Leading the Business of Healthcare
RCM Advisor

Quarter 2 2023 - Volume 28, ISSUE 2

30 Years of HBMA Government Relations

Special HBMA 30th Anniversary Section

By Matt Reiter

As we celebrate 30 years of HBMA, it’s helpful to reflect on how the value of HBMA membership has grown over this time. Government relations is one of the signature benefits of HBMA membership. Many of the policies that come out of Congress and federal agencies directly impact the RCM industry. Government relations ensures that members are educated about relevant policy changes and that our industry’s voice is heard during the policymaking process.  

HBMA was born partially in response to Medicare’s 1992 switch from the Customary, Prevailing and Reasonable (CPR) methodology for determining Medicare payment rates to the relative value unit (RVU)-based fee-for-service (FFS) system that is still in use today.

Since then, we have seen the passage of HIPAA, the Affordable Care Act, created and repealed the Sustainable Growth Rate (SGR) formula, the shift to MIPS and other value-based payment programs, the creation of Medicare Advantage and Part D, and the No Surprises Act, just to name a few. Through it all, HBMA has sought to be a resource to members and to policymakers who rely on the expertise of industry stakeholders such as our members.

We approach government relations very literally. Effective government relations is about creating collaborative and productive relationships with policymakers. In addition to our advocacy recommendations, HBMA always seeks to establish communication channels that allow us to continually share feedback and issues with policymakers throughout the year. In many cases, agency and congressional staff will bring questions to us about policies they are considering or want to hear our expert perspective on an idea that was shared with them.

The cornerstone of this work is our annual day of meetings with CMS and Congressional staff. For almost 15 years, HBMA’s Government Relations (GR) Committee has made regular visits (with a brief pause during the pandemic) to Capitol Hill and CMS headquarters in Baltimore, MD, to build and strengthen relationships with policymakers and advocate on behalf of the RCM industry.

While the first few years had some mild adversarial undertones to overcome, through our persistence, these offices now see HBMA as a partner that can provide invaluable “on-the-ground” perspectives into how the policies they write are working. During our most recent visit in June 2022, we received a compliment that speaks to the strength of this relationship when the person at CMS who helps plan these meetings for us remarked that he “doesn’t need to twist any arms” to schedule meetings for us.

The actions of our federal government can be overwhelmingly complex to understand and implement. For 30 years, HBMA members have benefited from the resources we have cultivated to help members understand how these policies impact their companies and their clients. Members rely on our in-depth summaries of the annual Medicare Physician Fee Schedule proposed rule and our ability to create educational resources on pressing topics such as the No Surprises Act.

Whether it’s the transition to value-based payments or changes to electronic standards, having a seat at the policymaking table is no longer a luxury, it’s a necessity! It’s hard to know exactly what the next 30 years will bring. However, you can be certain that HBMA will have a seat at the table as an advocate for you and the RCM industry. 

Matt Reiter is a principal and the managing partner at Capitol Associates, Inc., a bipartisan government relations and policy analysis firm that has represented HBMA’s interests in Washington for over 20 years. In this capacity, he serves as HBMA’s Director of Government Affairs. Matt has worked at Capitol Associates since 2014 and became a co-owner of the company after Bill Finerfrock’s retirement.