Plus: 2025 issue one-pagers within to keep you informed
Members of VACEP’s Board of Directors, and other leaders from the state chapter, advocated in Washington on April 29, 2025. They are pictured here at the Russell Senate Office Building.
A delegation of 19 Virginia emergency physicians and support staff traveled to Washington for this week’s American College of Emergency Physicians Leadership & Advocacy Conference. There, they joined emergency physicians from all 50 states (and D.C.), along with those from Puerto Rico, government agencies, and Canada to talk about some of the toughest issues affecting emergency departments.
“We’re here fighting and trying our hardest to make things better for you each and every day,” said Jesse Spangler, MD, FACEP, President of VACEP and an emergency physician at VCU Health.
They brushed up on advocacy education, connected with peers, and on Tuesday visited Capitol Hill, where they met with Virginia’s Congressional leaders to advocate for fixes to the boarding crisis, protecting emergency physician mental health, and stabilizing the safety net by ensuring the promise of Medicare and Medicaid.
Here’s a look at their advocacy efforts.
UP FIRST: THE RAND REPORT
Highlights from the RAND report on emergency medicine sustainability.
New research from the nonprofit, nonpartisan RAND took center stage at the Conference. Key statistics:
4% of all physicians are emergency physicians, yet ER docs see 66% of uninsured acute care patients.
One-fifth of expected ED payments across all payer types go uncollected, leading to an estimated $5.9 billion shortfall. Of that, $2.7 billion comes from treatments of uninsured patients.
Over the last decade, there have been unsustainable declines in payment for emergency care, putting the viability of EDs at risk.
The RAND report assesses the value of emergency care, evaluates sustainability challenges, measures payment trends, and identifies alternate funding strategies. Your Virginia delegation also shared the report's findings with members of Congress this week in D.C.
The 2025 Issues
(with excerpts from EmergencyPhysicians.org)
VACEP president-elect Joran Sequeira MD, FACEP leads the discussion with current VACEP president Jesse Spangler, MD, FACEP (right) during a meeting with Tracy Fasolino, a nurse practitioner and health and aging policy fellow in the office of Virginia Sen. Timothy M. Kaine.
Boarding
The issue: ED boarding has become a national public health crisis. The lack of available inpatient beds or transfer options creates gridlock leading to delayed care, poor outcomes, and overwhelmed systems.
The ask: Emergency physicians pushed lawmakers to support The Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act (H.R. 2936), a bipartisan bill introduced by Reps. John Joyce, MD (R-PA) and Debbie Dingell (D-MI).
In essence, the Act would provide funding to create a hospital tracking system to find available beds within the state and possibly across state lines.
The goal is to ensure more efficient use of health care resources, relieve pressures on strained EDs, and improve patient outcomes by modernizing infrastructure, spurring innovative care models, and improving accountability.
Physician Mental Health
The issue: Boarding, financial concerns, added administrative burdens, and rising violence are driving record levels of burnout. According to the 2024 Medscape Report, 63% of emergency physicians reported burnout or depression – more than any other specialty.
Passed in 2022, the bipartisan Dr. Lorna Breen Health Care Provider Protection Act (P.L. 117-105) has been a critical step forward, implementing long-overdue changes in licensing and credentialing processes that have unintentionally contributed to stigma associated with healthcare workers seeking mental health care. The Act is named in honor of Dr. Lorna Breen, our emergency physician colleague who died by suicide on April 26, 2020. The law has saved lives and protected careers.
The ask: The law must be reauthorized to keep up the momentum on this critical work. The need for the law is as great as ever and we must continue building on this important progress. ACEP is urging legislators to cosponsor and swiftly pass the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R 929 / S. 266).
VACEP members in the office of Virginia Sen. Mark Warner.
Ensuring the Promise of Medicare and Medicaid
The issue: Potential changes and reforms to Medicaid (insurance for low-income Americans and children) that are under consideration could result in tens of millions of individuals losing Medicaid eligibility and would add a surge of millions of uninsured individuals, especially if savings are not reinvested in improving access to care. In addition, repeated annual cuts to Medicare (health insurance for Americans 65+) harm the viability of the health care safety net and ability to effectively partner with Congress to address critical challenges facing physicians and patients.
Medicaid changes will force even more patients to seek care in already overburdened EDs as other physicians across our communities begin to close practices or stop accepting Medicaid — all while further driving up the annual losses EDs face from uncompensated care and risking increased burnout.
The ask: Protect access to quality emergency care by stabilizing Medicaid. On the Medicare physician payments front, ACEP is asking to:
Establish a permanent inflationary update to physician payments
Enact long-term reforms to bring predictability and sustainability to payments
Reverse the 2.83% Medicare cut that took effect on January 1, 2025
