The pandemic tragedy illuminated the frailty of our health care system. Shortages in personnel, equipment and disparities in access and treatment across our diverse population were laid bare. Although the public health emergency is now over, many underlying health policy issues remain and continue to challenge our mission of protecting sight and empowering lives.
The Academy stands ready to continue the patient-centered advocacy needed to address these issues. As Senior Secretary for Advocacy, I am continually impressed by the dedication, knowledge and insights of our advocacy teams in both Federal Affairs and State Affairs.
As an election year, 2024 may represent a turning point in health care financing and reimbursement. Since 2001, there has been a 26% decrease in Medicare physician payment when adjusted for inflation. Over the same period there has been a nearly 50% increase in practice expenses. This year the Centers for Medicare & Medicaid Services has proposed a 3.3% cut for 2024. There is now widespread acknowledgement that this is simply unsustainable. The Academy agrees with the AMA that an annual inflation update must be the foundation of physician payment reform. Such reform will allow practices to make the investments necessary to continue to provide high value care.
Prior authorization and step therapy continue to expand and hinder timely access to appropriate care. The explosion in Medicare Advantage enrollment is driving much of the increasing regulatory burden despite the increasing evidence that Medicare Advantage plans often deny or delay needed care while manipulating Medicare billing to obtain increasing profits. The Academy will continue to support the bipartisan Seniors Timely Access to Care Act that requires simplification and transparency of the prior authorization process.
The continuing optometric scope of practice battles remain a significant threat to quality eye care at both the state and now federal level. Multiple states remain in play for inappropriate expansion of surgical privileges, not through education, but through legislation. The State Affairs Secretariat remains a vigilant and responsive partner with our state societies. The federal expansion involves the VA’s proposed changes to national standards of practice, which seeks to standardize and likely expand optometric services across the VA system regardless of state law. The Academy will continue to work closely with our congressional advocates and the various veterans organizations to assure our veterans receive the care they so richly deserve.
Advocacy is a team sport, and I thank the thousands of ophthalmologists who actively participate at both the state and federal level. There is no doubt 2024 will be a critical year for our advocacy efforts. I humbly request that every Academy member find a way to support our advocacy mission. Currently, only about 20% of members contribute to the Surgical Scope Fund and OPTHPAC®. If every member contributed just one dollar a day to both the Surgical Scope Fund and OPHTHPAC, we would triple the financial resources available for our advocacy endeavors.