A Message from the President THANK YOU again to all physician members of AAHPM who are also American Medical Association (AMA) members. Every 5 years, AMA looks to see how many of its physicians are members of both organizations, and in 2023 we were successful at meeting the 20% threshold required to retain our seat for the next 5 years at the AMA House of Delegates (HOD) and representation on the Advisory Committee to the AMA RVS Update Committee, which advises Medicare on relative value units—how our work is valued and reimbursed by Medicare. Clearly, having AMA representation is critical for us to influence health care at the national level and affects our day-to-day practice. As in past years, I attended the June 2023 AMA HOD as an at-large delegate from California, meaning that through my leadership roles in my county and state medical associations I have been selected to be one of the delegates representing the physicians and patients of California at the HOD where policy of AMA is debated and adopted. Wearing that hat, I have had the opportunity to observe the work of the AAHPM delegation and collaborate with physicians and medical students who represent the different states, specialties, and communities caring for our nation and its people. This year it was particularly gratifying to be at the HOD, as our AAHPM delegation submitted two resolutions: one to improve hospice integrity without overburdening hospices taking good care of patients and one to modernize the Medicare hospice benefit. These were crafted from work with hospice experts, our public policy leaders, and the National Coalition for Hospice and Palliative Care (NCHPC). During the AMA meeting and after review by multiple committees, testimony online and in person, recommendations by a reference committee after considering all the testimony, and finally by additional testimony of the full HOD and voting, both resolutions were adopted as new AMA policy. It is a long process with a lot of opportunity for input, and I am grateful to those of you who provided online testimony to the AMA HOD. The resolution on improving hospice integrity was not controversial and passed with minimal debate. The one on modernizing the Medicare hospice benefit proved more of a challenge. Our delegation (Chad Kollas, Ruth Thomson, Ana Leech, and Kyle Edmonds)—with support from former AAHPM Director of Health Policy and Government Relations Jackie Kocinski and CEO Wendy-Jo Toyama—did an incredible job garnering support and clarifying concerns with various constituencies throughout the 5-day meeting. Providing additional assistance within our own networks and communities were myself; Karl Steinberg, who represented AMDA–The Society for Post-Acute and Long-Term Care Medicine; and Rachel Ekaireb, an HPM fellow and surgery resident who also represents California. Throughout this time, we had wonderful support from medical students; the section council that represents specialist physicians; the American Academy of Pediatrics, California; and the PacWest Conference to AMA (a coalition of 13 states and Guam). Some of you might ask, 'Why bother with all this?' First and foremost, it is part of creating a growing voice for change so that we can deliver on the promise of hospice care. I know hospice professionals are working hard every day in difficult circumstances to give the best care possible to every patient. Patients and families deserve high-quality hospice care they can trust. We cannot create change on our own. Like all of health care, it is complex and takes a team approach. By contributing to AMA policy, our AAHPM delegation has made it feasible for AMA to advocate with us on specific issues at the national level. Through this, we add a bigger voice that does not have the same perceived conflict of interest that those of us who practice in the field do. The other reason our AMA participation matters is that leaders in medical student and physician advocacy across our nation are now more knowledgeable about some of the issues that face our hospice clinicians and seriously ill patients and their families. Being involved with organized medicine—especially as it evolves to be more diverse, younger, and more focused on health equity and how to care for all people—has been rewarding in a way I didn’t think possible when I first was introduced to it. I have found it actually helps my well-being to be able to push for change in things that make my clinical care frustrating, like dealing with unnecessary prior authorizations for much-needed medications. I know there were other HPM physicians at the AMA HOD who were not on our delegation and were representing other constituencies who also provided support. We even have a pediatrician and HPM physician on the AMA Board of Trustees, Dr. Toluwalase “Lase” Ajayi, who can provide expertise on hospice and palliative care issues to AMA leadership. Much thanks goes to them as well for their time and efforts. I hope others also will get involved at their local and state levels. While we were at the AMA meeting, Dr. Ed Martin represented AAHPM in Washington, DC, with other NCHPC members as part of ongoing meetings with U.S. Rep. Earl Blumenauer (D-OR) on improving hospice care. We also recently submitted extensive comments on the Centers for Medicare & Medicaid Services Fiscal Year 2024 Hospice Proposed Rule. I am very proud of all of the work AAHPM staff and volunteers are doing, and I thank our membership for their support of the AAHPM delegation to AMA, our expert hospice volunteer leaders, and our dedicated AAHPM staff. I am thrilled at the outcome of their hard work, and we have more to do. Holly Yang, MD HMDC FACP FAAHPM Read the next article or go to the table of contents.
Making Progress in Hospice Advocacy
AAHPM President