LUGPA puts resources behind key policy initiatives, future leaders

Focused on preserving and advancing the independent practice of urology, LUGPA over the past year has dedicated its resources to health policy and advocacy, business excellence, clinical excellence, and the development of future leaders.

That was the core message of LUGPA President Neal D. Shore, MD, in his presidential address Nov. 10 at the LUGPA annual meeting in Chicago.

Many headwinds are facing urologists, said Dr. Shore, including:

• increased work volume with declining reimbursements
• burgeoning regulatory burdens at the federal, state, and local levels
• a deluge of health policy changes and clinical advances
• the “practice culture conundrum”-teamwork and collaboration versus working as a lone wolf
• practice ownership-what price for independence versus hospital employment versus private equity versus public commodity?
• internecine specialty conflicts
• federal barriers, including new Stark regulations and edicts from the U.S. Preventive Services Task Force
• the “person power” shortage facing the specialty
• life balance-recognizing and avoiding burnout.

Also see: LUGPA advocacy targets self-referral laws, USPSTF reform

“LUGPA is continuing to provide cutting-edge education for the implementation of breakthrough therapies and technologies, particularly in GU oncology, specifically for prostate, bladder, and kidney cancers,” Dr. Shore said. “We are dedicated to assisting our members who want to develop GU oncology centers of excellence.”

Noting that LUGPA is “dedicated to the development of future leaders of urology both within practices as well as the association,” he said a “young LUGPA group” was initiated for members in practice 15 years or less to assist them with many topics specific to their needs and concerns.

“This initiative is extremely important because it recognizes the fact that we have person power shortages in addition to an aging specialty, of which many are nearing retirement, as well as an expanding elderly population in need of urologic expertise,” Dr. Shore explained. “So it is very important to encourage our younger members to embrace leadership opportunities.”

Next: Other initiatives include UroCare Live TV, urology-specific measures

New initiatives for LUGPA, in addition to regional LUGPA meetings, include the initiation of UroCare Live TV, a series of live bimonthly programs to inform members about advances in clinical and therapeutic breakthroughs as well as topics discussing ways to optimize the business of health care.

“We will be providing in-practice education-going to specific member locations for multimodal education-and we’ll be co-sponsoring a winter CME meeting with the International Prostate Cancer Update, Jan. 24-27 in Beaver Creek, Colorado,” he said.

Dr. Shore said LUGPA and its member groups are “leading the way” in developing urology-specific measures that can be used for MIPS quality reporting.

The first electronic clinical quality measure LUGPA submitted, he explained, is related to bone-density screening for men who are prescribed androgen deprivation therapy with the intent to treat for a year or longer.

Additional measures under development include:

• use of active surveillance for low-risk prostate cancer
• urinary symptom score change 6-12 months after diagnosis of BPH
• treatment of osteopenia or osteoporosis in men with non-metastatic prostate cancer on androgen deprivation therapy
• intravesical bacillus Calmette-Guérin utilization for nonmuscle-invasive bladder cancer.

Dr. Shore noted that on July 5, LUGPA submitted to the Physician-Focused Payment Model Technical Advisory Committee the first urology-specific advanced alternative payment model (APM) to enhance urologists’ participation via the MACRA transition to value-based care.

Read: MedPAC advocates for MIPS termination

Accomplished through a collaborative effort with numerous LUGPA practices and industry partners, the proposed APM measure addresses newly diagnosed patients with localized prostate cancer, emphasizing the importance of patient shared decision-making for active surveillance and active treatment choices, thus optimizing patient care decisions and cost savings for the health care system.

Additionally, LUGPA continues its efforts of addressing and developing other practical advanced APMs.

Dr. Shore also noted that LUGPA has been a key driver for the Medicare Care Coordination Improvement Act of 2017, just introduced in Congress, which would:

• facilitate physician group practice development and participation in APMs by exempting “value and volume” from the fair market value standard. The measure allows practices to use “designated health service” (eg, radiation, pathology) revenue to incentivize physicians on treatment protocols.
• empower the Department of Health & Human Services to provide the same waiver authority for all types of APMs that have been provided to Medicare Shared Saving Program’s accountable care organizations.

Dr. Shore said LUGPA continues to seek expansion of its membership to all independent urology groups. “Our board is dedicated to ensuring the financial stability and fiduciary oversight of the association while being prepared for both the expected and unexpected ever-changing health care ecosystem,” he said.

He said LUGPA has optimized its infrastructure to “realistically achieve mission-critical goals,” including expanding from one to four full-time personnel over the past 2 years.

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