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Nov. 21, 2016

Issue Spotlight

The AMA's post-election advocacy agenda

In the near term, the AMA will focus on the following priorities: the future of health system reform, reducing regulatory burdens and the continued implementation of the Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act (MACRA).

Health system reform. Following action taken by the House of Delegates during the 2016 AMA Interim Meeting, the AMA issued a press release and two-page statement outlining and reaffirming its existing policies on health system reform. The AMA's comprehensive policy provides a solid foundation for upcoming deliberations on changes to the Affordable Care Act and other programs. The framework addresses key issues such as covering the uninsured and expanding choice, ensuring patient access to care and the providers they need, improving health equity for underserved and special needs populations and advancing initiatives that enhance practice efficiency and professional satisfaction.

These materials were shared with the Trump transition team, the Obama administration and congressional leaders, and the initial response has been positive. In the coming weeks, the AMA will be hosting a series of discussions with Federation members to prepare and position medicine to effectively engage in the debate about the future of health system reform.

Regulatory relief. The AMA will aggressively pursue new opportunities to secure significant reductions in regulatory burdens that take time from patient care and increase costs. To be assured efforts begin with the most pressing concerns in mind, the AMA has asked for input from Federation groups on suggestions for a regulatory relief agenda.

The AMA's plan is to provide the Trump transition team and key congressional offices with an initial set of regulatory relief recommendations before Jan. 1, while continuing to augment this work over the next several months.

Further QPP improvements. The first performance reporting period under the QPP begins Jan.1. Although medicine was able to secure many improvements in final regulations issued this fall, there are provisions of the MACRA law that must still be implemented by the Centers for Medicare and Medicaid Services.

Proposed regulations expected to be issued in the spring of 2017 will offer opportunities to seek further improvements to the QPP. As it has over the last 18 months, the AMA will seek to forge consensus across medicine on recommendations to improve the new Medicare payment system.

And, importantly, the AMA will continue its efforts to provide physician practices with the information and tools that will help them participate successfully in the QPP. Visit the AMA MACRA resource page for information about upcoming webinars and regional seminars, links to instructional podcasts and websites, and for access to our Payment Model Evaluator tool.

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National Update

Physicians back steps toward value-based drug pricing

Value-based pricing has the potential to reduce prescription drug spending in the U.S. within view of recent spikes in drug prices directly affecting patients, the AMA House of Delegates looks to address increases by adopting new guiding principles to support value-based prescription drug pricing.

Prescription drug spending was $457 billion in 2015, accounting for 16.7 percent of spending on personal health care services, according to the Department of Health and Human Services (HHS). Of that, 71.9 percent was for retail drugs at outlets that serve patients directly and 28.1 percent was for nonretail drugs.

Based on the results of a report of the AMA Council on Medical Service, delegates reaffirmed several existing AMA policies. Some support the use of value-based insurance design that could determine patient cost-sharing requirements based on the clinical value of treatment. Others establish guidelines to help maximize opportunities for clinical data registries to enhance the quality of care provided to patients.

Delegates also adopted new policy outlining principles to guide the support of value-based pricing programs, initiatives and mechanisms for pharmaceuticals.

Read more at AMA Wire®.

AMA joins call for action to stem tide of gun violence

The AMA has joined an advocacy effort, started by leading organizations representing physicians, public health professionals and attorneys, aimed at reducing gun-related deaths and injuries.

The "call to action," published in 2015 in Annals of Internal Medicine, seeks the elimination of so-called gun-gag laws that bar physicians from asking their patients about gun ownership and storage. The document, which the AMA House of Delegates endorsed at its 2016 Interim Meeting in Orlando, Fla., also opposes laws that mandate blanket reporting of "patients who are displaying signs that they might cause serious harm to themselves or others may have unintended consequences." Such statutes can "stigmatize persons with mental or substance use disorders, create a disincentive for them to seek treatment, and undermine the patient–physician relationship."

The document seeks universal background checks on gun purchases, restrictions on the sale of military-style weapons and large-capacity magazines to civilians and more research on how to cut morbidity and mortality involving firearms.

Read more at AMA Wire.

Wounded veterans deserve infertility benefits, physicians say

One of the ways we thank our veterans for their service in this country is through access to health care coverage through the Veterans Health Administration (VA). That should include assisted-reproductive technology benefits, including IVF, for those whose war injuries caused infertility, says a policy adopted at the 2016 AMA Interim Meeting.

The VA covers fertility assessments, counseling and some treatment, such as surgeries, medications and intrauterine insemination, but has not been able to provide IVF benefits under the Veterans Health Care Act of 1992. When the law was enacted, IVF was considered experimental.

New AMA policy supports lifting the ban on the VHA from covering IVF costs for veterans who have become infertile due to service-related injuries and encourages interested stakeholders to collaborate in lifting the ban.

Read more at AMA Wire.

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State Update

Opioid crisis needs training emphasis in GME

The AMA House of Delegates adopted policy to expand residency and fellowship training opportunities so that trainees can gain clinical experience in the treatment of opioid use disorders.

The Centers for Disease Control and Prevention (CDC) recently announced that drug overdose deaths reached an unprecedented 14.7 per 100,000 in 2014, with 61 percent of deaths involving some form of opioid.

In the wake of these sobering statistics, delegates adopted policy to encourage the expansion of residency and fellowship training opportunities to provide clinical experience in the treatment of opioid use disorders under the supervision of an appropriately trained physician.

Read more at AMA Wire.

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Other News

As care team leaders, physicians should set right tone

The AMA has adopted new policy that lays out the ethical obligations that physicians have to lead and participate in the team-based care model that research shows can improve health care quality and patient outcomes, enhance care access and slow the rate of medical spending while reducing burnout among health professionals.

Read more at AMA Wire.

High-quality mHealth apps can be blended into care

The AMA adopted a wide-ranging set of policies designed to help integrate the burgeoning field of mobile health applications and devices—dubbed mHealth—into clinical practice.

In its action, the AMA says that principles are needed to guide insurance coverage and payment decisions for mHealth apps, devices, trackers and sensors for use by patients, physicians and other health professionals.

Read more at AMA Wire.

Now Live: Newly Redesigned AMA Website and AMA Wire

To better meet physicians' needs at every stage of their life and career, the AMA redesigned its website and AMA Wire to offer improved user experience and relevant content.

Both the website and Wire are powerful touch points between the AMA and its core stakeholders to advance their shared mission of improving the health of the nation. The AMA worked tirelessly with physicians and physicians-in-training during this endeavor to design an improved digital experience.

The primary features of the AMA's redesigned website are:

The primary features of the redesigned AMA Wire are:

The AMA will continue working to ensure both platforms continue to provide the trusted resources and information you need.

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Upcoming Events

Nov. 21 and Dec. 6: MACRA Educational Webinars
The AMA will host two educational webinars to help physicians prepare for the new Medicare Quality Payment Program created by MACRA. Both sessions will cover the same material. Registration is open for the first webinar, which is tonight, Nov. 21, 7 p.m. EST, and the second webinar on Dec. 6, 8 p.m. EST. Physicians and medical society staff are welcome.

Dec. 1: MACRA Regional Seminar, Atlanta
The Medical Association of Georgia, the Medical Association of Atlanta, the Cobb County Medical Society and the DeKalb Medical Society invite physicians and medical staff to attend an educational session to help physicians understand what the Medicare Access and CHIP Reauthorization Act final rule means for their practices and what they need to do as part of the new Medicare Quality Payment Program. It will be held at Cobb Galleria Centre, Two Galleria Parkway, at 6:30 p.m. EST. The seminar is also available to stream or by webinar. Register and learn more.

Dec. 10: MACRA Regional Seminar, San Francisco
The AMA and California Medical Association will host an educational seminar similar to the Atlanta seminar, to be held at the Marriott Marquis, Nob Hill Ballroom, 780 Mission St., 9:30 a.m. PST. This seminar is also available to stream or via webinar. Register and learn more.

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