February 2018 Edition Vol.11, Issue 2

2018 Forecast Series: Barbara McAneny, MD, CEO of New Mexico Oncology Hematology Consultants

Barbara McAneny, MD, CEO of New Mexico Oncology Hematology Consultants, discusses her upcoming presidency of the American Medical Association.

The American Medical Association (AMA) House of Delegates elected Barbara McAneny, MD, CEO of New Mexico Oncology Hematology Consultants, LTD, as President Elect in June 2017. In June 2018, she will assume the office of the AMA president for a one-year term, making her the first oncologist to hold the AMA presidency since the late Joseph Painter, MD, served his 1993-1994 term. OBR asked Dr. McAneny about her new role, issues she plans to address, and the AMA’s vision for healthcare reform.

 

OBR: The AMA laid out its vision for reforming America’s healthcare system in “Patients Before Politics.” Can you touch on how some of those objectives reflect the current healthcare climate and what is happening with patients and providers?

BM: Our major push is to make sure that as many patients have access to healthcare as possible; in the United States, that means heaving health insurance. Therefore, we are working hard—and we’ll continue to work hard—to increase the number of people who have insurance. One of our basic procedures is any proposal from Congress gets judged against how well it meets AMA policy. If it increases the number of people with meaningful insurance, then we are for it. If it decreases, then we are not.

Meaningful insurance is insurance that covers patients with pre-existing conditions and is affordable. In the current market, affordable insurance means insurance that can be purchased by people who are living 400% below the poverty level. For those people, we need to subsidize their ability to purchase insurance and pay for high copays.

Also, meaningful insurance should offer patients a good network of providers and services. That means that when a patient needs a given service, they don’t have to go out of network. If insurance companies narrow their networks so far that patients can’t get what they need, that’s not meaningful insurance.

 

OBR: Whatever their specialty is, physicians are under a lot of pressure today. What are some of the biggest challenges physicians face, and how do you plan to fix these issues?

What I hear from physicians, and not just oncologists, is that they are challenged by increasing administrative burdens. Medical practices are concerned that the implementation of Medicare’s Quality Payment Program (QPP) will be burdensome and time consuming, according to a survey conducted by the AMA and the KPMG consulting firm. At the same time, we see reimbursement rates to physicians drop, and none of the payers or governmental entities seem to understand that the cost of complying with regulations takes resources from patient care.

Increasing regulatory requirements and the transition to MIPS and Alternative Payment Models (APMs) are challenges for physicians and the AMA is working closely with the Centers for Medicare & Medicaid Services (CMS) to ensure that Medicare regulations are workable as physicians transition to value-based care. Those advocacy efforts paid off when CMS adopted a majority of the AMA’s recommendations to help physicians avoid penalties, while providing greater flexibility, relief for small and rural practices, and reduced reporting burden. Because we know that not enough physicians feel prepared for the new law’s requirements, we have released a number of tools and resources to help them be successful.

 

OBR: What do you see as some of the “hot button” issues impacting healthcare delivery that the AMA hopes to address in 2018?

BM: One issue is that of market consolidation, in particular insurance mergers. For example, AMA worked hard to block the Anthem-Cigna merger. I testified in front of the Energy and Commerce Committee about how that merger would have increased the profitability of Anthem and Cigna, but taken about $500 million out of physicians’ fees and made it harder for patients to access care.

 

OBR: How do you perceive the new tax bill and its effect on physicians? What is AMA’s position regarding the new tax bill? 

The AMA is concerned that the tax law could impose additional sequestration cuts that lower physicians’ payment by 4%, making it very difficult for practices to continue seeing Medicare patients. For oncologists, this would put payment for oncology treatments significantly under the cost to acquire them. We are also concerned that young medical students on scholarships might have to pay taxes on money they never see.

 

OBR: As of June 2018, you’ll be at the helm of the country’s most powerful medical organization. What do you hope to accomplish during your tenure as president of the AMA?

BM: Each AMA president serves at the spokesperson for the AMA and advocates for the policies set up by the House of Delegates. So while my presidency will not focus on policies of my choosing, some of the policies that are of particular interest to me are physician satisfaction and practice sustainability. I am very concerned that we’re seeing a lot of practices being acquired by hospitals. Also, I think physician burnout is often directly related to the loss of control over how their day-to-day life is run.

 

OBR: The AMA president spends about 250 to 300 days a year on the road. How will this impact your role at your practice?

BM: I love my practice and I hope to be able to still see patients, but I know I will have a limited amount of time to do that. I will stop taking new patients as of this spring because when I become president, I know I will spend a lot more time out of the office, and that is just not fair to cancer patients.

I will admit that this is hard for me. I’m looking at the AMA presidency as a life transition, and my goal is to help my patients transition to my partners and to leave my practice in a very good position so that it will continue to be successful without me.

 

OBR: In what way do you think being involved in AMA benefits specialists, such as oncologists?

BM: We live in an economic environment where changes are budget neutral, so if one specialty comes up with new drugs, all the other specialties pay for it. That is just wrong and can divide us. We are better at taking care of our patients when we, as physicians, collaborate rather than compete, and that is the value of the AMA. It allows physicians to see the world from the viewpoint of other specialties and to understand what it is that we as physicians have in common rather than focusing on those smaller issues that divide us.

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