This Week in Washington DC – May 11, 2019

From Rhode Island Governor Alyn Adrain, MD, FACG

RI State Senator Maryellen Goodwin (D-RI-1) has introduced Senate Bill 679, "An Act Relating to Insurance--Accident and Sickness Insurance Policies," (S. 679). This bill prohibits insurers from requiring patient cost sharing for screening colonoscopy, when a screening colonoscopy turns therapeutic, or when a patient is referred for a diagnostic colonoscopy subsequent to another colorectal cancer screening test. We need Rhode Island ACG members to contact the House Speaker Nicholas A. Mattiello and urge him to support this important bill. Use the ACG Legislative Action Center to contact Speaker Mattiello!

Quick Link to Write RI Speaker Mattiello with Your Support for S. 679

On April 9th, Dr. Adrain and Samir A. Shah, MD, FACG, ACG's Treasurer, testified in front of the Rhode Island General Assembly in support of S. 679. Dr. Adrain highlighted the fact that while colorectal cancer is currently the second most common cancer killer in the United States, it is largely preventable--and we must make strides to increase screening and remove any potential barriers to patient access.

Dr. Adrain and Dr. Shah also joined a delegation of over 100 ACG members in Washington, D.C. for the 2019 Board of Governors Legislative Fly-In, where participants advocated for the "Removing Barriers to Colorectal Cancer Screening" bill (S. 668; H.R. 1570). ACG thanks Dr. Adrain and Dr. Shah for their steadfast dedication in advocating for clinical gastroenterology and improving patient care.

For the first time in the United States, employed physicians outnumbered self-employed physicians, according to a new study on physician practice arrangements by the American Medical Association (AMA). Some highlights:

• Employed physicians were 47.4% of all patient-care physicians in 2018, up 6% points since 2012. In contrast, self-employed physicians were 45.9% of all patient care physicians in 2018, down 7% points since 2012.
• Physicians in hospital-owned practices were 26.7% of all patient care physicians, an increase from 23.4% in 2012. In the aggregate, 34.7% of physicians worked either directly for a hospital or in a practice at least partly owned by a hospital in 2018, up from 29.0% in 2012.
• Younger physicians and women physicians are more likely to be employed. Nearly 70% of physicians under age 40 were employees in 2018, compared to 38.2% of physicians age 55 and over. Among female physicians, more were employees than practice owners (57.6% vs. 34.3%). The reverse is true for male physicians, more were practice owners than employees (52.1% vs. 41.9%).
• In 2018, 56.5% of physicians worked in practices with 10 or fewer physicians compared to 61.4% in 2012.
• In 2018, ownership ranged from 25.5% among physicians under the age of 40 to 54.3% among physicians age 55 and older. 34% percent of women physicians were owners, compared to 52.1% of men.
• In 2018, the percentage of physicians in physician-owned practices (internal medicine sub-specialties) was 57%. The distribution of physicians in internal medicine sub-specialties by practice type: 41.7% were in a single specialty group, 28.2% were in a multi-specialty group, 14.1% were in solo practice, 8.4% were a hospital employee or contractors, and 7.5% were “other.”

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