AOA President's Blog

Student Dr. Zotto, promoting DOs and osteopathic medicine to the public has been and will continue to be a priority for the AOA. Our promotional efforts include reaching out and educating the media about DOs and osteopathic medicine through media relations activities and empowering affiliates and supporters by providing them with tools and resources to help promote our profession on both the national and local levels.

In 2009, AOA media relations activities, which include pitching story ideas, working with reporters to find DO experts, and correcting inaccuracies reported in the press, resulted in 183 media placements in 172 different media outlets, reaching an audience of more than 89 million. And since the beginning of 2010, DOs and osteopathic medicine have appeared in the press numerous times, most of which have been a direct result of our media relations efforts. Here are some recent highlights from the AOA’s media center:

– On Jan. 1, Self magazine featured the article “The Big Snooze,” within which Carol Ash, DO, a sleep specialist, discusses how sleep is just as important as diet and exercise to staying healthy.

– On Jan. 3, the Billings Gazette featured on article titled, “Osteopaths Fill Niche in Montana Medicine,” which looked at the growing number of osteopathic physicians in Montana.

– On Jan. 5, Ronnie Mandal, DO, explains how frigid temperatures may worsen inflammatory conditions, such as joint pain and arthritis, within a Chicago Tribune article titled, “Why Does the Cold Make our Joints Hurt?”

– On Jan. 29, Medical News Today featured an article, “Osteopathic Manipulative Treatment Improves Back Function in Late Pregnancy,” about a study led by John C. Licciardone, DO.

– On Feb. 11, Medical News Today featured the article, “Future Osteopathic Physicians Find Their Perfect Matches Just in Time for Valentine's Day” highlighting the results of the 2010 osteopathic match.

– On Feb. 18, AOA Trustee Boyd R. Buser, DO, discussed the profession's focus on primary care in an article in the Indianapolis Star titled, “Osteopathic Approach to Patient Care Gains Favor.”

– A letter to the editor of Chicago, published in their March issue, from president-elect Karen J. Nichols, DO. The letter was in response to the magazine’s “Top Doctors” issue which used the term “MD” to refer to all physicians on both the cover of the issue and in the introduction to the listing of doctors. The letter explained that it was misleading to the readers to not explain that there are both DOs and MDs on the list.

The AOA also works with affiliate organizations and individual members of the osteopathic family from across the country to promote DOs and osteopathic medicine through grassroots campaigns. The Osteopathic Public Awareness Network (OPAN) provides resources, templates, and ideas to help alleviate some of the time and expense that usually accompanies promotional activities. If you’d like to join OPAN and help promote DOs and osteopathic medicine in your community, e-mail pr@osteopathic.org or log in to DO-Online and visit the OPAN section under Advocacy.

Finally, I would like you to take a look at this blog post from past president Carlo J. DiMarco, DO, on promoting DOs and osteopathic medicine through research. We can’t expect the mass media to produce stories on DOs just because we ask them to. We need to present them with relevant and thought-provoking research and position DOs as the experts.

Larry

In August, I posted about the National Health Service Corps (NHSC) loan repayment program, in which the NHSC will repay up to $50,000 in medical school loans for full-time clinicians working in one of their designated health professional shortage areas (HPSAs). NHSC has now opened up the loan repayment program to part-time clinicians.

Beginning in March 2010, clinicians working part-time (20 to 39 hours each week, at least 25 weeks each year) in an HPSA will be eligible to apply to the NHSC’s demonstration program for the Part-time Loan Repayment.

Here are the criteria and details:

-- Four-year service commitment for $50,000
-- Potential for additional years of support – two-year service contract
-- Application period open for 30 days
-- 400 awards anticipated
-- Same eligible disciplines as Full-time Loan Repayment Program (see Application Information Bulletin: Eligibility)

If you are interested, you can sign up to be notified when the Application Bulletin becomes available. And for more information, visit the NHSC Web site.

Larry

Dear Osteopathic Family:

As most of you know, physicians participating in the Medicare program face a 21 percent cut in their payments effective March 1. If Congress fails to act the Medicare physician conversion factor will drop by 21.2 percent to $28.39. This payment rate is $10 less than it was in 2001 and $3 less than in 1992. This cut will have a devastating impact upon beneficiaries’ access to health care and your practice. I feel it is important that the AOA provide all osteopathic physicians with a fair assessment of the current policy and political environment. Additionally, we believe it is important to provide you unbiased, yet factual information, on your options as a practicing physician.

While the AOA remains confident that Congress and the Administration will take the necessary steps to prevent the implementation of the 21 percent cut prior to its implementation on March 1, we are deeply concerned that actions taken by Congress will only provide a temporary reprieve versus the desired long-term solution we have been seeking for the past decade. The AOA continues to believe that Congress must take the necessary steps to ensure that our nation’s seniors, disabled, and military families have access to physician services. To this end, we continue our advocacy efforts aimed at repealing the current sustainable growth rate (SGR) formula and replacing it with a payment formula that compensates physicians for the full cost of care provided.

For more than a year Congress has debated and advanced health care reform proposals that would expand access to affordable health coverage, increase access to physicians – especially primary care physicians – transform our delivery system to promote quality and efficiency, and lower the cost of health care. The AOA supports each of these goals and remains an active participant in this debate. However, we are both concerned and confused as to why Congress has failed to act on one element of health care reform that is widely acknowledged to be an enormous problem with an identified solution. Reform of the Medicare physician payment formula is health care reform and is sound economic policy. It is a reform that preserves access to health care for millions of our nation’s seniors, disabled, and military families. Additionally, long-term reforms are essential to preserving millions of jobs in the health care sector, advancing quality improvement, and achieving our goal of transforming our health care system through health information technology.

Over the past decade the cost of providing health care has grown more than 20 percent, yet payments to physicians for their services have remained static. In fact, physicians are paid approximately one percent more today than they were in 2001. A majority of physicians operate small businesses. In fact, more than 80 percent of physicians practice in groups of 10 or less physicians. These small businesses employ people, contribute to the tax base, and are a primary driver of local economies. No business can be expected to exist in an environment where the differential between revenues and costs is greater than 20 percent.

The current situation is further complicated by the fact that a number of other provisions affecting physician payments for certain types of services or geographic localities remain unresolved. These policies include the floor on geographic adjustments for the work portion of physician payments that expired on December 31, elimination of consult codes, as well as several that increase payments for primary care services and limit geographic adjustments in practice costs. While these issues may be addressed this year, we can not be certain.

On February 25th I sent a letter to every Member of Congress urging them to take “immediate and definitive action this week to prevent the implementation of the projected 21 percent cut in Medicare physician payments.” My letter clearly articulated the negative impact the flawed and failed SGR formula has upon Medicare beneficiaries and physician practices.

The following information is designed to clearly articulate options available to you with respect to your participation in the Medicare program. The AOA is not advising our members to take a specific action regarding your participation in the Medicare program nor offering legal advice regarding these issues. Participation decisions involve binding legal documents and all members are strongly encouraged to consult with your own legal advisors and consultants prior to making a decision on these matters. Our goal is to provide you with the necessary information, thus enabling you to make an informed decision.

The Centers for Medicare and Medicaid Services has extended the deadline for physicians to change their Medicare participation or non-participation status in 2010 to March 17, 2010. Physicians who want to continue their current status do not need to do anything to maintain their status. Those who wish to switch their status need to notify their contractor through a written communication that is received or post-marked on or before March 17, 2010. We have not received any messages from CMS regarding a further extension of this deadline. There are three Medicare contractual options for physicians:

1. Medicare Participating Physician
Physicians may sign a participation (PAR) agreement and accept Medicare’s allowed charge as payment in full for all of their Medicare patients. Participating physicians agree to accept assignment on all Medicare claims, which means that they must accept Medicare’s approved amount, which is the 80 percent that Medicare pays plus the 20 percent patient copayment, as payment in full for all covered services for the duration of the calendar year. The patient or the patient’s secondary insurer is still responsible for the 20 percent copayment, but the physician cannot bill the patient for amounts in excess of the Medicare allowance. While participating physicians must accept assignment on all Medicare claims, Medicare participation agreements do not require physicians to accept every Medicare patient who seeks treatment from them or their practice.

2. Medicare Non-Participating Physician
Physicians may elect to be a non-participating (Non-PAR) physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Non-participating physicians agree to accept 95 percent of the Medicare approved amounts for services provided. Non-participating physicians may charge more than the Medicare approved amount, but are limited to 115 percent of the Medicare approved amount for non-participating physicians. Since approved amounts for non-participating physicians are 95 percent of the rates for participating physicians, the 15 percent limiting charge is effectively 9.25 percent above the participating approved amount for services provided. Given the projected 21.2 percent cut in Medicare physician payments, many physicians may consider balance billing an extra 9 percent as one means of helping close the gap between 2009 and the new 2010 payment amounts.

3. Private Contracting
Physicians may become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves. Provisions in the Balanced Budget Act of 1997 afford physicians and their Medicare patients the freedom to privately contract for health care services outside the Medicare program. However, private contracting decisions may not be made on a patient-by-patient basis. To become a “private contracting physician,” a physician must first opt-out of the Medicare program. Once a physician has opted out of Medicare, they cannot submit claims to Medicare for services provided to any Medicare patients for a two-year period. To privately contract with a Medicare beneficiary, a physician must enter into a private contract that meets specific requirements. In addition to the private contract, the physician must also file an affidavit that meets certain requirements. There is a 90-day period after the effective date of the first opt-out affidavit during which physicians may revoke the opt-out and return to Medicare as if they had never opted out of the Medicare program.

A physician who has not been excluded under Sections 1128, 1156 or 1892 of the Social Security Act (SSA) may order, certify the need for, or refer a beneficiary for Medicare-covered items and services, provided the physician is not paid, directly or indirectly, for such services (except for emergency and urgent care services). For example, if a physician who has opted out of Medicare refers a beneficiary for medically necessary services, such as laboratory, DMEPOS or inpatient hospitalization, those services would be covered by Medicare.

Physicians who have opted-out of Medicare under the Medicare private contract provisions may furnish emergency care services or urgent care services to a Medicare beneficiary with whom the physician has previously entered into a private contract so long as the physician and beneficiary entered into the private contract before the onset of the emergency medical condition or urgent medical condition. These services would be furnished under the terms of the private contract.

Physicians who have opted-out of Medicare under the Medicare private contract provisions may continue to furnish emergency or urgent care services to a Medicare beneficiary with whom the physician has not previously entered into a private contract, provided the physician submits a claim to Medicare in accordance with both 42 C.F.R. part 424 (relating to conditions for Medicare payment) and Medicare instructions (including but not limited to complying with proper coding of emergency or urgent care services furnished by physicians and practitioners who have opted-out of Medicare) and collects no more than the Medicare limiting charge, in the case of a physician (or the deductible and coinsurance, in the case of a practitioner). A physician who has been excluded from Medicare must comply with Medicare regulations relating to scope and effect of the exclusion (42 C.F.R. § 1001.1901) when the physician furnishes emergency services to beneficiaries, and the physician may not bill and be paid for urgent care services.


Again, any physician who wishes to change their status from PAR to Non-PAR or vice versa are required to do so on or before March 17, 2010. The decision will be retroactive to January 1. Unless CMS reopens the enrollment period, once made, the decision is binding throughout the calendar year except where the physician’s practice situation has changed significantly, such as relocation to a different geographic area or a different group practice. To become a private contractor, physicians must give 30 days notice before the first day of the quarter the contract takes effect. Prior to making a determination of a change in participation status, all osteopathic physicians should review all contracts with hospitals, health plans, or other entities to verify that they are not required to be a Medicare participating physician as a condition of their contract.

In closing, I urge each of you to continue to voice your concerns with current Medicare payment policies to your elected officials. The AOA has numerous vehicles by which you can communicate with your Representatives and Senators on this issue. You may use the AOA’s Legislative Hotline – (877) 262-9400 to call your elected officials or you can send a letter via the AOA’s Advocacy Website – www.capwiz.com/aoa-aoia.

The AOA, through our Department of Government Relations, continues to advocate for fair and equitable payment policies on your behalf. I assure you that we are deploying all available resources to protect your ability to provide quality health care to your patients. Again, I urge you to join our advocacy efforts by expressing your concerns to your elected officials today.


Fraternally,

Larry A. Wickless, DO
President

Dr. Watt, the discussion about the DO degree could go on and on. It’s been a discussion topic on this blog since its inception in 2006. As I, along with Past Presidents Ajluni and DiMarco have stated before, there is a process in place that would set this in motion. This process begins with a resolution that would be brought before the AOA House of Delegates. We know from other posts left on this blog that a resolution has been drafted to this effect. The next step would be to work with a state, specialty or student organization, if this isn’t already being done, to submit this resolution for consideration at the Annual Business Meeting just a few months away, July 16-18. Remember changing the degree is not as simple as it sounds. If any degree change is made, then changes must also be made to state statutes and laws and that will take time and financial resources.

When it comes to Australia, again as I have said earlier, the Australian Medical Council is in the process of moving from a state/territorial licensing body to a national body, and it is placing all of its attention on this effort. The AOA will continue to assist our members who wish to practice abroad—a move that will benefit all US-trained DOs, AOA members or not.

Again, if you are so disheartened with the AOA and its processes, get involved. You’ve referenced your membership with the American Academy of Dermatology, but I don’t know whether you are active in any osteopathic organizations. If not, I encourage you to become an active member of the American Osteopathic College of Dermatology or your state osteopathic medical association. Then, nominate a representative you believe will best serve your interests as an AOA delegate. As far as elected officers, each year delegates elect the President, President-Elect, First Vice-President, Second Vice-President, Third Vice-President and six Trustees. Nominations are a regular order of business during the House of Delegates meeting and elections are by ballot. You can read the nominating and election process in the AOA Constitution and Bylaws (page 13), which is available on DO-Online. This document also indicates that the House of Delegates serves as the legislative body of the AOA. Again, if you disagree with these bylaws, you need to take action by working with your specialty or state osteopathic medical association to bring the concern before the entire House of Delegates.

We’ve gone back and forth numerous times about these issues. I’ve stated the steps for you, or for any member of the osteopathic family for that matter, to take in order to advocate for the changes you want to see take place at the AOA. I can sense your passion for the issues, but you need to work within the system in place—even if you disagree with its structure.

With that said, I’d like to hear about other concerns and ideas on the minds of our fellow DOs and osteopathic medical students.

Larry

There has been a lot of talk on this blog about how to affect change within the osteopathic medical profession. One of the best ways to do this is to serve on one of the AOA’s bureaus, councils, and committees (B/C/Cs).

Karen J. Nichols, DO, AOA President-elect, recently sent out a message to the osteopathic family calling for nominations to the AOA’s B/C/Cs. Individual members of the osteopathic medical profession may self-nominate and organizations may nominate three individuals, in suggested order of preference, for each open position. Nominations must be received by May 1, 2010, with the exception of certain education committees, for which nominations are due March 15. Open positions as currently constituted can be viewed in the 2010-2011 Appointment Book.

Nominations and questions should be sent to nominations@osteopathic.org. For more information, read the letter from President-elect Nichols here.

Larry

The AOA works in countless ways to support our osteopathic family; from providing benefits and services to our members, to advocating on behalf of all DOs and osteopathic medical students in Washington, DC. Another way we support the osteopathic family is through the American Osteopathic Foundation (AOF), the AOA’s philanthropic arm, which strives to recognize some of the exceptional individuals within the osteopathic medical profession who are making a difference. Whether you are an osteopathic medical student, an educator or a researcher, I encourage you learn about and apply for the many scholarships, grants and awards that are available through the AOF.

Applications are now being accepted for many of the educational awards and scholarships, including: the Donna Jones Moritsugu Memorial Award; the AOF Educator of the Year Award; the AOA Presidential Memorial Leadership Award; the William G. Anderson, DO, Minority Scholarship; the Russell C. McCaughan, DO, Education Scholarship; the Welch Scholars Grant; and the Burnett Osteopathic Student Research Award.

For application forms and additional information, visit the AOF Web site at aof-foundation.org.

Larry

Earlier this week, I issued a video statement on the impending 21.2% cut to physician Medicare payments. These cuts would not only impact physicians, but also our nation’s seniors and military families, who could see a decrease in their access to care. I urge all members of the osteopathic family to do their part in stopping these cuts. View my video message here to learn how.

For more information on the impending cuts and what you can do, read the AOA’s Action Alert on DO-Online.

Larry

Dr. Watt, thank you for your comments. I am disappointed that osteopathic medical students are concerned over "retribution" from the AOA. First and foremost, the AOA is a membership organization. We have a market share in the neighborhood of 60%, which would be hard for us to attain if we regularly tread on members. I would like to know one instance where a student, DO or anyone wrote something in an AOA blog where some form of “punishment” was meted out. Our job is to represent the interests of all osteopathic physicians and students, not shackle any of them.

I’m interested that you find the process to change the osteopathic degree via the AOA House of Delegates "fatally flawed." Many people are disgruntled with a representational democracy, such as the one we employ in the United States. I think it was Winston Churchill who said that “democracy is the worst form of government except all the others that have been tried.” There are more than 300 million US citizens. Just because some choose not to vote or not to pay taxes does not mean that they are not US citizens. Also, just because "their" candidate does not win does not mean they have no representation.

Similarly, an individual earning a DO degree enters the community of DOs. That individual DO may choose not to participate in the DO community and may choose not to pay membership dues. They may wish not to participate in state activities. But that does not mean that they are not represented. I challenge you to find another national physician organization in the United States that represents DOs.

I understand that you might not like the outcome of actions taken by the AOA House of Delegates. Several years ago, the House addressed the issue of the DO degree. I guarantee there were people in the House who walked in wanting to change the degree. I spoke to several of them. But the House of Delegates heard testimony and read information that you did not hear or read...and the House concluded unanimously to retain the DO degree. Can you conclude that each of the House’s 500 members made the wrong decision?

When it comes to the Australian Medical Council, it is well aware of the US DO degree, as our advocacy for recognition of osteopathic physicians continues. However, as I have mentioned before, all health authorities in Australia for the past several years have been revising their licensure/registration bodies and processes to move to a national registration body, rather than a state or territorial one. With the Australian authorities’ recent recognition of DOs’ ability to sign visa forms, we are hopeful more sweeping licensure rights are around the corner. Recently, we have communicated with an osteopathic physician specializing in emergency medicine who practices in Australia.

Regarding the statements within the AOA International Licensure Summary about the British influence, several former British protectorates, and even the United Kingdom, have begun to register US-trained osteopathic physicians. The United Kingdom, New Zealand and Canada all recognize osteopathic physicians. Our efforts continue to help osteopathic physicians to become licensed and registered throughout the world, and we hope to continue our success in this regard.

I urge you to be an involved member, particularly through your state or specialty college, as that is the best way to change things that you don’t like about the AOA. If you do not get involved and continue to not like AOA policies, then it’s your fault, not ours. The system may be imperfect—and if so, I challenge you to get involved in the process to change it.

Larry

About one month from now, many of you could feel the impact of the more than 21% Medicare physician payment cut slated to take effect on March 1. Who can afford such a cut? I don’t know anyone who can. In fact, many members have told me they have reached the point where they can no longer afford to care for Medicare patients, but you can’t just share your story with me. You need to share it with your Members of Congress.

We’ve reached a critical point in our nation’s health care system. In order to reach a permanent solution to the flawed Medicare physician fee schedule, our voice needs to be louder than ever. But, you can’t just rely on the AOA to get this done. Rest assured, we’re committed to advocating on this issue—it’s a top priority for us. However, you need to play an active role, too.

If you don’t believe me, just this week a Senator told one of our lobbyists, “Many Senators just don’t feel physicians can move votes.  Most physicians never even mention this issue, more or less take the time to advocate on their own behalf.”

If there is one health care reform issue that needs your voice, it’s this one. Take a few minutes and call your Senators and Representatives and send them letters. Tell them how this cut will not only affect you but also your patients and your community—their community.

You owe it to your patients. They’re relying on you. You owe it to yourselves. You’ve worked too hard for your careers as DOs. You owe it to the generations of DOs and their patients to come.

Don’t waste another minute—take action today, or we must all accept blame for not resolving this problem once and for all.

Larry

Increasing awareness of DOs and osteopathic medicine is a priority for the AOA, and we know how important it is for you, too. While this endeavor is year-round, we’re asking the osteopathic family to make a united effort by promoting the profession during National Osteopathic Medicine (NOM) Week.

I am thrilled to tell you that NOM Week is back for 2010 and is set for April 18-24, to coincide with the AOA’s birthday on April 19. Along with the AOA’s efforts to raise awareness for our great profession, we need your help. And, we’ve made it easy for you to participate. While affiliate organizations are encouraged to host Mini-Medical School events, we also ask you to do your part. You can hand out the “What is a DO?” brochure to your patients; write and send a health article to your local paper; or volunteer to help staff a Mini-Medical School in your community. I also encourage you to take a look at the Osteopathic Public Awareness Network (OPAN) resources available in the password-protected area of DO-Online. Resources to promote DOs and osteopathic medicine, including talking points, press release templates, public service announcements, and much more, are available to AOA members at no cost throughout the year.

Let’s all do our part to make “DO” a household word this year.

Larry

If you’ve never taken part in the AOA’s DO Day on Capitol Hill, I invite you to join us for this year’s event, held April 29. For those of you who have made the trip to our nation’s capitol for a previous DO Day, plan to be part of the AOA’s 2010 delegation and participate in the legislative process once again.

Hundreds of DOs, osteopathic medical students and supporters are expected in DC for our largest advocacy effort of the year where you’ll spend the day meeting with your respective legislators and networking with members of the osteopathic family from across the country. Registration for this important event is now open. Sign up today, and I hope to see you in Washington, DC, in April.

Larry

Osteopathic Physicians, Students, and Affiliate Organizations:

Happy New Year! As we begin a new year, I wanted to provide you an update on the American Osteopathic Association’s (AOA) ongoing efforts regarding health care reform. As most of you know, prior to adjourning for the year, both the House of Representatives and the Senate approved comprehensive, yet uniquely different, health care reform proposals. The politics surrounding these bills has been a subject of great debate and scrutiny. However, we now find ourselves at the next phase of this long process – the reconciliation process.

While the formal process for reconciling the two bills has not been determined, we do know that the policy differences between the House and Senate bills require substantial debate and compromise. We also know that there is tremendous pressure to find areas of agreement and dispose of areas of contention. While the fate of this legislation teeters on philosophical issues, we continue to work to ensure that the AOA’s legislative objectives are met.

There are numerous areas of congruency between the two bills:

– Delivery system reforms that restore the physician-patient relationship through the creation of more longitudinal delivery models such as the patient-centered medical home and accountable care organizations;
– Bonus payments for primary care physicians;
– Workforce expansion with an emphasis on primary care and general surgery residency programs;
– Insurance reforms aimed at curbing predatory practices used by commercial health insurers;
– New programs promoting prevention and wellness;
– Individual and employer mandates as a means of encouraging all Americans to secure health care coverage;
– Expansion of Medicaid to assist more low-income individuals in securing health care coverage;
– Creation of an individual health insurance market through a health care exchange.

These are just a few of the areas where the bills are consistent. While these provisions are important, they will not be the subject of our advocacy efforts or public discourse over the next few days and weeks. Instead, the AOA and other physician organizations will target provisions that are included in one of the bills, but not the other – working to ensure their inclusion or exclusion in the final legislative package.

On January 8, 2010, I sent a letter to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid outlining the AOA’s policy priorities for a final bill. This letter was copied to the relevant Committee Chairs involved in the drafting of a final bill.

The following is a summary of the top priorities outlined in the letter:

– Promotion of the Osteopathic Profession – Our fundamental objective in all advocacy efforts is the promotion and protection of the osteopathic profession. The letter outlines a clear defense of our profession, our education system, our board certification programs, and the ability of osteopathic physicians to provide appropriate care to their patients.

– Physician Payment – Our top priority remains the elimination of the sustainable growth rate and establishment of an equitable Medicare physician payment methodology. The AOA continues to support the “Medicare Physician Payment Reform Act” (H.R. 3961), approved by the House on November 19. We will be using all our available resources to advance this policy in the coming days.

– Quality Improvement – The AOA continues to advocate provisions that allow for improvements in the quality and safety of health care. However, we continue to raise objection to those proposals that seek to base quality improvement upon faulty methodologies and those that rely upon claims data as a means of evaluating physician performance. Furthermore, we stringently oppose the creation of a public reporting program on physician performance.

– Medicaid Payment Rates – The AOA supports a provision included in the House approved bill that would increase Medicaid payment rates for primary care physicians to 90 percent of Medicare rates. A final bill likely will expand Medicaid to an estimated 15 million new beneficiaries. These individuals will face challenges accessing physicians because most physicians do not participate in the Medicaid program due to payment rates that average 66 percent of Medicare. This provision will provide financial stability for those physicians who choose to participate in the Medicaid program in the future.

– Workforce Expansion – The AOA calls for provisions that would expand our nation’s graduate medical education system by 15 percent. It remains our opinion that the lack of attention to ensuring an adequate physician workforce is one of the most glaring shortcomings of current bills.

– Delivery System Reforms – The AOA calls for the implementation of the “patient-centered medical home” throughout Medicare and Medicaid. Additionally, we outlined key recommendations on how the establishment of “accountable care organizations” should be carried forth.

– Medical Liability Reform – The AOA continues to support the inclusion of provisions that would address the nation’s broken medical liability system.

– Independent Payment Advisory Board - The AOA strongly opposes the establishment of the Independent Payment Advisory Board (IPAB) as currently set forth in the Senate bill. The AOA maintains that Congress is a representative, elected body and, as such, must assume responsibility for legislating sound health care policy, including that related to physician payment within the Medicare and Medicaid systems. Unlike an appointed body, members of Congress must find solutions to prevent decreased access to health care for their constituents.

I know that many of you are pessimistic about this process, while others are optimistic. Regardless of your opinions on the legislation under development, I want to ensure you that the AOA leadership is fully engaged in ensuring that any legislation reflects the priorities of our profession and those that promote quality patient care.

Will the final bill meet these objectives? The answer to this question remains unknown, but I can promise that the AOA will use all available resources to assure that it does. The AOA’s position on a final bill will be based upon the policies established by our members through the House of Delegates and will not be made independent of serious deliberation and careful evaluation.

The AOA will host its 7th Town Hall Meeting on health care reform on Thursday, January 21, at 8:00 p.m. Eastern. These Town Hall Meetings provide an excellent opportunity for you to gain a greater understanding of the legislation, AOA priorities, and our advocacy efforts. I encourage each of you to participate in this event. To register for the January 21 event, please visit www.capwiz.com/aoa-aoia.

In closing, I want to wish you health and happiness in this New Year. Your commitment to and support of the osteopathic profession and the AOA are deeply appreciated.

Fraternally,
Larry A. Wickless, DO
President

I know it is not easy for you to take time away from your practice and family to fulfill your CME requirements. This is why I’m happy to share that the AOA is co-hosting two Regional Osteopathic Medical Education (ROME) Conferences in 2010, during which you’ll have the opportunity to earn CME credit AND enjoy time with your family.

In association with the South Carolina Osteopathic Medical Society, ROME Southeast will occur May 6-8 in Myrtle Beach, South Carolina. ROME Mid-Atlantic, co-hosted by the Maryland Association of Osteopathic Physicians, will take place July 29-31 in Cambridge, Maryland. The 2010 ROME Conferences not only provide opportunities to earn up to 26 hours of Category 1-A CME credit and connect with fellow members of the osteopathic family, but they are also held at great family vacation destinations.

Program schedules (coming soon), registration, and hotel information can be found in the ROME section of DO-Online.

Larry

Student Doctor McNamara, the AOA looked at advocating for Emergency Medicine as a primary care specialty, but concluded that it did not make sense to pursue it. It was determined that the acute care of Emergency Medicine differs too greatly from Family Medicine, Internal Medicine, Obstetrics and Gynecology, and Psychiatry. The AOA’s position may change in the future, however. If you would like to discuss this further, please contact the AOA’s Department of Government Relations at 800-621-1773, option 3.

Larry

Dr. Mychaskiw, thank you for your thoughts on KCUMB seeking LCME accreditation.

Last week, AOA President-elect Karen J. Nichols, DO, and several other AOA Trustees and Past Presidents who graduated from KCUMB, wrote to KCUMB to express their concern over acquiring LCME accreditation to offer graduates a dual DO-MD degree. I’m aware that since the letter was sent there have been some changes made at KCUMB.

Respondents here and on the Daily Reports Blog have questioned the role of the AOA and the Commission on Osteopathic College Accreditation (COCA) in this matter, so I’d like to direct the osteopathic family to a recent response made by AOA Executive Director, John B. Crosby, JD, on his Daily Reports Blog.

Larry