How health systems rise to meet challenges in pandemic’s 2nd year

Well into its second year, the COVID-19 pandemic has continued to test U.S. health systems seeking to rebound from 2020, ensure vaccine uptake, battle physician burnout and innovate to improve care delivery.

Throughout this challenging year, the AMA has recognized the outstanding efforts of AMA Health System Program members. The program provides enterprise solutions to equip health system leadership, physicians and care teams with resources to help drive the future of medicine.

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COVID-19 vaccine requirements: Why U.S. doctors are fighting for them

With federal health officials warning that the SARS-CoV-2 Omicron variant is already spreading quickly in the U.S. and is likely to peak with a huge caseload in January, American doctors are redoubling their support for COVID-19 vaccination—and vaccine requirements—as the best way to save lives and keep patients out of the hospital.

The scientific experts at the Centers for Disease Control and Prevention say that booster doses can effectively fight the Omicron variant, which now has joined the SARS-CoV-2 Delta variant in a kind of tag team of viral attack.

That is just one huge reason why the AMA is continuing its legal efforts in support of policies that require widespread COVID-19 vaccination.

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Congress moves to tackle Medicare physician pay cliff

There appears to be a pathway emerging in Congress to address a combined 9.75% in Medicare physician payment cuts, which amount to a physician payment cliff and were set to take effect Jan. 1, 2022.

The Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) was considered by the House of Representatives. While the underlying bill is the Senate-passed Dr. Lorna Breen Health Care Provider Protection Act, the House passed its version of that bill separately under suspension of the rules.

Highlights of the physician-payment provisions include:

  • A delay in resuming the 2% Medicare sequester for three months (Jan. 1–March 31, 2022), followed by a reduction to 1% for three months (April 1–June 30, 2022).
  • A one-year increase in the Medicare physician payment schedule of 3%, which is 0.75% less than the conversion factor boost provided for 2021.
  • A one-year delay in the cuts to the clinical laboratory payment schedule.
  • A one-year delay in the Medicare radiation oncology demonstration.
  • Erasing the 4% Medicare pay-as-you-go (PAYGO) cut, and preventing any additional PAYGO cuts through 2022.

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Doctor participation in ACOs, medical homes grows amid pandemic

Physician participation in accountable care organizations (ACO) and medical homes continues to grow steadily amid the COVID-19 pandemic, according to the results of an AMA survey of about 3,500 physicians.

Nearly one-third of doctors worked in practices participating in medical homes in 2020, up from 23.7% in 2014. On the ACO front, 42.7% of physicians were in practices that participated in a commercial ACO in 2020, up from 31.7% in 2016. Meanwhile, 29.5% of physicians were in practices took part in a Medicaid ACO, up from 20.9% in 2016.

And the share of physicians in practices involved in Medicare ACOs has risen from 28.6% in 2014 to 36.7% in 2020, though it dipped from a high of 38.2% in 2018.

The findings are included in the AMA Policy Research Perspectives report, “Payment and Delivery in 2020: Fee-for-Service Revenue Remains Stable While Participation Shifts in Accountable Care Organizations During the Pandemic.”

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Top 10 stories from the November 2021 AMA Special Meeting

Nearly 700 physicians, residents and medical students gathered for the November 2021 AMA Special Meeting of the AMA House of Delegates to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health. As they have done since the global pandemic was declared last year, the delegates met virtually.

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Why doctors back state COVID-19 vaccine mandates for health care

Physicians are voicing their support for state efforts to require that doctors and other health professionals get vaccinated to protect themselves, their loved ones and their patients from the worst outcomes of COVID-19.

In particular, New York Gov. Kathy Hochul recently implemented such a COVID-19 vaccine mandate for the health care industry in the Empire State. The AMA joined with the Medical Society of the State of New York (MSSNY) to strongly support the governor’s efforts.

“The path to ending the pandemic must be based on science, and vaccination is an indispensable part of the solution,” says a joint statement from AMA President Gerald E. Harmon, MD, and MSSNY President Joseph R. Sellers, MD.

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How latest surprise-billing rule entrenches health insurers’ power

The Biden administration has issued a second interim final rule (IFR) to implement the No Surprises Act that takes effect in January, but unfortunately it represents an undeserved gift to the insurance industry that will reduce health care options for patients.

The IFR “ignores congressional intent and flies in the face of the Biden administration’s stated concerns about consolidation in the health care marketplace,” said AMA President Gerald A. Harmon, MD. “It disregards the insurance industry’s role in creating the problem of surprise billing at the expense of independent physician practices whose ability to negotiate provider network contracts continues to erode.”

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44% drop in opioid Rx since 2011, but overdoses spike. Here’s why.

A report newly issued by the AMA shows that opioid prescribing nationwide has dropped 44.4% in the past decade and fell nearly 7% from 2019 to 2020. At the same time, the country is facing a worsening epidemic of drug-related overdoses and deaths.

Overdoses and deaths are spiking even as physicians and other clinicians have greatly increased the use of prescription drug-monitoring programs (PDMPs)—more than 910 million times in 2020, according to the AMA’s “2021 Overdose Epidemic Report” (PDF). That’s up 21% from the 750 million times that PDMPs were used in 2019 by doctors and others.

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Medicare should pay for telehealth list services after pandemic

The AMA has weighed in with more than 100 pages of comments on the proposed 2022 Medicare physician payment schedule. The comments come with doctors eager to see extended coverage of telehealth amid a COVID-19 pandemic that has cut practice revenues. That income drop comes ahead of the combined 9.75% reduction in Medicare physician pay that will start Jan. 1 unless Congress takes action.

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For doctors hit hard by COVID-19 stress, there are tools to help

The COVID-19 pandemic’s emotionally pulverizing impact on physicians and the health-professional workforce has exacerbated the mental health and burnout crisis within health care and demands action. …

Here is a collection of news articles that detail other steps the AMA is taking to prevent suicide among doctors and the resources that individuals and organizations can use to help save lives.

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ATF on right track in fighting proliferation of “ghost guns”

The AMA is supporting a regulatory move to ensure that federal firearms control laws apply to so-called ghost guns.

The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) has proposed updating the definitions of “firearm” and related parts for the first time since 1968 to modernize the definition of “frame or receiver.” That would help close a regulatory loophole associated with the unserialized, privately made firearms that are increasingly being recovered at crime scenes across the country.

“These unmarked firearms, known as ‘ghost guns,’ are often assembled from kits that are sold without background checks, making them easily acquired by criminals who otherwise would not be permitted to possess a firearm,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to U.S. Attorney General Merrick Garland, who oversees the ATF, a Department of Justice agency. “The AMA supports this important proposed rule and urges that it be finalized without delay.”

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Texas SB 8 puts bounties on doctors’ heads for delivering care

A new Texas law bans virtually all abortions in the state after about six weeks’ gestation and invites private parties to file civil lawsuits against anyone performing or “aiding and abetting” an abortion.

A successful civil lawsuit under the Texas legislation, Senate Bill 8, would allow plaintiffs to collect a minimum of $10,00 for each abortion challenged. The U.S. Supreme Court has denied an emergency application to block the law from taking effect.

The AMA “is deeply disturbed by Texas SB 8 and disappointed” by the Supreme Court’s “allowing this egregious law to go into effect,” said Gerald E. Harmon, MD, a South Carolina family physician and president of the AMA.

“This significant overreach not only bans virtually all abortions in the state, but it interferes in the patient-physician relationship and places bounties on physicians and health care workers simply for delivering care,” he added. “Opening the door to third-party litigation against physicians severely compromises patient access to safe clinical care.”

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AMA: Time to mandate COVID-19 vaccination is now

With the Pfizer-BioNTech COVID-19 vaccine earning full approval from the Food and Drug Administration (FDA) and the SARS-CoV-2 Delta variant wreaking havoc amid sluggish national rates of immunization, the AMA is strongly urging employers to require that their workers get vaccinated.

“Now is the time for the public and private sectors to come together, listen to the science, and mandate vaccination,” said AMA President Gerald E. Harmon, MD.

“The FDA has approved the Pfizer-BioNTech COVID-19 vaccine and the meticulously collected evidence from more than 100 million vaccinated Americans is clear: The vaccines we have to defeat COVID-19 are safe, effective, and the only way out of this pandemic,” Dr. Harmon added, noting that “vaccine supply is ample, and for months, access has been easier.”

Nearly all U.S. doctors—over 96%—are vaccinated against COVID-19, according to an AMA survey conducted in May.

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