It was a real—as well as a virtual—convergence in Washington, D.C., on Feb. 4, 2015. Members of the American Association of Orthopaedic Surgeons (AAOS) and representatives from other medical specialty associations flew to the capital to urge members of Congress to repeal and replace the sustainable growth rate (SGR) formula before the current SGR patch expires on March 31. Physicians from around the country also participated virtually—using email, Twitter, and phone calls—to tell their representatives about the importance of a permanent SGR repeal to practices and their patients.
“Permanent repeal and replacement of the SGR formula has been and continues to be a top priority of the AAOS,” stated Thomas C. Barber, MD, chair of the AAOS Council on Advocacy. “Continuing the reckless system of patch after patch is harmful to the economy and to Medicare patients seeking access to specialties they desperately need.
“Physicians must have adequate support to provide coordinated care that will improve health, prevent costly complications, and enable physician participation in new payment and delivery models,” continued Dr. Barber. “We urge Congress to enact legislation to repeal and replace the SGR before the expiration of the current patch.”
Orthopaedists and other medical specialists held more than 50 different in-person meetings on Capitol Hill. Joining the AAOS leadership in Washington were representatives from the American College of Surgeons, the American Academy of Ophthalmology, the American Urological Association, and the American Congress of Obstetricians and Gynecologists.
Participation from around the country via email and social media was also strong. The American Academy of Otolaryngology-Head and Neck Surgery, American Association of Neurological Surgeons, American College of Cardiology, American Society of Hand Therapy, American Association of Orthopaedic Executives, and the North American Spine Society were among the groups with a strong virtual presence.
More than 780 emails were sent to members of Congress through the AAOS Legislative Action Center (http://advocacy.aaos.org). Approximately 350 tweets, using the hashtag #FixSGR, were posted on Twitter from approximately 100 different users. The postings reached more than 134,000 unique individuals and were seen more than 900,000 times. The AAOS Twitter account, @AAOSAdvocacy, also received nearly 70 retweets and mentions, and the number of followers increased by nearly 190 percent.
Even legislators got involved on Twitter, including Rep. Dave Brat (R-Va.) and Rep. Eric Swalwell (D-Calif.).
Will 2015 be the year?
Congress made significant progress toward a permanent fix in 2014 with the introduction of the “SGR Repeal and Medicare Provider Payment Modernization Act of 2014,” but partisan differences on how to pay for the measure eventually resulted in yet another patch (the 17th since 2003). However, the need to advance a permanent legislative solution to the SGR has already been the topic of House hearings.
“With the current ‘doc fix’ expiring at the end of March, we are faced with the best opportunity in a decade to permanently dispose of the SGR,” stated Health Subcommittee Chairman Joseph Pitts (R-Pa.). “We are committed to rising to meet this challenge.”
Still, the biggest challenge to a permanent solution remains the financial offsets. AAOS has urged Congress to consider bipartisan offsets that will not impede a patient’s ability to receive timely and appropriate care. Further, AAOS has stressed that patches to the SGR are costly; over the past 10 years, Congress has spent about $170 billion in short-term patches.
Patches also divert resources from the development of reimbursement systems that promote patient access to quality care. Because many physician offices are small businesses responsible for paying staff and bills, uncertainty about the pending 22 percent cut could mean that some offices will close, compromising patient access to care. A permanent fix of the SGR formula is essential in ensuring Medicare’s solvency and improving care delivery.
Visit the AAOS Advocacy Center (http://advocacy.aaos.org) to send a message to Congress on fixing the SGR or to obtain more information on the issue.
Elizabeth Fassbender is the communications specialist in the AAOS office of government relations. She can be reached at email@example.com