More than 200 hospitalists today took advantage of a unique opportunity to represent SHM and their institutions by advocating for physicians and patients as part of the annual “Hospitalists on the Hill.” The initiative provided education and coaching, talking points, and advice on how to influence the political process and the direction of our health care system.

Hospitalists then had meetings on Capitol Hill with elected representatives from their respective districts. Hospitalists were armed with packets of information containing detailed information on the issues pertinent to hospitalists and their patients. The three major issues to be discussed with legislators and their staff members included the following:

• Repeal of the SGR (H.R. 574), which now dictates a 24% reduction in Medicare reimbursement (if implemented/not rescinded); The Medicare Physician Payment Innovation Act of 2013 fully repeals the SGR, stabilizes current payment rates, eliminates scheduled SGR cuts, creates updates for undervalued primary, preventive, inpatient E&M and coordinated care services, and sets out a clear path toward comprehensive payment reform.
• Medicare Observation Status and the Three-Day Rule (H.R. 1179, S.569), which requires three consecutive overnights as an inpatient in order to qualify for Medicare benefits at a skilled nursing facility (SNF). This bill (Improving Access to Medicare Coverage Act of 2013) would adjust Medicare rules to allow observation status days to count toward the three-day inpatient rule for coverage of SNF care. There is also some discussion about eliminating observation status altogether.
• Commitment to QI and AHRQ funding; AHRQ is the only federal agency concerned with improving health care services, and does so by providing evidence-based information about the measures and standards that result or reflect true quality. SHM urges Congress to provide $434 million for AHRQ in FY 2014, in order to continue important work in improving the safety, quality, efficiency, and effectiveness of health care for all Americans.

Ron Greeno, MD, FCCP, MHM, chair of SHM’s Public Policy Committee encouraged Hill-goers, commenting that advocacy is “meaningful work,” and that this year’s training sessions were the most formalized and detailed that had been provided thus far for hospitalists with respect to prior Hill Days.

Laura Allendorf, senior advisor for SHM Advocacy and Government Affairs, said that face-to-face visits by constituents (especially busy physicians who are taking time away from work) have significant impact, and urged hospitalists to use this opportunity to further the hospitalists’ message of our specialty’s importance in the delivery of healthcare in today’s environment. As the fastest growing discipline in medicine, she reiterated the importance of the hospitalist’s role in communicating our focus on quality care and highlighted the impact the organization has already made in communicating our “non-self-serving messages,” in helping our leaders in Washington make informed decisions about what health care will look like in the future.

Former legislative staffer Stephanie D. Vance, of Advocacy Associates, LLC, helped crystallize specific points about the political process and “how Washington works—or doesn’t.” For example:

• Out of the approximately 10,000 bills introduced each year, about 2,500 have to do with healthcare;
• Of the approximately 4% of bills that are ultimately passed, about 1/3 are concerned with renaming post offices and federal buildings;
• The primary influential factor in advocacy is a personal visit with a constituent (not a lobbyist).

Vance encouraged hospitalists to use their experience to communicate personal patient-related stories to have greater impact, and to explain the relevance of the story to the bill and how it relates to their work as hospitalists. TH

Dr. Hunter is a member of Team Hospitalist.