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

NewsScope: May 10, 2019

ACS Testifies on MACRA Implementation

Frank G. Opelka, MD, FACS, Medical Director, Quality and Health Policy, American College of Surgeons (ACS) Division of Advocacy and Health Policy, testified May 8 on behalf of the ACS at a U.S. Senate Finance Committee hearing, Medicare Physician Payment Reform after Two Years: Examining MACRA Implementation and the Road Ahead. Dr. Opelka highlighted the College’s concerns about implementation of the provisions in the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA), specifically the lack of quality metrics applicable to surgery and the resulting negative impact on value.

He shared the ACS’s vision for meaningful measurement of surgical quality, including setting evidence-based standards for care, ensuring that the right infrastructure and systems are in place through measurement and verification, and incorporating data at the point of care to inform surgeon and patient decision making. Based on the Optimal Resources for Surgical Quality and Safety, referred to as the “Red Book,” the ACS proposed a surgical quality measurement structure that has three components: verification of key standards of care, clinical outcome measures, and patient-reported outcomes.

Dr. Opelka highlighted the ACS vision as a path forward for the Centers for Medicare & Medicaid Services and Congress. The College appreciated the opportunity to testify before a congressional committee on MACRA implementation as Congress continues its oversight of the law.

Read the ACS testimony or watch the hearing. For further information on congressional oversight of MACRA, contact Kristin McDonald, Manager, Legislative and Political Affairs at kmcdonald@facs.org.

ACS-Led Congressional Stop the Bleed Training Leads to New LegislationStop the Bleed

The American College of Surgeons (ACS) has provided Stop the Bleed training to numerous members of Congress and their staffs. As a direct result of the June 2018 Stop the Bleed training, bipartisan legislation was introduced earlier this week in the U.S. House of Representatives that would increase the number of bleeding control kits and training courses available in the U.S.

More specifically, Reps. Alcee L. Hastings (D-FL) and Brad Wenstrup, DPM (R-OH), introduced the Prevent Bleeding Loss with Emergency Devices (BLEEDing) Act of 2019, H.R. 2550. This legislation would provide grant funding to states for bleeding control kits and training and is a critical step toward empowering civilians to take lifesaving action when the need arises. The effort to make this training and bleeding control kits available to the public through a Department of Homeland Security grant program will help to drive the goal of reducing or eliminating preventable deaths from bleeding.

More than 180,000 people die each year from traumatic injuries sustained as a result of vehicle crashes, falls, industrial and farm accidents, shootings, and natural disasters. The most common preventable cause of these deaths is hemorrhage in the minutes before trained first responders arrive. The ACS Committee on Trauma (COT) is leading an effort to teach and empower the civilian population to serve as immediate responders in uncontrolled bleeding emergencies through a comprehensive and sustainable bleeding control program targeted to the more than 300 million people in the U.S.

Contact your Member of Congress and ask him or her to support the Prevent Bleeding Act through SurgeonsVoice, and read ACS’ letter of support. For details, contact Hannah Chargin, ACS Congressional Lobbyist, at hchargin@facs.org.

ACS-Supported End the Cycle of Violence Act Introduced

Rep. Dutch Ruppersberger (D-MD) held a press event May 6 at the R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, to announce the introduction of American College of Surgeons (ACS)-supported End the Cycle of Violence Act, H.R. 2464. This legislation would provide grant funding to hospital-based violence prevention programs (HVIPs) to conduct research on best practices. This research is critical in documenting the success of HVIPs and would create a road map for new programs to follow.

“Trauma surgeons are frequently the ones treating patients injured due to cyclical violence. We see firsthand the need for better research into effective methods of breaking this cycle,” said Eileen M. Bulger, MD, FACS, Chair, ACS Committee on Trauma. “The research that will be supported by this legislation and the best practices and lessons learned that will be disseminated will save lives. The American College of Surgeons thanks Congressman Ruppersberger for his efforts to address this problem.”

For more information, contact Hannah Chargin, ACS Congressional Lobbyist, at hchargin@facs.org.

ACS Comments on Interstate Insurance Sales

The American College of Surgeons (ACS) submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) May 6 in response to the agency’s request for information (RFI) about ways to facilitate the purchase of health insurance across state lines. In this RFI, CMS specifically sought input on how to operationalize interstate insurance sales, which the agency asserts would increase competition among payors and provide consumers with more affordable health plan options.

The ACS opposed CMS's efforts to promote the sale of insurance across state lines and indicated that such a business model could impede meaningful access to comprehensive medical care, shift out-of-pocket expenses to patients, create narrow networks of specialty providers, and unfairly reduce reimbursement rates for physicians. The College expressed concern that, without proper regulatory oversight, payors may design “bare bones” plans with limited benefits in order to reduce premiums and attract out-of-state consumers. Consequently, individuals who purchase these plans could unknowingly be left without coverage for the full spectrum of items, services, and providers needed to best manage their health care conditions. The ACS urged CMS to ensure that, before the agency modifies any policy change that could dramatically change insurance markets across the country, strict enforcement mechanisms for care access and quality are in place to protect patients’ ability to receive necessary treatment.

For more information about the RFI and College’s comments, contact Lauren Foe, Senior Regulatory Associate in the ACS Division of Advocacy and Health Policy, at lfoe@facs.org.

Dr. Donald D. Trunkey, Pioneer in Trauma Care, Passes Away

Dr. TrunkeyDonald D. Trunkey, MD, FACS, Past-Chair, American College of Surgeons (ACS) Committee on Trauma (COT), past-president of the American Association for the Surgery of Trauma, and a pioneer and advocate for trauma systems development, died last week at 81 years old.

In 1976, Dr. Trunkey led the COT’s efforts to publish Optimal Hospital Resources for the Care of the Seriously Injured, the first document aimed at defining and developing trauma centers and trauma systems. He published seminal work on the impact of trauma systems development on preventable death. In 1979, he wrote a paper comparing death rates among trauma patients in the more rural Orange County with patients in urban San Francisco County, CA. It was one of the earliest, most persuasive pieces of evidence on the effectiveness of trauma centers. His message was unwavering: injured patients deserve the best trauma care available, and the best care includes an organized trauma system.

Dr. Trunkey served in the U.S. Army from 1964 to 1966 before completing his surgical training. Five years into his term as the Mackenzie Professor and Chair (1986−2001), department of surgery Oregon Health Science University, Portland, Dr. Trunkey was activated from reserve status to active military to serve in the first Gulf War in 1991. He was stationed in Riyadh, Saudi Arabia, during Operation Desert Storm and Desert Shield. He dealt with a number of operational and cultural obstacles that prompted him to publish a commentary in Archives of Surgery in 1993, "Lessons learned." This document paved the way for how the U.S. Department of Defense trains its trauma personnel today.

Dr. Trunkey received many awards and honors for his service to trauma care, including the ACS Distinguished Service Award in 2005 and being named an ACS Icon in Surgery in 2018.

Read more about Dr. Trunkey’s storied career.

ACS Welcomes Dr. Rana Awdish as 2019 ACS Quality and Safety Conference Keynote Speaker

Dr. AwdishThe American College of Surgeons (ACS) is pleased to welcome to the 2019 Quality and Safety Conference, July 19–22 in Washington, DC, keynote speaker Rana L. Awdish, MD, an intensive care physician at Henry Ford Hospital, Detroit, MI. She will deliver her talk, In Shock, and share her amazing journey from near death to recovery, as well as her passion for improving the patient experience. Her story includes lessons learned from being both a physician and a patient and how her experience as a patient shaped her approach as a provider.

Dr. Awdish was selected for her powerful message and how her story fits into the conference theme for 2019, Putting Our Patients First. Her journey from a provider, to a patient, back to health care professional will provide an important perspective to the physician and patient relationship, while inspiring attendees to continually aim for optimal care and outcomes for every patient.

Other sessions at this year’s conference will include content from the several established ACS Quality Programs, including Cancer, the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®), the National Surgical Quality Improvement Program (NSQIP®), and Children’s Surgery. Additional tracks and sessions will be offered for those interested in Quality Improvement (QI) Principles and Tools; the Geriatric Surgery Verification Program, to be unveiled at the conference; and a list of important and emerging topics including the following:

  • Value improvement
  • Bundled care
  • Global health
  • Change management
  • Leadership principles
  • Team dynamics
  • Strong for Surgery
  • Enhanced recovery
  • Emergency general surgery
  • Transplantation
  • New ACS Quality Programs

Further details about the conference, including registration information, can be viewed online.