Today’s practicing hematologist faces many issues, including a reimbursement system that fails to adequately recognize cognitive care services and growing administrative burdens from routine practices such as prior authorization and new federal initiatives such as the Quality Payment Program. Because these issues are often affected by the happenings in Washington, DC, it is important for physicians to have their voices heard by policymakers; the ASH Committee on Practice represents practicing hematologists in this regard.
To learn more about how ASH advocates on behalf of practicing hematologists, The Hematologist spoke with the Chair of the ASH Committee on Practice, Joseph Alvarnas, MD. Dr. Alvarnas was first introduced to hematology advocacy after being selected to attend the ASH Advocacy Leadership Institute in 2012, and he has served as Chair of the Committee on Practice since 2016. “This experience gave me a great opportunity to get a sense of the full breadth of the activities of the Society in advocating for essential issues in our field,” said Dr. Alvarnas.
On April 30 , the ASH Committee on Practice visited more than 45 congressional offices to talk to lawmakers about two issues affecting patient access to care. The first was the need to pass oral chemotherapy parity legislation, which aims to end the out-of-pocket cost disparity that some patients face when prescribed an oral or self-injectable anticancer regimen versus receiving chemotherapy intravenously. Intravenous chemotherapy treatments are typically covered under a health plan’s medical benefit with a small office-visit copay; however, oral or patient-administered anticancer therapies are often only covered as part of a plan’s prescription benefit and typically at a lower rate, resulting in many patients being responsible for high and unmanageable copays and coinsurance.
The second issue the committee advocated for was adequate reimbursement for practicing hematologists. Hematologists face longstanding challenges, such as misvalued and outdated evaluation and management codes, as well as new challenges such as finding a sustainable reimbursement model for cell and gene therapies such as chimeric antigen receptor (CAR) T-cell therapy.
The committee works on an extremely diverse range of issues, Dr. Alvarnas explained, “It would be very difficult to distill the broad and complex work of the committee … some of the current initiatives include ensuring patient access to life-saving technologies and helping to ensure the human and economic sustainability of practicing hematology.” Recently, the committee has focused on sustainable access to cell and gene therapies; adequate reimbursement for cognitive care services; how to leverage new telemedicine opportunities; and how to appropriately capture what a modern hematologist looks like.
The committee uses various additional tactics in its advocacy efforts, including hosting congressional briefings, establishing working groups to focus on specific policy issues, and drafting comment letters to various federal agencies on rules, policies, and coverage decisions.
Meeting with legislators either in Washington or back home in the district is one of the most effective ways that ASH advocates for the issues that affect the Society’s members. Speaking about the Committee’s most recent trip to Capitol Hill in April, Dr. Alvarnas noted, “The best illustration of the impact of the committee’s work comes when we go into a congressional office for the second time. We are welcomed. The staff or member is actively engaged. They note the prior work of the Society and committee in engaging with them on a previous issue.”
All ASH members can participate in the Society’s advocacy efforts by joining the Grassroots Network to receive regular updates and information about how to contact their members of Congress. “The impact [of advocacy] is real and best manifested by the relationships that we foster and through which we provide valued input to congressional and administrative leaders,” said Dr. Alvarnas.
Additionally, physicians interested in practice-related issues can join the ASH Practice Partnership (APP). The APP is composed of practicing hematologists across the United States with interests in hematology care issues, quality of care, new health care delivery systems, and practice management issues. Members serve in a geographically diverse panel that provides feedback to ASH committees or staff about matters affecting the practice of hematology. The group also advises ASH about the Society’s practice-related policies, resources, and programs. Interested members can submit a nomination by visiting www.hematology.org/Clinicians/Practice-Partnership.aspx.
ASH members can also participate in the ASH Advocacy Leadership Institute (see below), a two-day workshop to learn how to advocate for hematology in Washington, or they can visit the ASH Advocacy Center to quickly write your legislators about issues affecting your research or practice. “Working with the Society to become an advocate is a meaningful path toward amplifying your voice and ensuring that the issues faced by you, your colleagues, and your patients are understood by legislators,” said Dr. Alvarnas.
