Advancing APMA’s Strategic Goals APMAs... · 2014-05-01 · Physician Payment Sunshine Act...

Advancing APMA’s Strategic Goals through Health Policy

Scott Haag, JD, MSPH

Chad Appel, JD

What We Will Cover Today

•APMA’s Mission Statement & Committee Charge •2013-2014 Activities Update •Review of APMA Membership Data •Considerations for HPPC Members

Mission Statement

APMA advances and advocates for the profession of podiatric medicine and surgery for the benefit of its members and the public.

Strategic Directions

Committee Charge

Health Policy and Practice Committee

The Committee develops policies, programs and other activities to position the doctor of podiatric medicine as the recognized

foot and ankle care specialists within public and private healthcare delivery and financing systems. It advocates with federal administrative agencies, private insurance plans, and other health-care delivery systems to end barriers to services

provided by podiatrists to foster better access to medical necessary care by podiatrists, and for fair and equitable payment for podiatrists. It advices the APMA Board of Trustees on matters

affecting the profession, including those associated with Medicare, Medicaid, DME, and related federal health policy and

private insurance issues.

New HPPC Committee Structure

Subcommittees

Medicare and Public Payer Subcommittee

Private Insurance Subcommittee

Workgroup

DME Workgroup

Advisory Committees

Carrier Advisory Committee

Private Insurance Advisory Committee

2014-15 Activities

But first, some review….

What does APMA look like today?

…and….

A look back to our observations from 2013 HPC meeting

Podiatric Medicine Today

Podiatric Medicine Today

Podiatric Medicine Today

Podiatric Medicine Today Other facts from survey:

• Average Hours Worked Per Week • Owners (O): 41.2

• Employed (E): 43.5

• Average Patients Per Week • O: 100.8

• E: 91.9

• Average New Patients Per Week • O: 41.2

• E: 16.2

• Full ONC Meaningful Use Certified • O: 61%

• E: 82%

Podiatric Medicine Tomorrow

Number of new doctor of podiatric medicine graduates using five production scenarios, 2005 to 2030.

Projections of the total US population and the number of podiatric physicians per 100,000 population using five scenarios, 2005 to 2030.

Podiatric Medicine Tomorrow

Three Hypotheses:

• Likely shortage in podiatrists could lead to higher demand in services by podiatrists

• Solo/small podiatrist offices will no longer be economically feasible and podiatrists will move towards multi-specialty groups, hospitals, etc.

• Podiatrists will need to adapt to changing health-care reimbursement and payment models

2013-2014 Activities Advocacy & Stakeholder Education

Physician Payment Sunshine Act

Medicare Advantage Termination Letters

Comment Letters/Request for Information

Private Insurance Companies Outreach (e.g. United)

Medicare Physician Payment – SGR Reform and Appeal

Member Education

Reimbursement Webinar Series

Update Private Insurance Resource Guide

Effect of ACA (e.g. narrow networks)

Planning for the Future

US Wound Registry

ACO and Impact on Podiatric Medicine

Follow-up from 2013 Strategy Meeting

- Need for data to improve patient outcomes and maximize reimbursement

- Working with US Wound Registry

Today’s Strategic Meeting

• Changes to Medicare Reimbursement

• Changes to Private Insurance companies contracts and networking issues

• Development of Data Registry

• Other Issues Important to Members

• ICD-10 Transition

• DME Outlook

Considerations?

• How will changes in health care alter the practice of podiatric medicine?

• In context of reimbursement, how can HPPC advance the profession?

• What can HPPC today to prepare for tomorrow?

• Additional thoughts on how HPPC can help advance the profession?