LUGPA, Chicago, Illinois

In 2024, independent practices nationwide faced new and mounting challenges, including increasing and expanding regulatory obligations and growing patient demands against a background of rising input costs and financial pressures. Amid a shifting health care landscape, urologists were tasked with the pressing challenge of doing more with less.

Over the past year, LUGPA has pursued an advocacy agenda focused on physician reimbursement reform, patient access to care, telehealth expansion, workforce retention, and access to advanced diagnostic testing. This agenda was designed to address the growing operational strains on independent practices and to prioritize sustainable and accessible care for patients.

Physician Reimbursement Reform

Physician reimbursement reform remains a central focus of LUGPA’s advocacy. In 2024, LUGPA’s top advocacy priority centered on calling for reforms to the Medicare Physician Fee Schedule, proposing that updates be tied to the Medicare Economic Index to ensure sustainable adjustments that reflect national economic conditions.

In addition to Medicare Physician Fee Schedule advocacy, LUGPA pushed for comprehensive reform of the Merit-Based Incentive Payment System and the Medicare Access and Children’s Health Insurance Program Reauthorization Act. Proposed reforms aimed to streamline payment structures, better aligning them with the realities of independent practice operations.

In addition, LUGPA supported site-neutral payment policy reform to address the growing gaps in reimbursement to independent practices and hospitals, which have contributed to the trends of hospital acquisition and market monopoly, which in turn raise patient costs and hinder access to care.

Expanding Patient Access to Care

LUGPA’s efforts to protect patient access were pivotal in 2024, particularly for patients with cancer and chronic urologic conditions. LUGPA championed reforms to Medicare parts B and D, with a focus on improving access to cancer therapies available in independent settings. LUGPA’s work on health care pricing transparency further supported patient access by advocating for clearer cost information, which empowers patients to make informed decisions about their care.

Telehealth Advocacy and Expansion

The rise of telehealth continued to be in focus in 2024. LUGPA has continued to push for the permanent expansion of telehealth services and has educated lawmakers about the importance of maintaining and expanding flexibility in telehealth delivery. LUGPA advocated for policies that will make audio-only (telephonic) visits a permanent telehealth option; these policies are essential for patients in rural and underserved areas as well as in areas without reliable internet access.

LUGPA’s telehealth advocacy underscores its commitment to evolving care models that meet the needs of diverse patient populations as well as the long-term and comprehensive nature of care that many urologic conditions make necessary for patients with chronic conditions.

Workforce Retention and Clinician Wellness

With the discipline of urology facing notable workforce challenges, LUGPA prioritized clinician wellness and workforce retention in its 2024 agenda. To combat high clinician burnout rates, LUGPA pushed for wellness policies that address the administrative and regulatory burdens contributing to clinician stress. Legislative solutions included incentives for recruitment and retention, particularly in underserved areas, which will help provide urologists with the latitude to practice based on their passion and interests rather than on the reimbursement-based and logistical realities often associated with these sites.

Advocacy Actions in 2024

LUGPA’s advocacy efforts also included numerous actions to advance our 2024 priorities. In March, LUGPA submitted a formal letter addressing the impact of the 340B Drug Pricing Program on urologic practices, calling for greater transparency and equitable benefit distribution.

In May, LUGPA took a strong stance on health care consolidation, with Dr Timothy Richardson testifying before the US House Ways and Means Committee. Dr Richardson highlighted the adverse effects of hospital acquisitions on health care costs, patient choice, and competition, urging lawmakers to support site-neutral payment policies and reform the Stark Law to level the playing field for independent practices.

In August, LUGPA submitted a letter to the US Congress advocating for Medicare Physician Fee Schedule updates aligned with economic indicators. In October, LUGPA had the opportunity to respond to the site-neutral legislation introduced by Senators Bill Cassidy and Maggie Hassan as a countermeasure against health care consolidation. These efforts underscored LUGPA’s position as a consultative partner and resource for information and education for our legislators and their staff.

Looking Ahead to 2025

The recent elections present an opportunity for meaningful health care reform, especially if organizations such as LUGPA remain proactive in shaping the agenda. LUGPA is committed to leading this effort by crafting and advancing actionable solutions to address the challenges facing independent practices and the broader health care system.

Through its advocacy for reforms in physician reimbursement, patient access, telehealth, workforce retention, and health care transparency, LUGPA has demonstrated its dedication to preserving quality health care and fostering sustainable practice environments. As we move into 2025, LUGPA will continue to champion policies that support independent practices and help them thrive in an evolving health care landscape.

Article Information

Published: December 13, 2024.

Conflict of Interest Disclosures: The author has nothing to disclose.

Funding/Support: None.

Author Contributions: Matthew Glans is solely responsible for the content of this editorial.

Data Availability Statement: No new data were generated for this editorial.