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A member of the American Geriatrics Society for nearly 25 rewarding years, I am particularly excited to be starting my term as president at what is clearly a turning point for elder healthcare in this country. A few months ago, we all witnessed an historic act - the President of the United States signing healthcare reform legislation into law. The new reform law, while not perfect, has a great deal to offer geriatrics. Thanks to the tireless advocacy efforts of AGS' leadership, staff, members and other champions of quality eldercare, the law includes a wide range of provisions that are good for seniors, good for geriatrics healthcare providers, and good for our field. The AGS still has a great deal to do, however. To start, the Society needs to inform older adults, and its members, of the changes the reform law will bring about, and how these will improve eldercare. There have been so many inaccurate and inflammatory claims about reforms that setting the record straight -- communicating factual information in ways everyone can understand -- will be a priority for the AGS this year. How will reform benefit older adults and the geriatrics healthcare professionals who care for them? Among other ways, by beginning to address two key contributors to the serious workforce shortages in our field -- inadequate Medicare reimbursement and training. For the next five years, the legislation will boost reimbursement for geriatricians and other primary care providers with a 10% Medicare bonus payment for specified primary care services. It will also institute periodic reviews of physician services that appear to be inappropriately valued. And it will establish a physician "value-based payment program" that rewards quality gains. On the training front, the health reform law will increase funding for the National Health Service Corps and establish a Graduate Medical Education policy that allows the reallocation of unused training slots in ways that increase the ranks of geriatricians and other primary care practitioners. The law also enhances programs at Geriatric Education Centers (GECs), and expands the Geriatric Academic Career Awards (GACA) program. And it creates new training opportunities for direct-care workers and elders' family caregivers. Seniors worried that reforms will erode their benefits should rest assured that the law guarantees basic benefits for all Medicare enrollees. It also shrinks beneficiaries' out-of-pocket expenses by making preventive services free for most, and phasing out the Part D "donut hole" coverage gap. Equally important, the reform law will step up the evaluation and implementation of promising new models of care for complex older patients who have multiple chronic illnesses or are homebound. These include models that provide interdisciplinary team care, both in the office and in seniors' homes. Older people who have multiple chronic illnesses will get better coordinated, higher quality care as a result. The law will help address long-term care needs as well, by creating a voluntary, public long-term care insurance program, and expanding community- and home-based long-term care services. Staying involved in the implementation of these and other measures in the reform law will also be a priority for the Society this year. During implementation, questions will arise, and judgment calls and changes will be made. As a result of our increased investment in policy advocacy work over the past several years, the AGS is now seen as a resource in Washington; it's consulted and asked to share its expertise. This is an important development, one that positions us well as implementation begins. Another top priority for the AGS will be continuing to advocate for necessary changes that were not included in reform legislation. A permanent, viable alternative to Medicare's Sustainable Growth Rate (SGR) formula, and further progress toward more equitable compensation for geriatrics healthcare providers are at the top of the list. One of the things AGS has been particularly successful in doing in the legislative arena is helping lawmakers understand the amount of time geriatrics professionals spend with patients and how reimbursement for these "cognitive" activities is disproportionate to that for procedure-based specialties. Health reform begins to address that -- with the 10% bonus, for example. We are being heard in Washington. But there's still considerable room for more progress, and I am optimistic that we'll see such progress. Needless to say, we will also continue to advocate for adequate financing of Title VII Geriatrics Health Professions programs - the GECs, GACAs and geriatric faculty fellowships - which are funded on an annual basis. Under the new reform law, eligibility for the GACAs has been expanded to include all members of the geriatric healthcare team. This may raise some concerns among geriatricians, since there will now be more applications for a finite amount of funding. But in the long term, I think this will benefit geriatrics by bringing more people into the field and, in turn, encouraging funders to provide more resources. Efforts on behalf of additional investment in training programs -- including those designed to ensure that core geriatrics concepts and skills are taught in all medical schools and residency programs across the disciplines -- will continue to be a priority for us this year. So will advocating for increased funding for research focused on health and aging. It is always a challenge to find dollars, so we will need to keep advocating for funding from both public and private sources. Ensuring that research has a broad base, covering everything from basic science to program and leadership development, is very important. I am excited to be starting my term as president with our new CEO, Jennie Chin Hansen, at the helm. We are all appreciative of the tremendous leadership of Linda Hiddemen Barondess that positioned the Society as the leading professional organization in our field. And now, under Jennie's leadership, we are ready to move to a new level. I am very excited about all of the opportunities that lie ahead. As you know, Jennie was a member of AARP's Board of Directors for six years, and president for the last two. She is a phenomenal person, leader and voice for geriatrics. Jennie's connections with other key organizations and individuals who share our priorities will help us form new relationships and alliances that will help us have an even greater impact for our members and our patients. I am also looking forward to continuing to work with AGS' talented and committed staff, who have been so integral to our successes. A final, but important priority will be to continue to ensure that our Society provides value to its members. This is something we review on a regular basis. We want to make sure that we are meeting your needs. I encourage you to share your thoughts about what the AGS is doing right and what we could be doing better. We are only as strong as our members. Please feel free to email me, at brangmas@upstate.edu, with any thoughts, questions, concerns or suggestions you may have. |
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