AMGA officials stress cost of being heard in D.C.

Medical groups need to tell their stories on how federal regulations are affecting their operations and it would be helpful if the physicians in those groups contributed financially to lobbying efforts, according to speakers at the American Medical Group Association annual conference, which ended March 16 in Orlando, Fla.

While it's important to be engaged in the legislative process, Karen Ferguson, AMGA director of regulatory affairs, said that—once legislation gets passed—it's “up to the federal agencies to put the meat on the bones,” and AMGA members should participate in the public comment period of this rulemaking process.

Speaking during a session updating members on federal legislative and regulatory matters, Ferguson called the comment period “a wonderful opportunity for you with your expertise to chime in.”

But Karen Kennedy, chief development officer for USMD Holdings, an Irving, Texas-based publicly traded health system, said AMGA member contributions have to go beyond providing comments.

Kennedy, the chairwoman of the AMGA-Political Action Committee, called on the 130,000 physicians in AMGA's 430 member group practices to contribute $20 to the PAC. If the PAC received this $2.6 million infusion, she said it could do a more comprehensive push focused on moving toward a value-based healthcare system and not just “fight these little issues piecemeal one at a time.”

Kennedy distributed a letter at the conference that compared the $42,000 the AMGA PAC received to the more than $4 million and almost $2 million, respectively, the American Hospital Association and American Medical Association PACs had to work with in the last election cycle.

Kennedy and Molly Ahearn, AMGA associate director of congressional affairs, both said a focus of the group's 2013 legislative efforts will be working to insert the AMGA definition of a “high-performing system” into healthcare bills. The AMGA's stated goal behind this is to educate Congress and the CMS about the characteristics of these provider systems, such as quality measurement, team-based collaborative care and meaningful use of information technology, and to reward these systems with “greater financial and regulatory predictability.”

This includes a separate payment update from the CMS that would be higher than what other providers receive.

Garrett Eberhardt, AMGA legislative coordinator, said that, “although it's very contentious on the Hill right now,” he thinks this could be the year Congress finds an alternative to the sustainable growth-rate Medicare payment formula. He explained that a major reason for this is that the Congressional Budget Office recently released a new estimate for the cost of repealing the SGR which was 40% lower than the previous estimate: $138 billion over 10 years rather than $245 billion.

Other reasons for hope listed by Eberhardt include a recent report released by House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and House Ways and Means Committee Chairman Dave Camp (R-Mich.) that recommended a phasing out of the SGR and that Upton's panel has already held a hearing on the SGR well in advance of the scheduled SGR-driven Medicare pay cut on Dec. 31, 2013.

“It's encouraging because there has been real movement,” Eberhardt said. “It seems like they have genuine interest.”