Advocacy in Action

Carter L. Alleman, J.D.

Global Survey Results

Participating does not take a great deal of time, some cases it takes 5 minutes. Completing a survey, responding to an email, sending a text, small actions which can change policy. The past two months, the ACOS worked with the surgical coalition on how to deal with the Centers for Medicare & Medicaid Services (CMS) proposed rule on global surgical codes. The coalition decided to create a survey for the members to gather information on the impact of the rule changes on surgeons and their practices. For a three-week period, almost every surgical specialty organization promoted the survey to its members, asking for their participation in taking the survey and sharing their opinions.

Over 7,100 surgeons responded to the survey, of that 343 signified that they were DOs. DO participation was given positive comments at the surgical staff meeting. Your participation helps promote the ACOS to a larger audience and shows others that our members participate and want to participate in advocacy efforts.

According to the survey’s findings, surgeons will face significant challenges integrating the proposed new G-codes and data collection processes into their practices. In an attempt to comply, most physicians will have to make major changes to their practice operations. Some examples include:
•    Developing new methods for tracking and collecting global surgery visit work;
•    Making modifications to their EHR and billing systems;
•    Incurring additional staff and physician time spent on tracking and processing global surgery information into EHR and billing systems;
•    Developing methods for transferring visit data from one treatment site to another;
•    Hiring scribes to shadow clinicians to document services;
•    Using additional technology, such as handheld devices or stopwatches, to document time spent providing global surgery services; and
•    Differentiating Medicare from other patients to ensure that G-codes are used based on the patient’s payer.

Additionally, just under one-half of respondents anticipate that they would have to hire new staff and purchase additional software to capture global surgery services under a new G-code system.

All of these practice changes will come at a significant cost to our surgeons. Nearly 40 percent of respondents anticipate it will cost them between $25,000 to $100,000, and another 15 percent estimate they will spend more than $100,000 on compliance. These costs include modifications to EHR and billing systems, staff costs, loss of productivity and the like.

These results were presented to CMS at their last town hall event. They will also be used for advocacy efforts in order to delay and possibly prevent the implementation of the proposed rules once they are finalized. The results were also used to formulate the ACOS comment letter which was submitted to CMS.