Early signals from the Obama administration have physician groups looking forward to the year ahead and wasting no time getting to work on their own legislative priorities.
“We are optimistic that the time is right to move on health reform in 2009,” said Rod Larson, the American Academy of Neurology's chief health policy officer.
As in the past, the AAN's top priority in 2009 will be reforming the Medicare payment schedule and the sustainable growth rate formula on which it is based—including increased compensation for the evaluation and management services that take up much of a neurologist's billable time.
Mr. Larson also highlighted the need to educate policy makers about the crucial role neurologists play in their patients' care. “While we certainly agree that reform should include measures to increase resources and access to primary care, we also are working to educate policy makers that we share many of the same concerns as a specialty,” he said. “Neurologists, in most practices, serve as 'principal care' physicians for very complex chronic neurologic conditions,” like Alzheimer's disease and Parkinson's disease.
The AAN also will seek increased funding for the National Institutes of Health, which has remained the same in recent years, and medical liability reform in 2009.
“The Academy leadership has formed a Health Reform Task Force with broad representation from our legislative, medical economics, and practice committees to develop our reform agenda, engage our members, and bring our message to Congress and the Obama administration,” Mr. Larson said. “We are already reaching out to the neurologic patient groups to coordinate on common issues as well as other medical specialties [that] share our concerns.”
The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.
While still President-elect, Barack Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary.
In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.
Sen. Daschle's HHS position must be confirmed by the Senate; however, the health care czar position does not.
Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of Governmental Affairs and Public Policy at the American College of Physicians.
The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.
The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the sustainable growth rate formula, which ties physician payments to the gross domestic product. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.
Associate editor Denise Napoli contributed to this report.
FULL TEXT