Looking forward – December 2015

David B. Hoyt

David B. Hoyt, MD, FACS

The American College of Surgeons (ACS) had another productive and successful year in 2015, thanks to the hard work and dedication of the organization’s volunteers and staff. As I have done the last few years, I would like to take this opportunity to reflect on some of the high points of the year—all of which are discussed in greater detail in the Executive Director’s annual report.

Advocacy and Health Policy

The College and other surgical and medical societies achieved a longstanding goal in April when Congress passed and President Barack Obama signed into law H.R. 2, The Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act of 2015 (MACRA). This legislation repeals the flawed sustainable growth rate (SGR) formula used to calculate Medicare reimbursement for physician services. Furthermore, MACRA establishes an annual payment update of 0.5 percent for five years; seeks to establish a new Merit-based Incentive Payment System in 2019; calls for establishing processes for development, evaluation, and adoption of alternative payment models; and reauthorizes the CHIP through fiscal year 2017. Moreover, MACRA prevents the Centers for Medicare & Medicaid Services (CMS) from implementing a final rule that would have transitioned 10- and 90-day global codes to 0-day global codes beginning in 2017 and 2018, respectively.

Also on the payment front, the College has developed resources and published information to help surgeons make the transition to the 10th revision of the International Classification of Diseases coding system (ICD-10) (see related article). Successful implementation of ICD-10 is essential to ensuring that providers receive appropriate payment for inhospital services.

To address concerns about variations in patient access to quality care, the College formally established the ACS Committee on Health Care Disparities. The leaders of this committee—ACS Past-President and Committee Chair L. D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon), FRCSGlasg(Hon), and Vice-Chair Adil Haider, MD, MPH, FACS—are to be commended for their efforts to establish a collaborative relationship with the National Institute on Minority Health and Health Disparities (NIMHD). As a first step in this important process, the ACS and NIMHD presented a successful symposium in May to determine key issues for further study.

Quality

The College’s National Surgical Quality Improvement Program (ACS NSQIP®) continues to grow in size and stature. ACS NSQIP was honored with the 2014 John M. Eisenberg Patient Safety and Quality Award for Innovation in Patient Safety and Quality at the National Level, presented by The Joint Commission and the National Quality Forum.

Furthermore, ACS NSQIP hosted its most widely attended conference this year. More than 1,500 surgeons and quality improvement team members from 676 institutions and 15 countries attended the 10th Annual ACS NSQIP National Conference.

To help improve the odds of survival among victims of mass casualty events, ACS Regent Lenworth M. Jacobs, Jr., MD, MPH, FACS, and members of the ACS Committee on Trauma led a multi-stakeholder effort to develop the Hartford Consensus III report on bleeding control. Dr. Jacobs also directed the publication of a compendium of strategies to enhance survival in these tragic events. The White House and leaders of law enforcement and emergency medical services agencies partnered with the ACS on this project.

The ACS is committed to improving surgical care for patients of all ages. To this end, we launched the Coalition for Quality in Geriatric Surgery Project in July with funding from the John A. Hartford Foundation and continued development of the Children’s Surgery Verification Program. In addition, the ACS Clinical Research Program continues to develop clinical trials and published the first edition of Operative Standards for Cancer Surgery—the first and only collection of guidelines for breast, lung, pancreas, and colon surgery.

Education

The ACS continues to ensure that surgical patients receive care from well-trained, highly qualified surgeons. This year, we have worked to improve surgical training through the efforts of the “Fix the Five” Committee on Residency Training, a newly created Committee on the Future of Surgery Residency and Training, and the Transition to Practice Program.

To help surgeons at all stages of their careers develop and sharpen their skills, expand their knowledge about clinical care, and meet Maintenance of Certification requirements, the ACS continues to present the annual Clinical Congress. This year’s meeting included a Scientific Forum featuring scientific paper and poster presentations and several member engagement events; and was attended by more than 13,480 physicians, other health care professionals, exhibitors, staff, and so on.

The ACS continues to play a leading role in advancing the field of simulation-based surgical education and training around the world through the Consortium of ACS-Accredited Education Institutes (ACS-AEIs). A total of 80 ACS-AEIs have been accredited, including 77 Comprehensive Institutes and 12 Focused Institutes. Education institutes accredited outside the U.S. include four in Canada, one in the U.K., two in Sweden, two in France, and one each in Greece, Italy, Argentina, Saudi Arabia, and Spain.

Member Services

The ACS seeks to develop and sustain programs of value to all surgeons of all specialties and of all interests at every stage of their career. To better understand your evolving needs and determine where we might be coming up short of some surgeons’ expectations, the ACS is conducting a survey of nonmember board-certified surgeons, the results of which will be analyzed to determine additional strategies to support member recruitment. We also have begun contacting members in an effort to reduce membership terminations.

To help surgeons who are interested in volunteerism and humanitarian efforts, the College recruited a new Medical Director, Girma Tefera, MD, FACS, for Operation Giving Back. Efforts are under way to assess member involvement and needs relative to volunteerism activities and to develop new programs, including a domestic volunteer program and a humanitarian volunteer boot camp.

We also recruited M. Margaret “Peggy” Knudson, MD, FACS, to serve as Medical Director of the Military Health Services Surgical Partnership ACS (MHSSPACS) established in 2014. This year, the MHSSPACS led an effort to revitalize the Excelsior Surgical Society, which held its first meeting at Clinical Congress 2015, featuring a half-day program that united surgeons from the U.S. Army, Navy, and Air Force.

Finally, last year we established the online ACS Communities. More than 100 of these communities are now up and running, allowing members to share their experiences, interests, and concerns.

Going strong

It is telling that at this year’s Clinical Congress, we initiated 1,679 new Fellows—one of the largest classes in ACS history. I believe that interest in ACS membership is on the rise because, as these highlights of the year indicate, this organization has real value for surgeons who are striving to ensure that they are able to provide optimal care to all surgical patients.

On behalf the ACS volunteers and staff, I wish you all a happy and successful new year. We look forward to continuing to exceed your expectations in 2016.

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