Without precedent, 2020 has been the most challenging year for US health care. Even before the coronavirus landed on our shores, it would have been a year of significant change due, in part, to the 21st Century Cures Act and other regulatory changes already underway. But COVID-19 created a seismic shift in coding, coverage, and payment for vital wound care services and products. Throughout, the Alliance of Wound Care Stakeholders (AWCS) proactively and tenaciously addressed public policies that could create barriers to patients’ access to care. Our impact in 2020 has been extensive.
Highlights of 2020 include the following:
• The AWCS led the wound care community’s rapid response to the COVID-19 public health emergency. We ensured that wound care was identified as “essential,” enabling hospital administrators to keep wound care clinics open to provide care for their patients.
• We advocated for and achieved regulatory relief and flexibilities to ensure that policies reflected the on-the-ground realities of wound care clinicians and manufacturers during the pandemic.
Our tenacious advocacy directly resulted in:
• CMS’ Durable Medical Equipment Medicare Administrative Contractors (DMEMACs) issuing a surgical dressing policy article update that expanded coverage for alginate and other fiber gelling dressings as both primary and secondary dressings.
• The A/B MAC Palmetto covering disposable negative pressure therapy (dNPWT) in nursing facilities.
The AWCS shaped policy development as we:
• Spoke out against physician payment cuts proposed in CMS’ 2021 Physician Fee Schedule.
• Submitted recommendations to CMS about a new payment methodology for cellular and/or tissue-based products (CTPs) for skin wounds.
• Spearheaded an effort to establish a distinct wound care subcategory in the USP Medicare Model Guidelines.
• Created a much-needed Wound Care Evidence Summit, designed to bring together payers, regulators, researchers, clinicians, and industry to provide an understanding of what evidence payers need to cover wound care products and procedures. The summit was postponed until 2021 due to the COVID-19 pandemic.
• Impacted clinical and procedural policies through diligent submission of comments about CMS policies (PHE regulatory flexibilities, Hospital Outpatient Payment System, Physician Fee Schedule, Medicare Coverage of Innovative Technology, Local Coverage Determinations [topical oxygen, CTPs, dNPWT], and Capitol Hill legislation (Cures 2.0). Overall, the AWCS submitted 16 sets of comments in 2020.
With the ongoing shifts in the US health care landscape, having a united voice to represent a wound care perspective in policies and regulations has never been more important. The AWCS is an association of 20+ physician and clinical organizations focused on promoting quality care and access to products and services for patients with wounds and the providers who treat them. Through advocacy and educational outreach in the regulatory, legislative, and public arenas, we unite the wound care community to advocate on public policy issues such as coding, coverage, payment, and quality measures that may create barriers to patient access to treatment or care.
The AWCS serves as a respected, effective communicator and resource on wound care issues for government agencies and policy makers. We will continue to bring the wound care clinician voice to health and public policy issues. Keep up with our 2021 advocacy work and ongoing activities at www.WoundCareStakeholders.org.
Marcia Nusgart is the Executive Director of the Alliance of Wound Care Stakeholders. She may be reached at firstname.lastname@example.org. The opinions and statements expressed herein are specific to the author and not necessarily those of Wound Management & Prevention or HMP Global. This article was not subject to the Wound Management & Prevention peer-review process.