COVID-19 has altered almost all of our lives to a degree previously unimaginable. Millions of Americans continue to lose their jobs, hundreds of thousands have contracted the disease and thousands have succumbed to this virus. In hard-hit states such as New York, the governor starts each day with an enumeration of these figures. At the same time, surgeons and their patients face great uncertainty, both clinically and financially, as normal operations have slowed to a near standstill and in most parts of the country are just taking the first steps on the path forward to re-opening.
The anonymous COVID-19 pandemic practice, anxiety, coping and support survey for vascular surgeons demonstrated that 75% of respondents in practice in the United States noted that financial concerns were a source of COVID-19-related stress during the period of April 14–24. The Society for Vascular Surgery Wellness Task Force sponsored the survey.
Congress and the Centers for Medicare and Medicaid Services (CMS) have acted on many fronts to provide support for physicians and practices.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act was intended to inject roughly $2.2 trillion into the economy through creating initiatives such as loans through the Paycheck Protection Program (PPP) and grants through the Provider Relief Fund; or enhancing existing programs, such as the Economic Impact Disaster Loan (EIDL) program, or the Medicare Accelerated and Advanced Payment Program.
In response to the challenges and concerns expressed by SVS members, the Society and volunteer surgeons and professional staff continue invaluable work advocating for the financial stability of our specialty and the resources we will need to take care of our patients going forward. Service continues, with new town halls and regular updates.
In addition, the SVS is a key participant in the newly formed Surgical Care Coalition, tasked with communicating our needs and concerns to Congress and the administration on behalf of vascular surgeons. The coalition specifically will demonstrate how the current COVID-19 crisis frames the urgent need to address the future of the conversion factor and the Physician Fee Schedule. This newly formed coalition will also work in concert with the longtime Surgical Specialty Coalition to help build understanding among both policymakers and the public of the critical importance of what we do and the need to address the fee schedule cuts proposed to begin Jan. 1, 2021.
This will be a large task and a critical one moving forward. At this moment, the SVS and the Surgical Care Coalition are starting the process of gathering data on the impact of COVID-19 in order to develop messaging. We will also be coordinating grassroots efforts to convey to Congress the need to avoid these scheduled cuts to payment for our services. Briefly, the Medicare Physician Fee Schedule for CY 2020 included broad changes to evaluation and management (E/M) services in the clinic. Due to physician fee schedule constraints requiring budget neutrality, increased overall payments to primary care for E/M services will have to be offset by deep cuts to non-E/M services.
In this time of worsening revenue shortages due to deferred visits and procedures, the additional financial strain these cuts would impose on vascular surgery practices is unsustainable.
We may ask for your help—such as to describe how your practice has been impacted or to help deliver the message to our leaders and the public. Please answer the call when you are asked by engaging in grassroots efforts to communicate with legislators on the SVS “Contact Congress” page.
SVS will be sending out grassroots activations over the summer. Also, please consider supporting the SVS Political Action Committee, whose work has never been more important.
Ali Rizvi, MD, Sherene Shalhub, MD, and Megan Tracci, MD, are members of the SVS Government Relations Committee.