Twenty minutes after Ronald Reagan finished his inaugural address, the Islamic Republic of Iran announced the release of 52 American hostages that Iran had held for the last year of Jimmy Carter’s presidency. The timing led to the “October Surprise conspiracy theory,” in which some inferred a deliberate plan to influence an American election. We now refer to any political event timed to an election as an “October Surprise.” We are awaiting some type of surprise prior to this November’s elections. Events unfolding this fall will have generational effects on American politics, our health care delivery models, our financial security, individual rights and the democratic infrastructure of our country. This is not an election to sit out.
The proposed rule the Centers for Medicare & Medicaid published in the summer has generated a massive public response. The major issues (as discussed in last month’s GI & Hepatology News issue, including the editorial) include a dramatic change in documentation requirements and payment for evaluation and management (E/M) codes for both new and returning patients. While the reduction in documentation is laudable, the reduction in reimbursement for complex visits is not. At Michigan Medicine (2.2 million outpatient visits per year), reimbursements would go down by $3.5 million annually for our E/M visits. Most responses to the proposed rule requested a year’s delay and intensive analysis of work involved prior to reducing payments (see further comments at gastro.org, the AGA website).
This month we cover a new anti-obesity drug that shows cardiovascular safety. This is a welcome potential addition to our therapies since another story updates us on the relentless rise in obesity in this country. We cover the world’s alcohol use this month. On a financial note, the anticipated savings from biosimilars may be less than we hoped if data from Medicare Part D can be generalized. We also cover a diagnostic update about eosinophilic esophagitis.
I hope you enjoy this issue of GI & Hepatology News and all the AGA publications that provide you with up-to-date science, clinical information, and news about gastroenterology in general. Remember to vote. On the wall across from my desk as I sit as a leader in ambulatory care at Michigan Medicine, there is a large sign that grounds me. It reads, “Does this help the patient?”
John I. Allen, MD, MBA, AGAF
Editor in Chief