Driving Change for Independent Practices at Third Community Practice Summit

	The Community Practice Coalition Meets with Representative Greg Murphy, MD.

January 2025

The Third Community Practice Summit brought together LUGPA members, policymakers, and healthcare leaders to address the pressing challenges facing independent practices. This year’s event was marked by dynamic discussions, critical advocacy priorities, and strategic insights to empower practices nationwide.

Pre-Summit Dinner with Rep. Greg Murphy, MD

The Summit began with an engaging dinner featuring Rep. Greg Murphy, MD, a practicing physician and senior member of the Ways and Means Committee. As Co-Chair of the GOP Doctors Caucus, Rep. Murphy provided a unique perspective on the intersection of medicine and policymaking.

Rep. Murphy’s remarks emphasized his unwavering commitment to safeguarding independent practices and enhancing patient care. He shared insights into his legislative priorities and highlighted the urgent need for reforms to address the challenges posed by rising healthcare costs, burdensome regulations, and shrinking Medicare reimbursements.

Legislative Priorities Advocated by Rep. Murphy (2024 Versions)

1. Preserving Seniors Access to Physicians Act (HR 6683):
   Rep. Murphy detailed how this legislation aims to stabilize Medicare reimbursement rates, ensuring seniors can maintain access to their trusted physicians.
2. Protecting Patient Access to Cancer and Complex Therapies Act (HR 5391/S. 2764):
   He highlighted the devastating impact of the Inflation Reduction Act on Medicare Part B drug reimbursements, which could see reductions exceeding 50%. His proposed bill would preserve fair reimbursement while implementing a rebate system for manufacturers to CMS, ensuring cost control without compromising access to critical treatments.
3. Advancing Seniors Access to Critical Medications Act (HR 5526/S. 3458):
   Rep. Murphy passionately advocated for restoring in-office dispensing (IOD) and enabling practices to deliver medications directly to patients' homes. This change, he argued, would reduce reliance on PBM-controlled mail-order pharmacies, enhance patient care, and improve medication affordability.

Key Discussion Points from Rep. Murphy’s Address

Rep. Murphy also touched on broader issues impacting independent practices, including:

• The unsustainable nature of Medicare Physician Fee Schedule (MPFS) cuts, calling for payment rates tied to inflation and reforms to MACRA.
• The harmful implications of the Inflation Reduction Act on cancer care and his efforts to mitigate its impact through targeted legislation.
• The need for site-neutral payment reforms to ensure fairness and sustainability across care settings.
• His advocacy for curbing healthcare consolidation, expanding residency programs, and addressing workforce shortages to protect the future of private practices.

Rep. Murphy closed by urging physicians to engage in advocacy, emphasizing the critical role independent practices play in shaping the future of healthcare.

Summit Sessions

Medicare Reimbursement Reform Updates

Led by Dr. Mara Holton, this session focused on the latest CMS updates, including the proposed 2.93% reduction in the Medicare Physician Fee Schedule for 2025. Dr. Holton highlighted the devastating impact of stagnant reimbursement rates and rising inflation on independent practices.

Participants emphasized the importance of tying Medicare Economic Index (MEI) adjustments to inflation, advocating for permanent telehealth expansions, and addressing administrative burdens. Site-neutral payment reform and strategic shifts in hospital reimbursement were also identified as critical advocacy priorities.

Malpractice Reform

Dr. Barry Kraushaar led an insightful discussion on the growing challenges posed by malpractice litigation, including high payouts, state variability, and frivolous lawsuits. Advocacy efforts focused on pushing for caps on non-economic damages, promoting arbitration and mediation, and establishing national standards for expert witnesses to mitigate liability risks.

340B Drug Discount Program Reform

Nicole Dixon, Michael Tobin and Karl Lobo addressed the rapid growth and misuse of the 340B program. Discussions emphasized the need for greater oversight, transparency, and reforms to ensure the program benefits patients, particularly those in underserved communities. Participants also highlighted how hospital misuse of 340B funds has driven up drug costs and undermined community practices.

COA Prescription for Health Reform

Nick Ferreyros introduced a comprehensive blueprint for addressing consolidation, reimbursement reform, and access to oncology therapies. Strategies included combating hospital consolidation, reforming PBM practices, and aligning MPFS with higher-funded outpatient payment systems. The session underscored the importance of bipartisan collaboration to achieve meaningful change.

In-Office Dispensing (IOD)

Dr. Dave Albala led a session advocating for in-office dispensing as a critical tool to improve patient outcomes. Participants explored legislative solutions to restore IOD, defend the IOASE exception, and educate policymakers about the benefits of streamlined medication policies.

Hospital Competition

Krista Stock highlighted the dangers of hospital consolidation, including rising costs, reduced access, and threats to rural healthcare services. Advocacy priorities included enforcing the Anti-Kickback Statute (AKS), supporting site-neutral payment reforms, and expanding recruitment incentives for private practices.

Conclusions

The Summit concluded with a collaborative discussion to identify top advocacy priorities for the coming months. Among the key issues were PBM reform, IOD advocacy, MPFS reform, and addressing the Inflation Reduction Act’s implications for patient care.

Action items included:

• Sharing each group’s fly-in schedule and advocacy materials with members.
• Engaging additional specialty groups to broaden advocacy efforts.
• Collaborating on outreach and advocacy efforts, letters, and contact with Congress.

The Third Community Practice Summit underscored the resilience and innovation of independent practices. LUGPA members left equipped with actionable strategies to tackle pressing challenges and advocate for reforms that prioritize patient care, affordability, and sustainability.