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Health Care Reform, Reimbursement, and More on New ACEP President’s Agenda

By Jay A. Kaplan, MD, FACEP | on October 22, 2015 | 0 Comment
ACEP Policy ACEP15
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Health Care Reform, Reimbursement, and More on New ACEP President’s Agenda

Jay A. Kaplan, MD, FACEPWELCOME TO BOSTON AND ACEP15! This annual meeting is a great opportunity to spend time networking with our colleagues from all over the United States and around the world. It is a time for outstanding CME, and perhaps even more important, it is a time to be reenergized to bring our passion for excellence to our practice.

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As your new President, I personally want to invite you to try to attend as many Section and Committee meetings as possible so that you can appreciate the breadth and depth of the interests of our members and colleagues from other disciplines. Please also note that I am gratefully accepting the baton of leadership from Immediate Past President Michael J. Gerardi, MD, FAAP, FACEP, in a continuous, sustained, multiyear effort on our specialty’s behalf to attain our goals. Michael has done an outstanding job representing us, and I look forward to his continued contributions.

Let me take this opportunity to share with you some of the major initiatives that our College—supported by Committee members, staff, the Board of Directors, and perhaps your assistance—will be working on this year.

  • In accordance with the ACEP strategic plan, we want our members to receive great benefits and services that are personalized for their interests and where they are in their careers. We also want to find ways to enhance emergency department operations to ensure long, fulfilling careers. This includes ways to support emergency physicians moving to and working in relatively underserved areas, such as rural and inner-city sites.
  • Our members have been decrying the lack of access to mental health resources for psychiatric and drug-dependent patients. We have already begun to convene a coalition of specialists and medical societies to investigate programs that have been successful in parts of the country. We will then build upon those models and attempt to promulgate them nationally.
  • In the Affordable Care Act era, it is paramount that ACEP delineates and promotes the incredible value we provide in caring for patients 24-7-365. We need to help drive health care reform in our role as incredibly adept diagnosticians who execute efficient workups and timely initiation of critical care. On the other hand, we also have to be stewards of resources and recognize when care would be considered ineffective and extraordinary, such as at the end of life.
  • Toward that end, we are proud to announce that ACEP was just awarded a $3 million grant from the Center for Medicare & Medicaid Innovation as part of the Transforming Clinical Practice Initiative. This project will help us demonstrate the incredible importance of what we do every day and help us do it better. It will require all of us to understand that the future is ahead of schedule, and we cannot rest on the past and expect that doing things the same way will bring us further success.
  • Last but not least, we have to advocate for our patients and ourselves to receive fair treatment from insurance companies and federal/state government payers. We will fight against balance-billing prohibitions for out-of-network care and work relentlessly for adequate compensation for our physicians negotiating in-network participation rates. ACEP has also been working with our Government Affairs Office and our Reimbursement Committee experts to have a reasonable and logical resolution to the confusing and inconsistent regulations created by the Centers for Medicare & Medicaid Services regarding the two-midnight rule, the three-day-stay rule, and observation versus admission status.

This is an exciting time in medicine and a time with great challenges. Because of the critical and central roles our specialty plays in the acute and unscheduled care of 140 million patients every year, we have incredible opportunities to advance emergency medicine and health care in general.

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