Decisions made at all levels of government have a direct impact on surgeons and patients.
While surgeons are focused on the daily work of delivering excellent clinical care, the ACS is working behind the scenes to advocate on behalf of its members. The Division of Advocacy and Health Policy in Washington, DC, includes a team of experienced government professionals who engage with policymakers at the state and federal levels.
However, meaningful change in Washington, DC, often requires more than traditional advocacy alone. The participation of surgeons from across the country, supporting policy priorities and making their voices heard, is necessary. Grassroots advocacy is one of the most powerful tools the ACS has to influence policy, protect surgical care, and ensure that the voices of surgeons are heard.
The Centers for Medicare & Medicaid Services (CMS) finalized its calendar year 2026 rule for the Medicare Physician Fee Schedule (MPFS) in November 2025, which included a provision that put in place a 2.5% reduction to work relative value units (wRVUs) with additional reductions every 3 years.
The rationale underlying this “efficiency adjustment” is directly contradicted by ACS-supported, peer-reviewed longitudinal data. A study reviewing 1.7 million cases from the ACS National Surgical Quality Improvement Program registry showed that instead of reaping the rewards of increased efficiency in the OR, as CMS has suggested, surgeons are doing longer cases on more complex patients than they were just a few years ago.*
To amplify this message, the ACS launched a coordinated grassroots campaign that helped more than 3,000 ACS members send more than 10,000 letters to members of Congress expressing their concerns with the new policy proposal. While the rule went into effect as scheduled on January 1, 2026, the powerful outreach by ACS members, anchored by strong data, has had real impact.
Elected officials have heard the call for action. Following this effort, Representatives Ron Estes (R-KS) and Tom Suozzi (D-NY) introduced HR 7520, the Efficiency Adjustment Delay Act, that would delay the “efficiency adjustment” until 2030 and direct CMS to put forward data on why an efficiency adjustment is necessary before implementing a one-time adjustment. For more information on this topic, read “Surgeons Advance Evidence-Based Critique of Medicare Payment Reform” later in this issue.
This effort demonstrates the powerful influence of grassroots advocacy. While the letter campaign reflected participation by a relatively small fraction of more than 95,000 ACS members, it helped drive congressional action; imagine the impact of even broader surgeon participation.
Members of the ACS can participate in grassroots advocacy by:
- Visiting SurgeonsVoice: The ACS Professional Association’s (ACSPA) nationwide, interactive advocacy program gives surgeon-advocates the ability to send pre-drafted, ACS-approved messages to their elected officials (SurgeonsVoice.org).
- Learning More About SurgeonsPAC: (only dues-paying US citizens and green card holders are eligible to contribute) ACSPA-SurgeonsPAC provides nonpartisan financial support to help elect and re-elect candidates for federal office who support and are positioned to advocate on behalf of ACS legislative issues.
- Joining the Grassroots Network: The new Grassroots Network provides ACS members with advocacy training, opportunities to build relationships with elected officials, and a platform for coordinated federal and state outreach on policies affecting the surgical profession.
- Attending the ACS Leadership & Advocacy Summit: The ACS Leadership & Advocacy Summit is held annually in Washington, DC, and offers attendees an opportunity to learn about the College’s overarching priorities while receiving extensive advocacy training before participating in meetings with lawmakers on Capitol Hill. Grants are available to support resident attendance at this meeting. Read more about the meeting in the April 2026 ACS Bulletin article, “Surgeons Bring Their Case to Capitol Hill at 2026 Advocacy Summit.”
- Organizing State Chapter Advocacy Lobby Days: Chapter grants are available to help chapters plan and host state-level advocacy days. Advocacy days provide chapter members with opportunities to engage in important issues ranging from prior authorization and medical liability reform to noncompete clauses in contracts and injury prevention. State advocacy resources, including toolkits, guides, and legislation trackers, are available at facs.org/advocacy/state-legislation.
- Participating in the Advocacy at Home Program: When senators and representatives return home during district work periods, they tend to visit with constituents to learn more about important issues facing their states and districts. Participating in in-district meetings provides valuable opportunities to meet with your policymakers and assist them in gauging what is important to surgeons and the surgical community.
Grassroots advocacy is essential to advancing the priorities of the surgical community and supporting the future of surgery. By getting involved, ACS Fellows have a voice and can help shape policies that protect our patients and profession.
More information about grassroots advocacy is available at facs.org/advocacy/get-involved/surgeonsvoice/grassroots-guide.
