News & Media

STS News, Summer 2020 — The past several months have been incredibly trying for health care professionals as COVID-19 continues its spread around the world. Fighting on the front lines, surgeons and other members of the health care team have shouldered a great share of the burden. Despite this global pandemic, the Centers for Medicare & Medicaid Services (CMS) is moving forward with planned Medicare payment cuts of 7%–8% for cardiothoracic surgery, starting on January 1, 2021. These cuts are a result of changes in office and outpatient evaluation and management codes. In addition, CMS is expected to propose a 20% cut in global surgery payments sometime this summer. The last time the specialty dealt with these types of drastic cuts was more than 20 years ago. In 1997, cardiothoracic surgeons came up against a proposal to reduce reimbursement by 27%. This was on top of a decade’s worth of cuts that already included a 60% decrease in reimbursement for coronary artery bypass graft surgery. At that time, the Society responded by creating an advocacy arm and forming an important presence in Washington, DC. This led to the opening of an “official” STS Washington office and the launch of STS-PAC—the only political action committee that exclusively represents cardiothoracic surgery. The Society recognizes that cuts of this magnitude jeopardize not only the financial viability of hospitals and cardiothoracic surgeons' clinical practices, but also patients’ timely access to quality care. In addition, it is expected that surgery will be critical to the post-COVID-19 financial recovery of the health care sector, and hospitals will be counting on increased surgical volumes to bolster their bottom lines. Also, smaller practices that are fighting to stay afloat will not be able to afford another financial hit. More information is available at surgicalcare.org. Follow the Coalition on Twitter @SurgeonsCare and LinkedIn at linkedin.com/company/surgical-care-coalition. So, in the face of a pandemic and these most recent proposed cuts, the Society is taking drastic, but necessary action. STS has joined the newly formed Surgical Care Coalition, committing significant resources to the group in an effort to prevent these substantial reimbursement cuts. This alliance of surgical specialty societies is tasked with developing and executing a comprehensive, multifaceted campaign to educate the public and policymakers about the importance and role of surgical services as an essential component of health care. The Coalition also will work to prevent new cuts from being proposed. The strategy will consist of legislative and regulatory advocacy, a public relations campaign, research and data collection on the impact of the cuts, and—potentially—legal action. “Coming together to combat this threat and protect and defend the interests of surgeons around the country, national surgical organizations have coalesced around a campaign to educate the public and policymakers about the value of surgeons and prevent significant reimbursement cuts,” said STS President Joseph A. Dearani, MD, from the Mayo Clinic in Rochester, Minnesota. As part of the campaign, the Coalition commissioned a survey of more than 5,000 surgeons from various specialties. The results showed that many surgeons are facing serious financial distress due to the COVID-19 pandemic. As a result, it is expected that the combined impact of the planned CMS cuts and economic fallout from the COVID crisis may cause surgeons and hospitals to face difficult decisions about keeping surgical practices open. The survey also found that even before the CMS cuts: 1 in 3 private practice surgeons were concerned that they may have to close their practices, limiting patient choices and access to care. Nearly half of surgeons who already were experiencing financial difficulties responded by instituting pay cuts for themselves and, in some cases, their employees. While Congress considers COVID-19 relief legislation, the Coalition will take steps to ensure it includes language that prevents CMS from implementing the January pay cuts. “Coming together to combat this threat and protect and defend the interests of surgeons around the country, national surgical organizations have coalesced around a campaign to educate the public and policymakers about the value of surgeons and prevent significant reimbursement cuts.”   Joseph A. Dearani, MD Separately, the Society will continue working with policymakers in Washington who have the ability to make a difference and help them understand how these pending pay cuts will negatively affect the health care system and patients. As was the case in 1997 when cardiothoracic surgeons faced a similar situation, the Society will again call upon its members to engage in this effort. “In the coming weeks and months, we will ask you to take action in support of this campaign,” said Dr. Dearani. “Whether it is responding to surveys, writing to your elected officials or penning an op-ed, your active participation in this campaign is imperative and crucial to its success.” Cardiothoracic surgeons have proven—time and time again—that they can produce exceptional outcomes, even in the direst circumstances. With this in mind, the Society will work diligently to help the specialty continue the critical work of saving patients’ lives. Take Action Now Encourage your legislators to reverse these reimbursement cuts! Even during this difficult time, there are still many ways to get involved virtually. STS can help you with scheduling and provide briefing materials. Schedule a phone call or virtual meeting with your representatives or members of their health care teams to provide details on how these cuts may impact patient care. Become a Key Contact. This program is a great way to stay informed while building relationships and advocating for the specialty. Get access to timely legislative updates and opportunities to engage. Encourage your STS colleagues to become involved. STS members are the heart of our grassroots advocacy efforts. The more participation we have, the greater impact STS can make. Contact advocacy@sts.org for more information and assistance.

STS News, Summer 2020 — Innovation, knowledge, research, patient care—these principles lie at the forefront of The Thoracic Surgery Foundation (TSF) mission. “The mission of the Foundation is so important. The first part is to develop cardiothoracic surgeon-scientists. They will be the investigators who help us better understand the causes of and treatments for cardiothoracic disease,” explained TSF Board Member Scott A. LeMaire, MD. “The second part of the mission is to provide better patient care. In order for us to deliver better care in the future, it is important to support the people who are in training now and their ongoing research efforts.” TSF President Joseph E. Bavaria, MD (left), and Sibu P. Saha, MD, MBA In an effort to continue advancing the TSF mission and the specialty, a new award will be offered for 2021—the Saha Scholarship Award—developed with the generous support of Sibu P. Saha, MD, MBA, from the University of Kentucky in Lexington. “My mentor, who was a great teacher and generous person, took me to the STS Annual Meeting, where we shared a room because of budgetary constraints,” said Dr. Saha. “Now it is my turn to give back. Residents will benefit by learning and networking at our Annual Meeting.” The Saha Award will allow two cardiothoracic surgery residents—one from the US and one from India—to attend the STS 57th Annual Meeting January 31–February 2, 2021, in Austin, Texas. The costs for registration, lodging, meals, and transportation will be covered.​ Apply Now for a 2021 TSF Award The Foundation is accepting applications for 2021 awards through September 15, 2020. Offerings include grants for research, education, leadership, and surgical outreach. A full menu of options, along with specific submission criteria, can be found at thoracicsurgeryfoundation.org/awards. In 2019, more than $1.1 million was awarded to 109 surgeons. So far in 2020, TSF has already provided approximately $1.1 million in grants and scholarships. A full list of this year's award recipients is available at sts.org/2020TSFawards. “The Foundation’s awards have been instrumental in developing hundreds of young surgeons by providing the support needed for their career advancement,” said Foundation President Joseph E. Bavaria, MD. “The contributions of these award recipients to cardiothoracic surgery and our patients will be significant.” TSF is the charitable arm of STS. For more information on the Foundation, go to thoracicsurgeryfoundation.org or see the 2019 TSF Annual Report at thoracicsurgeryfoundation.org/2019annualreport. ​ Double Your Impact: Donate to TSF Today Take part in the 2020 Surgeon Match Challenge with The Thoracic Surgery Foundation (TSF). STS will match all surgeon contributions up to $200,000. So far this year, the Society’s charitable arm has awarded approximately $1.1 million in funding to support surgeon-scientists in cardiothoracic surgery. Award recipients are investigating topics such as the predictive utility of machine learning algorithms in adult cardiac surgery, functionality of T cells in advanced lung cancer, and sphingosine-targeted therapies in heart transplants. They’re training with experts to learn new skills, including robotic esophageal surgery, cone repair, valve sparing root replacement, the Bentall procedure, and complex tracheal surgery. The funding also has allowed surgeons to provide lifesaving care to underserved patients in developing countries, including Armenia, Honduras, India, Kenya, Nepal, Nigeria, Pakistan, and South Africa. In addition to matching surgeon donations, the Society covers all of TSF’s administrative expenses so that 100% of each donation is applied to award programs. Plus, TSF donations are tax-deductible to the extent permitted by law. Help the Foundation continue supporting such important projects by contributing today at thoracicsurgeryfoundation.org/donate.

During a recent STS webinar on “Early Career Surgeons, COVID-19, and the Future,” panelists described some of the things that the pandemic has helped them better appreciate.   “One of the things that has really struck me is how much the patients themselves mean to me. It reminds me of why I went through all of this training and why the hard days are worth it. It’s all about the patients.” Elizabeth A. David, MD, MAS “Specific to the COVID crisis, there really was an ‘all hands on deck’ sense of solidarity both within and outside of the hospital. I think that is something that we desperately need to remember and keep hold of moving forward. Being reminded of our common humanity, I hope that mindset becomes the new normal.” Melanie A. Edwards, MD “We can take comfort in knowing that this pandemic will end. It may take until the end of the year, but it will end. So embrace the challenges, appreciate every day that you are healthy, and keep focusing on your mission and your patients.” Gabriel Loor, MD “I have learned that the things that are with you day in and day out are your family, your colleagues, and your patients. Really value those things in times of crisis and in times of calm.” HelenMari L. Merritt-Genore, DO

STS News, Summer 2020 — The COVID-19 pandemic has proven to be a powerful trigger that not only has changed just about everything in daily life, but also has accelerated adoption of new methods of education and information sharing. As temperature taking, elbow bumps, and face coverings, as well as constant hand washing and hand sanitizing become the proverbial “new normal,” the Society is managing the immediate impact and recognizing the importance of keeping an eye on longer-term changes. While there is much uncertainty about what the future holds, STS will be vigilant in its efforts to develop and share timely information, expanded resources, expert guidance, and superior educational opportunities. The Society’s top priority remains supporting the needs of its members and helping to ensure that those within the cardiothoracic surgery community stay connected, learn from one another, and lean on each other as the world tackles this historic public health crisis. Here are some of the ways that STS is continuing to support its members and offer valuable products and services during this challenging time: Education The Society canceled all remaining planned in-person meetings for 2020, but both the 17th Annual Perioperative and Critical Care Conference (September 24–26) and Advances in Quality & Outcomes: A Data Managers Meeting (September 29–October 2) will be held in virtual format. See page 11 for additional information about these upcoming courses.  At press time, STS was considering its options for the 57th Annual Meeting, scheduled for January 30–February 2, 2021, in Austin, Texas. The latest information can be found at sts.org/annualmeeting. Webinars The Society presented the free live webinar series, “Cardiothoracic Surgery in the COVID Crisis,” which focused on important topics related to the coronavirus. Featuring STS members and other expert participants, including public health, industry, and infectious disease specialists, the webinars provided information on lessons learned, best practices, and key considerations to help navigate cardiothoracic surgery during the COVID-19 pandemic and ramp up for the future. These webinars cumulatively attracted more than 8,000 viewers to the live broadcasts. An archive is available online at sts.org/webinars and on the STS YouTube channel. Also now under way is the “STS Summer Series,” a collection of biweekly, hour-long webinars featuring presentations and discussions on a variety of key topics—some are related to the COVID-19 crisis, while others are geared toward clinical or career development topics in cardiothoracic surgery. The webinars are broadcast live via Zoom and Facebook on Thursdays at 6:00 p.m. ET/3:00 p.m. PT. The first episode, “Early Career Surgeons, COVID-19, and the Future,” aired on June 4. Moderators Joseph A. Dearani, MD, and Mara B. Antonoff, MD, talked to colleagues from around the US and in varying practice situations about how they have been coping—both physically and emotionally. The panel shared insights on how cardiothoracic surgeons can thrive in the specialty as they begin to emerge from the COVID crisis. In addition, other episodes have explored topics such as robotic cardiac surgery and the financial impact of COVID on cardiothoracic surgery. The next webinar—scheduled for July 16—will highlight low-risk transcatheter aortic valve replacement, with the following episode delving into the challenging and controversial issue of Medicare reimbursement cuts. Webinar dates and topics may vary based on speaker availability. The series will include seven episodes, and each episode will be available on the STS website and the Society’s YouTube channel the day after the live broadcast. COVID-19 Resources Page The COVID-19 Resources page offers a plethora of helpful information and resources, including links to a real-time tracking map, guidance documents, active research projects, resource tools, a personal protective equipment (PPE) burn rate calculator, and video messages from Dr. Dearani, STS President. Also available are additional articles, videos, and PowerPoint presentations on topics such as extracorporeal membrane oxygenation, PPE, ventilator management, telehealth, and many others. Stay informed by visiting sts.org/covidresources. This visual abstract supported a guidance document detailing protective measures to reduce the risk of infection. Guidance Documents Throughout the past few months of the COVID-19 pandemic, seven STS-supported guidance documents have been published in The Annals of Thoracic Surgery. Members of a special STS COVID Task Force, as well as other surgeon leaders and leading organizations, collaborated on the articles, which cover all major disciplines within the specialty—adult cardiac, general thoracic, and congenital. These documents detail “granular guidance” and recommendations for ramping up cardiac surgery, safely reintroducing cardiovascular services, implementing aggressive infection mitigation strategies, stratifying adult cardiac patients, triaging congenital heart disease patients, and facilitating difficult decisions when caring for patients with thoracic malignancies. Links to all of the documents can be found at sts.org/covidresources. Resource Tools With informed resource allocation decisions more important than ever, the Society developed two interactive, online tools to help triage adult cardiac surgery cases: STS Resource Utilization Tool for Cardiac Surgery and the COVID-19 Resource Prediction Instrument. The Resource Utilization Tool is powered by more than 440,000 de-identified patient records from the most recent 2-year period in the Adult Cardiac Surgery Database (ACSD). It displays national averages of outcome metrics such as time in the operating room, time on the ventilator after surgery, hospital lengths of stay, and expected number of blood product units likely to be needed. Access the tool at sts.org/resourcetool. The Prediction Instrument, based on 10 years of data from the ACSD, is designed to be used in conjunction with the Resource Utilization Tool. This instrument, available at sts.org/covidinstrument, provides a rapid estimate of ventilator hours, ICU time, transfusions, and risk of acute reoperation. Both resources are free to use and open to everyone. Blog Articles A number of STS members have written blog articles, sharing their experiences and perspectives from the fight on the front lines of the coronavirus crisis. The columns covered a broad range of topics, including staying grounded during COVID-19, how leaders make decisions during times of crisis, embracing the changes in health care, and how different regions, the US and Hong Kong, in particular, are dealing with the pandemic. A full list of the articles is available at sts.org/covidresources. Throughout the upcoming weeks and months, the Society will continue to serve the surgical community by disseminating information, as well as facilitating opportunities and education.