It was a very active few days at this year’s AMA House of Delegates (AMA-HOD) meeting. ASCO had composed and successfully brought to the HOD several resolutions representing some of our most pressing concerns and/or initiatives.
ASCO proposed a resolution emphasizing concerns about new USP 800 regulations on how we as oncologists may be required to handle “hazardous” materials. Fulfilling these regulations will place a large burden on individual practices from the administrative, logistic, and financial aspects. Our resolution requests that the AMA advocate against policies mandating adherence to these elements.
A resolution highlighting the issues associated with the propensity, lack of standardization, and transparency of clinical pathways was crafted with the help of the ASCO’s pathway task force. Many resolves were pursued, including AMA support in the development of transparent collaboratively constructed pathways, as well as adopting policy that will be opposed to any effort that requires 100% physician concordance. Transparency will include making publically available all names, COIs, and affiliations contributing to or influencing a pathway's development. The AMA will also study the impact of pathways from all standpoints, including the implications of that process on access of patient care as well as their financial impact.
We (ASCO) posed a resolution requesting that the AMA work with Congress and CMS to exempt all Medicare Part B and Part D drug costs from any current and future resource-use measurement that may be implemented in the Merit-based Incentive Payment System (MIPS) and developing alternate payment models (APMs).
Finally, we presented a profound need to continue whatever means necessary to stop the implementation of the CMS Medicare Part B drug payment model. This resolve also requested that the AMA oppose any policy that may undermine access to the best course of treatment for our patients, as well as those that could lead to a lower quality of care or those that do not contain adequate patient safeguards.
All were debated (some with great passion) and all were adopted. Some language change had to be accepted, but the main theme and spirit of each resolution was not altered.
In addition, we sponsored individuals running for office in the AMA and prepared for future candidacies. We also cosponsored and spoke to many other reports and resolutions. Many were along the same themes as ours. Finally, the cancer caucus led by ASCO continues to be a forum of lively debate.
ASCO’s presence at this important body is growing in stature. We are now frequently sought out for needed thoughts, opinions, and support. This is all occurring at a time when our profession (as well as all of medicine) is undergoing a precedent-setting transformation. Medical oncology needs and concerns are many and the medical community is listening. We are not alone. All the community shares in those concerns. The AMA represents an absolutely essential partner in bringing those concerns to those responsible for policies affecting our profession and the care of our patients. It represents one of the few effective alternatives where our concerns might and will be acted on.
ASCO’s delegation (Tom Marsland, MD, FASCO; Ray Page, DO; Kristina Novick, MD; Steve Lee, MD; Barbara McAneny, MD, FASCO; and me) is dedicated and well prepared. Groundwork for this meeting can be daunting. The delegation’s effectiveness relies on an equally dedicated and strong ASCO staff (Ms. Kristin McDonald, Ms. Monica Tan, and Dr. Karen Hagerty). We are all pleased to have gotten so much done, but also realize that there is so much more to do.
The next AMA-HOD will be in November and I look forward to sharing the highlights of that meeting with you.