Published 4/1/2017
William J. Maloney, MD

Making Healthcare Advocacy a Priority

William J. Maloney, MD

2017 will no doubt be a major year for healthcare reform. President Donald J. Trump and Republicans in Congress have pledged that it will be a top priority, while legislators have crafted a framework for the potential replacement of the Affordable Care Act (ACA). Additionally, orthopaedic surgeon Tom Price, MD, recently confirmed as secretary of the Department of Health and Human Services (HHS), has expressed his commitment to saving, strengthening, and securing Medicare for today's beneficiaries and future generations.

Given this heightened focus on health care, it is more important than ever for orthopaedic surgeons to have a strong voice on Capitol Hill and beyond. We must speak out about issues that affect our profession and patients' access to care. Even though we may practice in different settings and have varying political preferences, all aspects of our professional lives are affected by the legislative and regulatory decisions made in Washington, D.C. Whatever our new healthcare system looks like, one thing is certain: It is critical that we orthopaedists take our place at the forefront of these discussions and decisions. The American Association of Orthopaedic Surgeons (AAOS) maintains our advocacy voice year round through several channels, including the AAOS Office of Government Relations (OGR), the AAOS Council on Advocacy, and our Orthopaedic Political Action Committee (PAC). Additionally, we consistently engage fellows and resident members through various committees, grassroots and grass-tops campaigns, the AAOS Congressional Ambassadors program, and Orthopaedic PAC fundraisers. We work directly with specialty societies through the Board of Specialty Societies and assist in state-level efforts by working with the Board of Councilors and state society executive directors. We also host several events throughout the year that bring orthopaedic surgeons from around the country to Washington, D.C., to meet with members of Congress and other officials. This involvement in advocacy from our membership is critical to our success. Not only do these events get us directly in front of policymakers, but they build support for legislation, result in hearings or congressional markups on issues of interest to orthopaedists, increase pressure on regulatory agencies to address problems, and can lead to the passage or rejection of legislation that affects the practice of orthopaedic surgery. Advocacy in action
Just as members of Congress and regulatory agencies set their top priorities each year, AAOS continually evaluates orthopaedists' legislative and regulatory concerns and determines how to best address them. Specifically, the Council on Advocacy plans, organizes, directs, and evaluates the Association's legislative, regulatory, and health policy programs and initiatives. Each year, the Council on Advocacy reviews and updates its Unified Advocacy and Regulatory Agendas, which guide the OGR's work in the legislative and regulatory arenas. The Association's major legislative and regulatory initiatives, which are aimed at enhancing the quality of orthopaedic care for our patients as well as ensuring access to that care, include Medicare reimbursement reform, addressing health information technology, increasing research funding, protecting in-office ancillary services, and increasing congressional awareness of the large and growing prevalence of musculoskeletal diseases. But these are just a few examples. You can find all of our advocacy issues, as well as the Unified Advocacy and Regulatory Agendas, online at www.aaos.org/dc Thanks to the Association's efforts, we saw a number of successes in 2016. First off, we achieved important modifications to the Centers for Medicaid & Medicare Services (CMS) Quality Payment Program, which implements the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). We also brought about positive changes to the Comprehensive Care for Joint Replacement Model (CJR) bundled payment program and successfully advocated for $30 million in funding for the Peer Reviewed Orthopaedic Research Program through the Department of Defense. Once the FY2017 defense appropriations money is allocated, this program will have received more than $300 million in funding since its inception in 2009! In addition, several pieces of legislation were passed to help ease burdens and reduce electronic health record (EHR) system-related penalties. And on the issue of opioids, although much of the focus was on additional funding for addiction treatment, AAOS scored a win when CMS proposed removing pain management questions from the Hospital Consumer Assessment of Healthcare Providers and Systems survey and from the hospital payment scoring calculation. Finally, we also celebrated a huge win late in the year when President Obama signed the 21st Century Cures Act into law. This legislation is focused on improving EHRs and interoperability, enhancing the flow of patient information by preventing interference in information exchange, and encouraging important research and device approval efforts. None of these successes would be possible without support from AAOS members, who do everything from engaging in grassroots efforts on Twitter to trekking to the nation's capital multiple times a year. Without you, we could not accomplish all that we do. And whether you are a seasoned advocate or haven't given it much thought, we continue to need your support. Follow the OGR on Twitter at @AAOSAdvocacy, read Advocacy Now and other publications, learn about the issues, and/or call your member of Congress. AAOS members who are interested in joining the Congressional Ambassador program to develop a relationship with their congressional representatives or who have already established relationships should email Jordan Vivian at vivian@aaos.org If you want to submit your story of advocacy, ask questions, or express concerns, email dc@aaos.org   And what about residents? As the future of our profession, residents can offer unique perspectives on important and pressing issues. Under the resident-run AAOS Resident Assembly (RA), the Health Policy Committee develops, refines, and presents health policy actions to the executive committee, and collaborates with the Association to promote resident engagement in political issues locally and nationally as well as to increase involvement with the Orthopaedic PAC. AAOS also established a “Bring a Buddy” program and the Futures Capitol Club to help engage and recognize residents with a strong commitment to the Orthopaedic PAC. These are important programs that make sure the generations coming into the profession have the chance to get involved in advocacy and shape the policies that will affect their careers and patients. More on the AAOS Orthopaedic PAC
The Association's Orthopaedic PAC is the only national political action committee in Washington, D.C., that is solely dedicated to representing the interests of orthopaedic surgeons before Congress. Formed in 1999, our PAC works to advance the advocacy agenda of the AAOS and orthopaedic specialty groups, enabling us to achieve the goals outlined in the Unified Advocacy Agenda and giving AAOS members a voice when it comes to issues that matter most to our profession and our patients. Regardless of personal political preferences or party labels, our PAC works to help win legislative battles that are unique to our profession. Every issue the Orthopaedic PAC supports is put forth and endorsed by the Council on Advocacy, which oversees the PAC Executive Committee. The PAC Executive Committee, led by Chairman John T. Gill, MD, then makes carefully studied, well-informed decisions on whom to support, ensuring that financial support is put where it will best represent the profession. Today, the Orthopaedic PAC remains one of the largest healthcare association PACs in the nation. Last election cycle we raised more than $3.5 million and enjoyed support from more than 5,200 of our colleagues. Every dollar raised is a direct investment on behalf of our specialty. During 2015 and 2016, PAC representatives attended more than 880 events, including 113 local events with AAOS fellows. This expansive political footprint helps us frame the debate on a number of critical healthcare issues. Importantly, we support our profession—not political parties—as evidenced by the fact that, of the $2.5 million that was disbursed in that time period, 60 percent went to Republicans and 40 percent went to Democrats. We are successful, too. In the 2016 election, the Orthopaedic PAC participated in 32 U.S. Senate races and 231 U.S. House races, winning an unprecedented 94 percent of those races. We also supported the Republican and Democratic Governors Associations, which further amplified our voice in the state political arena. The Orthopaedic PAC is also committed to training our own members to run for elected office. Now more than ever, as we find our healthcare delivery system being rebooted, we need physician expertise leading the policymaking discussions. Are you ready to take the plunge from practice to politics? Annually, we gather the nation's experts from both sides of the aisle and offer a crash course on winning elected office. The PAC will host its Eighth Annual Candidate Workshop on April 29–30, 2017, in conjunction with the National Orthopaedic Leadership Conference, in Washington, D.C. Registration is free for PAC donors. Email Stacie Monroe at monroe@aaos.org if you are interested in attending (by availability). Navigating the road ahead
We've accomplished so many great things over the past few years, but the most important battles are yet to come. For many, the recent election is being seen as the perfect opportunity to push through many of the policies that were not previously attainable. Many of the champions we have built through the Congressional Ambassador program and through our Orthopaedic PAC are now in a great position to help our legislative and regulatory agendas. Lifting the ban on physician-owned hospitals, obtaining relief from many of the regulations that can affect access to care, increasing access to Medicare claims data, and accomplishing medical liability reform are all important policy changes that are within reach, but only if we work together. Therefore, it bears repeating: There is no better time than NOW to become involved in shaping the political landscape for the betterment of our patients. PAC participation is crucial. Become an ambassador. Talk to your partners and your residents. Reach out to the OGR to learn more about staff members' roles and what you can do to help. Join the team today by texting the letters AAOS to 41444 to contribute by phone, or visit www.aaos.org/pac to make a donation. I'm confident that together our advocacy efforts will ensure a bright future.

Did you know…

The Orthopaedic PAC is 100 percent self-sufficient. Not a dime of membership dues goes toward funding it. Instead, the Association relies on corporate contributions for funding and support. To that end, last year the Association launched a sophisticated advocacy program, called the Advisor's Circle, which takes your group practice from apolitical to political elite. Our talented staff will build a customized program that helps give you the tools to advance your legislative and advocacy agenda. Membership in the program can cost anywhere from $10,000 to $80,000 from your practice's general treasury account.