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Partners in Advocacy ACS Fellows and The ACS Washington Office 2013 Wisconsin State Chapter Meeting. I don't make jokes. I just watch the government and report the facts. -- Will Rogers. ACS Division of Advocacy & Health Policy. Medical Director Vacant. Christian Shalgian, Director.

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Partners in AdvocacyACS Fellows and The ACS Washington Office2013 Wisconsin State Chapter Meeting



Acs division of advocacy health policy
ACS Division of Advocacy & Health Policy the facts.

Medical Director

Vacant

Christian Shalgian,

Director

Dr. Frank Opelka,

Associate Medical Director

Health Policy Fellow

Bob Jasak,

Deputy Director

D’Arcey Johnson,

Office Administrator

John Hedstrom,

Deputy Director

Jon Sutton

Manager,

State Affairs

Vinita Ollapally,

Sr. Regulatory

Associate

Jill Sage,

Sr. Quality

Associate

Jenny Jackson,

Practice Affairs Associate

Sana Gokak,

Quality Associate

Sarah Kurusz,

Quality/Regulatory

Assistant

Kelly Wilkins,

Staff Assistant

Kristin McDonald,

Senior Government Affairs

Associate

Matthew Coffron,

Government

Affairs Associate

Heather Smith,

Government Affairs

Associate

VACANT,

Legislative Asst.

Tara Leystra,

State Affairs

Associate

Justin Rosen,

State Affairs

Associate

Sara Morse,

PAC Manager

(ACSPA)


SEQUESTER! the facts.

Great for Scrabble, horrible for budgeting






We stand today at a crossroads. One path leads to despair and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

Woody Allen


Sgr legislation a comparison
SGR Legislation – A Comparison and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Sgr repeal concerns
SGR Repeal Concerns and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Sgr legislation a comparison1
SGR Legislation – A Comparison and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Value based program concerns
Value-Based Program Concerns and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Sgr legislation a comparison2
SGR Legislation – A Comparison and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Alternative payment model concerns
Alternative Payment Model Concerns and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Sgr legislation a comparison3
SGR Legislation – A Comparison and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


Valuation of services concerns
Valuation of Services Concerns and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.


ACS Proposed Solution and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.The Value Based Update (VBU)

  • The fusion of ACS’s 100 years of quality experience and physician payment system

  • Improved, high quality care, shared savings, and resultant cost reduction

  • The Clinical Affinity Group (CAG)

    • Breaking down physician silos of care

    • A group of physicians and providers who care for a specific condition, disease or patient population.

    • CAGs are the core of this proposal, and might include categories such as cancer care, surgery, cardiac care, frail elderly/end of life, digestive diseases, women’s health, rural and primary care/chronic care.

    • designed to account for regional variations in the provision of care

    • patient-oriented, outcomes-based, risk-adjusted quality measures designed to foster continuous improvement and help lower costs.


PQRS and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

Physician Level Payment Adjustments

EHR Meaningful Use

Registries??

Inflationary MEI Update

(0% - 3%)

(application determined by All-CAG Performance Score)

Program Level Payment Adjustments

High Risk Population

(e.g. frail elderly)

(-.5% to 1.5%)

Geographic

(e.g. Rural)

(-.5% to 1.5%)

Disease

(e.g. Cardiac, Cancer, Digestive)

(-.5% To 1.5%)

Clinical Affinity Group (CAG) Payment Adjustment

Based on 50/50 National/Local blend. Local performance based on Hospital Referral Regions (HRRs)

Women’s Health

(-.5% to 1.5%)

Dual Eligibles

(-.5% to 1.5%)

Primary Care Chronic Care

(-.5% To 1.5%)


The VBU and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

Further Development

  • Contracted with group from Brigham & Women’s Hospital and Brandeis University to further evaluate, develop CAG models, and score the VBU concept

    • Focus Groups with wide range of individual physicians

  • CAG Target Domains

    • Prevention, Quality, Safety, Patient experience, Resource Use/Cost

    • Not all need to be accounted for in a CAG

  • Example - Cardiovascular CAG

    • Diabetes Control, PCI/CABG Outcomes, Adverse drug events, H-CAHPS/S-CAHPS, ECHO appropriateness

  • Example – Prevention/Chronic Care CAG

    • Cancer Screening/Immunization, CHF Post-discharge care coordination, Drug reconciliation measures, C&G-CAHPS, Care coordination


The VBU and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

Complicated Issues

  • Accounting for all specialties and primary care

  • Value-Based Modifier – Should it fit? Where does it fit?

  • Voluntary Participation?

    • Designed so that penalties for non-VBU compliant physicians bear greater risk

  • HOWEVER, an initial report found that between 2014-2018:

    • Physician payments (incentive-based) increased $6.4 billion

    • Indirect reduction to Parts A and B totaled $15.77 billion

    • Net reduction of $9.355 billion in Parts A and B


Acspa surgeons voice
ACSPA- and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.SurgeonsVoice

Cutting Edge AdvocacyAn on-going, organized program of recruiting, educating, and motivating members to use their political power to advocate and influence.


Program and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.Components

  • Health Policy Advisory Council –Grassroots Committee

    • Region Chiefs and State Councilors

  • SurgeonsVoice Online Platform

  • SurgeonsVoice DOCS Program

    (District Office Contacts by Surgeons)

  • SurgeonsVoice Practice Tours

  • SurgeonsVoice at Advocacy Summit

  • SurgeonsVoice Recognition Program


Surgeons and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.Voice: Cutting Edge Advocacy

  • Purpose: United surgical voice influencing

    health policy

  • Goals: Educate, Advocate, Motivate

  • Participants: Leadership, Fellows, Residents

    • Committees and Councils of the ACS

  • Benefits: Broad-based, diversified, lifelong advocates


    • One Councilor and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.from each chapter

    • Responsible for fostering an extensive grassroots advocacy network throughout their chapter

    • Advocacy experts who promote grassroots and political advocacy among their peers

    • Communicate feedback from surgeons on the ground on legislative and regulatory policy and implementation, back to the Division of Advocacy and Health Policy.

    Health Policy Advisory Council

    Councilors


    • R and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.outinely meet with Representative and Senators in state district offices during House and Senate recesses (“in-district work periods”)

    • Advocate on issues critical to surgery

    • Foster lasting relationships between participating surgeons and members of Congress

    • Become knowledgeable and trusted resources on healthcare policy for elected officials

    DOCS Program

    District Office Contacts by Surgeons


    Platform and Program Tools and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

    www.surgeonsvoice.org


    Advocacy and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.Toolkit

    One Stop Shopping


    Additional resources
    Additional Resources and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

    • Take Action: Contact your Elected Officials

    • Share Your Story

    • Key Contact Survey

    • Interactive Map

    • Events Calendar

    • And More…


    Recap how can you get involved
    Recap: How and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.Can You Get Involved?

    Visit and use www.SurgeonsPac.org

    Visit and use www.SurgeonsVoice.org

    Become an Advocacy Councilor

    Join the DOCS Program

    Save the date: ACS Advocacy Summit– March 30-April 1, 2014

    Respond to Grassroots Action Alerts

    Host a fundraiser, facility tour, or PAC check delivery for your Congressmen.

    Get your colleagues involved!!


    Thank and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice. You

    You all deserve a drink


    We in America do not have government by the majority. and utter hopelessness. The other leads to total extinction. Let us hope we have the wisdom to make the right choice.

    We have government by the majority who participate.

    - Thomas Jefferson

    Thank you

    John E. Hedstrom, JD

    [email protected]

    202-672-1503


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