STS Advocacy Helps Fuel Payment Reform Talks

Washington Scene

STS News, Spring 2013 -- STS has long advocated for a Medicare physician payment model that relies on a clinical registry infrastructure to facilitate payment based on quality care. Now, thanks in part to efforts by both the surgeon leadership and STS grassroots advocates, policymakers are demonstrating that they understand the important role registries can play in health care payment. Notably, a recent Congressional hearing on Sustainable Growth Rate (SGR) reform focused on how to leverage “data, measures, and models” and develop payment proposals relying on clinical registry data.

The timing for these talks could not be better. The Congressional Budget Office’s Budget and Economic Outlook for 2013–
2023 shows that expected growth in Medicare spending has slowed. This means that the estimated cost of repealing the
SGR payment formula and replacing it with something new is significantly lower than previous estimates. Congress must act in the next few months to take advantage of this lower assessment.

As the reform process moves forward, the Society will continue to demonstrate how evidence-based data, such as through the STS National Database and the STS/ACC TVT Registry™, can reduce costs and improve patient outcomes.

Changes to PQRS
The increasing reliance on health care quality measurement was apparent in the American Taxpayer Relief Act (ATRA),
signed into law in early January. Section 601(b) of ATRA encourages the utilization and development of clinical registries.
ATRA also instructs the Government Accountability Office to study how registry data can help improve the quality and efficiency of the Medicare program.

Many STS members fulfill Physician Quality and Reporting System (PQRS) requirements by electing to have STS report data on their behalf. In the future, ATRA will allow data reporting to “qualified registries” instead of the arduous PQRS.
Because the term “qualified registries” has not yet been defined, the Centers for Medicare & Medicaid Services has issued
a Request for Information that could ultimately lead to a data registry qualification program and alignment of its quality improvement programs.

STS staff recently met with Department of Health and Human Services officials, White House staff, and other physician
organizations to discuss the role clinical data registries will play in a new and improved health care system.

Clinical Data Registries in the Media
The value of clinical data registries has been the topic of several recent newspaper reports, including a January 8 column syndicated by Bloomberg News. In the column, Peter R. Orszag, former Director of the Office of Management and Budget and current executive for Citigroup, called upon HHS to “make new registries for special care a priority.”

Orszag also highlighted ATRA as a bipartisan and bicameral effort: “At a time when politics in the United States are hyperpolarized, the Section 601(b)s of this world are few and far between. Yes, there’s much more we could be doing to limit cost growth, to continue the low growth rates we’ve seen over the past few years. But when big changes aren’t possible, let’s celebrate the baby steps.”

New Online Legislative Advocacy Center
All STS members are invited to visit the Society’s newly updated advocacy pages at The STS
Legislative Advocacy Center includes links to contact members of Congress, the STS Key Contact Program, and STS-PAC. The pages also include current and archived issues of STS Advocacy Monthly, the STS Health Policy Compendium, other health policy resources, and a new section on coding.

If you have comments or suggestions about our new advocacy pages, contact advocacy [at] sts [dot] org.