Introduction to Advocacy

Emergency Medicine Residents AssociationAdvocacy Week 2011

Created by Alison Haddock, EMRA Legislative Advisor

Objectives

•Defining Advocacy

•Healthcare Crises

•Health Care Reform

•Getting Involved

AdvocacAdvocacyy

PoliticsPolitics==

Advocacy

noun.

the act of supporting an idea or cause.

US!

Advocacy = Every Day•Negotiating with consultants•Aligning resources for our patients•Patient education•Public health efforts•Hospital boards and medical staff meetings•Solutions for crowding and boarding•State Laws•Federal Laws•Reimbursement•Regulatory Issues

Advocacy

Physician’s public role: advocacy for and participation in improving the aspects of

communities that affect the health of individuals.

Gruen RL, Pearson SD, Brennan TA. Physician-Citizens – Public Roles and Professional Obligations. JAMA. 291: 94-98. 2004.

We are the safety net.

•Average physician = $12,300 in bad debt

•Emergency physicians =

$138,300

How much does the US spend on health care each year?

$2.5 trillion

From 2000 OECD data

Basis for Health Care Reform

•Solutions to our crises▫Coverage▫Cost▫Quality

•Popular support for concept of reform

Patient Protection and Affordable Care Act (ACA): The Past•Kids on parents’ policies until 26yo

•No preexisting conditions for kids

•State-based high-risk pools

•Small business tax-credits

•Covering the Medicare “donut hole”

•No lifetime benefit limits or recissions

•Expanded quality reporting

Patient Protection and Affordable Care Act (ACA): The Future

•“Individual Mandate” in 2014•Preexisting conditions eliminated for all

•2019 Projections▫Cover 60% of the uninsured▫Cost ~4% of health expenditures▫Cut the deficit by <1%

From “What Will Happen Under Health Reform— and What’s Next?” by the Commonwealth Fund, published in May/June 2010 Columbia Journalism Review.

Patient Protection and Affordable Care Act (ACA): The Future•State insurance exchanges

▫For individuals and small businesses▫Premium subsidies▫Regulated benefits

•Cost offsets▫Cutting Medicare Advantage▫Decreased Medicare provider payments▫Taxes (tanning salons, high-income

Medicare beneficiaries, penalties)

Emergency Medicine and the ACA

•Essential Health Benefits Package

•Prudent Layperson

•EM Research

•Regionalization

(Un)Sustainable Growth Rate

-29.5%• Medicare’s flawed

formula for physician reimbursement

• Patched 5 times in 2010

• Now stable until… January 1st, 2012

SGR Solutions?

•Too expensive to fix!

•More than $369.8 billion

And there’s more!

•Access to care

•Overcrowding and boarding

•Workforce shortages

•On-call coverage

•Accountable Care Organizations (ACOs)

•The IPAB

Get Involved!

EMRA• 36 years representing

residents▫9,000+ members▫33% of ACEP

• Health Policy Committee

• EMRA-ACEP Health Policy Mini-Fellowship

ACEP• 9-1-1 Legislative

Network• Leadership and

Advocacy Conference• Ongoing advocacy

efforts from the Washington DC Office

• ACEP Committees▫ Federal Governmental

Affairs▫ State Legislative and

Regulatory▫ Medical-Legal

NEMPAC • 2 year election cycle fundraising

• Raised $1,090,166 in 2010

Physician PAC Rankings: Orthopedics (2.6M) Anesthesia (2.3M) **AMA (2.0M) Radiologists (1.8M) Emergency Medicine

(1.5M)

• Give-A-Shift!

Get involved!

Give a lecture or journal club on advocacy

Donate some of your time or $$

Speak out!

Take-Home Points

•Advocacy is a core competency…▫Bring it home to your fellow residents!

•The healthcare reform process has only just begun…

•And we need YOU to reachour goals!!!

Thank you!