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Better manage acute pancreatitis to improve patient outcomes
AGA has a new clinical guideline on the initial management of acute pancreatitis, published in Gastroenterology. In the U.S., acute pancreatitis (AP) is a leading cause of inpatient care among gastrointestinal conditions with more than 275,000 patients hospitalized annually, at an aggregate cost of over $2.6 billion per year. The guideline focuses on patient care within the first 48-72 hours of admission when management decisions can alter the course of disease and duration of hospitalization.
Guideline recommendations
AGA’s new guideline aims to reduce practice variation and promote high-quality and high-value care for patients suffering from acute pancreatitis. It addresses questions on the benefits of goal-directed fluid resuscitation, early oral feeding, enteral vs. parenteral nutrition, the routine use of prophylactic antibiotics, and routine ERCP in all patients with AP.
The guideline is accompanied by a technical review, a new spotlight (infographic) and a patient companion infographic, which provides key points and important information directly to patients.
AGA has a new clinical guideline on the initial management of acute pancreatitis, published in Gastroenterology. In the U.S., acute pancreatitis (AP) is a leading cause of inpatient care among gastrointestinal conditions with more than 275,000 patients hospitalized annually, at an aggregate cost of over $2.6 billion per year. The guideline focuses on patient care within the first 48-72 hours of admission when management decisions can alter the course of disease and duration of hospitalization.
Guideline recommendations
AGA’s new guideline aims to reduce practice variation and promote high-quality and high-value care for patients suffering from acute pancreatitis. It addresses questions on the benefits of goal-directed fluid resuscitation, early oral feeding, enteral vs. parenteral nutrition, the routine use of prophylactic antibiotics, and routine ERCP in all patients with AP.
The guideline is accompanied by a technical review, a new spotlight (infographic) and a patient companion infographic, which provides key points and important information directly to patients.
AGA has a new clinical guideline on the initial management of acute pancreatitis, published in Gastroenterology. In the U.S., acute pancreatitis (AP) is a leading cause of inpatient care among gastrointestinal conditions with more than 275,000 patients hospitalized annually, at an aggregate cost of over $2.6 billion per year. The guideline focuses on patient care within the first 48-72 hours of admission when management decisions can alter the course of disease and duration of hospitalization.
Guideline recommendations
AGA’s new guideline aims to reduce practice variation and promote high-quality and high-value care for patients suffering from acute pancreatitis. It addresses questions on the benefits of goal-directed fluid resuscitation, early oral feeding, enteral vs. parenteral nutrition, the routine use of prophylactic antibiotics, and routine ERCP in all patients with AP.
The guideline is accompanied by a technical review, a new spotlight (infographic) and a patient companion infographic, which provides key points and important information directly to patients.
How to talk with your patients about PPIs and cognitive decline
A 2018 study published in Clinical Gastroenterology and Hepatology, “Lack of association between proton pump inhibitor use and cognitive decline,” found no association between PPI use and cognitive decline in analyzing data from two large population-based studies in Denmark. While this data is reassuring, clinicians should continue to anticipate questions from their patients about the risks associated with PPI therapy.
- Reassure patients that you prescribed a PPI for a clear-cut indication, in the lowest possible dose, and for an appropriate period of time (lowest dose, shortest time). This advice echoes that offered by AGA and ABIM in the Choosing Wisely campaign.
- Educate patients not to ask “what side effects do PPIs have?” but rather “is it really indicated?” Reassure patients that, when PPIs are indicated, benefits outweigh risks.
- Keep conversation channels open with patients. When patients require long-term use of PPIs, the medication should not be stopped without a discussion with you about the risks and benefits.
- Recommend that patients also consider life-style modifications that may reduce or eliminate the need for PPIs for long-term use.
A 2018 study published in Clinical Gastroenterology and Hepatology, “Lack of association between proton pump inhibitor use and cognitive decline,” found no association between PPI use and cognitive decline in analyzing data from two large population-based studies in Denmark. While this data is reassuring, clinicians should continue to anticipate questions from their patients about the risks associated with PPI therapy.
- Reassure patients that you prescribed a PPI for a clear-cut indication, in the lowest possible dose, and for an appropriate period of time (lowest dose, shortest time). This advice echoes that offered by AGA and ABIM in the Choosing Wisely campaign.
- Educate patients not to ask “what side effects do PPIs have?” but rather “is it really indicated?” Reassure patients that, when PPIs are indicated, benefits outweigh risks.
- Keep conversation channels open with patients. When patients require long-term use of PPIs, the medication should not be stopped without a discussion with you about the risks and benefits.
- Recommend that patients also consider life-style modifications that may reduce or eliminate the need for PPIs for long-term use.
A 2018 study published in Clinical Gastroenterology and Hepatology, “Lack of association between proton pump inhibitor use and cognitive decline,” found no association between PPI use and cognitive decline in analyzing data from two large population-based studies in Denmark. While this data is reassuring, clinicians should continue to anticipate questions from their patients about the risks associated with PPI therapy.
- Reassure patients that you prescribed a PPI for a clear-cut indication, in the lowest possible dose, and for an appropriate period of time (lowest dose, shortest time). This advice echoes that offered by AGA and ABIM in the Choosing Wisely campaign.
- Educate patients not to ask “what side effects do PPIs have?” but rather “is it really indicated?” Reassure patients that, when PPIs are indicated, benefits outweigh risks.
- Keep conversation channels open with patients. When patients require long-term use of PPIs, the medication should not be stopped without a discussion with you about the risks and benefits.
- Recommend that patients also consider life-style modifications that may reduce or eliminate the need for PPIs for long-term use.
Four new and noteworthy IBD drug studies
Inflammatory bowel disease (IBD) is a vibrant area of clinical research. Many of the 250+ abstracts presented at the inaugural Crohn’s & Colitis Congress — a partnership of the Crohn’s & Colitis Foundation and AGA — looked at the efficacy and safety of IBD therapies. You can review all abstracts presented at the Crohn’s & Colitis Congress in Gastroenterology.
Double-blind, randomized, placebo-controlled, crossover trial to evaluate induction of clinical response in patients with moderate-severe Crohn’s disease treated with rifaximin
By Scott D. Lee, University of Washington Medicine, et al.
Significance: It is now known that the intestinal microbiome is integral to the pathogenesis of IBD. However, antibiotic treatments for IBD have previously shown limited effectiveness. In this 8-week clinical trial, there was a fourfold greater response to the antibiotic rifaximin in Crohn’s disease treatment, compared with placebo. The positive impact on clinical disease activity was seen even in patients with a significant disease burden and prior exposure to one or more biologic therapies. Quality of life and laboratory measurements were numerically improved. No new safety concerns were identified. These results offer renewed hope for the use of antibiotics in treating Crohn’s disease.
Post-hoc analysis of tofacitinib Crohn’s disease phase 2 induction efficacy in subgroups with baseline endoscopic or biomarker evidence of inflammation
By Bruce E. Sands, Icahn School of Medicine at Mount Sinai, et al.
Significance: Tofacitinib, a Janus kinase (JAK) inhibitor, is under investigation for treatment of ulcerative colitis and Crohn’s disease. To date, response rates in ulcerative colitis have been higher than for Crohn’s disease. In this report, investigators performed post-hoc analysis studies using objective baseline criteria of disease activity. Their findings showed a greater proportion of patients with moderate to severe Crohn’s disease were in remission with tofacitinib compared to placebo. These results provide evidence of JAK inhibition for the treatment of Crohn’s disease and support further investigation.
Refined population pharmacokinetic model for infliximab precision dosing in pediatric inflammatory bowel disease
By Laura E. Bauman, Cincinnati Children’s Hospital Medical Center, et al.
Significance: Long-term clinical remission from IBD with anti-TNF therapies has generally been limited to less than half of the treated patients. Improved outcomes are seen with optimal pre-infusion trough drug levels, a measurement of the level of drugs in the patient’s bloodstream. However, standard weight-based dosing for pediatric patients has provided widely varying trough drug levels. The investigators report the development of a multifactorial pharmacokinetic model for predicting infliximab trough levels during maintenance therapy for IBD. Such dynamic approaches to treatment address a specific gap in pediatric IBD therapeutic strategies.
Primary nonresponse to tumor necrosis factor antagonists is associated with inferior response to second-line biologics in patients with inflammatory bowel diseases: A systematic review and meta-analysis
By Siddharth Singh, University of California San Diego Health, et al.
Significance: Primary nonresponse to anti-TNF therapy is seen in 35%-65% of IBD patients and another 40%-60% lose responsiveness during the first year of treatment. Physicians struggle with what treatments to recommend for these patients. The investigators in this study performed a literature search and identified eight randomized controlled trials of biologics in patients with prior exposure to anti-TNF and compared outcomes based on their prior responses to anti-TNF. The analysis reveals a 24% decrease in likelihood to achieve remission in patients who changed medications because of immediate nonresponse compared to loss of responsiveness or intolerance during the treatment. These findings raise important questions about the biology of IBD, including the pharmacology of anti-TNF in a subset of patients.
Inflammatory bowel disease (IBD) is a vibrant area of clinical research. Many of the 250+ abstracts presented at the inaugural Crohn’s & Colitis Congress — a partnership of the Crohn’s & Colitis Foundation and AGA — looked at the efficacy and safety of IBD therapies. You can review all abstracts presented at the Crohn’s & Colitis Congress in Gastroenterology.
Double-blind, randomized, placebo-controlled, crossover trial to evaluate induction of clinical response in patients with moderate-severe Crohn’s disease treated with rifaximin
By Scott D. Lee, University of Washington Medicine, et al.
Significance: It is now known that the intestinal microbiome is integral to the pathogenesis of IBD. However, antibiotic treatments for IBD have previously shown limited effectiveness. In this 8-week clinical trial, there was a fourfold greater response to the antibiotic rifaximin in Crohn’s disease treatment, compared with placebo. The positive impact on clinical disease activity was seen even in patients with a significant disease burden and prior exposure to one or more biologic therapies. Quality of life and laboratory measurements were numerically improved. No new safety concerns were identified. These results offer renewed hope for the use of antibiotics in treating Crohn’s disease.
Post-hoc analysis of tofacitinib Crohn’s disease phase 2 induction efficacy in subgroups with baseline endoscopic or biomarker evidence of inflammation
By Bruce E. Sands, Icahn School of Medicine at Mount Sinai, et al.
Significance: Tofacitinib, a Janus kinase (JAK) inhibitor, is under investigation for treatment of ulcerative colitis and Crohn’s disease. To date, response rates in ulcerative colitis have been higher than for Crohn’s disease. In this report, investigators performed post-hoc analysis studies using objective baseline criteria of disease activity. Their findings showed a greater proportion of patients with moderate to severe Crohn’s disease were in remission with tofacitinib compared to placebo. These results provide evidence of JAK inhibition for the treatment of Crohn’s disease and support further investigation.
Refined population pharmacokinetic model for infliximab precision dosing in pediatric inflammatory bowel disease
By Laura E. Bauman, Cincinnati Children’s Hospital Medical Center, et al.
Significance: Long-term clinical remission from IBD with anti-TNF therapies has generally been limited to less than half of the treated patients. Improved outcomes are seen with optimal pre-infusion trough drug levels, a measurement of the level of drugs in the patient’s bloodstream. However, standard weight-based dosing for pediatric patients has provided widely varying trough drug levels. The investigators report the development of a multifactorial pharmacokinetic model for predicting infliximab trough levels during maintenance therapy for IBD. Such dynamic approaches to treatment address a specific gap in pediatric IBD therapeutic strategies.
Primary nonresponse to tumor necrosis factor antagonists is associated with inferior response to second-line biologics in patients with inflammatory bowel diseases: A systematic review and meta-analysis
By Siddharth Singh, University of California San Diego Health, et al.
Significance: Primary nonresponse to anti-TNF therapy is seen in 35%-65% of IBD patients and another 40%-60% lose responsiveness during the first year of treatment. Physicians struggle with what treatments to recommend for these patients. The investigators in this study performed a literature search and identified eight randomized controlled trials of biologics in patients with prior exposure to anti-TNF and compared outcomes based on their prior responses to anti-TNF. The analysis reveals a 24% decrease in likelihood to achieve remission in patients who changed medications because of immediate nonresponse compared to loss of responsiveness or intolerance during the treatment. These findings raise important questions about the biology of IBD, including the pharmacology of anti-TNF in a subset of patients.
Inflammatory bowel disease (IBD) is a vibrant area of clinical research. Many of the 250+ abstracts presented at the inaugural Crohn’s & Colitis Congress — a partnership of the Crohn’s & Colitis Foundation and AGA — looked at the efficacy and safety of IBD therapies. You can review all abstracts presented at the Crohn’s & Colitis Congress in Gastroenterology.
Double-blind, randomized, placebo-controlled, crossover trial to evaluate induction of clinical response in patients with moderate-severe Crohn’s disease treated with rifaximin
By Scott D. Lee, University of Washington Medicine, et al.
Significance: It is now known that the intestinal microbiome is integral to the pathogenesis of IBD. However, antibiotic treatments for IBD have previously shown limited effectiveness. In this 8-week clinical trial, there was a fourfold greater response to the antibiotic rifaximin in Crohn’s disease treatment, compared with placebo. The positive impact on clinical disease activity was seen even in patients with a significant disease burden and prior exposure to one or more biologic therapies. Quality of life and laboratory measurements were numerically improved. No new safety concerns were identified. These results offer renewed hope for the use of antibiotics in treating Crohn’s disease.
Post-hoc analysis of tofacitinib Crohn’s disease phase 2 induction efficacy in subgroups with baseline endoscopic or biomarker evidence of inflammation
By Bruce E. Sands, Icahn School of Medicine at Mount Sinai, et al.
Significance: Tofacitinib, a Janus kinase (JAK) inhibitor, is under investigation for treatment of ulcerative colitis and Crohn’s disease. To date, response rates in ulcerative colitis have been higher than for Crohn’s disease. In this report, investigators performed post-hoc analysis studies using objective baseline criteria of disease activity. Their findings showed a greater proportion of patients with moderate to severe Crohn’s disease were in remission with tofacitinib compared to placebo. These results provide evidence of JAK inhibition for the treatment of Crohn’s disease and support further investigation.
Refined population pharmacokinetic model for infliximab precision dosing in pediatric inflammatory bowel disease
By Laura E. Bauman, Cincinnati Children’s Hospital Medical Center, et al.
Significance: Long-term clinical remission from IBD with anti-TNF therapies has generally been limited to less than half of the treated patients. Improved outcomes are seen with optimal pre-infusion trough drug levels, a measurement of the level of drugs in the patient’s bloodstream. However, standard weight-based dosing for pediatric patients has provided widely varying trough drug levels. The investigators report the development of a multifactorial pharmacokinetic model for predicting infliximab trough levels during maintenance therapy for IBD. Such dynamic approaches to treatment address a specific gap in pediatric IBD therapeutic strategies.
Primary nonresponse to tumor necrosis factor antagonists is associated with inferior response to second-line biologics in patients with inflammatory bowel diseases: A systematic review and meta-analysis
By Siddharth Singh, University of California San Diego Health, et al.
Significance: Primary nonresponse to anti-TNF therapy is seen in 35%-65% of IBD patients and another 40%-60% lose responsiveness during the first year of treatment. Physicians struggle with what treatments to recommend for these patients. The investigators in this study performed a literature search and identified eight randomized controlled trials of biologics in patients with prior exposure to anti-TNF and compared outcomes based on their prior responses to anti-TNF. The analysis reveals a 24% decrease in likelihood to achieve remission in patients who changed medications because of immediate nonresponse compared to loss of responsiveness or intolerance during the treatment. These findings raise important questions about the biology of IBD, including the pharmacology of anti-TNF in a subset of patients.
Remember the AGA Research Foundation in your will or living trust
What if all you had to do to ensure that the AGA Research Foundation can have an impact for years to come is to write a simple sentence? Sound impossible?
The AGA Research Foundation provides a key source of funding at a critical juncture in a young investigators’ career. Securing the future of the talented investigators we serve really is as simple as one sentence.
Including the AGA Research Foundation in your will is a popular gift to give because it is:
- • Affordable. The actual giving of your gift occurs after your lifetime, so your current income is not affected.
- • Flexible. Until your will goes into effect, you are free to alter your plans or change your mind.
- • Versatile. You can give a specific item, a set amount of money, or a percentage of your estate. You can also make your gift contingent upon certain events.
We hope you’ll consider including a gift to the AGA Research Foundation in your will or living trust. It’s simple – just a few sentences in your will or trust are all that is needed. The official bequest language for the AGA Research Foundation is: “I, [name], of [city, state, ZIP], give, devise and bequeath to the AGA Research Foundation [written amount or percentage of the estate or description of property] for its unrestricted use and purpose.”
Join others in donating to the AGA Research Foundation and help fill the funding gap and protect the next generation of investigators.
Please contact us for more information at [email protected] or visit http://gastro.planmylegacy.org/.
What if all you had to do to ensure that the AGA Research Foundation can have an impact for years to come is to write a simple sentence? Sound impossible?
The AGA Research Foundation provides a key source of funding at a critical juncture in a young investigators’ career. Securing the future of the talented investigators we serve really is as simple as one sentence.
Including the AGA Research Foundation in your will is a popular gift to give because it is:
- • Affordable. The actual giving of your gift occurs after your lifetime, so your current income is not affected.
- • Flexible. Until your will goes into effect, you are free to alter your plans or change your mind.
- • Versatile. You can give a specific item, a set amount of money, or a percentage of your estate. You can also make your gift contingent upon certain events.
We hope you’ll consider including a gift to the AGA Research Foundation in your will or living trust. It’s simple – just a few sentences in your will or trust are all that is needed. The official bequest language for the AGA Research Foundation is: “I, [name], of [city, state, ZIP], give, devise and bequeath to the AGA Research Foundation [written amount or percentage of the estate or description of property] for its unrestricted use and purpose.”
Join others in donating to the AGA Research Foundation and help fill the funding gap and protect the next generation of investigators.
Please contact us for more information at [email protected] or visit http://gastro.planmylegacy.org/.
What if all you had to do to ensure that the AGA Research Foundation can have an impact for years to come is to write a simple sentence? Sound impossible?
The AGA Research Foundation provides a key source of funding at a critical juncture in a young investigators’ career. Securing the future of the talented investigators we serve really is as simple as one sentence.
Including the AGA Research Foundation in your will is a popular gift to give because it is:
- • Affordable. The actual giving of your gift occurs after your lifetime, so your current income is not affected.
- • Flexible. Until your will goes into effect, you are free to alter your plans or change your mind.
- • Versatile. You can give a specific item, a set amount of money, or a percentage of your estate. You can also make your gift contingent upon certain events.
We hope you’ll consider including a gift to the AGA Research Foundation in your will or living trust. It’s simple – just a few sentences in your will or trust are all that is needed. The official bequest language for the AGA Research Foundation is: “I, [name], of [city, state, ZIP], give, devise and bequeath to the AGA Research Foundation [written amount or percentage of the estate or description of property] for its unrestricted use and purpose.”
Join others in donating to the AGA Research Foundation and help fill the funding gap and protect the next generation of investigators.
Please contact us for more information at [email protected] or visit http://gastro.planmylegacy.org/.
Congressional budget includes AGA wins
AGA spends a lot of time on Capitol Hill advocating to help gastroenterologists in practice better care for their patients and receive fair reimbursement. Therefore, we were pleased that the budget deal passed by Congress and signed by the president in February included several policy victories that AGA has been working diligently on for many years.
IPAB repeal
AGA, and all of organized medicine, have long opposed the Independent Payment Advisory Board (IPAB) that was created as part of the Affordable Care Act. IPAB is an unelected, unaccountable board whose sole purpose is to cut Medicare spending from providers should Medicare reach a certain threshold of spending. Since hospitals are exempt from their purview, physicians would be particularly vulnerable to cuts. However, repealing IPAB has had bipartisan support over the years, and we applaud Congress for listening to us and the medical community and taking action.
Misvalued codes
AGA and the physician community were also successful in removing a provision that would have extended the misvalued codes initiative for the next two years to reallocate savings from potentially overvalued codes. AGA, the Alliance of Specialty Medicine and the AMA opposed the original provision expanding the misvalued codes initiative and have argued that virtually all codes under the fee schedule, including gastroenterology, have been reevaluated and have already faced significant cuts. In the final agreement, Congress eliminated recapturing savings from the misvalued codes initiative and instead lowered overall updates for physician reimbursement under Medicare by .25 percent for 1 year. Although AGA would prefer this reduction not be included, it is much better than the misvalued codes provision, which disproportionately impacts specialties, like gastroenterology.
Geographic Practice Cost Index
The budget agreement extends the work for the Geographic Practice Cost Index (GPCI) floor for two additional years, which avoids a decrease in Medicare reimbursement for physicians that practice in rural areas. The work GPCI is a variable that Medicare uses to adjust the work component of physician payment based on where they live. A work GPCI floor of 1.0 protects physicians in low-cost, often rural areas, from being paid less for the work they do.
Meaningful use standards
The package addresses electronic health record (EHR) standards and eases requirements for physicians. The language removes the mandate that meaningful use standards become more stringent over time, which is a major financial burden for physician practices. The language also gives physicians more time to submit and receive a hardship exemption from the current EHR standards that would apply to meaningful use and the Quality Payment Program’s advancing care information performance category.
Biosimilars coverage under Medicare Part D
The agreement also levels the playing field between biologics and biosimilars by adding biosimilars to the Medicare Coverage Gap Discount Program. Additionally, by providing the 50 percent discount equally, beneficiary out-of-pocket costs will be reduced and the Medicare program will save money as a result of covering the less expensive medication.
AGA and the medical community have fought long and hard for these provisions and are happy to see them finally being implemented. We thank all of our members who have worked along with us to ensure that the voice of gastroenterology continues to be heard on Capitol Hill.
AGA spends a lot of time on Capitol Hill advocating to help gastroenterologists in practice better care for their patients and receive fair reimbursement. Therefore, we were pleased that the budget deal passed by Congress and signed by the president in February included several policy victories that AGA has been working diligently on for many years.
IPAB repeal
AGA, and all of organized medicine, have long opposed the Independent Payment Advisory Board (IPAB) that was created as part of the Affordable Care Act. IPAB is an unelected, unaccountable board whose sole purpose is to cut Medicare spending from providers should Medicare reach a certain threshold of spending. Since hospitals are exempt from their purview, physicians would be particularly vulnerable to cuts. However, repealing IPAB has had bipartisan support over the years, and we applaud Congress for listening to us and the medical community and taking action.
Misvalued codes
AGA and the physician community were also successful in removing a provision that would have extended the misvalued codes initiative for the next two years to reallocate savings from potentially overvalued codes. AGA, the Alliance of Specialty Medicine and the AMA opposed the original provision expanding the misvalued codes initiative and have argued that virtually all codes under the fee schedule, including gastroenterology, have been reevaluated and have already faced significant cuts. In the final agreement, Congress eliminated recapturing savings from the misvalued codes initiative and instead lowered overall updates for physician reimbursement under Medicare by .25 percent for 1 year. Although AGA would prefer this reduction not be included, it is much better than the misvalued codes provision, which disproportionately impacts specialties, like gastroenterology.
Geographic Practice Cost Index
The budget agreement extends the work for the Geographic Practice Cost Index (GPCI) floor for two additional years, which avoids a decrease in Medicare reimbursement for physicians that practice in rural areas. The work GPCI is a variable that Medicare uses to adjust the work component of physician payment based on where they live. A work GPCI floor of 1.0 protects physicians in low-cost, often rural areas, from being paid less for the work they do.
Meaningful use standards
The package addresses electronic health record (EHR) standards and eases requirements for physicians. The language removes the mandate that meaningful use standards become more stringent over time, which is a major financial burden for physician practices. The language also gives physicians more time to submit and receive a hardship exemption from the current EHR standards that would apply to meaningful use and the Quality Payment Program’s advancing care information performance category.
Biosimilars coverage under Medicare Part D
The agreement also levels the playing field between biologics and biosimilars by adding biosimilars to the Medicare Coverage Gap Discount Program. Additionally, by providing the 50 percent discount equally, beneficiary out-of-pocket costs will be reduced and the Medicare program will save money as a result of covering the less expensive medication.
AGA and the medical community have fought long and hard for these provisions and are happy to see them finally being implemented. We thank all of our members who have worked along with us to ensure that the voice of gastroenterology continues to be heard on Capitol Hill.
AGA spends a lot of time on Capitol Hill advocating to help gastroenterologists in practice better care for their patients and receive fair reimbursement. Therefore, we were pleased that the budget deal passed by Congress and signed by the president in February included several policy victories that AGA has been working diligently on for many years.
IPAB repeal
AGA, and all of organized medicine, have long opposed the Independent Payment Advisory Board (IPAB) that was created as part of the Affordable Care Act. IPAB is an unelected, unaccountable board whose sole purpose is to cut Medicare spending from providers should Medicare reach a certain threshold of spending. Since hospitals are exempt from their purview, physicians would be particularly vulnerable to cuts. However, repealing IPAB has had bipartisan support over the years, and we applaud Congress for listening to us and the medical community and taking action.
Misvalued codes
AGA and the physician community were also successful in removing a provision that would have extended the misvalued codes initiative for the next two years to reallocate savings from potentially overvalued codes. AGA, the Alliance of Specialty Medicine and the AMA opposed the original provision expanding the misvalued codes initiative and have argued that virtually all codes under the fee schedule, including gastroenterology, have been reevaluated and have already faced significant cuts. In the final agreement, Congress eliminated recapturing savings from the misvalued codes initiative and instead lowered overall updates for physician reimbursement under Medicare by .25 percent for 1 year. Although AGA would prefer this reduction not be included, it is much better than the misvalued codes provision, which disproportionately impacts specialties, like gastroenterology.
Geographic Practice Cost Index
The budget agreement extends the work for the Geographic Practice Cost Index (GPCI) floor for two additional years, which avoids a decrease in Medicare reimbursement for physicians that practice in rural areas. The work GPCI is a variable that Medicare uses to adjust the work component of physician payment based on where they live. A work GPCI floor of 1.0 protects physicians in low-cost, often rural areas, from being paid less for the work they do.
Meaningful use standards
The package addresses electronic health record (EHR) standards and eases requirements for physicians. The language removes the mandate that meaningful use standards become more stringent over time, which is a major financial burden for physician practices. The language also gives physicians more time to submit and receive a hardship exemption from the current EHR standards that would apply to meaningful use and the Quality Payment Program’s advancing care information performance category.
Biosimilars coverage under Medicare Part D
The agreement also levels the playing field between biologics and biosimilars by adding biosimilars to the Medicare Coverage Gap Discount Program. Additionally, by providing the 50 percent discount equally, beneficiary out-of-pocket costs will be reduced and the Medicare program will save money as a result of covering the less expensive medication.
AGA and the medical community have fought long and hard for these provisions and are happy to see them finally being implemented. We thank all of our members who have worked along with us to ensure that the voice of gastroenterology continues to be heard on Capitol Hill.
Learn About New ABS Continuous Certification Program
The American Board of Surgery has announced the details of its new Continuous Certification Program, shaped by surgeon feedback and designed to provide greater value, flexibility and convenience in maintaining ABS board certification. Instead of taking one recertification exam every 10 years, surgeons will use the new program to demonstrate their surgical knowledge on a continual basis. General surgeons will follow the new assessment this year; members of other ABS specialties will do so over the next few years.
The American Board of Surgery has announced the details of its new Continuous Certification Program, shaped by surgeon feedback and designed to provide greater value, flexibility and convenience in maintaining ABS board certification. Instead of taking one recertification exam every 10 years, surgeons will use the new program to demonstrate their surgical knowledge on a continual basis. General surgeons will follow the new assessment this year; members of other ABS specialties will do so over the next few years.
The American Board of Surgery has announced the details of its new Continuous Certification Program, shaped by surgeon feedback and designed to provide greater value, flexibility and convenience in maintaining ABS board certification. Instead of taking one recertification exam every 10 years, surgeons will use the new program to demonstrate their surgical knowledge on a continual basis. General surgeons will follow the new assessment this year; members of other ABS specialties will do so over the next few years.
Deadline is March 30 to Apply for Council, Committee Spots
SVS members who want to serve on an SVS Council or Committee must complete the brief application by Friday, March 30, 2018. Please note: Members must create a new account; SVS log-in credentials will not work.
SVS members who want to serve on an SVS Council or Committee must complete the brief application by Friday, March 30, 2018. Please note: Members must create a new account; SVS log-in credentials will not work.
SVS members who want to serve on an SVS Council or Committee must complete the brief application by Friday, March 30, 2018. Please note: Members must create a new account; SVS log-in credentials will not work.
VIDEO: Digital health technologies are here to be embraced
BOSTON – One of the innovations in gastroenterology that is used on a day-to-day basis is digital technology, said Sri Komanduri, MD, in a video interview at the 2018 AGA Tech Summit, which is sponsored by the AGA Center for GI Innovation and Technology.
Everything from Internet rate-your-doctor sites to bowel prep apps and EHRs qualify as digital health technology, said Dr. Komanduri, the medical director of the GI laboratory and director of interventional endoscopy at Northwestern University in Chicago and vice chair of the AGA Center for GI Innovation and Technology.
Digital technology can facilitate endoscopy procedures, help patients communicate with their doctors about chronic conditions, and help patients better understand their illness. The role of the physician is to embrace those technologies that improve the quality of care.
BOSTON – One of the innovations in gastroenterology that is used on a day-to-day basis is digital technology, said Sri Komanduri, MD, in a video interview at the 2018 AGA Tech Summit, which is sponsored by the AGA Center for GI Innovation and Technology.
Everything from Internet rate-your-doctor sites to bowel prep apps and EHRs qualify as digital health technology, said Dr. Komanduri, the medical director of the GI laboratory and director of interventional endoscopy at Northwestern University in Chicago and vice chair of the AGA Center for GI Innovation and Technology.
Digital technology can facilitate endoscopy procedures, help patients communicate with their doctors about chronic conditions, and help patients better understand their illness. The role of the physician is to embrace those technologies that improve the quality of care.
BOSTON – One of the innovations in gastroenterology that is used on a day-to-day basis is digital technology, said Sri Komanduri, MD, in a video interview at the 2018 AGA Tech Summit, which is sponsored by the AGA Center for GI Innovation and Technology.
Everything from Internet rate-your-doctor sites to bowel prep apps and EHRs qualify as digital health technology, said Dr. Komanduri, the medical director of the GI laboratory and director of interventional endoscopy at Northwestern University in Chicago and vice chair of the AGA Center for GI Innovation and Technology.
Digital technology can facilitate endoscopy procedures, help patients communicate with their doctors about chronic conditions, and help patients better understand their illness. The role of the physician is to embrace those technologies that improve the quality of care.
FROM THE 2018 AGA TECH SUMMIT
VAM Registration Now Open
Registration and housing for the 2018 Vascular Annual Meeting are now open. Register today for VAM, June 20 to 23 in Boston, including looking over housing options. Following a full day of postgraduate courses, VESS abstracts, workshops and international programming on Wednesday, June 20, abstract-based scientific sessions will open June 21 and continue to June 23. The Exhibit Hall will be open June 21 to 22.
Registration and housing for the 2018 Vascular Annual Meeting are now open. Register today for VAM, June 20 to 23 in Boston, including looking over housing options. Following a full day of postgraduate courses, VESS abstracts, workshops and international programming on Wednesday, June 20, abstract-based scientific sessions will open June 21 and continue to June 23. The Exhibit Hall will be open June 21 to 22.
Registration and housing for the 2018 Vascular Annual Meeting are now open. Register today for VAM, June 20 to 23 in Boston, including looking over housing options. Following a full day of postgraduate courses, VESS abstracts, workshops and international programming on Wednesday, June 20, abstract-based scientific sessions will open June 21 and continue to June 23. The Exhibit Hall will be open June 21 to 22.
Catch the Innovation Spirit: Register for VRIC
Register today for this year’s Vascular Research Initiatives Conference, May 9, in San Francisco. The theme “Road to Innovation, Invention and Enterprise,” is reflected in the Translational Panel presentation, "Road to Entrepreneurship." Also part of VRIC are four abstract sessions, on stem cells and regeneration, PAD, vascular endothelium and thrombosis and vascular inflammation and injury.
Register today for this year’s Vascular Research Initiatives Conference, May 9, in San Francisco. The theme “Road to Innovation, Invention and Enterprise,” is reflected in the Translational Panel presentation, "Road to Entrepreneurship." Also part of VRIC are four abstract sessions, on stem cells and regeneration, PAD, vascular endothelium and thrombosis and vascular inflammation and injury.
Register today for this year’s Vascular Research Initiatives Conference, May 9, in San Francisco. The theme “Road to Innovation, Invention and Enterprise,” is reflected in the Translational Panel presentation, "Road to Entrepreneurship." Also part of VRIC are four abstract sessions, on stem cells and regeneration, PAD, vascular endothelium and thrombosis and vascular inflammation and injury.