Capitol Hill Report: Are Neurologists Worth It?

June 17, 2011

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468, mamery@aan.com

Of Course Neurologists Are Worth It—And We Have the Data

When I'm on Capitol Hill, I often get questions about whether neurologists are worth it. Members of Congress frequently act on anecdotes, but their staffs want data showing Medicare dollars spent on neurologists are a good use of resources. Academy staff has been working for quite some time developing solid data that clearly shows the benefit of seeing a neurologist compared to other physicians when dealing with neurologic conditions.

Last week, the Academy published some of that data in two documents. The first is "Compelling Neurology Statistics," which details trends related to an increasing prevalence of neurologic disease and decreasing supply of neurologists. The second is "Evidence of High Quality Cost Efficient Neurologic Care," which references studies showing how care provided by neurologists benefits patients, limits unnecessary costs, and avoids prolonged hospitalization.

I will be using this information during my visits to the Hill, and I encourage all Academy members to read these documents and be prepared to discuss them if you ever have a minute with your members of Congress or key decision makers within your community.

No Health Reform Fixes in 2011?

I talked personally with several members of Congress of this week including physicians Paul Brown (R-GA), Tom Price (R-GA), and Larry Buschon (R-IN). Although you can't get away from the topic of Congressman Anthony Weiner (D-NY) and his Twitter account, the conversation eventually gets around to the debt crisis and the need for increasing the debt limit by August 2. The Academy is looking for some changes to the health care bill as well as a permanent repeal of the SGR formula, which is set to cut physician payments by almost 30 percent on January 1, 2012. Ideally, some of these changes would be made in a compromise to increase the debt limit, as this is one of just a few "must pass" pieces of legislation left this year. We have been making our case over the past few months to literally hundreds of members of Congress, but I'm concerned that an SGR fix may not happen until much later in the year and adjustments to the health reform bill, however minor, might not happen at all.

My conversation with Budget Committee Chairman Paul Ryan (R-WI) confirmed these concerns. Ryan steadfastly opposes parts of the Affordable Care Act, including the IPAB (see the last report for more on the IPAB), but says he doubts anything is going to happen in 2011. Republicans repealed health care reform in the House, and according to Ryan, they have no interest in trying to open up the bill to make it better piece by piece.

The Academy will keep working to include an SGR fix in the debt limit increase and you can urge your members of Congress to act by sending a message, but I wouldn't be surprised if we are looking at Christmas before any real solution is adopted.

Patient Groups Are Often Key

Last week, the Academy's DC office hosted a meeting with representatives of the National MS Society, Epilepsy Foundation, Alzheimer's Association, Alzheimer's Foundation, Parkinson's Action Network, Neuropathy Association, and American Stroke Association. We have worked with these groups for a long time and are appreciative they could come together to discuss pressing issues being debated in Congress.

Collaboration between physicians and patients can be a powerful tool while advocating on Capitol Hill. A prime example was in 2007-08 when the AAN teamed up with the Epilepsy Foundation to pass legislation that created the Epilepsy Centers of Excellence within the VA. Working with Rep. Ed Perlmutter (D-CO), who has a daughter with epilepsy, we convinced Congress to pass the legislation in late 2008 and today the centers are flourishing.

The groups at the table last week agreed to develop a plan to support funding for neurologic research that would benefit all neurology stakeholders. This is in contrast to more recent efforts by individual patient groups to pass to legislation that only impact their particular disease. These attempts have been largely unsuccessful as Congress has shown little interest in picking winners and losers based on disease.