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Grassroots Newsletter

Fall/Winter 2017

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In this newsletter:

Key Issue Update: Observation

Support Advance Care Planning

SHM Position on IPAB Repeal

Save the Date: Grassroots Calls

Key Issue Update: Observation

The Society of Hospital Medicine (SHM) Public Policy Committee published a new white paper calling on policymakers to eliminate hospital outpatient observation status in its current form. In reviewing the current state of policy and listening to the perspectives of front-line hospitalists, SHM believes observation policy has strayed far from its original intent and is in need of significant reform.

In the new white paper, SHM includes perspectives from members on how observation impacts their practice. The sentiment was resoundingly clear: Observation in general, the 2-midnight rule, and NOTICE impede efficiency, strain the doctor-patient relationship, confuse patients in an already stressful situation, and likely reduce patient/provider satisfaction, while adding nothing to patient care.

The white paper lays out both short, (helping patients gain access to necessary SNF coverage,) and long-term solutions, (a complete overhaul of observation as we know it). With this white paper, SHM and its membership will continue to advocate for meaningful reforms to observation care policies with Congress and Medicare.

Read a copy of the white paper.

What next?

In October, the PPC brought copies of the white paper to key Congressional offices on the Hill, and asked them to do more on observation. By supporting Rep. Joe Courtney’s (D-CT-3) Improving Access to Medicare Coverage Act, legislators could ensure that more Medicare beneficiaries get the right care in the right setting without fear of financial strain by counting observation time towards Skilled Nursing Facility (SNF) coverage requirements. We have supported this bill in the past, and will continue to ask Congress to move on this, and other bills that will improve observation policies. Join us by asking your member of Congress to co-sponsor Rep. Courtney’s bill.

More importantly, PPC members have been actively educating Congress that observation has not yet been solved, even with recent legislative and regulatory changes. They left a clear reminder that hospitalists would like to partner with Congress to work on more comprehensive fixes to this broken policy. Hospitalists are the primary caregivers of patients receiving observation care, and as such, SHM will continue to advocate for comprehensive reform and reasonable solutions.

Reminder: Video Resource from SHM on Observation

Earlier this year, SHM put together a video resource for members on talking with patients about observation. The video goes hand-in-hand with the implementation of the NOTICE Act requirements for notifying patients when they are receiving observation care. If you or your hospital would like to use this video in a wider manner with your hospital staff or patients, please contact SHM.


Support Advance Care Planning

On September 20th, SHM came out in support of the Medicare Choices Empowerment and Protection Act. This legislation aims to incentivize Medicare beneficiaries to take control of their end of life care decisions by offering a payment for filing an advance directive outlining desired treatments. For SHM, this concept isn’t about the payment per se, but that payment will in turn raise patient awareness of the need and importance of being proactive in making advance care plans. By encouraging beneficiaries to make these decisions, hospitalists and other providers will be able to provide care with greater certainty and efficacy.

Join SHM in asking Congress to pass this important legislation. Send a message to your Congress members today.


SHM Position on IPAB Repeal

Under the ACA, the Independent Payment Advisory Board (IPAB) is responsible for submitting recommendations to Congress to slow the growth of national health care expenditures using a spending target system and a fast track legislative approval process. The IPAB’s recommendations come into play if Medicare’s projected average growth rate in per capita spending exceeds a specified target. IPAB recommendations must be enacted unless an alternate plan to achieve the same savings is approved by a three-fifths Congressional majority.

Considering recent Congressional interest in repealing the IPAB, SHM developed the following statement in support of repeal:

SHM believes the future sustainability of the Medicare Trust Fund will require changes to directly address the growth in Medicare spending.  However, the IPAB, as established by the Affordable Care Act (ACA), is an unaccountable body that would force spending cuts without any safeguards in place to ensure that such cuts wouldn’t be to the detriment of patient care. Rather than selectively targeting inefficiencies or finding better ways to deliver care, the IPAB mechanism would target provider payments for cuts, potentially resulting in a negative impact on Medicare beneficiaries’ access to care and disrupting reform efforts that are already underway. As such, SHM supports efforts to repeal the IPAB.


Save the Date: Grassroots Calls

As we mentioned in our recent newsletters and emails, the Grassroots Network is expanding to include more engagement opportunities for members. On August 31st, SHM staff and the new Chair of the Grassroots Network, Melinda Johnson, MD, SFHM, held the first Grassroots Call where we discussed new engagement opportunities, such as more frequent calls and updates, and brought the Network up to date on what SHM policy work is being done. We will be hosting the next Grassroots Call on December 7, 2017 at 3:30 PM (ET). Please mark your calendar and register today.

We look forward to improving and expanding our Grassroots Network and hearing from you all on a more frequent basis. Contact Us if you have suggestions on how we can improve.