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ACP, AMA Renew Vow to Champion Medicare Payment Reform

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At most recent meeting, House of Delegates urged AMA to increase awareness of Medicare payment reform and voted against specialty switching among NPs and PAs

July 12, 2024 (ACP) -- Medicare physician payment reform took center stage once again at this year's American Medical Association House of Delegates Annual meeting.

The House of Delegates is the legislative and policy-making body of the AMA. This year's annual meeting was held June 7 to 12, 2024.

Specifically, the House of Delegates directed the AMA to increase awareness about the need for Medicare payment reform in the media, in the general public and among physicians. To increase awareness, the delegates suggested revving up the Fix Medicare Now campaign with ads on podcasts, Facebook, Instagram, X and LinkedIn and at train stations, bus shelters, digital billboards, and rideshare and urban panels in Washington, D.C., before the November elections.

In other efforts to encourage Medicare physician payment reform, the House of Delegates amplified calls to eliminate budget neutrality. This policy requires any increase in the relative expenditures in one area of the Medicare program to be offset by cuts in other areas. The House of Delegates also pushed for passage of bipartisan legislation that would provide physicians with an annual, permanent inflationary payment update in Medicare tied to the Medicare Economic Index.

"There is movement on Medicare payment reform in the Senate Finance Committee, and we have to keep this issue top of mind," said Dr. Sue Bornstein, chair of the ACP AMA delegation. Medicare payment reform is directly tied to another critical advocacy issue: patient access. Without reform, the physician supply will continue to dwindle, she noted.

Another hot-ticket issue at the meeting was the ongoing efforts to curtail scope of practice expansion. The House of Delegates voted against specialty switching among nurse practitioners (NPs) and physician assistants (PAs) and urged hospitals and other employers to ensure that certification aligns with the specialty in which a person practices. They also voted to continue supporting expanding access to physicians in under-resourced areas, which can help decrease scope expansion by NPs and PAs.

The AMA will also lobby for an indefinite extension of Medicare reimbursement for telemedicine services and plans to fight the date that Medicare will cease reimbursement for these services, which is scheduled to occur on Dec. 31, 2024.

ACP, which now has the largest delegation in the AMA House of Delegates, cosponsored three resolutions at the meeting, and they all passed, according to Bornstein.

The "Support for Physicians Pursuing Collective Bargaining and Unionization" resolution urged the AMA to study opportunities for the AMA or physician associations to support physicians initiating a collective bargaining process, including unionization. "As more and more physicians are employed in private equity-backed practices, they have less ability to make decisions for themselves, and we asked AMA to study this and help provide solutions," Bornstein said.

ACP also cosponsored a resolution seeking to improve access to water for federally recognized American Indian and Alaska Native Tribes and Villages. A third resolution, "Improving Supplemental Nutrition Programs," called for extending multi-eligibility for the U.S. Department of Agriculture Food Assistance to enrolled members of federally recognized American Indian and Alaska Native Tribes and Villages to all federal feeding programs, including SNAP and the Food Distribution Program on Indian Reservations.

Every ACP member can help with advocacy issues, Bornstein said, adding: "Pay attention to the policy process, and if you have a concern or idea about a policy, bring it to your chapter, and your chapter can help bring it forward to the House of Delegates or other bodies."

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Back to the July 12, 2024 issue of ACP Advocate