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2011 National Orthopaedic Leadership Conference. Welcome to the NOLC.

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Presentation on theme: "2011 National Orthopaedic Leadership Conference. Welcome to the NOLC."— Presentation transcript:

1 2011 National Orthopaedic Leadership Conference

2 Welcome to the NOLC

3 The 2010 Election: House of Representatives 111th Congress Democrats: 257 Republicans: th Congress Democrats: 193 Republicans: 242

4 The 2010 Election: Senate 111th Congress Democrats: 56/2 Republicans: th Congress Democrats: 51/2 Republicans: 47

5 112 th Congress Tea Party Tea Party  53 House  4 Senate  Jim DeMint (SC)  Rand Paul, MD (KY)  Mike Lee (UT)  Jerry Moran (KS) Blue Dogs - 22/46 lost Blue Dogs - 22/46 lost Retiring Senators - Daniel Akaka (D-HI) Jeff Bingaman (D- NM), Kent Conrad (D-ND), John Ensign (R-NV), Kay Bailey Hutchison (R-TX), Jon Kyl (R-AR), Joe Lieberman (I-CT), Jim Webb (D-Va.) Retiring Senators - Daniel Akaka (D-HI) Jeff Bingaman (D- NM), Kent Conrad (D-ND), John Ensign (R-NV), Kay Bailey Hutchison (R-TX), Jon Kyl (R-AR), Joe Lieberman (I-CT), Jim Webb (D-Va.)

6 Hill Visit 101 Before your meeting: Map out the meeting Map out the meeting Review talking points Review talking points Bring your materials Bring your materials Getting there: 10 min. between buildings 10 min. between buildings 20 min. between House and Senate 20 min. between House and Senate Running late: Call the office immediately! Running late: Call the office immediately!

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8 Hill Visit 101 When you arrive: Check in with the staff assistant Check in with the staff assistant Sign the guest book Sign the guest book Bring and be sure to give staff or member/Senator your business cards Bring and be sure to give staff or member/Senator your business cards

9 Hill Visit 101 Meeting Basics: Usually short about 15 minutes Usually short about 15 minutes Build a relationship Build a relationship Be flexible! Be flexible! Stay on message Stay on message Follow up Follow up

10 When Meeting with Staffers: Try to establish a relationship Try to establish a relationship  Where are they from (from the district?) Judge if they are aware of the issues Judge if they are aware of the issues  Ask how long they have been working for the Congressperson If staffer is experienced, then go more in detail about issues and answer any questions If staffer is experienced, then go more in detail about issues and answer any questions

11 Hill Visit Materials Congressional leave behinds Congressional leave behinds  Blue AAOS folders  One pagers NOLC Participant Packets NOLC Participant Packets  Lapel Card  Congressional Directories  Congressional Maps  One pagers

12 2011 NOLC Issues

13 The AAOS Act of 2011

14 AAOS Advocacy Issues The AAOS Act of 2011 The AAOS Act of 2011 Aims to Increase Knowledge and Awareness of Musculoskeletal Diseases.

15 Musculoskeletal Conditions: Leading cause of disability in the US Leading cause of disability in the US Greatest cause of total lost work days and medical bed days Greatest cause of total lost work days and medical bed days Affect 1 in 4 Americans Affect 1 in 4 Americans Affect more than one-half of people over 50 Affect more than one-half of people over 50 Cost US more over $849 billion annually Cost US more over $849 billion annually AAOS Advocacy Issues The AAOS Act of 2011

16 AAOS Act of 2011 will: Provide reports to Congress on funds given for research Provide reports to Congress on funds given for research Collect data on new investigators Collect data on new investigators Identify existing trauma care initiatives Identify existing trauma care initiatives AAOS Advocacy Issues The AAOS Act of 2011

17 AAOS Act of 2011 will: Promote treatment of musculoskeletal diseases across various populations Promote treatment of musculoskeletal diseases across various populations Urge Office of Minority Health to consider musculoskeletal conditions a priority Urge Office of Minority Health to consider musculoskeletal conditions a priority

18 AAOS Advocacy Issues The AAOS Act of 2011 AAOS Act of 2011 will: Promote bone health initiatives among adolescent girls Promote bone health initiatives among adolescent girls Take steps to reduce disease burden among children and elderly Take steps to reduce disease burden among children and elderly

19 AAOS Advocacy Issues The AAOS Act of 2011 Congressional Ask: Congressional Ask: Support specialty care and co-sponsor the Access to America’s Orthopaedic Services (AAOS) Act

20 Integration of Clinical Services

21 AAOS Advocacy Issues Integration of Clinical Services Stark Law contains in-office ancillary services (IOAS) exception Stark Law contains in-office ancillary services (IOAS) exception IOAS exception: IOAS exception: Improves patient care Improves patient care Improves coordination among providers Improves coordination among providers Ensures greater patient adherence to treatment plans Ensures greater patient adherence to treatment plans

22 AAOS Advocacy Issues Integration of Clinical Services Benefits of integrated clinical services: Benefits of integrated clinical services:  Timely initiation and continuity of care  Sharing patient/case information among providers (knowledge spillover) Successful models of integration include ambulatory surgical centers and physician owned hospitals. Successful models of integration include ambulatory surgical centers and physician owned hospitals.

23 AAOS Advocacy Issues Integration of Clinical Services Recent attention on increase in utilization of ancillary services Recent attention on increase in utilization of ancillary services Two factors affect recent increase in use: Two factors affect recent increase in use: Patients more educated about health care choices Patients more educated about health care choices Patient demand increases provision of ancillary services Patient demand increases provision of ancillary services

24 AAOS Advocacy Issues Integration of Clinical Services Reports suggesting IOAS exception is a main driver of increased utilization are misleading Reports suggesting IOAS exception is a main driver of increased utilization are misleading There is no research that has shown that the increase in the volume of ancillary services provided by physicians is related to physician ownership. There is no research that has shown that the increase in the volume of ancillary services provided by physicians is related to physician ownership.

25 AAOS Advocacy Issues Integration of Clinical Services Allows surgeons to manage patient treatment from start to finish Allows surgeons to manage patient treatment from start to finish Key component of Congressional and Administration efforts Key component of Congressional and Administration efforts

26 AAOS Advocacy Issues Integration of Clinical Services Congressional Ask: Congressional Ask: Enact policies to encourage the integration of clinical services Cosponsor H.R to repeal the provisions of the Patient Protection and Affordable Care Act that restrict the establishment and growth of specialty hospitals. Cosponsor H.R to repeal the provisions of the Patient Protection and Affordable Care Act that restrict the establishment and growth of specialty hospitals.

27 Independent Payment Advisory Board (IPAB)

28 AAOS Advocacy Issues Repeal of the Independent Payment Advisory Board (IPAB) Panel devised by PPACA will make choices on Medicare spending Panel devised by PPACA will make choices on Medicare spending Limits congressional authority and transparency Limits congressional authority and transparency AAOS committed to providing cost efficient quality care AAOS committed to providing cost efficient quality care

29 AAOS Advocacy Issues Repeal of the Independent Payment Advisory Board (IPAB) IPAB Membership:  15 members appointed solely by the President  Fewer than half of the IPAB members can be health care providers  No IPAB member can be otherwise employed

30 AAOS Advocacy Issues Repeal of the Independent Payment Advisory Board (IPAB) Cuts based on unrealistic spending targets Cuts based on unrealistic spending targets IPAB recommendations automatically go into effect unless blocked or amended by Congress IPAB recommendations automatically go into effect unless blocked or amended by Congress Over 1/3 of providers exempt from IPAB cuts until 2020 Over 1/3 of providers exempt from IPAB cuts until 2020 With SGR, physicians could be subjected to the piling on of two different cuts With SGR, physicians could be subjected to the piling on of two different cuts

31 AAOS Advocacy Issues Repeal of the Independent Payment Advisory Board (IPAB) IPAB threatens the ability of Representatives in Congress to ensure access to health care

32 AAOS Advocacy Issues Repeal of the Independent Payment Advisory Board (IPAB) Cosponsor H.R. 452, the Medicare Decisions Accountability Act, to repeal the IPAB Congressional Ask: Cosponsor H.R. 452, the Medicare Decisions Accountability Act, to repeal the IPAB

33 Current Cosponsors of H.R. 452 as of 3/22/11 Rep 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 ARep 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, Glenn Rep Tiberi, Patrick J. Rep Griffith, H. Morgan Rep Grimm, Michael Rep Hall, Ralph M. Rep Hayworth, Nan A. S Rep 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, Bill Rep Rohrabacher, Dana Rep Rooney, Thomas J. Rep Schock, Aaron Rep Sessions, Pete Rep Wilson, Joe 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, Bill Rep Rohrabacher, Dana Rep Rooney, Thomas J. Rep Schock, Aaron Rep Sessions, Pete Rep Wilson, Joe Rep Westmoreland, Lynn A.

34 Medical Liability Reform

35 AAOS Advocacy Issues Medical Liability Reform The Hostile Medical Litigation Climate: Encourages practice of defensive medicine Encourages practice of defensive medicine Emergency Medical Treatment and Labor Act (EMTALA) puts surgeons at risk Emergency Medical Treatment and Labor Act (EMTALA) puts surgeons at risk Raises health care costs Raises health care costs

36 AAOS Advocacy Issues Medical Liability Reform Rising Insurance Premiums: Liability insurance has increased through the years Liability insurance has increased through the years Some states and specialties have more dramatic increases Some states and specialties have more dramatic increases Tort reform would save the government $62 billion over 10 years Tort reform would save the government $62 billion over 10 years

37 AAOS Advocacy Issues Medical Liability Reform Congress should pass legislation that: Includes time tested, reasonable limits on non- economic damages such as successful reforms in California and Texas. Includes time tested, reasonable limits on non- economic damages such as successful reforms in California and Texas. Protects physicians volunteering services in disaster or emergency Protects physicians volunteering services in disaster or emergency Applies Federal Tort Claims Act to cases involving EMTALA-mandated services Applies Federal Tort Claims Act to cases involving EMTALA-mandated services

38 AAOS Advocacy Issues Medical Liability Reform Congress should pass legislation that: Directly explores medical liability alternatives Directly explores medical liability alternatives Makes clear no new cause of legal action was created in PPACA Makes clear no new cause of legal action was created in PPACA Fully funds $50 million liability grant program and prevents plaintiffs from opting out of program once enrolled Fully funds $50 million liability grant program and prevents plaintiffs from opting out of program once enrolled

39 More About the Grant Program The planning grants for the Patient Safety and Medical Liability Initiative give States and health systems the opportunity to create detailed plans for patient safety and medical liability reform. The planning grants for the Patient Safety and Medical Liability Initiative give States and health systems the opportunity to create detailed plans for 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 one or more of the patient safety and medical liability reform goals. These grants represent a variety of models that meet one or more of the patient safety and medical liability reform goals.

40 The Planning Grants Include: The development of a "safe harbor" for physicians who can prove they followed State-endorsed evidence- based care guidelines The development of a "safe harbor" for physicians who can prove they followed State-endorsed evidence- based care guidelines Shared decision-making Shared decision-making Early disclosure and offer models-which inform injured patients and families promptly, and make efforts to provide prompt compensation. Early disclosure and offer models-which inform injured patients and families promptly, and make efforts to provide prompt compensation. Transparency and enhanced communication between providers and patients when avoidable injuries occur. Transparency and enhanced communication between providers and patients when avoidable injuries occur.

41 AAOS Advocacy Issues Medical Liability Reform Congressional Ask: Co-sponsor H.R. 5 and S.218, the Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act of 2011 Co-sponsor H.R. 5 and S.218, the Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act of 2011

42 Current Cosponsors of H.R. 5 as of 3/22/11 Rep 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 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 Gerlach, Jim Rep Gibbs, Bob Rep Gosar, Paul A. Rep Graves, Sam Rep Grimm, Michael G. Rep Gibbs, Bob Rep Gosar, Paul A. Rep Graves, Sam Rep Grimm, Michael G. Rep Ellmers, Renee L Rep 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, Pete Rep Pearce, Stevan Rep Platts, Todd Russell Rep Price, Tom Rep Quayle, Benjamin Rep Reed, Tom Rep Roe, David P. Rep Rogers, Harold [ Rep Miller, Jeff Rep Myrick, Sue Wilkins Rep Neugebauer, Randy Rep Olson, Pete Rep 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 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, CathyRep 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

43 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 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. 218 Sen Blunt, Roy Sen Kirk, Mark Steven Sen Blunt, Roy Sen Kirk, Mark Steven

44 R ESPONSIBLY REDUCING COSTS The AAOS has been a committed partner in patient safety, cultural competency, and providing high quality health care. The AAOS has been a committed partner in patient safety, cultural competency, and providing high quality health care. The AAOS currently develops clinical practice guidelines and appropriate use criteria; we initiated and are a partner in the American Joint Replacement Registry (AJRR); and, we have published a primer to help educate orthopaedic surgeons on issues related to ACOs. The AAOS currently develops clinical practice guidelines and appropriate use criteria; we initiated and are a partner in the American Joint Replacement Registry (AJRR); and, we have published a primer to help educate orthopaedic surgeons on issues related to ACOs.

45 Tips to Remember  Plan Ahead  Strategy-Who’s going to talk?  Leave yourself time  If you’re running late, call!  Materials  Business cards  Leave behinds  Meeting  Tell your story  Stay on message  Be a resource

46 “We in America do not have government by the majority. We have government by the majority who participate.” - Thomas Jefferson

47 Contacts Washington Office: Alanna Porter


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