Being “part of a larger voice” in VACEP
Adam Rochman always knew he wanted to go into medicine, though he wasn’t set on a specific field. He landed on the emergency route during his residency when he discovered the energy, diversity, and passion that’s often found in the emergency department.
As medical director of the Emergency Department at Augusta Health, Adam leads a team that caters to more than 53,000 patients a year from the rural western corners of the Commonwealth. He leads various projects for his team at the Shenandoah Valley community hospital, and has remained an active member of VACEP since his residency.
This year, Adam was recognized by his VACEP peers with the Medical Director Award for his efforts serving rural and often impoverished communities that span for hundreds of miles. “Furthermore,” his nominating peers wrote, “Dr. Rochman has a wonderful sense of humor, which makes him a pleasure to work with while improving the health of our community through a superbly directed Emergency Department.”
In 2018, Adam led a Sepsis quality team at Augusta, and improved the overall sepsis mortality rates. He also led the emergency department team in developing educational and clinical care guidelines, which decreased intravenous injections of the sedative Phenergan in the emergency department by 39%. He also leads Augusta’s Primary Care Connection (PCC) Program, a team working to improve medical care to complex patients in the region. In 2018, the team took a group of 78 high ED utilizers and reduced their annual visits by 71%.
Adam is guiding the two-year expansion of Augusta’s emergency department, which opened in 1994 and was built to serve 35,000 patients. The two-year project that will enable the ED to serve more than 60,000 patients per year, as volumes have exceeded in recent years due to population growth in the Valley. Rooms are being upgraded, as well as equipment and technology dating back to the 1990s. The department will also serve patients who have needs for higher acuity and more complex needs for cardiac and stroke, trauma and behavioral health and substance abuse.
Adam also has a commitment to having the best ancillary staff possible in the ED, working closely with its management team to improve training and education for nursing and technologists. He collaborates heavily with nursing staff to identify challenges and top priorities for continuous improvement.
Between his extracurriculars at Augusta, with his wife and two sons, or in the local community, Adam has kept up yet another role: staying engaged with the Virginia College of Emergency Physicians.
“I want to make sure things are running as smoothly as possible for anyone in the Emergency Department, whether it’s my patients, colleagues in the department, or fellow VACEP members,” says Adam. “In order to make things better for all parties, we need a larger group, a larger voice. And that voice is VACEP.”
““In order to make things better for all parties, we need a larger group, a larger voice. And that voice is VACEP.””
On the issues
Adam is passionate about finding a solution to fix surprise billing and believes there is a happy medium in everyone’s favor that can be found. VACEP supports protecting patients and ending the practice of surprise billing, but believes it is critical to determine payment in a fair and even-handed way that doesn’t unduly advantage one side over the other.
“I see it from both sides. It’s not ideal getting these large, ridiculous bills that land on your doorstep because you were sick,” he says. “But if we go to a rate the insurance agencies use, reimbursement goes down, and it will become hard to recruit quality physicians to practice. I believe there is a middle ground that we can reach, but we won’t be able to reach it if we don’t take action—and that’s where VACEP comes in.
Adam and his VACEP colleagues have lobbied legislators both in Richmond and Washington, D.C., where the balance billing issue is playing out. At the federal level, emergency physicians support creating an “independent dispute resolution” process, or IDR, which sets a fair, reasonable interim payment for providers. If there is disagreement, insurers and providers participate in arbitration where they present their best offer, and an arbiter determines fair payment with an independent database, such as FAIR Health or a state’s all-payer claims database.
How he got involved, and why he stays
Adam joined VACEP during his residency, along with the rest of his class. Since then, Adam has seen great strides being made because of VACEP—like Medicaid expansion to more lower-income Virginians, reimbursement for level 3 patients , and a more recent rule outlining proper medical clearance for psychiatric patients. All these efforts were led by VACEP.
“These are all issues that matter, and affect each and every one of us,” Adam says. “The reason I’m a VACEP member is to be there as soon as these issues arise, and to have a say in how it’s handled. Or else, I won’t have a say at all.”
