Trip Offers Physicians Inside View of Health Policy Process

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Sometime this summer, possibly as early as next month, the Supreme Court will once again issue a ruling on a legal challenge to the Affordable Care Act.

It will be the third time in three years that the court has made a ruling related to the ACA. In 2012, the Supreme Court upheld the constitutionality of the law’s individual mandate. Last year, in Burwell v. Hobby Lobby Stores and Conestoga Wood Specialties v. Burwell, the court weakened the law’s birth control provisions.

The court’s latest ruling on King v. Burwell will determine if nothing changes or if more than 7 million people receiving subsidies through the federal exchange will be impacted.

But how exactly does a 900-page document like Obamacare become law? And whether it’s the ACA or any other federally-enacted health care legislation, what roles do agencies like the Federal Trade Commission play in the process; how do decisions on Medicare and Medicaid impact the federal budget? And what is the future of health care reform in Congress?

A newly-developed residency course in the Kelley School’s Business of Medicine MBA program aims to answer those questions and more during the first week of June, when more than two dozen students in the school’s physician-only program will get an inside look at how health care policy is shaped during a week-long trip to Washington, D.C.

“All law is evolving and ever-changing, but in the health care industry it is changing at such a rapid pace that you can’t just keep up with new laws, you have to understand what the drivers are behind it,” said Julie Manning Magid, associate professor of business law at the Kelley School of Business. “This class will take physicians behind the scenes to understand how the policy is created and why; and how they can have input on affecting the policy.”

Held in conjunction with The Washington Campus, a 16-university consortium that offers university credit and certificate programs, the Health Care Policy course is designed to explore both the content and the process of how federal health care policy is enacted. The course will delve into the dynamics and players that shape those policies, as well as address legislation and regulation that govern health care policy.

Students participating in the course will visit with a variety of policy and advocacy experts, such as current and former members of Congress, congressional staff, and various agencies, as well as meet with corporate and association executives, consultants, and lobbyists. The week is jam packed with multiple back-to-back meetings, and Magid is particularly excited about an end-of-week session called “Media, Politics and Public Policy.” The lecture will feature a national political reporter for The Washington Post and the health care editor for Politico.

“It’s a really nice other dimension to understand how the media plays into this and how they think they play into it,” she said. “And you also have the difference between new media, like Politico, vs. the old media, like The Washington Post, and how they have different roles in it. Most people probably wouldn’t think about exploring an area like this as part of understanding how policy is made, but it’s really exciting.”

Magid has been working on the curriculum for the course for nearly a year with three goals in mind: provide content from all sides of the process; have students gain knowledge of what the legislative process looks like in action; acquire access to information that physicians can digest in a way that has meaning to them. Students prepared for the course with a variety of pre-trip reading assignments, and will end the week with an individual exam that covers key topics from both the readings and the D.C. experience.

“This course is much broader than knowing how to lobby for a particular organizational standpoint,” Magid said. “This is about understanding how to work with the system in a much broader sense – from the media, to the agencies that actually enact the regulations, to the budgeting process.

“We wanted to make sure, knowing what our curriculum already is able to provide, that we could fill in the gaps that we don’t cover in the curriculum as extensively. This isn’t a course about the Affordable Care Act. It’s much bigger than that.”

Anca Pop, a gastroenterologist from Memphis, Tenn., is in her second year of the Business of Medicine MBA program. In April, she was part of the American Society for Gastrointestinal Endoscopy (ASGE) delegation that advocated for the repeal of the sustainable growth rate (SGR) formula that adjusted Medicare payments to physicians.

The opportunity to go behind the scenes with a team of experienced physicians and ask questions is a “dream come true,” Pop says.

“Having had the opportunity to get introduced to the current system, I am fascinated by the inner workings in Washington,” said Pop, who will be among the Business of Medicine program’s first graduates later this summer. “There’s a delicate balance of give and take, compromises and considerations behind many debates, the economic realities that are the background of the political process, and the multitude of moving parts that actually make the system work.”

While Magid hopes the course inspires other physicians to become active participants in the legislative process, the ultimate objective is to make Business of Medicine students better managers and leaders, with the added knowledge of how to advance their own objectives in the context of an ever-changing governmental, political, and policy landscape.

“You have to be able to work with the law after it becomes law, but you don’t have to wait for an output,” she said. “You can be part of the entire process, and should be.”