AANS and CNS Launch Campaign to Protect Patient Access to Care

On June 18, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), along with 10 other national surgical associations, officially launched the Surgical Care Coalition (SCC). The coalition represents more than 150,000 surgeons and was formed because of concerns about new Medicare payment policies for office and outpatient visits that the Centers for Medicare & Medicaid Services (CMS) will implement in January 2021. Changes to these visit codes — also known as evaluation and management (E/M) codes — will reduce payments for surgical care, which may lead to reduced access to care for older Americans. The AANS and CNS are asking Congress to waive Medicare’s budget neutrality requirements to prevent the cuts and to require CMS to apply the increased E/M payment adjustments to all 10- and 90-day global surgery codes.

The SCC recently commissioned a survey of more than 5,000 surgeons, which found that surgical practices are facing severe financial distress due to the COVID-19 pandemic. While the cuts were announced before the pandemic, with the combined impact of the planned CMS cuts and the financial challenges due to COVID-19, surgeons and hospitals will face difficult decisions to keep surgical practices afloat. For neurosurgeons, the survey found that even before the CMS cuts take effect:

• More than one-half (54%) of respondents are concerned that they could be forced to shut down their practice, limiting choice and access to neurosurgical care;
• Three-quarters (74%) of neurosurgeons are concerned about the finances of their practice, and to keep the doors open, 38% have cut their own salary, and one-quarter (24%) have taken on debt as a result of COVID-19; and
• In the face of declining revenues, 86% of respondents are worried that they will have to cut employee’s salaries and 76% fear that they may have to permanently layoff employees.

In announcing the SCC initiative, John A. Wilson, MD, FAANS, president of the AANS, noted that “Neurosurgeons take care of critically ill patients who suffer from painful and life-threatening neurologic conditions such as traumatic brain injury, brain tumors, debilitating degenerative spine disorders and stroke, and without timely neurosurgical care, our patients can face permanent neurologic damage or death. He added, “The planned cuts to Medicare payments will further stress a healthcare system critically affected by the pandemic crisis and may negatively impact Medicare beneficiaries’ access to care.”

Echoing his remarks, Steven N. Kalkanis, MD, FAANS, president of the CNS, stated, “It is essential that policymakers understand how these payment cuts may impact access to surgical care. COVID-19 has placed an unprecedented strain on our health care system, and additional Medicare payment cuts will not only threaten timely access to quality care but will also stress an already fragile health care system.”

Click here to read the AANS and CNS press release. Neurosurgeons are encouraged to follow the coalition on Twitter and LinkedIn.