American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Bulletin Advocacy Brief: July 16

Take Action Today: Tell Congress to Stop the Cuts!

In the previous issue of the Bulletin Advocacy Brief, we explained how planned 2021 payment cuts to Medicare would reduce payments for surgical care and could force surgeons to see fewer Medicare patients, which would lead to reduced access to care for older U.S. patients and lower their quality of life (read more).

To prevent these cuts, Congress needs to waive Medicare’s budget neutrality requirements. We need your help. Contact your senators and representatives in Congress and ask them to ensure your Medicare patients continue to have the best access to the best care—when they need it and where they need it.

Write to your senators and representatives

The Three “A’s” Critical to Lead a Surgeon’s Financial World: Financial Planning for Surgeons from the ACS Practice Protection Committee

In this two-part video series from the American College of Surgeons Practice Protection Committee, Mark Aeder, MD, FACS, associate professor, transplant and hepatobiliary surgery, University Hospitals, Cleveland Medical Center, discusses financial planning for surgeons with Patrick V. Bailey, MD, MLS, FACS, Medical Director, Advocacy, ACS Division of Advocacy and Health Policy. Dr. Aeder said, “We’re never taught about financial literacy in medical school. It’s not emphasized in residency.”

In part one, he explains the “three A’s” of financial team—advisor, accountant, attorney—that are critical to help lead your financial future, understand your financial goals and aims, and guide you through contracts, wills, estate planning, long-term care, and so on.

Dr. Aeder goes into more detail about how to choose a financial advisor who is right for you and your loved ones in part two. He encourages surgeons to discuss retirement goals with their spouses or partners and to have a clear understanding of their needs. He explains the difference between financial planning and wealth management and explains how financial advisors are paid, noting that his preferred payment system is based on the advisor being reimbursed based on a percentage of the surgeon’s investments.

“You’re going to have a really good, healthy relationship if you know you’re both on the same page and going out with the same goals,” he said.



House Committee 2021 Appropriations Bill Mark Up: The Good, The Bad and The Path Forward

The U.S. House Committee on Appropriations passed July 13 the fiscal year 2021 Labor, Health and Human Services, Education and Related Agencies (LHHS) bill. The marked-up $196.5 billion package includes several American College of Surgeons priorities, such as increased funding for cancer research and prevention programs and funding for firearm morbidity and mortality prevention research.

In addition, the committee submitted report language supportive of the MISSION ZERO program, a longtime advocacy priority of the ACS, encouraging the Assistant Secretary for Preparedness and Response to pursue partnerships between military and civilian care providers to ensure trauma care readiness and requested an update on those efforts in the FY 2022 Budget Justification that the agency submits to Congress.

The ACS has significant concerns about language in the committee’s report that supports the Centers for Medicare & Medicaid Services changes to Evaluation and Management services. The finalized Calendar Year 2020 Medicare Physician Fee Schedule E/M policies will have a devastating effect on a significant portion of specialty care. Although the report language as written will have no actionable impact, the ACS is working diligently to express concerns that the included language does not acknowledge the negative impact on surgical specialties.

In advance of the committee markup and vote, the ACS sent a letter to House Appropriators outlining several considerations. The FY 21 LHHS appropriations bill will move forward to be voted on by the U.S. House of Representatives. Once approved, it is unclear what, if any, path forward the bill will have in the U.S. Senate.

For more information about appropriations, please contact Amelia Suermann, ACS Congressional Lobbyist at asuermann@facs.org.

CMS Releases MIPS Quality Measures Including Telehealth Guidance

The Centers for Medicare & Medicaid Services (CMS) released a list of Merit-based Incentive Payment System quality measures that includes telehealth for the 2020 MIPS performance year. The resource provides guidance for eligible clinicians, groups, and virtual groups that intend to report these measures to achieve a score in the MIPS quality performance category. CMS notes that in some instances, the quality action cannot be completed via a telehealth encounter. In these cases, CMS explains that it is the MIPS clinician’s responsibility to ensure all other requirements within the measure specification are met, including other quality actions that cannot be completed by telehealth. The list of clinical quality measures are listed within the 2020 Quality Measures List with Telehealth Guidance.

CMS also shared telehealth guidance related to electronic clinical quality measures in the Electronic Clinical Quality Improvement (eCQI) Resource Center, and more information is listed in “Telehealth Guidance for eCQMs for Eligible Professionals/Eligible Clinicians for 2020 Quality Reporting.” Providers that submit quality measures via the CMS Web Interface should refer to the tool’s measure specifications and supporting documentation for details regarding the use of telehealth within this collection type found in the QPP (Quality Payment Program) Resource Library. Additional questions can be directed to QualityDC@facs.org.

COT-Supported HVIP Legislation Clears Health Subcommittee

The Health Subcommittee of the House Energy and Commerce Committee held a hearing June 30, High Anxiety and Stress: Legislation to Improve Mental Health During Crisis, during which the subcommittee reviewed 22 bills to improve both the quality of and access to mental health care in America.

This review included the American College of Surgeons Committee on Trauma (COT)-supported Bipartisan Solution to Cyclical Violence Act of 2020, H.R. 5855. This legislation, introduced by Reps. C.A. “Dutch” Ruppersberger (D-MD) and Adam Kinzinger (R-IL), would provide grant funding to create new hospital-based violence intervention programs, as well as expand successful programs already in place.

In addition, the bill calls for research on best practices, which will play a critical role in documenting the success of these programs and will create a road map for hospitals to follow. Read the letter of support from the ACS COT

Now that this bill has been reviewed by the appropriate subcommittee, it has been slated for mark up in the full House Energy and Commerce Committee. 

ACS Advocates to Increase Medicare-Supported Graduate Medical Education Slots

The American College of Surgeons joined more than 60 health care stakeholder organizations in urging Congress to include the Resident Physician Shortage Reduction Act (H.R. 1763/S. 348) in the next COVID-19 relief legislation. H.R. 1763/S. 348 would increase the number of Medicare-supported graduate medical education slots by 3,000 per year for five years, which would go a long way toward ensuring a robust physician workforce.

For more information about GME or health care workforce issues, contact Amelia Suermann, ACS Congressional Lobbyist, at asuermann@facs.org.

Patient Matching: An Essential Tool in the COVID-19 Era

As a founding member of the recently launched Patient ID Now Coalition, the American College of Surgeons co-hosted a virtual briefing for congressional staff highlighting the importance of ensuring patients are accurately matched to their medical records. The briefing, Patient Matching: An Essential Tool in the Era of COVID-19, examined the implications of patient matching and identification during the pandemic and featured an expert panel of speakers, including Rep. Bill Foster (D-IL).

For more information, contact Amelia Suermann, ACS Congressional Lobbyist, at asuermann@facs.org.

Patient Impact: Outpatient Practices in the “New Normal”

It’s no secret that outpatient practices have had to adapt to a “new normal” during COVID-19. The Commonwealth Fund recently published research that outlines how these practices have changed to prevent COVID-19 transmission and ensure social distancing measures. According to the findings, visits to physicians have rebounded across all regions of the U.S, but they remain significantly lower than before the pandemic began. States that had more severe lockdowns in the early stages of the pandemic suffered a greater reduction in patient visits, while those that maintained a relative state of openness experienced less dramatic effects. Read the full report.

ICYMI: ACS Executive Director David Hoyt Interview on NBC Dallas

David B. Hoyt, MD, FACSAmerican College of Surgeons Executive Director David B. Hoyt, MD, FACS, recently appeared on NBC Dallas-Fort Worth to highlight the incredible work being performed by surgeons in response to the COVID-19 pandemic and the financial effects incurred. He told NBC, "Surgeons are trained to care for intensive care unit patients, and surgeons step up—that’s what they do,” adding that the pandemic “has had a substantial effect [on surgeons] just like it has in every other aspect of the economy.” Watch the full interview.