Pierce County Medical Society President Dr. Brian Mulhall, Treasurer Dr. Aaron Pace, and Executive Director Bruce Ehrle met with United States Representative Dave Reichert on June 1, 2016 to advocate for physician and PA members of the Society.
Rep. Reichert is a senior member of the US House Ways and Means Committee that includes health care within its jurisdiction and who represents Washington’s 8th Congressional District that includes eastern Pierce County. He and PCMS leaders spent 45 minutes discussing a wide variety of issues.
Society leaders advocated for a fair and sensible implementation of the Quality Payment System brought about by passage of MACRA that will not unduly harm health systems such as CHI Franciscan or MultiCare with metrics that impact reimbursement which do not reflect the realities of front line care nor place independent practitioners at a disadvantage that will hurt their ability to continue to deliver care in that setting. The group discussed recent testimony by the CMS Administrator before the House Ways and Means Committee where he was questioned by committee members about the impact MACRA implementation will have on private practices whereupon the Administrator stated that it is not the intention of the agency to drive such practices out of business or put them in a position where they find it impossible to succeed in the new payment models focused on quality and patient outcomes. Rep. Reichert noted that the committee will be continuing such oversight and expressed his willingness to remain in close contact with PCMS about how implementation is impacting physicians across the wide spectrum of care settings. He noted the importance of having the movement away from fee-for-service toward payment for quality and value include physician input and reflect physicians being valued partners in the process.
With HIT adoption being rolled in to MACRA implementation, PCMS leaders also reviewed the challenges that remain toward achieving full interoperability and full inclusion of both medical and behavioral data in such records. Rep. Reichert expressed his continued commitment to seek sensible solutions to the tremendous hurdles that have yet to be overcome with regard to HIT adoption and use. Additionally, PCMS attendees discussed methods by which first responders could achieve access to unified, interoperable EHRs in order to direct patients to the correct physicians in the correct care settings and as a former first responder himself, the Congressman was very interested in the improved patient outcomes and reduced costs that such approaches for paramedics and EMTs could assist with.
Society leaders and Rep. Reichert spent a significant period of time discussing elements of medical and behavioral health integration along with the need to overcome substantial barriers that prevent the best care and outcomes for patients including frequent lack of referral capability and incongruities in the payment system to adequately reimburse for certain types of care in a seamless manner. With graduate medical education increasingly providing incentives for new physicians to go in to primary care, PCMS leaders recommended similar measures to increase the number of behavioral health care providers in order to overcome a significant shortage nationally and especially within the State of Washington. The group also discussed how getting military personnel in to confidential behavioral health care off post in off-duty hours is hampered by these same payment and care supply issues and the Congressman agreed that they absolutely must be solved. Society leaders also noted the importance of appropriate resources for primary care physicians, especially those treating patients going through a first economic or housing crisis and in the pediatric setting to prevent traumas from leading to severe behavioral health conditions. Rep. Reichert stated his strong interest in these issues and a willingness to work in partnership with PCMS on public policy solutions as well as innovative privately based behavioral health programs. The Society continued its advocacy for federal funding for the new mental health hospital being pursued by CHI Franciscan and MultiCare as a way to help address the behavioral health capacity crisis in Pierce County with a facility that will represent the best aspects of 21st Century care.
With regard to two final issues addressed in the meeting, PCMS leaders expressed a willingness to work with Rep. Reichert to explore ways to direct health care resources to the underserved rural eastern part of Pierce County that he represents and asked him to keep in mind that dramatically higher health insurance deductibles, co-pays, and annual out-of-pocket costs are increasingly impacting patients’ ability to seek and pay for care by physicians. He acknowledged an appreciation for both issues and agreed that ongoing collaboration with the Pierce County Medical Society will be important including through Bruce Ehrle’s continued service on his Healthcare Advisory Committee and other future interactions with the Society.