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Partners in Advocacy ACS Fellows and The ACS Washington Office 2013 Wisconsin State Chapter Meeting

Partners in Advocacy ACS Fellows and The ACS Washington Office 2013 Wisconsin State Chapter Meeting. I don't make jokes. I just watch the government and report the facts. -- Will Rogers. ACS Division of Advocacy & Health Policy. Medical Director Vacant. Christian Shalgian, Director.

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Partners in Advocacy ACS Fellows and The ACS Washington Office 2013 Wisconsin State Chapter Meeting

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  1. Partners in AdvocacyACS Fellows and The ACS Washington Office2013 Wisconsin State Chapter Meeting

  2. I don't make jokes. I just watch the government and report the facts. -- Will Rogers

  3. ACS Division of Advocacy & Health Policy Medical Director Vacant Christian Shalgian, Director Dr. Frank Opelka, Associate Medical Director Health Policy Fellow Bob Jasak, Deputy Director D’Arcey Johnson, Office Administrator John Hedstrom, Deputy Director Jon Sutton Manager, State Affairs Vinita Ollapally, Sr. Regulatory Associate Jill Sage, Sr. Quality Associate Jenny Jackson, Practice Affairs Associate Sana Gokak, Quality Associate Sarah Kurusz, Quality/Regulatory Assistant Kelly Wilkins, Staff Assistant Kristin McDonald, Senior Government Affairs Associate Matthew Coffron, Government Affairs Associate Heather Smith, Government Affairs Associate VACANT, Legislative Asst. Tara Leystra, State Affairs Associate Justin Rosen, State Affairs Associate Sara Morse, PAC Manager (ACSPA)

  4. SEQUESTER! Great for Scrabble, horrible for budgeting

  5. History of Physician Payment

  6. How Physicians Are Paid Today

  7. How Most Physicians Feel

  8. Problems With Current Payment Model

  9. We stand today at a crossroads. One path leads to despair and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice. Woody Allen

  10. SGR Legislation – A Comparison

  11. SGR Repeal Concerns

  12. SGR Legislation – A Comparison

  13. Value-Based Program Concerns

  14. SGR Legislation – A Comparison

  15. Alternative Payment Model Concerns

  16. SGR Legislation – A Comparison

  17. Valuation of Services Concerns

  18. ACS Proposed SolutionThe Value Based Update (VBU) • The fusion of ACS’s 100 years of quality experience and physician payment system • Improved, high quality care, shared savings, and resultant cost reduction • The Clinical Affinity Group (CAG) • Breaking down physician silos of care • A group of physicians and providers who care for a specific condition, disease or patient population. • CAGs are the core of this proposal, and might include categories such as cancer care, surgery, cardiac care, frail elderly/end of life, digestive diseases, women’s health, rural and primary care/chronic care. • designed to account for regional variations in the provision of care • patient-oriented, outcomes-based, risk-adjusted quality measures designed to foster continuous improvement and help lower costs.

  19. PQRS Physician Level Payment Adjustments EHR Meaningful Use Registries?? Inflationary MEI Update (0% - 3%) (application determined by All-CAG Performance Score) Program Level Payment Adjustments High Risk Population (e.g. frail elderly) (-.5% to 1.5%) Geographic (e.g. Rural) (-.5% to 1.5%) Disease (e.g. Cardiac, Cancer, Digestive) (-.5% To 1.5%) Clinical Affinity Group (CAG) Payment Adjustment Based on 50/50 National/Local blend. Local performance based on Hospital Referral Regions (HRRs) Women’s Health (-.5% to 1.5%) Dual Eligibles (-.5% to 1.5%) Primary Care Chronic Care (-.5% To 1.5%)

  20. The VBU Further Development • Contracted with group from Brigham & Women’s Hospital and Brandeis University to further evaluate, develop CAG models, and score the VBU concept • Focus Groups with wide range of individual physicians • CAG Target Domains • Prevention, Quality, Safety, Patient experience, Resource Use/Cost • Not all need to be accounted for in a CAG • Example - Cardiovascular CAG • Diabetes Control, PCI/CABG Outcomes, Adverse drug events, H-CAHPS/S-CAHPS, ECHO appropriateness • Example – Prevention/Chronic Care CAG • Cancer Screening/Immunization, CHF Post-discharge care coordination, Drug reconciliation measures, C&G-CAHPS, Care coordination

  21. The VBU Complicated Issues • Accounting for all specialties and primary care • Value-Based Modifier – Should it fit? Where does it fit? • Voluntary Participation? • Designed so that penalties for non-VBU compliant physicians bear greater risk • HOWEVER, an initial report found that between 2014-2018: • Physician payments (incentive-based) increased $6.4 billion • Indirect reduction to Parts A and B totaled $15.77 billion • Net reduction of $9.355 billion in Parts A and B

  22. ACSPA-SurgeonsVoice Cutting Edge AdvocacyAn on-going, organized program of recruiting, educating, and motivating members to use their political power to advocate and influence.

  23. Program Components • Health Policy Advisory Council –Grassroots Committee • Region Chiefs and State Councilors • SurgeonsVoice Online Platform • SurgeonsVoice DOCS Program (District Office Contacts by Surgeons) • SurgeonsVoice Practice Tours • SurgeonsVoice at Advocacy Summit • SurgeonsVoice Recognition Program

  24. SurgeonsVoice: Cutting Edge Advocacy • Purpose: United surgical voice influencing health policy • Goals: Educate, Advocate, Motivate • Participants: Leadership, Fellows, Residents • Committees and Councils of the ACS • Benefits: Broad-based, diversified, lifelong advocates

  25. One Councilor from each chapter • Responsible for fostering an extensive grassroots advocacy network throughout their chapter • Advocacy experts who promote grassroots and political advocacy among their peers • Communicate feedback from surgeons on the ground on legislative and regulatory policy and implementation, back to the Division of Advocacy and Health Policy. Health Policy Advisory Council Councilors

  26. Routinely meet with Representative and Senators in state district offices during House and Senate recesses (“in-district work periods”) • Advocate on issues critical to surgery • Foster lasting relationships between participating surgeons and members of Congress • Become knowledgeable and trusted resources on healthcare policy for elected officials DOCS Program District Office Contacts by Surgeons

  27. Platform and Program Tools www.surgeonsvoice.org

  28. Advocacy Toolkit One Stop Shopping

  29. Additional Resources • Take Action: Contact your Elected Officials • Share Your Story • Key Contact Survey • Interactive Map • Events Calendar • And More…

  30. Recap: How Can You Get Involved? Visit and use www.SurgeonsPac.org Visit and use www.SurgeonsVoice.org Become an Advocacy Councilor Join the DOCS Program Save the date: ACS Advocacy Summit– March 30-April 1, 2014 Respond to Grassroots Action Alerts Host a fundraiser, facility tour, or PAC check delivery for your Congressmen. Get your colleagues involved!!

  31. Thank You You all deserve a drink

  32. We in America do not have government by the majority. We have government by the majority who participate. - Thomas Jefferson Thank you John E. Hedstrom, JD jhedstrom@facs.org 202-672-1503

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