Washington Scene: STS Sees Movement on Advocacy Priorities in 2013

STS News, Winter 2014 -- The Society made great strides in 2013 with some of its advocacy priorities, including physician payment reform and patient advocacy efforts. In addition, STS released the first five policy papers in its seminal STS Health Policy Compendium. This document, drafted by the Workforce on Health Policy, Reform, and Advocacy and approved by the STS Board of Directors, contains policy papers on:

• Comparative Effectiveness Research;
• Coverage with Evidence Development and Parallel Review of Medical Devices;
• Healthcare Associated Infections;
• Graduate Medical Education; and
• Physician Medicare Payments and the Sustainable Growth Rate Formula.

In 2014, the Workforce plans to add papers on medical liability reform and lung cancer screening. To review the Compendium, visit www.sts.org/healthpolicycompendium.

Each year, the Workforce sets the Society’s advocacy priorities based on pressing issues that require action from policymakers. Surgeon leaders—especially STS Key Contacts—along with STS Government Relations staff actively lobby on these issues throughout the year. For 2013, advocacy priorities included:

Medicare Physician Payment Reform
With input from STS, Congress made considerable progress toward a long-term legislative fix for the flawed Medicare physician payment formula. Under the current Sustainable Growth Rate (SGR) model, physician payments would be cut by an estimated 24% in 2014.

In June, STS Immediate Past President Jeffrey B. Rich, MD testified at the House Energy & Commerce Subcommittee on Health hearing, “Reforming SGR: Prioritizing Quality in a Modernized Physician Payment System.” Dr. Rich discussed how clinical registries, such as the STS National Database, can be used to improve the quality and efficiency of health care delivery. He also explained how to utilize these resources in a pay-for-quality paradigm.

Since his testimony, congressional committees have released two proposals that would not only repeal SGR, but also would incentivize the creation of “Alternative Payment Models.” As of late November, lawmakers were still working to resolve the differences between these two proposals.

Access to Clinical Outcomes Data
In 2011, the Social Security Administration (SSA) rescinded its policy that allowed public access to death data previously reported to the SSA by individual states. This change has compromised research facilitated by the STS National Database and other clinical registries. Such research has been vital in evaluating the success of medical interventions and tracking other medical and public health trends.

During his SGR testimony before the House Energy & Commerce Subcommittee on Health, and in light of the SSA’s 2011 policy reversal, Dr. Rich addressed the need for continuous access to both administrative claims data and outcomes data from the Social Security Death Master File (SSDMF). While considerable progress has been made in allowing qualified clinical data registries to access Medicare claims data, barriers to SSDMF data remain.

Support for Patient Advocacy Efforts (Lung Cancer Screening)
STS President Douglas E. Wood, MD participated in a May Congressional briefing on lung cancer screening hosted by the Lung Cancer Alliance. The panelists discussed research showing that low-dose computed tomography screening to detect early stage lung cancer can dramatically improve a patient’s chance for survival. They also called for immediate action by the United States Preventive Services Task Force (USPSTF) and asked Congress to ensure that lung cancer screening is an essential health benefit under the Affordable Care Act.

In a huge victory reflecting the Society’s support for patient advocacy efforts, the USPSTF issued a draft recommendation in July supporting the use of low-dose CT to screen people at high risk for lung cancer. STS submitted comments on the draft recommendation and congratulated the USPSTF for making a “critical recommendation that likely will have a larger impact on lung cancer survival than any of the new treatment developments in the last several decades of lung cancer care.”

Cardiothoracic Surgery Workforce Shortage
STS is working with a coalition of medical societies in support of graduate medical education (GME) and specialty-specific loan repayment programs. Reductions in Medicare support for GME could worsen an already critical national physician workforce shortage, which has been particularly pronounced in cardiothoracic surgery. As part of the effort to address GME funding and stave off this shortage, STS is supporting an increase in GME funding of at least 15%.

STS needs involvement from every member to help ensure that cardiothoracic surgeons have a voice on Capitol Hill and beyond. For more information on how you can help, please visit www.sts.org/advocacy.