Advocacy in Action - Policy Positions for 2017

The American College of Osteopathic Surgeons (ACOS) advocates for sound federal health care policy that fosters patient access to the highest quality specialty care and improves timely access to care for all Americans.

Outlined below are key policy issues of importance to ensure access to specialty care and to promote transparency, oversight and accountability in the healthcare system.

The ACOS believes that:

1. Everyone should have access to healthcare when they need it.

Patient Access to Surgical Care

The ACOS supports universal access to affordable, high­quality surgical care delivered in a timely and appropriate manner and to serve all with skill and fidelity. To achieve this goal, a well­trained surgical workforce must be available to the nation to meet the full spectrum of needs patients have for surgical specialist care.

Provisions Important to Maintain in the Healthcare System

The ACOS continues to believe that the ongoing, broad health care reform initiative will require ongoing efforts directed at reform of the health insurance industry to include addressing issues of cost containment, adequate coverage for the poor and those with pre­existing conditions, as well as the reduction in administrative overhead. A careful review and adoption of thoughtful improvements to the ACA are essential to address the ongoing shortcomings of the healthcare delivery system.  The ACOS supports efforts to ensure access and coverage of preventive screening services; and prohibit annual and lifetime coverage limits.

Medical Liability Reform

The ACOS believes the current medical liability system is broken and fails both physicians and their patients. Reform allows cost reduction in healthcare systems, improvement to access to care, and improves quality and accountability in healthcare systems. We believe that reforms need to be based on quality, safety, and accountability. Any reforms need to address caps on noneconomic damages; and culture change among hospitals and providers to embrace swift adoption of alternative patient­centered reforms, such as communication and resolution programs.

2. Doctors’ advice be based on the most current medical information and aimed at keeping patients healthy.

Graduate Medical Education Reform

The ACOS believes that an appropriate supply of well-educated and trained physicians — both in specialty and primary care — is essential to ensure access to quality health care services for all Americans.  The nation is facing an acute shortage of physicians, due to an aging population and the expansion of health insurance coverage through the Affordable Care Act (ACA), which has resulted in physician program training crisis.   While osteopathic medical schools in the U.S. have increased their enrollments, and new osteopathic schools have been established, the number of Medicare-funded resident positions has been capped by law at 1996 levels. We support efforts to increase the number of Medicare-supported GME residency slots and direct the newly available positions to training in shortage specialties. The ACOS supports additional resources directed to the support and recruitment of underserved populations into the medical profession as well as additional support for those physicians practicing in rural and physician shortage areas.

Exempt CME from Physician Sunshine Act Reporting

The ACOS supports physician access to independent educational resource and accredited or certified CME that are important to upgrade knowledge and skills and improve patient outcomes. The ACA acknowledged that importance and provided specific exclusions for this type of CME. However, CMS determined that these accredited or certified CME that benefit patient care and reduce costs would be reported as cash payments under its Physician Sunshine Act. The ACOS urges Congress to exempt medical journal reprints, textbooks, and independent continuing education from Sunshine Act reporting.

3. Hospitalization receive the best care possible and provide data and information to patients so that they can make the best decision for care.

Quality and Safety

The ACOS supports well-designed, clinical comparative effectiveness research, physician quality data, and appropriate public reporting, and encourages realistic health information technology (HIT) use and adoption.

Maintain Viable Fee-for-Service Option

Americans should have a range of coverage options whether they get their health care in the private market, through an exchange plan, or under the Medicaid or Medicare programs.  Congress and the Administration should maintain a viable fee-for-service option, particularly since many communities do not have many health plans from which to choose and may not have an adequate number of specialists in those plans.  Furthermore, many alternative payment models are not appropriate for all medical specialists at this time; thus fee-for-service must be maintained.

Repeal the Independent Payment Advisory Board

Established by the ACA, the IPAB is a 15-member government board — whose members are appointed by the president — with little or no clinical expertise or the oversight required to protect access to care for our country’s seniors, has only one job: to arbitrarily cut billions of dollars from Medicare.  Proposed spending cuts automatically go into effect if Congress does not replace the recommendations with cuts of equal magnitude.  The ACOS supports efforts in Congress to fully repeal the IPAB.