President

Progress toward value-based care by Medicare and commercial payors will continue regardless of the election outcome in November. The health care market will continue to move away from fee-for-service and toward reimbursement systems that reward physicians for improving the quality of patient care and controlling costs. AGA is shaping the future of practice. We continue to be at the forefront of the value-based movement, creating the tools gastroenterologists need for success in new reimbursement environments and preparing our members for a successful future.

Did you know?

• AGA has created bundle and episode payment models for GI issues, including colonoscopy screening and surveillance and GERD, with obesity to launch in 2016 and more to come. These alternative payment models reward providers for identifying efficiency gains, effectively coordinating patient care and improving quality. By the time the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015, AGA was ready with fully developed, practical alternative payment model solutions for GI.

• AGA is the only GI society to advocate for Medicare to recognize established GI payment models as advanced alternative payment models (APMs) so that gastroenterologists will have a pathway to greater earnings than under the Merit-based Incentive Payment System (MIPS). Not sure what MACRA, MIPS, and APMs are? AGA can help.

• AGA is also the only GI society to develop a MACRA education tool that explains, in plain language, MACRA’s impact on GIs and offers a customized plan for how to prepare based on your practice situation.

• AGA has established relationships with Medicare and commercial payors that allow us to provide input on coverage decisions. We recognize that payor coverage of procedures and technology plays a vital role in reimbursement success and we take every opportunity to provide payors with input from AGA member experts.

• In addition to AGA’s rigorous, evidence-based clinical practice guidelines, we provide expert reviews and other clinical practice guidance documents to provide best practice advice for physicians in areas in which there is not yet enough literature to produce a clinical guideline. Additionally, Technology Coverage Statements provide support when working with payors on coverage and reimbursement for proven procedures, diagnostics, and therapies that advance the science and practice of gastroenterology and improve care for the patients you treat.

AGA works hard for the gastroenterology field to ensure that you are poised for success under new reimbursement models and will continue to do so. Learn more at http://www.gastro.org/practice-management.

Progress toward value-based care by Medicare and commercial payors will continue regardless of the election outcome in November. The health care market will continue to move away from fee-for-service and toward reimbursement systems that reward physicians for improving the quality of patient care and controlling costs. AGA is shaping the future of practice. We continue to be at the forefront of the value-based movement, creating the tools gastroenterologists need for success in new reimbursement environments and preparing our members for a successful future.

Did you know?

• AGA has created bundle and episode payment models for GI issues, including colonoscopy screening and surveillance and GERD, with obesity to launch in 2016 and more to come. These alternative payment models reward providers for identifying efficiency gains, effectively coordinating patient care and improving quality. By the time the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015, AGA was ready with fully developed, practical alternative payment model solutions for GI.

• AGA is the only GI society to advocate for Medicare to recognize established GI payment models as advanced alternative payment models (APMs) so that gastroenterologists will have a pathway to greater earnings than under the Merit-based Incentive Payment System (MIPS). Not sure what MACRA, MIPS, and APMs are? AGA can help.

• AGA is also the only GI society to develop a MACRA education tool that explains, in plain language, MACRA’s impact on GIs and offers a customized plan for how to prepare based on your practice situation.

• AGA has established relationships with Medicare and commercial payors that allow us to provide input on coverage decisions. We recognize that payor coverage of procedures and technology plays a vital role in reimbursement success and we take every opportunity to provide payors with input from AGA member experts.

• In addition to AGA’s rigorous, evidence-based clinical practice guidelines, we provide expert reviews and other clinical practice guidance documents to provide best practice advice for physicians in areas in which there is not yet enough literature to produce a clinical guideline. Additionally, Technology Coverage Statements provide support when working with payors on coverage and reimbursement for proven procedures, diagnostics, and therapies that advance the science and practice of gastroenterology and improve care for the patients you treat.

AGA works hard for the gastroenterology field to ensure that you are poised for success under new reimbursement models and will continue to do so. Learn more at http://www.gastro.org/practice-management.

Progress toward value-based care by Medicare and commercial payors will continue regardless of the election outcome in November. The health care market will continue to move away from fee-for-service and toward reimbursement systems that reward physicians for improving the quality of patient care and controlling costs. AGA is shaping the future of practice. We continue to be at the forefront of the value-based movement, creating the tools gastroenterologists need for success in new reimbursement environments and preparing our members for a successful future.

Did you know?

• AGA has created bundle and episode payment models for GI issues, including colonoscopy screening and surveillance and GERD, with obesity to launch in 2016 and more to come. These alternative payment models reward providers for identifying efficiency gains, effectively coordinating patient care and improving quality. By the time the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015, AGA was ready with fully developed, practical alternative payment model solutions for GI.

• AGA is the only GI society to advocate for Medicare to recognize established GI payment models as advanced alternative payment models (APMs) so that gastroenterologists will have a pathway to greater earnings than under the Merit-based Incentive Payment System (MIPS). Not sure what MACRA, MIPS, and APMs are? AGA can help.

• AGA is also the only GI society to develop a MACRA education tool that explains, in plain language, MACRA’s impact on GIs and offers a customized plan for how to prepare based on your practice situation.

• AGA has established relationships with Medicare and commercial payors that allow us to provide input on coverage decisions. We recognize that payor coverage of procedures and technology plays a vital role in reimbursement success and we take every opportunity to provide payors with input from AGA member experts.

• In addition to AGA’s rigorous, evidence-based clinical practice guidelines, we provide expert reviews and other clinical practice guidance documents to provide best practice advice for physicians in areas in which there is not yet enough literature to produce a clinical guideline. Additionally, Technology Coverage Statements provide support when working with payors on coverage and reimbursement for proven procedures, diagnostics, and therapies that advance the science and practice of gastroenterology and improve care for the patients you treat.

AGA works hard for the gastroenterology field to ensure that you are poised for success under new reimbursement models and will continue to do so. Learn more at http://www.gastro.org/practice-management.

This January I was fortunate to spend a day on Capitol Hill meeting with AGA senior policy staff and key members of Congress who have jurisdiction over critical policy priorities for AGA and the profession of gastroenterology. It was an interesting and informative day. Among other things, I learned that individuals on Capitol Hill are interested in hearing from us to gain our insight and expertise on the practice and science of gastroenterology and patient care.

Senate

During my time visiting the Senate side of Capitol Hill, I met with the offices of Sen. Bill Cassidy (R-La.), Sen. Ben Cardin (D-Md.), Sen. Sherrod Brown (D-Ohio), and Sen. Amy Klobuchar (D-Minn). Sen. Cassidy, as you may be aware, has been an AGA member and champion for many of our policy priorities. Most recently, he, along with Sen. Cardin, spearheaded the Senate effort in contacting CMS and expressing concern over cuts in reimbursement for colonoscopy. Sen. Cassidy was critical in implementing the new transparency policy at CMS, which led to the announcement of changes in physician values in the proposed rule, instead of the final rule. This will ensure that stakeholders have the opportunity to participate in the rulemaking process.

We also discussed the AGA obesity initiative that is being developed. This is a multidisciplinary approach to treating the disease. I had the opportunity to educate Sen. Cassidy’s staff on some of the new drugs that have been approved to treat obesity and the emergence of new endoscopic procedures that could have an impact on how we treat this growing epidemic. I also learned about Sen. Cassidy’s legislation, S. 1509/H.R. 2404, Treat and Reduce Obesity Act, which would cover behavioral therapy, as well as drugs, to treat obesity under Medicare. Sen. Cassidy is very concerned with obesity, especially in Louisiana, where it is a major public health problem. We will continue to work with Sen. Cassidy on this important initiative, as well as other public health initiatives, given his role on the Senate Health, Education, Labor and Pensions Committee.

I also had the honor of meeting with Sen. Brown’s staff. Sen. Brown is the main sponsor of the Removing Barriers to Colorectal Cancer Screening Act legislation that would fix the current co-insurance problem requiring Medicare beneficiaries to face out-of-pocket expenses when their screening colonoscopy becomes therapeutic. We impressed upon the staff our concern that this is a deterrent to undergoing colonoscopy for colorectal cancer screening. One of the main obstacles to getting this bill over the finish line is a favorable “score” (or additional cost) from the Congressional Budget Office and finding an appropriate legislative vehicle given this year’s short legislative session. I was able to thank Sen. Brown for his support of NIH, given that Congress gave the institute a $2 billion budget increase last year as part of the Omnibus Appropriations Bill.

In my discussions with Sen. Klobuchar’s staff, I thanked her for her support of NIH and access to colorectal cancer screening. She has been a champion of repealing the medical device tax, which received a 2-year delay as part of the recent Omnibus Bill. Finally, I met with Sen. Cardin, who has a long history of supporting colorectal cancer screening and was instrumental in first implementing the benefit under Medicare, as part of the Balanced Budget Act. He continues to champion many of our priorities, including NIH funding, fair reimbursement for colonoscopy and fixing the coinsurance waiver.

House of Representatives

I was also fortunate to meet with the staff for several representatives on the House side, including those key individuals involved in health legislation. The staff to Labor, HHS Appropriations Subcommittee Chair Tom Coles (R-Okla.) who was critical in ensuring that NIH received a bump in funding, conveyed that they would like to continue with sustained funding just as Congress did during the period when the NIH budget was doubled. They were very interested in learning about my own research on obesity at Mayo Clinic and the implications it could have in more effectively treating the disease.

I also met with staff for Rep. Jim McGovern, (D-Mass.), a senior member of the House Rules Committee and a longtime supporter of improving access to colorectal cancer screening, and Rep. Tim Walz, (D-Minn.), who is a representative from my congressional district in Minnesota. Both are strong supporters of NIH funding and colorectal cancer screening.

My experience showed me how willing our lawmakers on Capitol Hill are to meet with gastroenterologists, to learn about our experiences and our patients, and to find ways to work with us to ensure the correct laws are in place to ensure our patients are receiving the best care.
Medical research advances and the practice of medicine affect everyone in this country. We need to work with Congress to continue to advocate for the programs and initiatives that are vital to our patients and to our specialty, gastroenterology.

This January I was fortunate to spend a day on Capitol Hill meeting with AGA senior policy staff and key members of Congress who have jurisdiction over critical policy priorities for AGA and the profession of gastroenterology. It was an interesting and informative day. Among other things, I learned that individuals on Capitol Hill are interested in hearing from us to gain our insight and expertise on the practice and science of gastroenterology and patient care.

Senate

During my time visiting the Senate side of Capitol Hill, I met with the offices of Sen. Bill Cassidy (R-La.), Sen. Ben Cardin (D-Md.), Sen. Sherrod Brown (D-Ohio), and Sen. Amy Klobuchar (D-Minn). Sen. Cassidy, as you may be aware, has been an AGA member and champion for many of our policy priorities. Most recently, he, along with Sen. Cardin, spearheaded the Senate effort in contacting CMS and expressing concern over cuts in reimbursement for colonoscopy. Sen. Cassidy was critical in implementing the new transparency policy at CMS, which led to the announcement of changes in physician values in the proposed rule, instead of the final rule. This will ensure that stakeholders have the opportunity to participate in the rulemaking process.

We also discussed the AGA obesity initiative that is being developed. This is a multidisciplinary approach to treating the disease. I had the opportunity to educate Sen. Cassidy’s staff on some of the new drugs that have been approved to treat obesity and the emergence of new endoscopic procedures that could have an impact on how we treat this growing epidemic. I also learned about Sen. Cassidy’s legislation, S. 1509/H.R. 2404, Treat and Reduce Obesity Act, which would cover behavioral therapy, as well as drugs, to treat obesity under Medicare. Sen. Cassidy is very concerned with obesity, especially in Louisiana, where it is a major public health problem. We will continue to work with Sen. Cassidy on this important initiative, as well as other public health initiatives, given his role on the Senate Health, Education, Labor and Pensions Committee.

I also had the honor of meeting with Sen. Brown’s staff. Sen. Brown is the main sponsor of the Removing Barriers to Colorectal Cancer Screening Act legislation that would fix the current co-insurance problem requiring Medicare beneficiaries to face out-of-pocket expenses when their screening colonoscopy becomes therapeutic. We impressed upon the staff our concern that this is a deterrent to undergoing colonoscopy for colorectal cancer screening. One of the main obstacles to getting this bill over the finish line is a favorable “score” (or additional cost) from the Congressional Budget Office and finding an appropriate legislative vehicle given this year’s short legislative session. I was able to thank Sen. Brown for his support of NIH, given that Congress gave the institute a $2 billion budget increase last year as part of the Omnibus Appropriations Bill.

In my discussions with Sen. Klobuchar’s staff, I thanked her for her support of NIH and access to colorectal cancer screening. She has been a champion of repealing the medical device tax, which received a 2-year delay as part of the recent Omnibus Bill. Finally, I met with Sen. Cardin, who has a long history of supporting colorectal cancer screening and was instrumental in first implementing the benefit under Medicare, as part of the Balanced Budget Act. He continues to champion many of our priorities, including NIH funding, fair reimbursement for colonoscopy and fixing the coinsurance waiver.

House of Representatives

I was also fortunate to meet with the staff for several representatives on the House side, including those key individuals involved in health legislation. The staff to Labor, HHS Appropriations Subcommittee Chair Tom Coles (R-Okla.) who was critical in ensuring that NIH received a bump in funding, conveyed that they would like to continue with sustained funding just as Congress did during the period when the NIH budget was doubled. They were very interested in learning about my own research on obesity at Mayo Clinic and the implications it could have in more effectively treating the disease.

I also met with staff for Rep. Jim McGovern, (D-Mass.), a senior member of the House Rules Committee and a longtime supporter of improving access to colorectal cancer screening, and Rep. Tim Walz, (D-Minn.), who is a representative from my congressional district in Minnesota. Both are strong supporters of NIH funding and colorectal cancer screening.

My experience showed me how willing our lawmakers on Capitol Hill are to meet with gastroenterologists, to learn about our experiences and our patients, and to find ways to work with us to ensure the correct laws are in place to ensure our patients are receiving the best care.
Medical research advances and the practice of medicine affect everyone in this country. We need to work with Congress to continue to advocate for the programs and initiatives that are vital to our patients and to our specialty, gastroenterology.

This January I was fortunate to spend a day on Capitol Hill meeting with AGA senior policy staff and key members of Congress who have jurisdiction over critical policy priorities for AGA and the profession of gastroenterology. It was an interesting and informative day. Among other things, I learned that individuals on Capitol Hill are interested in hearing from us to gain our insight and expertise on the practice and science of gastroenterology and patient care.

Senate

During my time visiting the Senate side of Capitol Hill, I met with the offices of Sen. Bill Cassidy (R-La.), Sen. Ben Cardin (D-Md.), Sen. Sherrod Brown (D-Ohio), and Sen. Amy Klobuchar (D-Minn). Sen. Cassidy, as you may be aware, has been an AGA member and champion for many of our policy priorities. Most recently, he, along with Sen. Cardin, spearheaded the Senate effort in contacting CMS and expressing concern over cuts in reimbursement for colonoscopy. Sen. Cassidy was critical in implementing the new transparency policy at CMS, which led to the announcement of changes in physician values in the proposed rule, instead of the final rule. This will ensure that stakeholders have the opportunity to participate in the rulemaking process.

We also discussed the AGA obesity initiative that is being developed. This is a multidisciplinary approach to treating the disease. I had the opportunity to educate Sen. Cassidy’s staff on some of the new drugs that have been approved to treat obesity and the emergence of new endoscopic procedures that could have an impact on how we treat this growing epidemic. I also learned about Sen. Cassidy’s legislation, S. 1509/H.R. 2404, Treat and Reduce Obesity Act, which would cover behavioral therapy, as well as drugs, to treat obesity under Medicare. Sen. Cassidy is very concerned with obesity, especially in Louisiana, where it is a major public health problem. We will continue to work with Sen. Cassidy on this important initiative, as well as other public health initiatives, given his role on the Senate Health, Education, Labor and Pensions Committee.

I also had the honor of meeting with Sen. Brown’s staff. Sen. Brown is the main sponsor of the Removing Barriers to Colorectal Cancer Screening Act legislation that would fix the current co-insurance problem requiring Medicare beneficiaries to face out-of-pocket expenses when their screening colonoscopy becomes therapeutic. We impressed upon the staff our concern that this is a deterrent to undergoing colonoscopy for colorectal cancer screening. One of the main obstacles to getting this bill over the finish line is a favorable “score” (or additional cost) from the Congressional Budget Office and finding an appropriate legislative vehicle given this year’s short legislative session. I was able to thank Sen. Brown for his support of NIH, given that Congress gave the institute a $2 billion budget increase last year as part of the Omnibus Appropriations Bill.

In my discussions with Sen. Klobuchar’s staff, I thanked her for her support of NIH and access to colorectal cancer screening. She has been a champion of repealing the medical device tax, which received a 2-year delay as part of the recent Omnibus Bill. Finally, I met with Sen. Cardin, who has a long history of supporting colorectal cancer screening and was instrumental in first implementing the benefit under Medicare, as part of the Balanced Budget Act. He continues to champion many of our priorities, including NIH funding, fair reimbursement for colonoscopy and fixing the coinsurance waiver.

House of Representatives

I was also fortunate to meet with the staff for several representatives on the House side, including those key individuals involved in health legislation. The staff to Labor, HHS Appropriations Subcommittee Chair Tom Coles (R-Okla.) who was critical in ensuring that NIH received a bump in funding, conveyed that they would like to continue with sustained funding just as Congress did during the period when the NIH budget was doubled. They were very interested in learning about my own research on obesity at Mayo Clinic and the implications it could have in more effectively treating the disease.

I also met with staff for Rep. Jim McGovern, (D-Mass.), a senior member of the House Rules Committee and a longtime supporter of improving access to colorectal cancer screening, and Rep. Tim Walz, (D-Minn.), who is a representative from my congressional district in Minnesota. Both are strong supporters of NIH funding and colorectal cancer screening.

My experience showed me how willing our lawmakers on Capitol Hill are to meet with gastroenterologists, to learn about our experiences and our patients, and to find ways to work with us to ensure the correct laws are in place to ensure our patients are receiving the best care.
Medical research advances and the practice of medicine affect everyone in this country. We need to work with Congress to continue to advocate for the programs and initiatives that are vital to our patients and to our specialty, gastroenterology.