Last week, I had the privilege of attending the 11th Annual ASTRO Advocacy Day in Washington, D.C. Each year, the American Society for Radiation Oncology (ASTRO) organizes Advocacy Day to give radiation oncologists an opportunity to learn about healthcare policy issues that could affect one’s practice. Experts present on such topics as safety, quality initiatives, physician reimbursement, Stark law, cancer research, and other current healthcare policy issues. On the second day of the event, attendees visit Capitol Hill, and have an opportunity to advocate for issues important to our industry.
This was the first time that I have participated in this important event, and I came away with a renewed sense of gratefulness that we live in a country where we can have a civil dialogue with our leaders about somewhat controversial topics, without fear of injury or insult. It is always inspiring to see our democratic process in action.
There are so many legislative issues on the table right now that directly affect our specialty. ASTRO does a great job of preparing the attendees for our day on Capitol Hill; we were given ample information, valid talking points, and well-crafted visuals that helped us to distill the issues into focused conversations.
ASTRO also previewed a new self-reporting incidence registry that will be rolled out this summer. RO-ILS is ASTRO’s response to the publicity our specialty received in recent years, when patient safety issues were brought to light in newspapers such as The Wall Street Journal and the Washington Post. This registry is optional and blinded, and will offer no root cause analysis – only aggregated data that can be reviewed from an educational standpoint. I am very pleased to see this opportunity to advocate safety for our specialty, and we will be participating in the registry at our own RBSE cancer centers.
Armed with all of this education, we were well prepared to have very focused conversations on Capitol Hill… and those conversations HAD to be focused; in most offices, we were lucky to get 15 minutes with a Legislative Assistant. Speaking of the Legislative Assistants, I couldn’t help but notice they were all half my age, and masters of multi-tasking! These very professional young people were simultaneously listening to us, taking notes, and tweeting. I was impressed; as you can see from the photos, I have yet to even master a good selfie.
Besides the assistants, I was able to meet personally with two Senators and two Congressmen, of different political parties. In all of my discussions, I focused on two main points:
1. Stabilizing Medicare physician payments and repealing the flawed Medicare sustainable growth rate (SGR)
I think all healthcare providers can agree that the current payment system is broken, and in our specialty many providers are facing a 25% reduction in Medicare payments if the SGR is left in place. The stop-gap measures are only confusing matters and in fact are costing taxpayers more than implementing a permanent solution. In fact, the 16 temporary “doc fixes” that Congress has passed over the last 11 years have cost $171 billion dollars. This is one billion dollars OVER the amount needed to legislate a permanent fix.
Every Representative that I met stated that they were in favor of an SGR fix.
2. Ending self-referral abuse by supporting the Promoting Integrity in Medicare Act of 2013 (H.R. 2914).
The Promoting Integrity in Medicare Act (PIMA) would close the current in-office ancillary loophole in the self-referral laws. As reports from the Government Accountability Office (GAO), the New England Journal of Medicine, and others have repeatedly shown, physician self-referral leads to increased utilization of services that may not be medically necessary. These unnecessary services not only pose a threat of potential harm to patients, but they cost the healthcare system millions of dollars each year. Closing this loophole would provide an estimated $6 billion in savings, which could then be used to offset some of the cost of the proposed SGR fix.
The House has introduced PIMA 2914 to eliminate this loophole. Although passage of the bill is unlikely at this time, it is at least encouraging that it is being discussed. In my discussions with the Representatives, I advocated for the language of PIMA 2914 to be incorporated in the final SGR fix.
It was a whirlwind of an event, but in my opinion it was well worth the time and travel costs in order to advocate for our industry, and to participate in our democratic process. If you have any questions about Advocacy Day or would like more information on the topics presented above, please feel free to contact me, or learn more at www.ASTRO.org.