Specialty Practice Pathologist Patient cap.org v. # Advocacy Workshop for Engaged Pathologists Mike Giuliani, Senior Director, Legislation and Political Action Division of Advocacy December 8, 2013

Advocacy © 2013 College of American Pathologists. All rights reserved.2 Federal Affairs State AffairsPathNET PathPAC Economic & Regulatory Affairs Policy Roundtable

Advocacy: What’s it all about? Shape policies that impact pathology practice All federal and state advocacy efforts are coordinated out of the CAP’s DC office 3 © 2013 College of American Pathologists. All rights reserved. How: Policy development Direct advocacy Who: Policy makersStakeholders Where: Federal government State governments

Federal Affairs Influencing federal legislation Fighting 2014 Medicare Physician Fee Schedule cuts Working for SGR Reform Ending Self-Referral Stopping EHR/Meaningful Use Penalties © 2013 College of American Pathologists. All rights reserved. 4

State Affairs Influencing state laws, regulations, and administrative rules Promoting pathologists in ACOs Enacting direct billing requirements Banning EHR donations by clinical laboratories Protecting scope of practice © 2013 College of American Pathologists. All rights reserved. 5

PathNET Grassroots network of over 1,400 pathologists Engage and encourage pathologists to participate in advocacy activities First point of contact for communicating about advocacy Expanding focus to state level advocacy © 2013 College of American Pathologists. All rights reserved. 6

PathPAC CAP’s political action committee Only political entity representing the interests of pathologists Supports Members of Congress who advance the CAP’s position on key issues All contributions come from CAP members PathPAC Board made up of pathologists © 2013 College of American Pathologists. All rights reserved. 7

Economic and Regulatory Affairs Advocating to federal agencies like CMS, FDA Influencing Medicare reimbursement Educating regulators about pathologists’ roles and concerns Analyzing trends and communicating with CAP Members © 2013 College of American Pathologists. All rights reserved. 8

Policy Roundtable Developing and implementing agenda for health services research and policy Recent work: roles in Accountable Care Organizations; estimating future workforce; Graduate Medical Education Co-sponsored Pathology Workforce Conference © 2013 College of American Pathologists. All rights reserved. 9

2014 Annual Policy Meeting May 5-7, 2014 in Washington, DC Engaging with CAP leaders and health care decision makers Visiting with Members of Congress © 2013 College of American Pathologists. All rights reserved. 10

Reality in Washington Today Divided government remains December 13th: Budget conferees to report fiscal agreement January 15th: Current funding agreement expires February 7th: Debt ceiling expires Key Takeaway: Budget negotiations and fiscal challenges will impact CAP’s advocacy agenda © 2013 College of American Pathologists. All rights reserved. 11

Key Drivers… ACA: Shift from volume to value ACA: Shift to accountable care HITECH: Electronic health records Competition from other specialists Consolidation in health care Genomics and personalized medicine Key Takeaway: Policy can enable or disable future of the specialty © 2013 College of American Pathologists. All rights reserved. 12

CAP Objectives… Mitigate payment reductions Preserve level playing field for pathologists Adapt to new payment models Ensure future supply of pathologists Secure leadership role in genomics Position pathologists as stewards of HIT Key Takeaway: Pathology must engage to influence its destiny © 2013 College of American Pathologists. All rights reserved.13

CAP Strategy Mitigate expected payment cuts as we advocate for policies that enable the future of the specialty Raise our policy credibility and visibility Tell the story: pathologist role and value Strengthen our alliances, cultivate new allies Mobilize pathologists to engage and support the advocacy agenda at the state and federal levels Key Takeaway: Future of pathology depends on members © 2013 College of American Pathologists. All rights reserved.14

Takeaways © 2013 College of American Pathologists. All rights reserved.15 Pathologists are the foundation of CAP Advocacy Budget negotiations and fiscal challenges will impact CAP’s legislative agenda Policy can enable or disable future of specialty Pathology must engage to influence its destiny Future of pathology depends on members If we’re not at the table, we’ll be on the menu