The AC and the AMA – Part II

| November 11, 2019

The AC and the AMA – Part II

The Advocacy Council and College often work quietly behind the scenes with the American Medical Association (AMA).  This collaboration goes back many years and has become stronger because of changes in the U.S. national health care system.

Since 1967, the College and other allergists have been represented in the AMA House of Delegates (HOD). The AMA Section on Allergy was organized in 1962 by Drs. Farr, de Gara, Henderson, Rapaport, Kaplan and Matthews. Dr. Matthews served as the allergists’ AMA HOD voting member starting in 1967.  

Early on, Drs. Perlman, Green, Pittsburg, Brennan, Van Arsdale, Hale and Caplin also served in the AMA HOD Allergy Section. The College achieved its own vote in the AMA’s HOD in 1980 and has since faithfully and ably been served by its Delegates: Drs. Brennan, Triplett, Lanier and currently Malick. The three allergy organizations (the College, the ENT Allergists and the American Academy of Allergy, Asthma and Immunology) now caucus at AMA with other physician groups including Critical Care, Chest, Pulmonary and Sleep Medicine organizations. 

Dr. Sue Bailey, former College board member and powerful Speaker of the AMA HOD, now serves as the AMA’s President-elect. The College and AMA recently joined forces in response to changes in U.S. health care policy laws and regulations; and to changes at the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP) over compounding regulations.

The College organized a new Alternative Payments Model (APM) Committee in 2015 to respond to changes in U.S. health care policy after the replacement of the RBRVS reimbursement system. The new committee was placed under the College’s Advocacy Council with members J. A. Meadows, D. Aaronson, T. Miller, B. Smart, V. Tubiolo, S. Imbeau and K. Tyler, competently staffed by Jennifer Pfeifer. Later J. Sublett, B. Finerfrock, R. Burke and individuals from the asthma test sites were added. To show its support of our efforts, the AMA arranged and paid for Sandy Marks (AMA staff) and Harold Miller, a consultant with the Center for Health Care Quality and Payment Reform, to lead us in development of the APM.

We chose to first develop an APM for Asthma. Mr. Miller moderated an in-person APM Committee meeting and helped develop the initial steps on the APM. A draft model for asthma was developed by the early fall. In November 2016 and in early 2017, we presented the model to colleagues at national conferences, including the National MACRA Conference.  The model development demanded a huge amount of work.  

At the November 2016 College meeting, we began a search for Asthma APM test sites among our colleagues; this work continues. In the summer of 2017, we submitted our intent to file an Asthma APM with the Center for Medicare and Medicaid Services (CMS). The final APM draft was filed this past summer with CMS’ Physician-Focused Payment Model Technical Advisory Committee (PTAC). PTAC reviews models for acceptance by CMS for reimbursement under Medicare. Dr. J. Tracy now leads the College APM Committee and was recently elected to serve as chair of the Advocacy Council. 

If your practice is interested in becoming a test site for the Asthma APM, contact Jennifer Pfeifer.

The Advocacy Council has you covered.