to attend the Alliance of Specialty Medicine fly-in to advocate for our specialty, and once again the heat was close to unbearable and our story was as compelling as ever.

The alliance is a group of thirteen specialty medical organizations representing more than 100,000 specialty doctors from across the country. Our annual alliance fly-in includes Capitol Hill visits and presentations by health policy experts, senators and representatives. By working together, we become more effective in influencing health-care policy and achieving our primary goal of providing our patients optimal care.

This year, I was struck by an overwhelming concern — how, as physicians, do we handle all of the new government regulations, while preserving access for our patients to specialty medicine. The hurdles to overcome are numerous and challenging (to say the least) and we needed to convey this to our members of Congress.

Continuously burdened with decreasing reimbursement for our services, we have asked Congress (over the past 12 years) to repeal the sustainable growth rate formula, which has led to cuts to Medicare physician reimbursements. This threatens the viability of many physicians’ practices and imperils patient’s access to specialty care. So, we urged Congress (again) to please enact a permanent solution to this never-ending problem. In addition, we encouraged them to repeal the Independent Payment Advisory Board, a board of non-elected non-physician government officials who can recommend Medicare cuts when spending exceeds targeted growth rate. Even though hospitals and long-term facilities comprise one–third of Medicare spending, they are exempt from these cuts until 2020. Again, a disportionate share of the burden will fall onto the physician.

We explained to our audience that the new regulatory burdens are causing more seasoned physicians to seek early retirement and causing younger physicians to feel the unexpected pressures coming from these regulations. We urged Congress to give only financial incentives linking physician payment to meaningful quality measures, rather than doubling penalties, and to make adjustments to physician payments transparent in a timely manner. This would give us time to prepare for reimbursement changes and provide opportunities for us to comment on these changes.

We explained that electronic health record interoperability standards are needed for us to achieve common platforms for data exchange, avoid repetitive work and improve quality care. Adding to this, we pointed out that medicine will face an overall shortage of more than 130,000 physicians by 2025 with half of that coming from specialty physicians. With 10,000 seniors aging into the Medicare program every day, along with the influx of patients seeking access to care as a result of the Affordable Care Act, the need for specialist services will increase significantly.

We told our representatives that action is needed to increase the number of residency slots to ensure access to specialty medicine. We spoke to our representatives about the importance of significant medical liabilty reform that reduces growth in health-care costs and encourages physician engagement in meaningful quality improvement activities, all indirectly preserving access to specialty care.

At the end of the day, my Massachusetts colleague from the National Association of Spine Specialists and I had walked (in the heat) to five different offices on the Hill. We discussed our concerns, listened to our representatives’ points of view, and then prayed that our issues were heard and changes will come.

In any event, we will be back next year.

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