Washington Scene: New Campaign Sets Sights on Reversing Impending Reimbursement Cuts

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.