Doctors' ads target Grassley on Medicare

Later this week, the American Medical Association (AMA) will bring its traveling road show to Iowa to target Sen. Chuck Grassley’s (R) constituents with an outreach campaign aimed at generating support for higher Medicare payments for doctors.

As chairman of the Finance Committee, Grassley wields considerable power over the future of physician payments, and the AMA and its allies must secure his support if they hope to persuade Congress to make expensive changes to Medicare.

As it did in Texas last month, the AMA plans to blanket the state with radio advertising beginning today that will explain how doctors’ payments from Medicare will be cut next year if Congress does not step in. Doctors in rural states such as Iowa also receive lower average payments than physicians in more populous states.

In addition to the radio advertising, the AMA plans a “house call” news conference in Hiawatha, Iowa, tomorrow. The doctors group will also court the media through other means, including meetings between AMA and Iowa Medical Society officials and newspaper editorial board meetings, as well as offering officials for appearances on television and radio shows.

A radio ad singles out Grassley’s role in shaping Medicare policy. “It’s vital that Congress listen to leaders like Senator Grassley,” the ad says. Listeners are urged to telephone Grassley and “thank him for his strong leadership to fix the Medicare crisis and urge him to keep fighting to preserve access for Iowans.” The AMA will also run print ads.

Although Grassley has been instrumental in obtaining additional Medicare dollars for rural healthcare providers in Iowa and other states, he has not established a strategy for dealing with the roughly 5 percent payment cut on tap for next year.

A spokeswoman for the Iowa Medical Society called Grassley the group’s “biggest supporter” on rural healthcare issues. But while Grassley has called for changes to the Medicare payment system, his plans may be different from what the AMA seeks.

Grassley and Sen. Max Baucus (Mont.), the ranking Democrat on the Finance Committee, have written legislation that would tie Medicare payments to improvements in the quality of healthcare provided — but it does not preclude a payment cut next year. The AMA recently adopted a set of principles on pay-for-performance programs that specified that the underlying payment system needed to be replaced if the quality of healthcare is to be improved.

By contrast, Iowa Sen. Tom Harkin (D) on Monday signed on to co-sponsor Sen. Jon Kyl’s (R-Ariz.) bill to increase doctors’ payments for 2006 and 2007. Iowa Reps. Jim Leach (R), Tom Latham (R) and Leonard Boswell (D) are co-sponsors of Rep. Clay Shaw’s (R-Fla.) House version of the bill.

Grassley may revisit the payments issue before the year is out, possibly during budget reconciliation, a spokeswoman said.

In the past, the House has initiated efforts to stop reductions in the amount Medicare devotes to covering doctor fees. Ways and Means Committee Chairman Bill Thomas (R-Calif.) has railed against the Medicare payment system for years and has hinted that he may have plans to overhaul it.

Rep. Nancy Johnson (R-Conn.), who chairs the Ways and Means Committee’s Health Subcommittee, is finalizing legislation that would combine permanent changes to Medicare’s payments to doctors with a pay-for-performance mechanism.

Johnson presented an outline of her bill to physician-group lobbyists last week. Several attendees said the measure was well-received by the audience, although an AMA spokeswoman declined to comment on the meeting. Johnson plans a subcommittee hearing on the measure tomorrow.