2011 national orthopaedic leadership conference. welcome to the nolc
TRANSCRIPT
2011 National Orthopaedic 2011 National Orthopaedic Leadership ConferenceLeadership Conference
Welcome to the NOLCWelcome to the NOLC
The 2010 Election: House of Representatives
111th Congress Democrats: 257
Republicans: 178
112th CongressDemocrats:
193
Republicans: 242
The 2010 Election: Senate
111th CongressDemocrats: 56/2Republicans: 42
112th Congress Democrats:
51/2
Republicans: 47
112th Congress Tea Party Tea Party
53 House53 House 4 Senate4 Senate
Jim DeMint (SC) Jim DeMint (SC) Rand Paul, MD (KY) Rand Paul, MD (KY) Mike Lee (UT)Mike Lee (UT) Jerry Moran (KS)Jerry Moran (KS)
Blue Dogs - 22/46 lostBlue Dogs - 22/46 lost Retiring Senators - Retiring Senators - Daniel Akaka (D-HI) Jeff Bingaman (D-Daniel Akaka (D-HI) Jeff Bingaman (D-
NM), Kent Conrad (D-ND), John Ensign (R-NV), Kay Bailey NM), Kent Conrad (D-ND), John Ensign (R-NV), Kay Bailey Hutchison (R-TX), Jon Kyl (R-AR), Joe Lieberman (I-CT), Hutchison (R-TX), Jon Kyl (R-AR), Joe Lieberman (I-CT), Jim Webb (D-Va.)Jim Webb (D-Va.)
Hill Visit 101 Before your meeting:Before your meeting: Map out the meetingMap out the meeting Review talking pointsReview talking points Bring your materialsBring your materials
Getting there:Getting there: 10 min. between buildings10 min. between buildings 20 min. between House and Senate20 min. between House and Senate Running late: Call the office immediately!Running late: Call the office immediately!
Hill Visit 101
When you arrive:When you arrive: Check in with the staff assistantCheck in with the staff assistant Sign the guest bookSign the guest book Bring and be sure to give staff or Bring and be sure to give staff or
member/Senator your business cardsmember/Senator your business cards
Hill Visit 101
Meeting Basics:Meeting Basics: Usually short about 15 minutesUsually short about 15 minutes Build a relationshipBuild a relationship Be flexible!Be flexible! Stay on messageStay on message Follow upFollow up
When Meeting with Staffers:
Try to establish a relationshipTry to establish a relationship Where are they from (from the district?)Where are they from (from the district?)
Judge if they are aware of the issuesJudge if they are aware of the issues Ask how long they have been working Ask how long they have been working
for the Congresspersonfor the Congressperson If staffer is experienced, then go more in If staffer is experienced, then go more in
detail about issues and answer any detail about issues and answer any questionsquestions
Hill Visit Materials Congressional leave behindsCongressional leave behinds
Blue AAOS foldersBlue AAOS folders One pagersOne pagers
NOLC Participant PacketsNOLC Participant Packets Lapel CardLapel Card Congressional DirectoriesCongressional Directories Congressional MapsCongressional Maps One pagersOne pagers
2011 NOLC Issues
The AAOS Act of 2011
AAOS Advocacy Issues The AAOS Act of 2011
The AAOS Act of 2011 Aims to The AAOS Act of 2011 Aims to Increase Knowledge and Awareness Increase Knowledge and Awareness
of Musculoskeletal Diseases. of Musculoskeletal Diseases.
Musculoskeletal Conditions:Musculoskeletal Conditions: Leading cause of disability in the USLeading cause of disability in the US Greatest cause of total lost work days and Greatest cause of total lost work days and
medical bed daysmedical bed days Affect 1 in 4 AmericansAffect 1 in 4 Americans Affect more than one-half of people over 50Affect more than one-half of people over 50 Cost US more over $849 billion annuallyCost US more over $849 billion annually
AAOS Advocacy Issues The AAOS Act of 2011
AAOS Act of 2011 will:AAOS Act of 2011 will: Provide reports to Congress on funds given Provide reports to Congress on funds given
for researchfor research Collect data on new investigatorsCollect data on new investigators Identify existing trauma care initiativesIdentify existing trauma care initiatives
AAOS Advocacy Issues The AAOS Act of 2011
AAOS Advocacy Issues The AAOS Act of 2011
AAOS Act of 2011 will:AAOS Act of 2011 will: Promote treatment of musculoskeletal Promote treatment of musculoskeletal
diseases across various populations diseases across various populations Urge Office of Minority Health to consider Urge Office of Minority Health to consider
musculoskeletal conditions a prioritymusculoskeletal conditions a priority
AAOS Advocacy Issues The AAOS Act of 2011
AAOS Act of 2011 will:AAOS Act of 2011 will: Promote bone health initiatives among Promote bone health initiatives among
adolescent girlsadolescent girls Take steps to reduce disease burden among Take steps to reduce disease burden among
children and elderlychildren and elderly
AAOS Advocacy Issues The AAOS Act of 2011
Congressional Ask:Congressional Ask:
Support specialty care and co-sponsor Support specialty care and co-sponsor the Access to America’s Orthopaedic the Access to America’s Orthopaedic Services (AAOS) Act Services (AAOS) Act
Integration of Clinical Services
AAOS Advocacy Issues Integration of Clinical Services
Stark Law contains in-office ancillary services Stark Law contains in-office ancillary services (IOAS) exception (IOAS) exception
IOAS exception:IOAS exception:• Improves patient careImproves patient care• Improves coordination among providersImproves coordination among providers• Ensures greater patient adherence to treatment Ensures greater patient adherence to treatment
plansplans
AAOS Advocacy Issues Integration of Clinical Services
Benefits of integrated clinical services: Benefits of integrated clinical services: Timely initiation and continuity of careTimely initiation and continuity of care Sharing patient/case information among Sharing patient/case information among
providers (knowledge spillover)providers (knowledge spillover) Successful models of integration include Successful models of integration include
ambulatory surgical centers and physician owned ambulatory surgical centers and physician owned hospitals.hospitals.
AAOS Advocacy Issues Integration of Clinical Services
Recent attention on increase in utilization of Recent attention on increase in utilization of ancillary services ancillary services
Two factors affect recent increase in use:Two factors affect recent increase in use:• Patients more educated about health care Patients more educated about health care
choiceschoices• Patient demand increases provision of Patient demand increases provision of
ancillary servicesancillary services
AAOS Advocacy Issues Integration of Clinical Services
Reports suggesting IOAS exception is a Reports suggesting IOAS exception is a main driver of increased utilization are main driver of increased utilization are misleadingmisleading
There is no research that has shown that There is no research that has shown that the increase in the volume of ancillary the increase in the volume of ancillary services provided by physicians is services provided by physicians is related to physician ownership.related to physician ownership.
AAOS Advocacy Issues Integration of Clinical Services
Allows surgeons to manage patient treatment from Allows surgeons to manage patient treatment from start to finishstart to finish
Key component of Congressional and Key component of Congressional and Administration effortsAdministration efforts
AAOS Advocacy Issues Integration of Clinical Services
Congressional Ask:Congressional Ask:
Enact policies to encourage the integration of clinical Enact policies to encourage the integration of clinical servicesservices
Cosponsor H.R. 1159 to repeal the provisions of the Cosponsor H.R. 1159 to repeal the provisions of the Patient Protection and Patient Protection and Affordable Care Act that restrict the establishment Affordable Care Act that restrict the establishment and growth of specialty hospitals.and growth of specialty hospitals.
Independent Payment Advisory Board (IPAB)
AAOS Advocacy Issues Repeal of the Independent Payment Advisory
Board (IPAB)
Panel devised by PPACA will make choices on Panel devised by PPACA will make choices on Medicare spendingMedicare spending
Limits congressional authority and transparencyLimits congressional authority and transparency
AAOS committed to providing cost efficient AAOS committed to providing cost efficient quality carequality care
AAOS Advocacy Issues Repeal of the Independent Payment Advisory
Board (IPAB)
IPAB Membership:IPAB Membership: 15 members appointed solely by the President15 members appointed solely by the President Fewer than half of the IPAB members can be Fewer than half of the IPAB members can be
health care providershealth care providers No IPAB member can be otherwise employedNo IPAB member can be otherwise employed
AAOS Advocacy Issues Repeal of the Independent Payment Advisory
Board (IPAB)
Cuts based on unrealistic spending targetsCuts based on unrealistic spending targets IPAB recommendations automatically go into IPAB recommendations automatically go into
effect unless blocked or amended by Congresseffect unless blocked or amended by Congress Over 1/3 of providers exempt from IPAB cuts Over 1/3 of providers exempt from IPAB cuts
until 2020 until 2020 With SGR, physicians could be subjected to the With SGR, physicians could be subjected to the
piling on of two different cutspiling on of two different cuts
AAOS Advocacy Issues Repeal of the Independent Payment Advisory
Board (IPAB)
IPAB threatens the ability of IPAB threatens the ability of Representatives in Congress to ensure Representatives in Congress to ensure
access to health careaccess to health care
AAOS Advocacy Issues Repeal of the Independent Payment
Advisory Board (IPAB)
Congressional Ask:
Cosponsor H.R. 452, the Medicare Cosponsor H.R. 452, the Medicare Decisions Accountability Act, to repeal the Decisions Accountability Act, to repeal the IPABIPAB
Current Cosponsors of H.R. 452 as of 3/22/11Current Cosponsors of H.R. 452 as of 3/22/11Rep Akin, W. ToddRep Akin, W. Todd Rep Benishek, Dan Rep Blackburn, Marsha Rep Broun, Paul C. Rep Burgess, Michael C. Rep Capuano, Michael E. Rep Coble, Howard Rep Coffman, Mike Rep Conaway, K. Michael Rep Crawford, Eric A. "Rick" Rep Duncan, John J., Jr. Rep Ellmers, Renee L. Rep Fitzpatrick, Michael G. Rep Flake, Jeff Rep Fleming, John Rep Flores, Bill Rep Frelinghuysen, Rodney P. Rep Gingrey, Phil Rep Gosar, Paul A.Rep Griffith, H. Morgan Rep Grimm, Michael Rep Hall, Ralph M. Rep Hayworth, Nan A. S.Rep Thompson, GlennRep Thompson, Glenn Rep Tiberi, Patrick J.
Rep Heck, Joseph J. Rep Hunter, Duncan D. Rep Jones, Walter B., Jr. Rep Kissell, Larry Rep Lamborn, Doug Rep Latta, Robert E. Rep Long, Billy Rep Marino, Tom Rep McClintock, Tom Rep McCotter, Thaddeus G. Rep McKinley, David B. Rep Miller, Gary G. Rep Miller, Jeff Rep Murphy, Tim Rep Neugebauer, Randy Rep Nunnelee, Alan Rep Paul, Ron Rep Pearce, Stevan Rep Posey, BillRep Rohrabacher, Dana Rep Rooney, Thomas J. Rep Schock, Aaron Rep Sessions, Pete Rep Wilson, Joe Rep Wilson, Joe
Rep Westmoreland, Lynn A. Rep Westmoreland, Lynn A.
Medical Liability Reform
AAOS Advocacy Issues Medical Liability Reform
The Hostile Medical Litigation Climate:The Hostile Medical Litigation Climate: Encourages practice of defensive medicineEncourages practice of defensive medicine Emergency Medical Treatment and Labor Act Emergency Medical Treatment and Labor Act
(EMTALA) puts surgeons at risk (EMTALA) puts surgeons at risk Raises health care costsRaises health care costs
AAOS Advocacy Issues Medical Liability Reform
Rising Insurance Premiums:Rising Insurance Premiums: Liability insurance has increased through the yearsLiability insurance has increased through the years Some states and specialties have more dramatic Some states and specialties have more dramatic
increasesincreases Tort reform would save the government $62 Tort reform would save the government $62
billion over 10 years billion over 10 years
AAOS Advocacy Issues Medical Liability Reform
Congress should pass legislation that:Congress should pass legislation that: Includes time tested, reasonable limits on non-Includes time tested, reasonable limits on non-
economic damages such as successful reforms in economic damages such as successful reforms in California and Texas.California and Texas.
Protects physicians volunteering services in disaster Protects physicians volunteering services in disaster or emergencyor emergency
Applies Federal Tort Claims Act to cases involving Applies Federal Tort Claims Act to cases involving EMTALA-mandated servicesEMTALA-mandated services
AAOS Advocacy Issues Medical Liability Reform
Congress should pass legislation that:Congress should pass legislation that: Directly explores medical liability alternativesDirectly explores medical liability alternatives Makes clear no new cause of legal action was Makes clear no new cause of legal action was
created in PPACAcreated in PPACA Fully funds $50 million liability grant program Fully funds $50 million liability grant program
and prevents plaintiffs from opting out of program and prevents plaintiffs from opting out of program once enrolledonce enrolled
More About the Grant Program The planning grants for the Patient Safety and The planning grants for the Patient Safety and
Medical Liability Initiative give States and health Medical Liability Initiative give States and health systems the opportunity to create detailed plans for systems the opportunity to create detailed plans for patient safety and medical liability reform. patient safety and medical liability reform.
AHRQ funded 13 planning grants for $3.5 million.AHRQ funded 13 planning grants for $3.5 million. These grants represent a variety of models that meet These grants represent a variety of models that meet
one or more of the patient safety and medical liability one or more of the patient safety and medical liability reform goals. reform goals.
The Planning Grants Include: The development of a "safe harbor" for physicians The development of a "safe harbor" for physicians
who can prove they followed State-endorsed evidence-who can prove they followed State-endorsed evidence-based care guidelinesbased care guidelines
Shared decision-makingShared decision-making Early disclosure and offer models-which inform Early disclosure and offer models-which inform
injured patients and families promptly, and make injured patients and families promptly, and make efforts to provide prompt compensation.efforts to provide prompt compensation.
Transparency and enhanced communication between Transparency and enhanced communication between providers and patients when avoidable injuries occur.providers and patients when avoidable injuries occur.
AAOS Advocacy Issues Medical Liability Reform
Congressional Ask:Congressional Ask: Co-sponsor H.R. 5 and S.218, the Help Co-sponsor H.R. 5 and S.218, the Help
Efficient, Accessible, Low-Cost, Timely Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act of 2011Healthcare (HEALTH) Act of 2011
Current Cosponsors of H.R. 5 as of 3/22/11Current Cosponsors of H.R. 5 as of 3/22/11Rep Akin, W. Todd Rep Alexander, Rodney Rep Austria, Steve Rep Bass, Charles F. Rep Benishek, Dan Rep Biggert, Judy Rep Bilbray, Brian P. Rep Bishop, Rob Rep Black, Diane Rep Blackburn, Marsha Rep Bono Mack, Mary Rep Boustany, Charles W., Jr. Rep Brady, Kevin Rep Buchanan, Vern Rep Bucshon, Larry Rep Burton, Dan Rep Calvert, Ken Rep Canseco, Francisco "Quico" Rep Capito, Shelley Moore Rep Coffman, Mike Rep Cole, Tom Rep Conaway, K. Michael Rep Crawford, Eric A. "Rick" Rep Crenshaw, Ander Rep Dent, Charles W. Rep Dold, Robert J. Rep Rogers, Mike J.
Rep Gerlach, Jim Rep Gibbs, Bob Rep Gosar, Paul A. Rep Graves, Sam Rep Grimm, Michael G.
Rep Ellmers, Renee LRep Fitzpatrick, Michael G. Rep Fleming, John Rep Flores, Bill Rep Forbes, J. Randy Rep Franks, Trent Rep Gallegly, Elton Rep Garrett, Scott
Rep Miller, Gary G. Rep Miller, Jeff Rep Myrick, Sue Wilkins Rep Neugebauer, Randy Rep Olson, PeteRep Pearce, Stevan Rep Platts, Todd Russell Rep Price, Tom Rep Quayle, Benjamin Rep Reed, Tom Rep Roe, David P. Rep Rogers, Harold [ [
Rep Guinta, Frank C.Rep Guinta, Frank C. Rep Guthrie, Brett Rep Harper, Gregg Rep Harris, Andy Rep Heller, Dean Rep Herger, Wally Rep Huelskamp, Tim Rep Huizenga, Bill Rep Issa, Darrell E.Rep Johnson, Bill Rep Jones, Walter B., Jr. Rep Kinzinger, Adam Rep Kline, John Rep Lamborn, Doug Rep Latham, Tom Rep Latta, Robert E. Rep Luetkemeyer, Blaine Rep Manzullo, Donald A. Rep Marchant, Kenny Rep Marino, Tom Rep Matheson, Jim Rep McClintock, Tom Rep McKinley, David B. Rep McMorris Rodgers, Cathy
Current Cosponsors of H.R. 5 ctd…Current Cosponsors of H.R. 5 ctd… Rep Rohrabacher, Dana
Rep Ross, Dennis Rep Royce, Edward R. Rep Scalise, Steve Rep Schock, Aaron Rep Scott, David Rep Sessions, Pete Rep Shimkus, John Rep Shuster, Bill Rep Simpson, Michael K. Rep Smith, Lamar Rep Stearns, Cliff Rep Tiberi, Patrick J. Rep Tipton, Scott Rep Turner, Michael R. Rep Walberg, Tim Rep Walden, Greg Rep Walsh, Joe Rep Westmoreland, Lynn A. Rep Wilson, Joe Rep Wittman, Robert J. Rep Wolf, Frank R. Rep Woodall, Rob Rep Young, C.W. Bill
Current Cosponsors of S. 218Current Cosponsors of S. 218Sen Blunt, Roy Sen Blunt, Roy Sen Kirk, Mark Steven Sen Kirk, Mark Steven
RESPONSIBLY REDUCING COSTS The AAOS has been a committed partner in The AAOS has been a committed partner in
patient safety, cultural competency, and providing patient safety, cultural competency, and providing high quality health care. high quality health care.
The AAOS currently develops clinical practice The AAOS currently develops clinical practice guidelines and appropriate use criteria; we guidelines and appropriate use criteria; we initiated and are a partner in the American Joint initiated and are a partner in the American Joint Replacement Registry (AJRR); and, we have Replacement Registry (AJRR); and, we have published a primer to help educate orthopaedic published a primer to help educate orthopaedic surgeons on issues related to ACOs.surgeons on issues related to ACOs.
Tips to Remember
“We in America do not have government by the majority. We have government by
the majority who participate.” - Thomas Jefferson
