Bipartisanship Efforts Continue on Capitol Hill, Despite the Rhetoric
While acrimony between the two leading political parties grabs the national headlines, the reality is that Republican and Democratic politicians build bridges across the political chasm and collaborate to make the government work on a daily basis. The congressional Bipartisan Working Group, co-chaired by Reps. Jim Renacci (R-OH) and Derek Kilmer (D-WA), is one such bridge. The group, founded in 2011 for lawmakers who share the belief that fostering interparty collegiality can lead to meaningful legislative partnerships and tangible results, meets weekly when Congress is in session. A typical meeting involves discussion of bills and ideas under consideration, the progress of legislation on the House floor, and the issues that are facing Congress.
For example, John Daly, MD, FACS, Co-Chair of American College of Surgeons (ACS) Patient Education Committee, met with the Bipartisan Working Group November 29, 2017, to discuss public health concerns related to the opioid epidemic. Dr. Daly used his experience as Co-Chair to provide key insights to lawmakers regarding how to best address the opioid crisis, while ensuring that physicians can appropriately treat their patients.
In addition to the Bipartisan Working Group, many congressional caucuses are composed of both Democratic and Republican legislators. These groups meet privately to discuss the issues before Congress. One such group is the 35-member House Problem Solvers Caucus, which considers issues including tax reform and infrastructure and focused health reform proposals. A list of bipartisan caucuses is available on the House website.
In addition, one-off bipartisan working groups often form to address specific issues. For example, the Senate Chronic Care Working Group is a small bipartisan group created to develop legislative proposals aimed at improving outcomes for Medicare patients with chronic health care conditions. These task forces work with stakeholders to find solutions. For example, the ACS wrote to the Chronic Care Working Group to emphasize that any efforts to reform chronic care must include surgical input when surgical care is involved in the treatment of patients with chronic conditions.
For more information about how the ACS works with lawmakers to achieve positive legislative outcomes for surgical patients and surgeons, e-mail Carrie Zlatos, ACS Congressional Lobbyist, at czlatos@facs.org.
Update on ACS Alternative Payment Efforts
Recently, ACS staff members have participated in multiple conference calls and meetings with government officials to discuss the ACS-Brandeis Advanced Alternative Payment Model (A-APM). The ACS-Brandeis A-APM was developed by the ACS and a team of health care data experts at Brandeis University, Waltham, MA. The model is intended to give surgeons additional opportunities for voluntary participation in APMs. Under the new Quality Payment Program (QPP), Medicare physicians who participate to a sufficient degree in certain advanced APMs are excluded from the Merit-based Incentive Payment System (MIPS) and may be eligible for a five percent lump-sum bonus payment and other incentives.
The ACS-Brandeis A-APM got the green light for further development work with the Centers for Medicare & Medicaid Services (CMS) in September 2017 from then-Department of Health and Human Services Secretary, Tom Price, MD. Soon after, CMS and the Center for Medicare and Medicaid Innovation (CMMI), which had set up multiple work groups on various aspects of the model involving many CMS staff members, contacted the ACS about the model.
On November 30, ACS staff participated in an initial conference call with a workgroup at CMS tasked with reviewing and assessing the model’s quality measure framework. The ACS has proposed a team-based system that measures quality across the entire episode of patient care, incorporating the phases of care concept outlined in the recently published Optimal Resources for Surgical Quality and Safety.
In addition, on December 11, staff participated in an in-person meeting at CMMI in Baltimore, MD, to explore the capabilities of the Episode Grouper for Medicare (EGM). EGM consists of a software application coupled with physician-vetted clinical episode definitions and is used by the ACS-Brandeis A-APM to identify episodes and set a patient-specific risk-adjusted target price.
While a number of hurdles remain, these meetings have been productive and encouraging. The ACS Division of Advocacy and Health Policy staff remains enthusiastic about continuing to work on the model in 2018.
ACSPA 2017 Achievements at a Glance
The American College of Surgeons Professional Association (ACSPA) is an affiliated not-for-profit corporation founded by the ACS Board of Regents in 2002 to leverage the College’s advocacy and education efforts. ACSPA resources include SurgeonsVoice and ACSPA-SurgeonsPAC, both of which are crucial to improving the legislative and regulatory climate in which surgeons practice. Following are key SurgeonsVoice and SurgeonsPAC 2017 highlights:
SurgeonsVoice
- More than 300 surgeons and residents participated in the ACS Advocacy Summit
- Circulated more than 1,000 messages to Congress regarding federal legislative priorities
- Gained 382 followers via the @SurgeonsVoice Twitter handle
- Facilitated several Stop the Bleed® in-district trainings, meetings, and trauma facility tours
- Hosted the first ACS cancer programs virtual Capitol Hill day, resulting in 14,344 Twitter impressions/engagements, 50 retweets, and more than 245 #cancerprogramsday mentions
SurgeonsPAC
- Received contributions from more than 1,200 ACSPA members during 2017
- Facilitated more than 30 in-district check deliveries
- Hosted 8 physician community events for key surgical champions in Congress
- Attended more than 200 health care industry events
- Served on several steering committees led by members of Congress
For more information regarding the College’s advocacy and grassroots priorities, contact ahp@facs.org or at 202-672-1520. To learn more about SurgeonsPAC fundraising and disbursement activities, contact surgeonspac@facs.org.
Members of Congress Show Support for Stop the Bleed® Program
Several members of Congress recently have spoken on the floor of the U.S. House of Representatives in support of the College’s Stop the Bleed® program. In October 2017, Reps. Roger Marshall, MD (R-KS), and Rodney Davis (R-IL) participated in an ACS-hosted congressional Stop the Bleed training event, during which members of Congress and their key staff learned about bleeding control techniques.
Upon completion of their training, Dr. Marshall and Rep. Davis voiced their support for the Stop the Bleed program on the House floor and urged their colleagues to help raise awareness about the program and to become trained in bleeding control. View the remarks from Dr. Marshall and Rep. Davis.
For more information on trauma advocacy, contact Justin Rosen, ACS Congressional Lobbyist, at jrosen@facs.org or 202-672-1528.
CMS Updates Physician Compare Website
The Centers for Medicare & Medicaid Services (CMS) recently announced new quality information on its Physician Compare website. CMS is publicly reporting certain 2016 performance information. New data are available on public-facing profile pages and via the Physician Compare Downloadable Database. In addition, CMS has released a small subset of 2016 group-level measures from the predecessor quality reporting program, the Physician Quality Reporting System (PQRS), on group profile pages as star ratings.
The updated 2016 measures that CMS released on the Physician Compare profile pages include the following:
- 15 2016 PQRS measures for groups as “star ratings”
- 2016 Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS patient experience measures for groups as top-box scores
- 2016 non-PQRS Qualified Clinical Data Registry measures with performance rates expressed as percentages for clinicians and groups
- 2016 Accountable Care Organization measures
For more information about star ratings, visit the CMS Physician Compare Initiative page. If you have questions or would like more information, contact qualityDC@facs.org.
HHS Provides HIPAA Guidance to Help Address Opioid Epidemic
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights has made guidance available on its website to assist surgeons and other health care professionals who are treating patients in the midst of the opioid crisis. HHS has taken the step in conjunction with the declaration of a nationwide public health emergency. The guidance conveys when and how providers can share patient health information with family members, friends, and legal representatives during a crisis such as an opioid overdose.
The American College of Surgeons has created informational tools to help educate both patients and prescribers about the effects of opioids. These materials include the Statement on the Opioid Abuse Epidemic, a patient education guide, and the August opioid-focused edition of the Bulletin.
