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The Road to Reform

The tsunami of change coming out of Washington reminds us that not “all politics is local,” as the saying goes. And that’s why the Chicago Medical Society advocates for you at the county, state and national levels.

With the goal of influencing those who make decisions, CMS paid house calls on Capitol Hill last Feb. 23-25. Working both sides of the political aisle, we met our target of having personal contact with one-third of Illinois’ lawmakers.

Joining me were CMS President-elect Kathy M. Tynus, MD, and Tina Shah, MD, MPH.

Your CMS team conveyed what members tell us about day-to-day clinical situations. Each new regulation burdens the medical practice, adding to physicians’ mounting responsibilities. Distractions, whether from EMRs or a plethora of rules, interfere with patient care. Despite what politicians say, many of us believe the new regime is more concerned with raising revenue than encouraging quality.

As 2015 shapes up as the year of converging rules and penalties, CMS has made educating the 114th Congress a top priority. Nearly half of all U.S. House and Senate members came into office in 2010 or later, during a highly partisan era. Yet our agenda requires bipartisan support.

On some fronts, momentum is growing. GME expansion, for example, is one issue on which CMS is quite visible. Over two years’ time, U.S. House members of both parties agreed to sign on to critical GME legislation, thanks to CMS outreach. These bills would create new medical residency slots, with emphasis on primary care.

While in Washington, Dr. Shah gave a compelling firsthand account to our own Senator Richard Durbin. As chair of the AMA’s Resident and Fellow Section, Dr. Shah spoke with the authority of someone on the frontlines. This, along with her interest in hospital system operations and their impact on patient care, make Dr. Shah a unique witness to the challenges facing academic medical centers, such as the University of Chicago, where she is a fellow in pulmonology and critical care.

Dr. Shah relayed horror stories of medical students unable to land residency training spots. The 1997 cap on Medicare-funded training put a stranglehold on the production of new physicians, not long before the nation’s health care needs began to soar, Dr. Shah said. Yet medical residents are the backbone of much hospital care and the future of medicine.

The second pillar of CMS’ Medicare reform plan calls for scrapping the SGR formula. And CMS renewed its pressure on lawmakers to reach a bipartisan solution. Like the residency cap, the funding mechanism was set in place in 1997. The good news is that Congress may soon put an end to the annual SGR drama.

Finally, CMS gave testimony in support of the 21st Century Cures Consortium. Also known as the Medical Innovations Act, this bipartisan effort would modernize the discovery, development, and delivery of new drug treatments. The initiative is sponsored by U.S. House Reps. Fred Upton and Diana DeGette. We were pleased to give input on how Congress can accelerate these changes.

The 21st Century Cures initiative marks a new point in the national conversation. Along the same lines, CMS asks that you join us at this turning point in medicine. As our health system shifts from fee-for-service to value-based care, we need your voice.

Kenneth G. Busch, MD
President, Chicago Medical Society

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