AMA National Advocacy Conference Report

Friday, March 01, 2013 12:18 PM

Colorado leaders take concerns to Washington, DC

Kate Alfano, CMS contributing writer

More than a dozen Colorado physician leaders and CMS and component chapter staff members traveled to Washington, D.C., for the American Medical Association’s National Advocacy Conference, Feb. 11-13, where they heard from political insiders and industry experts, interacted with peers from other states, and lobbied members of Congress on health system reform, fiscal concerns, and efforts to combat firearm violence and prescription drug abuse.

CMS President Jan Kief, MD, says it’s important for physicians to get involved on the federal level because the work the congressional delegation does in Washington greatly affects “our realm.”

“Our members benefit from the conference because we gain insights from great AMA speakers and get to talk with physicians from around the country to find out what’s happening in other states. We also get to see what goes on in DC and gain a better understanding of what our congressional leaders are doing everyday. It gives you a better appreciation of the process and allows you to bring that local perspective to them. It takes resolve. You have to be proactive, let them know you’re engaged and offer to work with them. Then you can affect positive changes.”

The conference opened Monday afternoon. Attendees heard an overview of AMA’s priority issues from a panel of leaders that included AMA President Jeremy Lazarus, MD, of Denver and they received talking points on top federal issues that they would take to meetings with their congressional leaders on Tuesday and Wednesday.

Attendees also heard an address by Chuck Todd, NBC News’ political director and chief White House correspondent. He focused on the impending federal budget sequester scheduled to take effect March 1 that will slash federal funding for defense and domestic programs. It includes a 2 percent decrease in Medicare payment for physicians.

CMS CEO Alfred Gilchrist says that much of the focus during meetings with the Colorado congressional delegation was on stopping the proposed 2 percent Medicare cut. “It is a viable threat and prospects for further delay are uncertain,” he says. “The major driver in the 113th Congress is the budget, specifically deficit reduction and the strong partisan divide over the ‘balance’ between revenues and spending cuts.”

“The SGR fatigue is apparent in the Capitol,” Mr. Gilchrist says, “but a draft proposal to permanently fix the SGR is being circulated among the two health care committees in the House of Representatives. It was encouraging to learn that a proposal is being circulated and discussed on both sides of the aisle.”

Kevin Fitzgerald, MD, medical director of Rocky Mountain Health Plans and president of Mesa County Medical Society, participated in the meetings with Sen. Mark Udall and Sen. Michael Bennet. He says that in addition to the SGR, they “talked about sequestration and said it probably won’t be fixed, at least not for a couple of weeks after the March deadline. They thought that Congress would probably figure it out and get it fixed pretty fast. That means we may have to suffer a 2 percent decrease in Medicare reimbursements temporarily.”

First-time AMA-NAC attendee Floyd Russak, MD, an internal medicine physician in Denver and current president of the Arapahoe, Douglas and Elbert County Medical Society, says another focus issue was gun safety. “We talked about the importance of preserving the right for physicians to talk to their patients about whatever they think is important about safety and also about releasing information from the CDC and other organizations that collect information on gun violence so we can identify the problem and make a decision on what to do next.”

CMS President-elect John Bender, MD, presented data from a recent CMS member poll on firearm safety that was well received by both senators. Christie Reimer, MD, an internal medicine physician in Fort Collins and president of the Larimer County Medical Society, says, “They felt it was representative of the general population of Colorado, which is why I think they said they could support all of our views.”

A recurring sentiment from congressional leaders and top agency officials throughout the conference was encouragement for physicians to continue leading the effort to improve the health care system on behalf of their patients. In an address on Tuesday, Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, talked about new payment and delivery models taking shape across the country.

“Her message to doctors seemed to be for us to help [federal agencies] know what to do,” says Dr. Reimer. “She requested feedback on innovative methods that work, and even pilots that don’t work, to determine the best way to practice medicine. She seemed open-minded and interested in learning.”

“Two of our delegation, Congressman Perlmutter and Congresswoman DeGette, are on the committee dealing with violence in society,” Dr. Kief continues. “So we know that they have heard our message and we know they’re going to be working on gun safety very diligently.”

Dr. Bender says CMS has a long history of having a strong relationship with the
Colorado delegation that has allowed us to influence policy at both the state and national level. He stresses the importance of continued physician advocacy.

“Legislators are responsive to their constituents. When doctors are actively engaged in making phone calls, sending e-mails, and making personal visits at both the Colorado office and the offices here in DC, legislators hear the message. If we don’t do those sorts of things they figure we’re okay with the status quo. If we don’t advocate for our patients and our profession, other special interests will take over.”

“It’s an exciting time in medicine,” he continues. “We’re just on the brink of implementing the Affordable Care Act and though it’s going to be a lot of work it appears the Colorado delegation fully supports our efforts back home in Colorado. We’re looking forward to implementing the exchange, Medicaid expansion, and other reforms in a way that’s meaningful for patients and for physicians in Colorado.”