Amid political divisions, physicians unify to protect patients

For the first time since the pandemic’s onset, hundreds of physicians, medical society staffers and others met in person in a bitterly divided Washington, D.C., for the AMA National Advocacy Conference.

This year’s legislative and regulatory priorities are crystal clear, driven by the urgent need to protect patients’ access to high-quality care and help physicians who have put so much on the line during the COVID-19 pandemic.

My latest for the AMA. The whole shebang.

CMS takes big steps to fix prior authorization in Medicare Advantage

The AMA and nearly 120 physician organizations are strongly supporting proposed reforms of prior authorization in Medicare Advantage and the Medicare prescription drug benefit.

The physician organizations sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure thanking her and urging the agency to finalize proposed reforms that target the inappropriate use of prior-authorization requirements by Medicare Advantage plans to delay, deny and disrupt the provision of medically necessary care to patients.

My latest for the AMA. The whole shebang.

Listen and learn with the AMA’s top podcast episodes

Physicians and medical students’ time is more squeezed than ever by the demands of practicing and studying amid the tripledemic and soaring rates of professional burnout. It’s no surprise that a growing number of physicians and future doctors are taking advantage of listening to podcasts to enhance their knowledge of trends in medicine while commuting, running errands, making dinner or doing housework.

In 2022, more than 600,000 episodes of AMA podcasts were downloaded as listeners learned from doctors and other experts who give voice to an array of original AMA podcasts.

My latest for the AMA, which highlights 10 of our most popular episodes in 2022. Read the whole shebang.

Big provisions in $1.7 trillion omnibus: What doctors should know

In enacting the 4,000-plus page, end-of-the-year spending package, Washington politicians failed to stop the entirety of scheduled Medicare pay cuts, which will come at a financially precarious time for physician practices left reeling in the COVID-19 pandemic’s third year.

Because of that, physicians will face a 2% cut in Medicare payment in 2023, and 2024 will bring at least a 1.25% cut. Nevertheless, the $1.7 trillion bill signed by President Joe Biden does include a number of important AMA-supported provisions that physicians should know about.

My latest for the AMA. Read the whole shebang.

Medicare physician pay cuts underscore need to fix broken system

U.S. physicians will face a 2% cut in Medicare payment in 2023, and 2024 will bring at least a 1.25% cut under the massive, must-pass omnibus spending deal struck by congressional leaders.

“The AMA is extremely disappointed and dismayed that Congress failed to prevent Medicare cuts next year, threatening the financial viability of physician practices and endangering access to care for Medicare beneficiaries,” said AMA President Jack Resneck Jr., MD. “This 2% cut, following two decades of flat payment rates, will have consequences on health care access for older Americans.”

Doctors had been staring down as much as 8.5% in 2023 Medicare pay cuts, but an advocacy campaign led by the AMA and joined by more than 150 organizations representing over 1 million physicians and other health care clinicians helped stave off many of the reductions.

My latest for the AMA. Read the whole shebang.

3-year study of NPs in the ED: Worse outcomes, higher costs

Nurse practitioners delivering emergency care without physician supervision or collaboration in the Veterans Health Administration increase lengths of stay by 11% and raise 30-day preventable hospitalizations by 20% compared with emergency physicians, says a working paper published by the National Bureau of Economic Research.

That higher preventable hospitalization rate “may reflect two possibilities,” says the working paper, written by David Chan, MD, PhD, associate professor of health policy at Stanford University School of Medicine, and Yiqun Chen, PhD, assistant professor of economics at the University of Illinois at Chicago.

One is that “NPs have poorer decision-making over whom to admit to the hospital, resulting in underadmission of patients who should have been admitted and a net increase in return hospitalizations, despite NPs using longer lengths of stay to evaluate patients’ need for hospital admission.”

The other possibility is that “NPs produce lower quality of care conditional on admitting decisions, despite spending more resources on treating the patient (as measured by costs of the ED care). Both possibilities imply lower skill of NPs relative to physicians.”

My latest for the AMA. Read the whole shebang.

News from the 2022 AMA Interim Meeting

It was another eventful policymaking meeting for the AMA House of Delegates, which held its first in-person Interim Meeting since the onset of the COVID-19 pandemic. While the delegates met in Honolulu, I led our news team’s editorial coverage from that earthly paradise known as the Midwest.

This article, “ICYMI: 10 stories to read from the 2022 AMA Interim Meeting,” offers a relatively brief rundown of the meeting.

Our blog, “Highlights from the 2022 AMA Interim Meeting,” provides a more complete account of our news coverage and includes actions that didn’t result in full-blown news articles.

I also filed these two stories based on actions at the meeting:

How the 10 largest PBMs hold huge sway in health care marketplace

The AMA has gathered first-of-its-kind data on pharmacy benefit managers and its analysis finds a widespread high degree of market concentration in local markets across the U.S. where PBMs provide services to commercial health insurers.

At the national level, the analysis found that a handful of PBMs have a large collective market share for the three PBM services most used by insurers:

  • The 10 largest PBMs had a collective share of 97%.
  • The four largest PBMs had a collective share of roughly 66%.
  • Six PBMs are used exclusively by one insurer or a set of Blue Cross Blue Shield affiliates.

From my latest at the AMA. The whole shebang.

Optometrists doing eye surgery? Radical bill vetoed on safety grounds

California Gov. Gavin Newsom this week vetoed a radical measure that would have allowed optometrists without the necessary training and education to perform complex procedures such as laser eye surgery and administering needle injections to the eye.

“I am not convinced that the education and training required is sufficient to prepare optometrists to perform the surgical procedures identified,” Newsom wrote in his veto message. “This bill would allow optometrists to perform advanced surgical procedures with less than one year of training. In comparison, physicians who perform these procedures must complete at least a three-year residency program. For this reason, I cannot sign this bill.”

My latest for the AMA. Read the whole shebang.

Telehealth is fundamental to care. The Senate must act like it.

The AMA and more than 300 other physician, health care and patient organizations are calling on the U.S. Senate to follow the example set by a bipartisan 416–12 vote in the House of Representatives and continue regulatory and payment telehealth flexibilities for at least two years.

Access through telehealth “has been transformational—patients now expect and often prefer telehealth as a key component of our health care system,” says the letter, which notes that doctors and other health care organizations “have been able to reach many patients that previously had access barriers through virtual care.”

My latest for the AMA. Read the whole shebang.

Another question for patients: Are you registered to vote?

With voter-registration deadlines for the November elections fast approaching, physicians and medical students now have a new way to engage patients in quick, productive and nonpartisan discussions about how to take part in the electoral process.

The House of Delegates in June updated AMA policy to acknowledge that “voting is a social determinant of health and significantly contributes to the analyses of other social determinants of health as a key metric.”

Emory University MD-PhD student Jasmin Eatman was part of the effort to update that policy, and she appeared this week on “AMA Moving Medicine” with Aliya Bhatia, who is executive director of Vot-ER. About 25,000 doctors and other health professionals have worked with Vot-ER, and anyone in such a role can order a free Vot-ER badge, which includes a QR code that patients with smartphones can scan to complete the voter-registration process on their own time.

My latest for the AMA. The whole shebang.

Huge House win puts telehealth extension in Senate’s hands

The House of Representatives voted overwhelmingly for a bipartisan bill that extends Medicare telehealth payment and regulatory flexibilities through the end of 2024. The House’s 416–12 vote last week is a manifestation of the massive support among lawmakers, patients and physicians to build on the gains of telehealth seen during the COVID-19 pandemic and ensure it continues to be an accessible mode of care for the long haul.

My latest for the AMA. Read the whole shebang.

Also, check out these two recent stories on congressional bills to rein in prior authorization: