During annual planning season, organizations take stock of where they stand financially and chart a course for operational improvements in the year ahead. Unfortunately, even the most disciplined business plans can be undermined by external factors, such as unfavorable coverage policies and aggressive payor tactics. With all the attention paid to tax filings, revenue cycle management, staffing models, purchasing programs, and overhead reduction, there is one dimension of business planning that many physician organizations overlook: advocacy and government affairs.
Why Advocacy Belongs in Your Business Plan
Large physician practices and membership associations prioritize financial plans and compliance programs. An advocacy strategy deserves the same level of intentionality. The policies that affect physicians, e.g., reimbursement rates, coverage criteria, prior authorization requirements, and scope-of-practice rules, are not static. They are the product of decisions made by legislators, regulators, and payors—decisions that can be influenced by organized, credible voices from the physician community. As we indicated in a previous article, “Power in Numbers: The Importance of Coalition-Building to Advocate for Change,” the question is not whether external forces are affecting your group’s bottom line, but whether you are doing anything to shape them.
Consider the math. A practice may spend months renegotiating a payor contract to improve reimbursement by a few percentage points on a handful of codes, but a successful advocacy effort that changes a payor’s coverage policy for a widely used test or procedure can yield benefits that repay the cost of the effort many times over, and those benefits flow not just to one practice, but to every practitioner affected by the policy. In terms of return on investment, few line items in a business plan can match the potential long-term, systemic impact of a well-executed advocacy initiative.
Midterm Elections and the Window of Opportunity
With midterm elections on the horizon, the current political environment presents a critical window for large physician practices and membership associations to engage. Legislators must always be attentive to the concerns of their constituents, but they tend to be more responsive to their constituents during a re-election year because they need to demonstrate tangible results to secure voter support at the polls. Healthcare access and cost remain among the issues that resonate most with voters, and independent physicians are a critical component of affordable and accessible care. This is the time to identify your policy objectives, build relationships with elected officials, and ensure that the perspective of physicians is part of the conversation.
Common Ground Across Specialties
One of the most powerful aspects of advocacy, particularly among physicians in private practice, is the degree to which different clinical disciplines experience similar frustrations. While every specialty has its niche regulatory and reimbursement issues, the core challenges (e.g., payor clawbacks, administrative burdens, prior authorization abuse, unfair competitive tactics and market pressures exerted by some hospitals and health systems) are remarkably consistent. Frier Levitt has helped clients to develop their own strategic advocacy plans, and we have observed significant common ground across specialties. Indeed, the time is ripe for a variety of practices and organizations to amplify their individual impact by aligning around shared policy priorities. Cross-specialty coalitions are not only viable, but strategically valuable. A message endorsed by a broad cross-section of physician groups is likely to carry more weight than one advanced by a single specialty.
From Isolation to Influence: A Call to Action for Practice and Organization Leaders
It is easy for physicians to feel isolated as they manage the day-to-day challenges of the practice of medicine. That sense of isolation can make advocacy feel like a luxury, something to think about after the more immediate “fires” are extinguished. The opposite is true: advocacy is how you address the root causes of those fires, rather than perpetually fighting them one by one.
Annual financial planning should extend beyond the balance sheet. A truly comprehensive business strategy accounts not only for what is happening inside the practice or association, but for the external policy environment that shapes its future. If you lead a large physician practice or a membership association, now is the time to evaluate whether your physicians’ collective voice is being heard on the issues that matter most.
Frier Levitt’s Advocacy and Government Affairs Practice Group collaborates with clients to develop their advocacy initiatives and advance their policy objectives at the state and federal level. To learn more, contact Frier Levitt to speak with an attorney.
Co-Managing Partner
