Dr. Wetzel's goals for his one-year term as NASS president include:
· Advance the organization’s reputation as a premier spine society
· Maintain leadership on ethical issues
· Improve services provided to its almost 9,000 members
· Expand NASS' international reach
· Grow the organization's advocacy efforts
Wetzel hopes to hit 100 percent of NASS membership attendance at the annual meeting and support a new path toward voting membership for non-physicians, including nurse clinicians and chiropractors. The organization will continue to support educational opportunities, such as webinars and symposia.
"People learn very differently, and in the past we relied on face-to-face summits and meetings that weren't inclusive for everyone," says Dr. Wetzel. "Some members can't leave their practices to attend a long meeting, while others learn better with online modules. The real challenge will be utilizing the different ways of learning while maintaining a degree of engagement in face-to-face meetings."
The coming year will also pose interesting challenges as U.S. President-elect Donald Trump takes office and Republicans assume control over both the House of Representatives and Senate, vowing changes to the Affordable Care Act (ACA). The past eight years, healthcare policy has steered providers toward high-quality, low-cost care and focused on universal healthcare insurance coverage for Americans—the next eight years could be different.
One aspect of the healthcare changes has shared relative bipartisan support and could survive changes on Capitol Hill: the Medicare Access and CHIP Reauthorization Act (MACRA).
"One of the things on everyone's mind is what will happen with healthcare because of the election," says Dr. Wetzel. "Everyone is nervous about MACRA and value-based care. Some aspects of Obamacare may be repealed, such as the individual mandate or the rules on pre-existing conditions. This is clearly a time of transition and a time when NASS could be most valuable to its members. Times of uncertainty create opportunity. We have lots of opportunity with advocacy and public policy, and we can stay on top of these developments in real time."
Changes to the ACA could create access to care issues if some parts are repealed while others stay in place. A selective repeal could mean healthcare premiums will rise and enrollment will go down — as in states that implemented only portions of the ACA.
"This is a great concern, indeed," says Dr. Wetzel. "However, NASS is ahead of the curve in policy, research and education. That ties into the future of healthcare, including reimbursement. In research NASS made inroads and got a seat at the table — most notably in the discussion about PCORI, and with those organizations that fund research to guide delivery of evidence-based care."
The organization has released several clinical guidelines with extensive citations to research supporting treatment indications for spinal surgery and nonoperative care. All members of the clinical guidelines committees are evidence-based trained and maintain high standards for their recommendations.
"Our guidelines are used by many insurers and we are optimistic that it will be accessed on a regular basis by agencies like CMS," says Dr. Wetzel.
The organization also recently finished a pilot of its spine registry and plans to make the registry available to all members in the future. The registry is designed to provide a real-time log of data for evidence-based research, precision medicine and pragmatic studies.
NASS also launched a foundation to engage in public health education and advocacy. The foundation has funding from industry and third-party payers; its goal is to decrease spine disability 10 percent by 2025.
"We are partnering with many stakeholders to support our goal," says Dr. Wetzel. "This includes a direct outreach to patients. An informed patient, particularly in the setting of the workplace, is critically important for healthcare policy as you increase the value delivered. The patient has to be a partner, and the best way to do that is through education and enrollment."
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