This document represents AACOM’s Public Policy Agenda for the 117th Congress. It reflects the association’s federal advocacy priorities to ensure that the full continuum of osteopathic medical education (OME) plays a robust role in impacting the formulation of national health and higher education policies. These federal advocacy priorities are aligned with the AACOM strategic pillars of “solution,” “pathway,” and “scholarship.”
Future osteopathic physicians currently comprise 25% of all U.S. medical students. Therefore, we must ensure federal policies and programs invest in and support the OME community, as prioritized below. AACOM will aggressively pursue these goals, notwithstanding the challenging political and fiscal environment, as OME and osteopathic medicine continues to be a solution for the nation’s health care needs.
Osteopathic Representation and Research
AACOM will work to elevate the visibility of OME and osteopathic medicine to Congress and the Administration by promoting OME as a solution to the nation’s healthcare needs and as a preferred pathway to medical practice. We will demonstrate the importance of representation from our community and the value of osteopathic principles and practice as we work to impact national healthcare and higher education policy. In pursuit of this priority, efforts will include:
- Collaborating with and providing recommendations to Congress, the Administration, and federal agencies to ensure OME is an active force in the formulation and implementation of federal policies;
- Nominating osteopathic medical educators and osteopathic physician experts for federal committees, commissions, councils, advisory and scientific peer review panels, and task forces—partnering with the American Osteopathic Association, osteopathic specialty colleges, and other national associations to strategically increase osteopathic representation on these federal bodies;
- Investing in longitudinal studies and evidence gathering of existing diversity training programs for healthcare professionals in order to further understand the comprehensive impact and effectiveness these programs have on the promotion of diversity in the healthcare workforce;
- Ensuring that statutes and regulations recognize the uniqueness of OME and do not interfere with the educational mission of member institutions, creating unintended consequences with great impact to OME.
As osteopathic medical schools continue to educate increasing numbers of students across the country, AACOM supports fully integrating osteopathic medicine into the nation’s federal research infrastructure. In pursuit of this priority, efforts will include:
- Enhancing the National Institutes of Health (NIH) funding to support programs that assist osteopathic institutions to build research capacities and infrastructure, increase research opportunities for and partnerships with community-based institutions, and promote collaboration with the OME community;
- Investing in and increasing funding for NIH to include programs that focus on increasing physician presence in the research community and loan repayment programs that recruit and retain health professionals pursuing research careers;
- Engaging with federal bodies to support evidence-based research and promote osteopathic manipulative medicine (OMM) to ensure it is recognized for the important role it can play in the treatment of medical and musculoskeletal conditions and beyond;
- Funding research by the Centers for Medicare and Medicaid Services’ (CMS) Center for Medicare & Medicaid Innovation, AHRQ, and other agencies to explore innovation in physician training models and health care delivery;
- Securing opportunities to maximize OMM as an effective method of treatment, through the implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act and other federal laws and policies to address the opioid epidemic.
Graduate Medical Education, Physician Workforce, Medical Students and Federal Student Financial Aid
Graduate Medical Education
AACOM strongly supports programs that promote medical education, particularly innovative programs designed to better prepare physicians to provide high quality care to patients and improve the health of communities in the 21st century. Federal graduate medical education (GME) funding is critical to ensure the stability and continuity of both the nation’s medical residency training programs that produce future physicians and the health care system that provides care to our nation. In pursuit of this priority, efforts will include:
- Preserving Medicare GME funding, as any cuts to GME will ultimately increase, not decrease, health care costs;
- Exploring innovative methods of financing GME while simultaneously recognizing the need for GME funding accountability;
- Continuing and providing sustainable funding for the Health Resources and Services Administration (HRSA)’s Teaching Health Center GME Program, which addresses the nation’s primary care workforce shortage by increasing physician training and retention in primary care;
- Lifting the statutory cap on Medicare-funded GME slots;
- Supporting programs that expand community-based GME and advocating for increased GME opportunities in rural and underserved communities;
- Associating GME funding directly with workforce needs to meet the health care needs of a growing, aging, and diverse population.
AACOM advances federal health care workforce policies intended to support an adequately trained and culturally competent physician workforce to meet all patients’ health care needs in the 21st century. In pursuit of this priority, efforts will include:
- Reauthorizing and sustainably funding HRSA’s Title VII health professions education and workforce training programs, which have been vital to primary care training and are critical to shaping a diverse health care workforce to address obstacles to care access and quality;
- Consistently funding and investing in federal scholarship and loan repayment programs, such as the National Health Service Corps and the Indian Health Service, which recruit and retain physicians and other health care professionals—particularly those in primary care—in rural and medically underserved areas and areas most impacted by national epidemics;
- Adequately funding U.S. Department of Health and Human Services (HHS) initiatives and training programs to develop evidence-informed strategies and innovative systems approaches to the identification and mitigation of burnout and long-term mental health impacts on medical students, residents, and physicians, and support further research in this arena, including the alignment of measurements among various well-being and burnout programs for the purposes of effectiveness;
- Targeting healthcare workforce data production, analysis, and oversight to ensure that investments in the future of healthcare appropriately address the demographic and geographical areas of greatest need.
Medical Students and Federal Student Financial Aid
AACOM recognizes the significant student loan debt burden osteopathic medical students and graduates shoulder, as well as the overall impact this has on students pursuing primary care and other critical specialties. As osteopathic medical student debt rises, addressing accruing interest on federal loans, which considerably inflates the overall cost of medical student debt, must be addressed. Many of these students are also entering medical school with high debt from their undergraduate education, further exacerbating their loan debt after graduation into residency. In pursuit of this priority, efforts will include:
- Urging Congress to explore fiscally responsible solutions to lower medical student debt;
- Reauthorizing the Higher Education Act (HEA) and maintaining and protecting the Public Service Loan Forgiveness and Grad PLUS Loan Programs;
- Employing AACOM’s ED to MED campaign to protect federal financial aid programs in the HEA reauthorization to help prospective and current medical students finance their education;
- Reinstating the in-school interest subsidy for graduate students on Federal Stafford Loans;
- Requiring foreign medical schools to meet the same standards and accountability as U.S. medical schools to qualify to receive Title IV federal financial aid.
Telehealth and Innovation
AACOM strongly supports innovations in the delivery of high-quality patient-centered care. Throughout the course of their training and careers, osteopathic physicians will likely participate to varying degrees in telehealth and other innovative modalities to provide care to their patients. Telehealth strengthens the ability for physicians and other providers to offer care in rural and medically underserved areas, enhances the continuity of care, and provides a delivery vehicle for increased collaboration with frontline providers during public health emergencies (PHE) and beyond. In pursuit of this priority, efforts will include:
- Urging Congress to explore solutions guided by the standard of care to support a robust national infrastructure needed to provide sustainable telehealth services, and address barriers for implementation, particularly in rural and underserved areas, such as liability and reimbursement;
- Collaborating with federal agencies and exploring additional sources of innovation to support medical education in building out telehealth capabilities and other technological advances to train future physicians;
- Funding CMS, HRSA, the Federal Communications Commission, and other federal agencies’ research and grant programs to further explore the impact of telehealth investments that will inform improvements in health care access and population health;
- Urging Congress and CMS to make permanent certain flexibilities granted during the COVID-19 PHE that support the expanded access and increased quality of telehealth and other technologies.