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Rome isn’t really burning, but the headline got your attention, didn’t it?

I’m not sure how many fires consumed that great city in ancient times—one or many. But, in that vein, I can tell you that the pressure on O&P reimbursement rates is not coming from one massive blow, but rather from a series of smaller, continual challenges that AOPA has been fighting for years.

O&P, like Julius Caesar, may be the victim of many cuts and not one large wound.

The O&P field is beginning this new year with a number of serious threats on the horizon, including the possibility of a two-year extension of the Medicare payment freeze and the expansion of competitive bidding to more O&P devices and services.

Both of those items could appear in another Medicare bill that is likely to be considered this year. The question is, if Rome is burning, how can we start putting the fires out?

A call to action

We need to start building our relationships on Capitol Hill from the ground up—and strengthen the relationships we already have. We need to become well versed on the issues and talk with our congressional representatives about those issues—especially the impact they will have on the O&P field and the quality of patient care.

This is a call to action, not only for individual company leaders, but to everyone who works in the field and to the patients who are served by O&P.

The only way we will be able to defend our interests is through a collective effort, with everyone pitching in.

Get the facts

Before the Medicare Modernization Act passed in 2003, a respected group of Medicare policy experts calculated that spending for O&P in that program had increased by 42 percent from 2000 to 2002.

We ended up with competitive bidding for some orthotic devices and a three-year payment freeze on all O&P and DME as a result of legislative wranglings addressing the same issue: bringing Medicare spending in O&P under control.

At this point, it does no good to point fingers about who is responsible for what. Instead, our goal—and the best use of our time and resources—is to limit any further damage that will harm the O&P field.

AOPA feels a little information in this area will go a long way in arming us with what we need to fight capricious cutbacks. So, throughout 2004, we have been working to determine what is driving O&P spending and to show the financial benefit of O&P services.

Has spending increased because we have a sicker population needing more services? Is it the cost of technology? Or is it the result of the actions of some other health care group, such as pharmacists or physical therapists, that is leading to rapidly increasing Medicare costs?

We are on the verge of answering the first question with the help of our statistical analyst, who is poring over Medicare data.

Through the same analysis, we also hope to see the costs of a patient who receives proper O&P treatment and compare those costs to someone who does not receive appropriate care.

If the answers come out as expected, we should be able to show that beneficiary costs are higher when a patient does not receive proper care. This data should go a long way in helping defend ourselves from additional payment cuts in the coming years.

Take the lead on advocacy AOPA will be at the forefront carrying this information to our policymakers on Capitol Hill when it becomes available.

But advocacy from AOPA can only have so much impact. We need to make our message memorable. To do that, we need O&P professionals to maintain and develop relationships with their elected leaders.

AOPA has developed relationships with a number of policymakers who have, over time, moved up the rungs of leadership and are now in a good position to ensure that access to and quality of O&P care can be maintained.

We would like to see O&P professionals and patients do this as well.

Nothing works better than having a lawmaker hear directly from a constituent. Lawmakers can only help if they hear from you and understand the impact that legislative proposals have on your business and the patients you serve. Developing a trusting relationship and letting lawmakers know what O&P is all about will benefit both you personally and the field as a whole.

Here's how to develop a relationship:

• Invite your member of Congress to visit your facility. Senators and representatives don't spend all of their time in Washington, D.C. They visit their home districts often. When your congressional representatives are in town, invite them to come and see what you do. Let them hear first hand from a patient the difference you have made in that person's life.
• Stay in touch. When something happens on Capitol Hill that will affect your patients and your livelihood, say something about it. When you get an action alert from AOPA, do something. It only takes a few minutes to go online and write a letter to your senator and representatives. And you can do this through AOPA's Web site: www.AOPAnet.org.
• Plan to attend AOPA's 2005 Policy Forum next June so you can meet personally with your lawmakers and let them know what is important to you. O&P professionals are sent to Capitol Hill in delegations, so you won't be alone. And AOPA will take some time to educate participants on the issues before sending them out.

More information on AOPA's Policy Forum will be available soon.

If you would like to get involved or if you have developed a relationship with your lawmakers, please let me know at (571) 431-0809. We can help you make the most of your efforts and protect the field for years to come.

Ask The Experts

Walter Gorski is the director of legislative affairs for AOPA.

PAC Facts

American Physical Therapy Association (APTA) members think their political action committee is important to their government relations efforts.

As of Oct. 13, their members have contributed $812,310 this year to the PT PAC, while spending $567,561. That averages out to about $2,000 per day in campaign contributions to lawmakers in 2004.