What is the Issue?
With a new presidential administration and Congress expected to undertake large-scale health care reform proposals, it will be imperative for neurologists to make policymakers aware of the unique needs of neurology and patients with neurologic conditions. In addition to continuing to advocate for the elimination of the flawed Sustainable Growth Rate (SGR) formula, this effort will also include taking steps to make sure it is recognized that neurologists provide specialized “principal care, and that neurologic conditions often require physicians to spend considerable time managing these complex conditions.
Why is it important?
An estimated one out of every six people currently suffer from a neurologic disease. Chronic conditions such as Alzheimer’s, Parkinson’s, and dementia are expected to become more prevalent, making it vital that neurologists remain accessible.
Currently, the majority of neurologic care is provided through evaluation and management (E/M) services, also known as “cognitive care.” Cognitive care can best be described as physicians using their expertise and training to meet face-to-face with their patients to disgnose and manage their complex conditions. It is considered a very time intensive process that is not appropriately recognized in the current reimbursement system.
Compounding this situation is the fact that physician payments under Medicare have not kept pace with physician costs since 2001. While Congress passed an 18-month Medicare physician payment fix in July 2008 (giving physicians a 1.1 percent payment increase in 2009), a 21-percent cut in Medicare payments is scheduled to take effect on January 1, 2010. Should this scheduled cut take place, it will likely result in physicians refusing to take on new Medicare patients, as well as fewer physicians participating in Medicare altogether.
What is the Academy's position?
The AAN Professional Association (Academy) supports legislation to avert any further cuts to Medicare physician reimbursement by replacing the flawed SGR formula with one based on the Medical Economic Index, which measures annual practice cost increases. Paying physicians according to the actual costs associated with treating patients is necessary to maintain consistent access to providers. The Academy also supports efforts to recognize neurologists as the "principal care" providers for complex neurologic conditions they diagnose and treat.
What can you do to help?
The Academy has developed an advocacy toolkit (to the right) to help you advocate on this important issue. Ways to advocate for this issue include:
- Contacting your members of Congress using Vocus.
- Distribute The Critical Role of Neurologists in Our Health Care System, Neurology's Commitment to Quality, and A Patient-Centered Approach to Healthcare Reform when visiting with members of Congress or the media.