STS Advocacy Monthly

August 2012

 

New Name, Same Strong Commitment to CT Surgery Advocacy
STS Advocacy Monthly replaces Beltway Briefings as the name of our monthly e-newsletter dedicated to informing you about the latest and most important regulatory and legislative news relevant to cardiothoracic surgery. The name STS Advocacy Monthly better illustrates the content you will find in this STS member communication. As always, please send your questions, comments, or suggestions to advocacy@sts.org.

In this issue:
1. Make Your Voice Heard
2. Standards Proposed for Patient-Centered Outcomes Research
3. Congress Focuses on SGR
4. CMS Releases FY 2013 Physician Fee Schedule Proposed Rule
5. STS Members Encouraged to Comment on Proposed CABG Measures

Make Your Voice Heard
If you were unable to participate in our August Legislative Fly-In in Washington, you can still make your voice heard. Support your colleagues right now by sending a message to your Congressional representatives from the STS Advocacy Center. You can also take advantage of the August Congressional recess and meet with your representative and senators in their home districts—where you live. A face-to-face meeting is a great way to express your concerns about cardiothoracic surgery and bring the Society’s policy priorities to table.

Another extremely effective way to engage your lawmakers is to invite them to visit your facility or practice to see health policy in action. A personal visit will make a strong and lasting impression.

CT surgeons are leading innovators in health care, so it is important that you have a significant voice in discussions about health policy in Congress, including:

  • Replacing the unsustainable Medicare physician payment formula before a 27% reimbursement cut goes into effect on Jan. 1 and averting additional cuts to Medicare payments as a result of budget sequestration;
  • Restoring access to data in the Social Security Death Master File;
  • Supporting patient advocacy issues like early detection and prevention of lung cancer; and
  • Other issues important to your own practice.

We are here to help! To schedule meetings, receive briefing materials, and obtain advice as you prepare to meet with your elected officials, please contact the STS Government Relations staff at (202) 787-1230 or advocacy@sts.org.

Standards Proposed for Patient-Centered Outcomes Research
The Patient-Centered Outcomes Research Institute (PCORI), which is a private entity authorized by Congress to conduct research that’s aimed at helping patients and health care providers make more informed decisions, has released a landmark Draft Methodology Report, "Our Questions, Our Decisions: Standards for Patient-centered Outcomes Research."

The report identifies 60 standards for patient-centered outcomes research. These standards could impact research that is conducted using information in the STS National Database.

STS is preparing comments on the report that will emphasize the value of longitudinal, observational, outcomes-based research. PCORI will analyze all public comments for potential incorporation into a revised report that will be considered for adoption by the PCORI Board of Governors in November.

Congress Focuses on SGR
Several Congressional committees and subcommittees dedicated time in July to discussion about the Sustainable Growth Rate (SGR) formula that governs Medicare Part B payments to physicians.

STS staff met with staff from the Senate Finance Committee to advocate in favor of a payment model that rewards providers for health care quality and patient outcomes. The committee has expressed an interest in the lessons the Society has learned from the STS National Database and the new model of collaboration exemplified by the STS/ACC TVT Registry.

During a House Ways and Means Subcommittee on Health hearing, Rep. Pete Stark (D-Calif.) highlighted the STS National Database as a model to help improve health care quality and efficiency, stating that other specialties should follow suit, while Rep. Michael Burgess, MD (R-Texas), an OB-GYN, introduced legislation in the House Energy and Commerce Committee that would provide a one-year delay of SGR-related cuts to physician payments. The Energy and Commerce Health Subcommittee also held a hearing on physician payment reform, setting the stage for further SGR-related talks in nearly all the committees with jurisdiction over the issue.

STS will continue to monitor these and other SGR proposals in Congress and advocate that lawmakers avert the impending payment cuts for a period long enough to provide the stability necessary for real payment reform.

CMS Releases FY 2013 Physician Fee Schedule Proposed Rule
The Centers for Medicare & Medicaid Services has published its annual regulation governing Medicare Part B physician payments, among other issues. The proposal includes actions that could directly or indirectly impact cardiothoracic surgery, including:

  • An estimated 27.4% pay cut in addition to a probable 2% sequestration of all federal outlays mandated under the Budget Control Act of 2011;
  • Significant cuts in payments to radiation oncology (-14%) and radiology (-19%); and
  • Details on Medicare programs, such as the Physician Compare Initiative, Physician Quality Reporting System, Value Base Payment Modifier, and Electronic Prescribing (eRx) Program.

STS staff and surgeon leaders are evaluating the proposed rule and will respond with formal comments to CMS by the Sept. 4 deadline.

STS Members Encouraged to Comment on Proposed CABG Measures
As mandated under Section 3025 of the Affordable Care Act, CMS is required to develop and report readmission measures for a number of procedures and conditions, including Coronary Artery Bypass Grafting (CABG) surgery.

These measures require risk-adjustment, and two separate risk models are currently under development. One, developed by the Yale Center for Outcomes Research and Evaluation, uses administrative claims data. The second, being developed by STS and the Duke Clinical Research Institute, uses STS clinical data for risk-adjustment with linkages to Medicare data to accurately ascertain all readmissions. The results of these models will be compared by CMS, who will then decide which model to use in their public reporting and readmission penalty programs.

A similar initiative for risk-adjusted CABG mortality rates is also planned, and the STS 30-day mortality risk model may be considered for implementation. The results of this model will first be compared with those of a similar model developed by Yale using administrative claims data.

CMS is requesting stakeholder review and public comment by Aug. 8 on all three proposed measures. We encourage STS members to comment on the advantages of the measures based on clinical data, particularly their wide acceptance across the provider community.

 


STS Advocacy Monthly is an e-publication for members of The Society of Thoracic Surgeons. Comments concerning content and advocacy initiatives may be referred to STS Director of Government Relations Phil Bongiorno at advocacy@sts.org. Please forward this issue to any colleagues, patients, and friends who are interested in the latest happenings in national health policy as it relates to cardiothoracic surgery. © 2012.