What we work on

Hospitals, large corporations and private equity firms keep buying physician practices. Consolidation tends to raise prices and spending, especially for people with commercial insurance, and it threatens the future of independent practice.

Independent physicians see it every day:

• Bargaining power is eroding. Independent practices often cannot get the same rates from insurers that hospital systems can.
• Referrals get steered inside systems, which limits patients' freedom to choose an independent physician.
• When a rural or underserved practice closes or sells, patients can lose access, or depend on a large system that may drop lower-margin services.

What we support

• Site-neutral payment. Pay the same for the same outpatient service, whether or not a hospital owns the clinic.
• Real review of practice acquisitions. Lower the federal merger-review (Hart-Scott-Rodino) reporting threshold for health care deals so that physician-practice purchases get a look.
• Ownership transparency. Verify and publish who owns physician practices.
• Physician-led networks. Help independent practices share services and form physician-led collaborative networks, so they get economies of scale without selling.

Evidence-based, guideline-supported treatments and prescriptions are now frequently rejected through prior authorization, non-medical administrative reviews and other hurdles set by insurers. Our physicians, and physicians in every other practice setting, run into these denials almost daily. The problem is especially sharp in Medicare Advantage plans.

Every hour spent on appeals, peer-to-peer reviews and paperwork is an hour taken away from patients. Delays can mean patients give up on treatment their doctor recommended. They also wear down physicians and damage the relationship between doctor and patient.

Costs must be balanced, but patient welfare comes first. We support measures that streamline or eliminate inappropriate prior authorization and step therapy for standard, evidence-based care, and that return clinical decisions to physicians.

Few people know what a pharmacy benefit manager is, but PBMs have been affecting Minnesota patients and pharmacies for years. We think reforming them is one of the most effective things Congress can do for health care.

Minnesota has lost many of its independent pharmacies, and PBM practices are a big reason. We want to rein in the abuses and shed light on how PBMs operate. That means:

• paying PBMs a flat fee for their services instead of a cut tied to drug prices;
• ending spread pricing, where a PBM charges a health plan more than it pays the pharmacy and keeps the difference;
• making sure rebates and discounts reach patients at the pharmacy counter.

PBM reform has bipartisan support in Minnesota's delegation. We want to see it passed.

Independent physicians care for patients over the course of their lives, and prevention and screening are a routine part of that care. Physicians encourage patients to follow recommended cancer screenings because we know the value of finding disease before it causes symptoms.

Physicians also know where today's screening options end. That is why multi-cancer early detection matters to clinical practice.

We support Medicare coverage for multi-cancer early detection screening. It has broad support from both parties in Congress, because cancer affects people regardless of party.