AGS Expands Efforts to Reform Public Policy
Public policy has the potential to profoundly affect clinical care, especially care for older Americans—the majority of whom have healthcare coverage through Medicare. Consider the findings of a recent American Medical Association (AMA) survey of 9000 physicians. Nearly half (45%) said a 10% cut in Medicare payments to healthcare providers that’s mandated for 2008 would force them to see fewer, or stop seeing any, new Medicare patients.
As we know too well, the formula Medicare uses to determine payments to providers is seriously flawed. Known as the Sustainable Growth Rate formula, or SGR, it mandates cuts in payments whenever increases in expenditures for these services outstrip growth in gross domestic product. Each year for the last several years, Congress has blocked SGR-mandated cuts, providing a short-term fix but setting the stage for even larger cuts in subsequent years. In addition to calling on Congress to block the pending 10% cut and substitute a modest 1.7% increase, the AMA, the American Geriatrics Society (AGS), and other organizations are urging legislators to come up with a better alternative to the SGR. A recent report from the Congressional Budget Office revealed that the major determinant of the increase in Medicare spending over the past few years has been a significant increase in volume and intensity of services provided by physicians and other healthcare professionals, and not due to any changes in the Medicare payment rate to providers of geriatric medicine services. A change in the determination of payment rates is imperative.
Reforming Medicare payment policy in this and other ways clearly needs to be a top priority if geriatrics is to remain a viable field—and the growing number of older Americans are to have access to appropriate healthcare. Practice and healthcare system redesign, and public policies that create a less fragmented, more comprehensive healthcare system, are also critical.
The AGS Board of Directors recently voted to make these and several other goals, including addressing the shortage of academic healthcare professionals specializing in geriatrics and supporting research to improve healthcare design, the Society’s top public policy priorities for the coming year. This is welcome news. This list of priorities, and a slate of strategies aimed at achieving them, were developed during the AGS Annual Scientific Meeting in May and a two-day public policy planning session in March. The March session, which included AGS and Association of Directors of Geriatric Academic Programs board members and leaders involved in public policy issues, was the first of what will be annual AGS public policy planning meetings.
Over the last year, the AGS has expanded its public policy advocacy work considerably, and with it, efforts to raise public awareness of the unique value of geriatrics care. It’s crucial to do both so that legislators and their constituents realize what’s at stake here: access to care that’s tailored to the special needs of older people. Lawmakers and voters need to recognize that advocating for improved reimbursement isn’t a self-serving endeavor—it’s in everyone’s interest.
The AGS’ increased investment in public policy advocacy is already paying off. Among other things, Congress is now considering legislation—The Geriatric Assessment and Chronic Care Coordination Act (GACCCA) of 2007—that would authorize Medicare to cover geriatric assessment and care coordination for beneficiaries with multiple chronic conditions. As geriatrics care professionals, we invest a great deal of time (currently uncompensated) providing these services, which help keep our patients healthier and more independent, and prevent costly complications and hospitalizations.
The AGS worked closely with the far-sighted legislators who introduced the GACCCA and is planning a major coordinated advocacy campaign on its behalf. As busy as we all are these days, I hope you’ll join these and other efforts to influence public policy in ways that benefit our field and our patients. An easy and quick way to get involved is to visit the AGS advocacy site at www.healthinaging.org/advocacy/, and sign up to get e-mailed alerts of upcoming campaigns. Joining these campaigns takes only the time needed to type your name and address. It’s simple, and it can be very effective.
For more about the AGS top public policy priorities, visit www.americangeriatrics.org/newsletter/2007Q2/public_policy.asp.