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Published 11/1/2013
Elizabeth Fassbender

Report from the Council on Advocacy

On Oct. 8, 2013, the Council on Advocacy met in Washington, D.C. to discuss upcoming legislative and regulatory advocacy priorities. Council Chair Thomas C. Barber, MD, welcomed the members, and encouraged them to share key happenings around the country that affect orthopaedics, including issues such as state healthcare exchange models, changes to Medicaid and Medicare, tort reform, and implementation of the International Classification of Diseases–10th Edition (ICD–10).

Michael S. Kolber, JD, an associate with the healthcare practice of Manatt, Phelps & Phillips, LLP, who focuses his practice on regulatory and transactional matters in the healthcare industry, discussed the impact of the Affordable Care Act (ACA) on healthcare coverage, particularly as it relates to employer-sponsored coverage and total numbers of uninsured.

According to Mr. Kolber, employer-sponsored coverage should remain constant and, after a full rollout of the ACA, the number of uninsured should drop from 55 million people to about 31 million people. He provided an overview of benefit designs and patient protections, and emphasized that insurer participation, rate variations, and state premiums would be issues to watch.

Craig A. Butler, MD, chair of the Health Care Systems Committee, provided a recap of the recent symposium on payment reform and led a discussion on payment policy proposals. According to Dr. Butler, the symposium resulted in seven recommendations, including active participation in efforts to reform and/or repeal the Sustainable Growth Rate (SGR) formula, proactively engaging payers, and assisting in their efforts to develop value-based payment models for orthopaedics.

Dr. Butler noted that the committee will be conducting a series of webinars that will overview payment reform, healthcare insurance exchanges, and bundled payments. The first webinar is scheduled for Jan. 14, 2014, on health insurance exchanges.

Stuart L. Weinstein, MD, chair of the Orthopaedic PAC, provided an update on the goals of the PAC, its connection to advocacy, and the criteria for giving. He also discussed the candidate workshop program that encourages AAOS members to run for office.

The meeting also featured a strategic discussion on regulatory advocacy and a legislative discussion focused on the SGR and maintaining the in-office ancillary services (IOAS) exemption. On the following day, fellows conducted Hill visits with members of Congress to raise awareness of the value of orthopaedics and advocate on key issues such as the SGR and the IOAS.

Elizabeth Fassbender is the communications specialist in the AAOS office of government relations. She can be reached at fassbender@aaos.org