In January, to advance the AAOS Strategic Plan, AAOS President Kristy L. Weber, MD, FAAOS, traveled to Washington, D.C., to connect with legislators on priority AAOS issues, including preserving the value of hip and knee payment codes and securing appropriations language for musculoskeletal disparities research.
Dr. Weber also secured critical support on policies that will help AAOS members provide the best possible care for patients. Her willingness to advocate on behalf of the musculoskeletal community demonstrated her understanding of and appreciation for the importance of directly influencing federal policy.
Meetings on Capitol Hill
Dr. Weber is well aware that relationship-building is essential to advocacy. In an example of the benefits of an established relationship, she observed Andy Pollak, MD, FAAOS, successfully advocate for funding for the Peer-
reviewed Orthopaedic Research Program in 2009. Dr. Pollack introduced her to Representative Dutch Ruppersberger (D-Md.), who has been instrumental in getting Congress to fund the program ever since. To date, the Peer-reviewed Orthopaedic Research Program has received nearly $400 million to support research grants that provide veterans affected by musculoskeletal injuries improved opportunities for recovery of function.
Dr. Weber then met with Representative Andy Harris (R-Md.), with whom she had worked at Johns Hopkins. She was able to secure his leadership on a letter to the Centers for Medicare & Medicaid Services (CMS) discouraging the agency from accepting the Relative Value Update Committee’s recommendation to further reduce reimbursement for hip and knee arthroplasty codes—a top priority of both AAOS and the American Association of Hip and Knee Surgeons (AAHKS). AAOS and AAHKS are actively seeking additional Congressional signatories for the letter in an effort to influence CMS’ decision-making in the Medicare Physician Fee Schedule proposed rule, to be released later this spring.
Senator John Barrasso, MD (R-Wyo.), also met with Dr. Weber after appearing on CNN to discuss the impeachment trial. Although they had not previously met, they quickly connected through shared experiences as orthopaedic surgeons and mutual acquaintances. Senator Barrasso agreed to sign onto the aforementioned CMS letter and to help with other AAOS priorities, including addressing the new appropriate use criteria for advanced diagnostic imaging. He said he would spearhead a letter from the Senate to CMS urging it to delay full implementation of the duplicative, burdensome, and expensive new requirements.
Dr. Weber then had an important meeting with Representative Rosa DeLauro (D-Conn.), who chairs the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, to discuss the importance of research into sexual dimorphism, race/ethnicity, socioeconomic status, and other inequities in musculoskeletal care. They immediately bonded over a passion for women’s health issues. Dr. Weber asked for language to be added to the subcommittee’s appropriations bill emphasizing the need for further research into those areas, as Representative DeLauro’s support is critical to the effort.
Opportunities to engage in advocacy
Dr. Weber’s visit to the AAOS Office of Government Relations (OGR) in Washington, D.C., is an example of how important it is for AAOS members to get involved with advocacy. In her President’s Message in AAOS Now in June 2019, she wrote, “I cannot overstate the importance of the Academy’s influence on all government policy-making levels. It helps to fulfill our mission: ‘Serving our profession to provide the highest-quality musculoskeletal care.’”
When the OGR advocacy team sends an urgent action alert on a pressing issue, it is critical that members react quickly and contact their legislators. The aggregation of asks from individual members helps to ensure that the orthopaedic voice is loud and clear on Capitol Hill. After all, constituents are the most effective advocates, and constituent outreach exponentially amplifies AAOS’ efforts. Members can view breaking and evergreen issues on AAOS’ Advocacy Action Center at https://www.bit.ly/2SjUv0d.
AAOS Congressional Ambassadors are also extremely effective advocates. They work to develop and/or strengthen relationships with their members of Congress through frequent contact. The ambassadors are top-tier advocates, and legislators often use them as resources regarding healthcare policy. Ambassadors are so valuable that AAOS sometimes flies them to Washington, D.C., to meet with legislators on critical issues. For more information on the Congressional Ambassador program, contact Julie Williams at firstname.lastname@example.org.
Of course, the simplest way to stay engaged with advocacy is to regularly read the biweekly Advocacy Now e-newsletter and the advocacy section of AAOS Now. The association regularly provides updates on healthcare initiatives, progress, and calls to action. You can read high-level summaries on advocacy issues in the newsletter and get more in-depth looks in longer-form magazine articles.
Importance of working together
Working together, the OGR team can help AAOS members keep abreast of all current legislative and regulatory issues that may impact them as providers and help shape policy to offer the best possible musculoskeletal care for patients. Their efforts are critical not only today, but also tomorrow, as the Academy continues working toward the Strategic Plan through 2023. As such, Dr. Weber’s commitment to advocacy and visit to Capitol Hill will have long-term implications for both the association and the field of orthopaedics for years to come.
Julie Williams is a senior manager in the AAOS OGR.