Earlier this summer on June 25th and 26th , 81 radiation oncologists arrived en masse at Capitol Hill to share our perspective with Congressional leaders, learn more about current health policy issues pertinent to radiation oncology, and of paramount importance, advocate on behalf of our cancer patients. Residents made a strong showing this year with 24 attendees, and their enthusiasm was evident. Many of the trainees in attendance were women involved with SWRO who were excited to serve our field and discover more about advocacy.
The first day of the session included the Chair Address regarding processes for improving quality care for our patients by Dr. Brian Kavanagh, followed by a discussion with representatives from the Center for Medicare and Medicaid Innovation (CMMI). Chief Medical Officer, Dr. Anand Shah, and Director of the Division of Specialty Payment Models, Ellen Lukens, shared updates on the Oncology Care Model, which is a new Advanced Alternative Payment Model (APM) being tested, meant to improve quality care for cancer patients. While this model is well intentioned, ASTRO is working with the CMMI to propose their own Radiation Oncology APM that more comprehensively takes into account the aspects of treatment for patients receiving radiation as part of their multidisciplinary care. After 20% cuts to Medicare reimbursement rates for freestanding clinics from 2009-2014, legislation (PAMPA) was passed which froze reimbursement rates through 2019, allowing more time for radiation oncology stakeholders to develop the RO-APM with the CMMI. Especially interesting
was hearing how Dr. Shah, a radiation oncologist himself, followed his passion for advocacy and created a career path in health policy with the NCI. Following this, social media supporters in radiation oncology inspired many more attendees to become engaged in Twitter and demonstrated the value that it can bring to advocacy, education and networking. Be on the look out for a future blog post with tips on how to become more active.
The following day, attendees broke out into their respective states and participated in senate
and house office visits on Capitol Hill. Key issues discussed included urging congress to allow
radiation oncologists to participate in an advanced APM, stabilizing Medicare reimbursements, increasing cancer research funding through the National Cancer Institute (NCI), and reducing physician burden and delays in patient care from prior authorizations. The highlight of the day came when the Surgeon General, Dr. Jerome Adams, made an impromptu visit during lunch and spoke about his priorities for the health of our nation. He also told how our mission was personally meaningful to him, as his wife is being treated for metastatic melanoma.
Figure 1. Radiation oncology residents with the Surgeon General, Dr. Jerome Adams
Why is all of this important? We are at a key juncture with regards to health policy. Payment
models are being proposed that may influence how cancer patients are treated, and unless we as a collective specialty make a seat for ourselves at the discussion table, we will be left out and critical decisions about the future of cancer care will be made without our input. Ideally, the best model is one that takes the expertise of all parties of the multidisciplinary team into consideration, with the end goal of creating a model that incentivizes the system to deliver the best evidence based care for our patients.
The fervor and passion with which our ASTRO leaders responded, as well as the attentiveness of representatives from the CMMI, reassured me that our patients and the future of our specialty are in good hands. Someone reminded us: as physicians in all specialties, we will still be compelled to do what is right for the patient. We must, however, stay involved and continue to grow a crop of young physicians (that’s my inner Kansan showing) who are committed to making progress and improving quality care at a national level.
I believe this is why ASTRO awarded an abundance of travel grants that supported residents’
attendance. Many of these awardees are women who have have been involved in SWRO or hold other professional leadership positions. I love the collaborative energy that this inclusive group brings when we gather together at meetings. In addition to advocacy, we met and discussed career development, ideas for research projects, and brainstormed initiatives to increase and promote women in our field. We were encouraged that the ASTRO board recognized that the dip in women entering our field deserves action. I always leave inspired and hopeful for our future after meeting with these women who are dedicated to elevating the profile of radiation oncology.
Figure 2. Radiation oncology residents making connections at ASTRO Advocacy Day
Figure 3. SWRO Happy Hour with support from some of our male colleagues