The American Association of Cardiovascular and Pulmonary Rehabilitation’s (AACVPR) Day on the Hill, which was March 4-5 this year, is an opportunity for cardiac and pulmonary rehabilitation professionals to visit Washington, D.C. to advocate for their profession and ask legislators for support for beneficial legislation on Medicare decisions. It was Stacey Greenway’s 10th year participating in this event, a milestone made all the more significant by her recent election as treasurer to the AACVPR board.
Stacey, the director of cardiovascular disease management services at ECU Health Medical Center, wasn’t initially interested in health care policy, but her zeal for her work inspired her to get involved.
“I’m passionate about what I do, and when I realized the impact these legislative decisions make on our patients, I wanted to get involved,” she said. “When the North Carolina Cardiopulmonary Rehabilitation Association (NCCRA), which works on the state level, asked if anyone was interested in participating in Day on the Hill, I thought how cool it would be to help our patients and our programs. After the first time, I was hooked.”
Each year, the AACVPR’s legislative priorities are different, but the goal is the same. “We want to help the legislators see things from the patient perspective and put a face to the people these bills are affecting,” Stacey said. “From that angle, you see the increase in a patient’s quality of life. From a health system perspective, it decreases the rates of hospital readmission. It’s a win-win.”
This year’s priorities centered on two bills: HR-955/S.1849, the Sustaining Outpatient Services Act, and HR-1406/S.3021, the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act. The Sustaining Outpatient Services Act seeks to correct a legislative error from a previous bill that reduces reimbursement for cardiac and pulmonary rehabilitation services when they are provided in off-hospital campus clinics. The reduced reimbursement rate makes cardiac and pulmonary rehabilitation services financially unsustainable and thus eliminates patient access to these resources, especially in rural communities. “Some rural hospitals, which don’t have a lot of real estate on campus, haven’t even tried to open a rehab clinic because of this issue,” Stacey said. This bill would establish an exemption status to certain hospital outpatient services, including cardiac and pulmonary rehabilitation, from that fee reduction.
The Sustainable Cardiopulmonary Rehabilitation Services in the Home Act would allow Medicare beneficiaries to receive cardiac or pulmonary rehabilitation services through real-time telehealth in their homes. This hybrid type of service was very successful during the pandemic, and it allowed more patients to be treated from across eastern North Carolina.
“Think of that 45-year-old patient who had a heart attack and would benefit from rehab services but has also been cleared to work and needs to make an income,” Stacey explained. “This bill would allow that patient to not have to make a choice between income and health; they could do both.”
During her time in Washington, D.C., Stacey and 74 other AACVPR members spoke with their respective House Representatives and Senators to advocate for these bills. Stacey said overall, the discussions were productive.
“I had some good conversations about both bills,” she said. “The telehealth bill was one the legislators could wrap their heads around easier; it was something they were familiar with. That was encouraging.” While more work needs to be done to increase support for the outpatient services bill, Stacey said she felt the needle moved a bit. “This is partly because the government seems to be changing their focus from thinking about the up-front costs of health care to the savings incurred on the back end,” Stacey said. “That means things are changing, and I’m hoping we’ll get a few more co-signatures on that bill.”
As a board member, Stacey said she now has other opportunities to support her profession.
“To represent eastern North Carolina and discuss at the national level some of the things that impact those who practice locally is really important,” she said. Because she was on the board this year, Stacey was also able join the board meeting the day before Day on the Hill and participate in the selection of a new legislative firm. “We met with the firm and prepped for Day on the Hill, but we also strategically planned for the future,” Stacey said. “It was exciting to be involved in that process.”
Stacey’s interest in running for the AACVPR’s treasurer position stemmed from her desire to stay involved in the national organization and escalating care for patients.
“The board is involved in regulatory and government relations, and that’s one of my big interests. Day on the Hill is just one way we stay involved. It’s a way of understanding and supporting initiatives and bringing that back to ECU Health,” she said. “We have six cardiac and pulmonary rehab programs within ECU Health, and I want to make sure those programs are aware of the initiatives the AACVPR promotes to escalate their practice and ensure we’re doing the best we can for our patients.”
Now that the initial conversations with Congress members are over, the next step is to follow up in a few weeks with those representatives still on the fence. “We’ll also bring in a constituent from that person’s district to speak to the impact of these bills,” Stacey said. Some representatives have already signed on to at least one of the bills, including Rep. Don Davis, Rep. Deborah Ross, Rep. Greg Murphy, Rep. Wiley Nickel and Rep. Jeff Jackson.
It’s important to be involved in the policy issues surrounding health care, Stacey said. “You don’t go into health care thinking about these operational or political issues, but when you’re faced with the repercussions in the clinic, you see the impact it has.”
She encouraged all health care professionals to get involved: “Let’s do this for the betterment of the patient experience,” she said. “For me, this has been one of the highlights of my professional life.”