Looming budget cuts were set to hit payments for outpatient services, graduate medical education and “bad debt.” However, lobbying efforts by the American Hospital Association, the Federation of American Hospitals and the Association of American Medical Colleges helped to stave them off.
For instance, evaluation and management changes would have paid hospitals and physician offices the same reimbursements under a site-neutral policy, recommended by the Medicare Payment Advisory Commission (MedPAC). Although it passed in the House bill, the provision died in the Senate bill.
AHA, in particular, fought the policy, saying it would cost hospitals billions. Although MedPAC said patients shouldn’t have to pay more for a service in one setting over another, AHA said the increased costs at hospitals goes toward providing safety-net and emergency care.
In the end, E/M cuts didn’t make it through the final deal.
Why? Hospitals frequently are the largest employers in their area and have the “strongest lobbying muscle” because every member of Congress has at least one hospital in their district, Politico noted.
In addition, Congressional members may be willing to listen to provider concerns, as 20 members hold physician credentials. Democratic physicians make up 4 seats in the House, while Republican doctors make up 13 spots in the House and three in the Senate, American Medical News reported.
“We are trained as physicians to listen to patients and work with them and help them. In many ways, that is the same with constituents,” Rep. Ami Bera (D-Calif.) said. Bera also encouraged other providers to engage in leadership discussions in ways not limited to Congress.
“They should not just be at the table; they should be sitting at the head of the table,” he said about providers. “It is not necessarily running for office. But it is supporting your professional organization. It is going to city council meetings. This is a time for us as a profession to be involved.”
