As a second-year fellow in the Division of Vascular Surgery in the University of Colorado Anschutz Department of Surgery, LaVerne Thompson, MD, knows how important Medicare reimbursement is to keeping clinics up and running.
“A lot of people, when they envision a doctor, they envision somebody who’s very wealthy and doesn't have any money problems,” Thompson says. “But if you run a private practice, or if you’re part of a small group or an independent group, if that lack of reimbursement doesn't keep up with inflation, it's barely enough to cover supplies, let alone staffing and the cost of doing business. A lot of private practices and smaller groups are closing down or being eaten up by larger systems, which limits the ability for people to choose exactly where they're getting their care.”
Thompson joined the effort to increase government awareness around Medicare reimbursement — which has declined by 33% in recent years — when she attended the Society for Vascular Surgery’s inaugural Advocacy Conference in September. Long interested in issues around health equity, Thompson went to the conference to grow as a physician-leader and advance systems-level work that can make a difference in patient care and academic medicine.
“We spent the first two days of the conference going over strategies for how to communicate with congressional and senatorial staff, because they have very limited time to understand these things, and many of them don't have a background in medicine,” Thompson says. “We learned the fundamentals of how physician reimbursement is determined, which committees in the government have a say in this, and what changes have been made recently to address the issues of physician reimbursement. We also talked about the Protect Our Seniors Act, which is a bill that will help ensure Medicare and Medicaid benefits for seniors. We learned about the pieces of legislation that are currently on the table and potentially affect our field — not just for vascular surgeons, but for many specialties.”
After that preparation, Thompson and her fellow conference attendees went to Capitol Hill to meet with legislators and their advisors, explain the Improving Seniors’ Timely Access to Care Act and other pending legislation that will affect Medicare and Medicaid funding and reimbursement.
“The only senator I spoke to directly was Senator Maria Cantwell, of Washington,” Thompson says. “They paired us with people who were in our same region and tried to make it so that we could talk to our own lawmakers as their constituents. In addition to Senator Cantwell, I spoke to the health policy advisors for Colorado Senator Michael Bennet, Senator John Hickenlooper, and Representative Diana DeGette. They were all open and responsive, and I think they understand this legislation helps ensure that health care is not just affordable for their constituents, but it can be delivered effectively and mitigate any shortages of care that they're going to incur in the long run.”
Thompson and the other conference attendees also spoke with lawmakers about the Resident Education Deferred Interest (REDI) Act, a pending piece of legislation that would increase participation in medical residency programs by deferring student loan interest while residents are in training.
“That would give a lot of medical students and residents the financial freedom to consider specialties that require a longer training program and not worry about how much debt they're getting into or how much income they're losing,” Thompson says. “It's easier to say, ‘I can go into internal medicine, do three or four years of residency, get out, and start making money,’ versus saying, ‘I like vascular surgery, but that's seven years of training, and I'm worried about these loans, and I have a child. It helps give you that financial freedom.”
In addition to speaking with lawmakers, Thompson also appreciated the Advocacy Conference for the sense of community it gave her with other vascular surgeons from around the country.
“We were all sharing stories of times that we had been held up by insurance, or patient care had to play second fiddle to insurance or cost or whatever the case may be,” she says. One of the physicians shared that because of issues with funding and physician availability, he has patients that have to go two hours away in order to get their care. Making sure that we have a stable platform to improve the presence of physicians in the future, and especially vascular surgeons, is so important. It was great to get their insight and hear things that they've done to navigate that process more easily.”
Most of all, though, she was proud to be able to communicate directly with lawmakers and educate them on legislation that has the potential to help so many people.
“I didn't realize that I could participate in American politics, so there was a lot of pride in that,” she says. “I felt like I was getting to speak for my patients and affect the way that policymakers think about what we need. And that really felt good."
Featured image: LaVerne Thompson, MD, and Muhammad Ali, MD, a general surgery chief resident from Buffalo, New York, prepare for a day of speaking with lawmakers.