Q&A with LUGPA Immediate-Past President [PART ONE]
Making Policy Progress During a Pandemic

Ahead of the 2022 LUGPA Annual Meeting, we caught up with outgoing LUGPA President Jonathan Henderson, MD, for a question-and-answer session, during which Dr. Henderson reflected on his past two years as president of LUGPA. This blog post will be part of a two-part series.

	Jonathan Henderson, MD

What accomplishments are you most proud of during your time as president?

First of all, I’m honored to have held this position. Serving as the president of LUGPA has been a highlight of my career. It has been a humbling experience to be recognized and trusted as a leader of such an incredible and tightknit group of physicians and administrators.

My presidency was notably marked by the COVID-19 pandemic. I am tremendously proud of the way LUGPA was able to not only remain stable during the pandemic, but also to make progress. Over the past two years, LUGPA has come a long way, returning to in-person meetings and relaunching all our programming, including the Bladder and Kidney Cancer and Prostate Cancer Academies. Our membership remained strong and steady, looking to LUGPA for guidance during an unpredictable and tumultuous landscape.

This past year, we also graduated our first leadership class, began the Diversity, Equity and Inclusion Committee and launched the Radiation Oncology working group, all of which show the continuous growth of LUGPA. We have also begun to collaborate with other organizations who share our goals and values, including Specialty Networks and UroGPO, and created mutually beneficial relationships, which I believe will continue to support our mission in the future.

How has LUGPA made progress on key advocacy issues?

While there is more work to be done, we have seen significant progress on issues in the past few years, including increased accessibility with cutting-edge platforms like telehealth, a patient’s right to price transparency and fair drug pricing. LUGPA’s advocacy groups and health policy teams in Washington, D.C. have been instrumental in advancing that progress through lobbying virtually and in-person, as well as other efforts including submitting public comments, educating others on policy issues and working with coalitions to express support for legislation. For example, LUGPA was involved with the No Surprises Act and had a seat at the table with Congress when the act was initially being discussed.

What progress is still needed across those policy issues?

Telehealth has come a long way, and we are seeing consistent wins year by year. However, for practices to truly implement telehealth to its maximum ability and efficiency, they need to know that reimbursements are here to stay. Right now, only 3% to 10% of our LUGPA groups are sufficiently utilizing telehealth because of uncertainty surrounding long-term plans.

There are two main layers to the progress of price transparency. First, there was the No Surprises Act, which CMS rolled out differently than Congress intended. While the act is well-intentioned, and we certainly don’t want patients to be gouged for unexpected prices when they are out of network, in practice, it has been undermining and placing an undue burden on physicians. The other level to this issue is hospital price transparency. CMS has come down hard on hospitals to force them to be more transparent, but hospitals have continued to game the system, showing that paying fines to CMS is still more affordable for them than to truly be honest about their prices.

With fair drug pricing, the major issue we are facing is that it doesn’t mean the same thing to everyone. In current policies, we hear about fair pricing for patients, which is critical; however, we need to also discuss fair pricing for the manufacturers, payers and medical practices. LUGPA has been extremely engaged with reimbursement and fair drug pricing bills, because so many of the drugs we use in our practices are in Medicare Part B and to some extent Part D. If everyone isn’t accounted for in fair pricing equations, then it will not be workable, and the result will be a lack of access for patients.

The perennial lack of adjustments by CMS remains a significant policy challenge that needs to continue being addressed. There has not been a positive uptick in reimbursement for years, and yet inflation continues to rise, putting physicians in an extremely difficult position.

Overall, I am incredibly proud that LUGPA has played such a pivotal role in the positive progress made so far, and I am certain that we will continue to further these advancements on behalf of independent urologists everywhere.