AMERICAN ACADEMY OF NEUROLOGY
201 Chicago Avenue, Minneapolis, MN 55415 www.aan.com

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Organizations Filed Purposes: The Academy's mission is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction.

The American Academy of Neurology (AAN) exists for the benefit of its members, to do the things collectively that would be nearly, if not completely, impossible to do individually. No matter what stage our members are in their career, or what their role is within the field of neurology, our commitment to be indispensable to our members' professional lives is evident in what we do throughout the year. We knew 2020 would bring significant change to the AAN: For the first time in 21 years, we were going to have a new chief executive officer with the April retirement of Catherine M. Rydell, CAE. To succeed her, the Board of Directors chose Mary E. Post, MBA, CAE, who had formerly worked at the AAN for 16 years in a variety of positions, culminating as deputy executive director. We also were searching for a successor for our Chief Financial Officer Tim Engel, CPA, who was scheduled to retire after 14 years with the AAN. Kevin C. Myren, CPA, was ultimately hired for the position.

MEMBERSHIP: This was another record year for AAN membership recruitment and retention. Neurologists and neuroscience professionals from around the world now make up more than 36,000 AAN members, and the Academy can claim to be home to nearly 93 percent of US neurologists. Successful year-over-year recruitment and retention of members is attributed to the AAN's ongoing commitment to grow the available resources for neurologists as well as the various members of a neurology care team no matter their practice setting, career stage, or geographic location. This success also underscores that members feel the AAN provided tremendous value throughout the disruptive COVID-19 pandemic. Neurologists prize their memberships with the AAN and the AAN applied 81 cents of every dollar to member benefits. The Advanced Practice Provider membership category saw continued record growth and interest, with 1,662 members in 2020. The category has grown significantly in recent years; in 2014, there were just 228 advanced practice provider members. The AAN had another strong year with 191 approved applications for new Fellow of the AAN status in 2020. Fellow status acknowledges exemplary work and achievements in the neurosciences, the clinical practice of neurology or academic/administrative neurology, in the AAN, and in the community. To assist members during the pandemic, the Neurology Career Center at Careers.AAN.com shared a listing of employers in need of temporary, short-term physician resources to help neurologists displaced due to clinic closures or other issues. Additionally, without a physical Annual Meeting in 2020, there was no event for employers and job seekers to connect in person. The Neurology Career Center staff brainstormed a possible online solution and surveyed AAN members regarding their preferences. As a result, a new event was created within the existing Neurology Career Center software by incorporating an existing events page with Zoom breakout rooms. The new Virtual Career Fair is now a recurring Neurology Career Center event averaging 927 job views and 77 applications per event. In 2020, AAN.com saw a 37-percent growth in visitors and a 23-percent increase in sessions. Organic search remains the primary driver of traffic to the site, accounting for 58 percent of total visitors. Mobile use of AAN.com continues to rise, increasing by 47 percent in 2020. Press & Media, Online Learning, and Guidelines were the most popular areas of the site. The strength of SynapseSM Online Communities continues to grow. There were more than 21,000 AAN members belonging to one or more of the 60 Synapse open or private communities. Synapse provides a platform for AAN section members to openly share special interest and subspecialty-related information and resources with colleagues. The AAN remains dedicated to serving the needs of our members around the globe. Members outside of the United States make up 22 percent of total membership and represent 144 countries.

PUBLICATIONS: The publication of scientific, scholarly, and practice-related content is a vital part of the AAN's activities, and essential to the careers of our members. The AAN's publications also provide an opportunity to generate revenue that helps keep membership dues low. Founded in 1951, Neurology(R) is the official scientific journal of the AAN, and subscriptions are a benefit of membership. As the leading clinical neurology journal worldwide, Neurology is directed to physicians concerned with diseases and conditions of the brain and nervous system. José G. Merino, MD, MPhil, FAHA, FAAN, was selected to become editor-in-chief in April 2020. Major accomplishments this year include achievement of gender parity in the core editorial team and the editorial board. Neurology experienced an increase in submissions from 5,362 in 2019 to 7,548 papers in 2020; Resident & Fellow submissions increased from 815 in 2019 to 1,133 in 2020. Much of the increases can be attributed to manuscripts related to neurologic manifestations of COVID-19. The journal launched a specialty site "COVID-19" to handle additional commentaries and blog entries detailing experiences of neurologists throughout the world during the pandemic. The Neurology(R) Podcast broadcast 17 Special Podcasts on COVID-19; the podcast program enjoyed more than 976,000 downloads during 2020. International editions of the publication include those in Argentina, Japan, India, China, Spain, and Brazil. The journal's impact factor increased to 8.770 in 2020. Neurology(R) Clinical Practice submissions increased from 753 in 2019 to 1,348 in 2020. The feature "Practice Current-An Interactive Exchange on Controversial Topics" continues to be popular, garnering responses from more than 60 countries for each of the worldwide surveys; a companion feature, "Practice Buzz," was launched in 2020 and surveys readers about contemporary issues such as work/life balance during the pandemic and diversity, equity, and inclusion. Neurology(R) Genetics, a free open access journal, continued to publish new papers, which are searchable in PubMed. The journal received its first impact factor in 2020, 3.509. Submissions increased from 156 in 2019 to 264 in 2020. Neurology(R) Neuroimmunology and Neuroinflammation, a free open access journal, continued to publish new papers, and is indexed in MEDLINE, with NLM Medical Subject Headings (MeSH) within a few weeks of publication. The journal's impact factor increased to 7.724 in 2020. Submissions increased from 462 in 2019 to 837 in 2020. Continuum: Lifelong Learning in Neurology(R), published six times a year on core subspecialty topics in neurology, has served an important role in the AAN's publications portfolio by educating practicing neurologists since 1993. Continuum was relied upon more than ever by members in 2020. Paid member circulation for Continuum(R) grew to 8,226-an increase of 3.1 percent over 2019. Total circulation, which includes nonmembers and Junior members, was 13,067, a 3.2 percent increase over the same time last year. The number of unique users completing Continuum(R) CME grew by 10 percent, and the number of tests taken increased by 14 percent. Twitter followers jumped 227 percent, from 987 to 3,230, and Facebook followers increased nearly 10 percent, from 7,794 to 8,589. Neurology Today(R), the AAN's official news source published biweekly, reported widely and broadly on the impact of COVID-19 on the field of neurology and neurologic patients in 2020, offering more than 100 articles online and in print on clinical, professionalism, wellness, and societal-impact topics related to the pandemic. Among the most popular articles were "The Spread of COVID-19: Questions Raised, Some Answered by Neuroinfectious Disease Experts" and "COVID-19: Neurologists in Italy to Colleagues in US: Look for Poorly Defined Neurologic Conditions in Patients with the Coronavirus." Coverage of COVID-19 resulted in a more than three-time uptick in the traffic to the publication website and an online landing page devoted to COVID-19 coverage. Social media followers grew, as well, with more than 47,000 followers on Facebook and nearly 14,000 on Twitter. AANnews(R), the official monthly member magazine of the Academy, is mailed to more than 28,000 US members and is posted online in the "About the AAN" area of AAN.com for international and US members to easily access. While promoting Academy events and resources in 2020, the magazine kept members informed of regulatory changes, federal legislation and advocacy opportunities, nominations of the new Board of Directors, and success stories of neurology advocates and AAN Leadership Program graduates. Brain & Life(R) magazine, published six times a year, is free to patients with neurologic disorders, their caregivers, and anyone interested in brain health. In 2020, Brain & Life mailed to more than 313,000 individuals with more than 180,000 copies sent to AAN member offices for waiting room distribution in 2020. BrainandLife.org, the companion website to the publication, saw a 118-percent increase in traffic, with more than 2.26 million sessions in 2020. Digital subscribers to the website also grew by 108 percent to 43,229. Social followers across Facebook, Twitter, and Instagram grew 19 percent to 120,136. Brain & Life en Español mails as a supplement to print issues four times a year and has a print run of 100,000 copies per issue. The number of individuals specifically opting in to receive Spanish issues with their English copies grew to 11,023 in December 2020, up 49 percent since December 2019.

TRAINING, TOOLS and RESOURCES: Academy members and staff fervently advocated in Washington, DC, for assistance for neurologists because of the pandemic. As relief rolled out from Congress, the Academy provided members with helpful webinars and resources to understand the Small Business Paycheck Protection Program, Economic Injury Disaster Loan Program, and other opportunities. As lockdowns lifted, members needed guidance to safely reopen their neurology practices, and the AAN published webinars and articles to help show the way to safely expand in-person visits and services. For many neurologists, telemedicine became a vital tool in connecting with their patients. Telehealth was new for many of our members, and AAN staff and member volunteers quickly developed a webinar on how to set up telemedicine in practice. The recorded webinar continues to provide value as it has been viewed more than 13,600 times. When members continued to have difficulties procuring essential personal protective equipment, the AAN helped connect them with a broker through Project N95 that provided access to highly discounted masks, shields, and gowns. Prior to the onset of pandemic lockdowns, the AAN held its 18th annual Neurology on the Hill event on February 24 in Washington, DC. Representing 48 states, 211 members participated in nearly 300 congressional visits. Advocates focused on reducing the regulatory burden of prior authorization; reducing Medicare Part D price caps to improve medication access by patients; and increasing research funding. Two other in-person advocacy events continued through online meetings. Neurology off the Hill took place over the August recess, when members of Congress were back in their home states and districts and virtually met with constituent neurologists. The second annual AAN Legislative Summit also was held virtually, instead of in Washington, DC, in September with 95 members from 47 states meeting with their Senate offices via video or conference call to urge Congress to support the implementation of the new payment structure for E/M services as proposed in the 2021 Medicare Physician Fee Schedule, as well as continuation of relaxed telehealth regulations following the end of the public health emergency. Despite the difficulties imposed by the pandemic, the AAN had a strong year advancing its legislative priorities in Washington, DC. Over the year, we sent 11 extensive AAN letters and joined 40 coalition sign-on letters to Congress, the US vice president, Centers for Medicare & Medicaid Services, and private payers. The Academy's efforts were supported by more than 2,800 US members who engaged with their lawmakers. AAN President James C. Stevens, MD, FAAN, coauthored an op-ed in MedPage Today titled "Medicare Is Doing the Right Thing on E/M Payment-But We're Not Across the Goal Line Yet." Some other accomplishments include: Reimbursement A new coding and payment structure is set to be implemented for Evaluation and Management (E/M) services on January 1, 2021, which will simplify existing documentation requirements and provide a substantial increase in reimbursement for neurologists. The Centers for Medicare & Medicaid Services (CMS) projects the overall positive impact of the new E/M structure after budget neutrality adjustments to result in a six-percent increase in reimbursement for neurologists overall, although the impacts will vary across the specialty. This positive outcome is a product of a multi-year advocacy effort that reversed a previous proposal that was projected to be highly detrimental to neurology and other cognitive specialties. We estimate the overall impact of the AAN's advocacy on this issue as resulting in an additional $150 million annually in Medicare payments to neurologists for E/M services. Telehealth The AAN has strongly advocated for additional flexibilities related to promoting telehealth access for telehealth services. During the COVID-19 public health emergency (PHE), there have been significant advocacy wins including coverage and payment parity for medically necessary telehealth services, including telephone services. In the Medicare Physician Fee Schedule final rule, CMS is implementing several permanent flexibilities that we support associated with providing telehealth services, including additional services being added to the Medicare telehealth list, new coding and payment for an extended virtual check-in service, and modifications to direct supervision requirements. Responding to COVID-19 Immediately in response to the COVID-19 PHE, the AAN strongly advocated for improved access to personal protective equipment, financial support for practices struggling in the wake of the PHE, improved access to telehealth services, and a reduction in regulatory burdens. In addition to the telehealth changes mentioned above, there have also been numerous changes made by the Department of Health and Human Services and CMS to reduce regulatory burdens throughout the PHE, including the delay of the Appropriate Use Criteria program, modifications to the Quality Payment Program, and the relaxation of certain prior authorization requirements. The AAN also supported the allocation of funding through the provider relief fund and other financial assistance programs. Reducing Administrative Burdens The Trump administration permanently implemented changes to the Anti-kickback Statute and Stark Law to promote value-based care and improve access to Alternative Payment Models. The AAN previously submitted comments that were highly supportive of these changes. In line with AAN recommendations, CMS proposed several permanent changes to prior authorization requirements for Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally Facilitated Exchanges (FFEs). The AAN submitted comments in support of these changes and will urge the agency to extend them to Medicare Advantage and Medicare Part D plans. The AAN's award-winning patient and caregiver magazine, Brain & Life(R), and its companion website, BrainandLife.org, centralize all AAN patient education content in one location. A Spanish version, Brain & Life(R) en Español, published quarterly in 2020. Brain & Life won two Awards for Excellence in the category Interviews and Profiles, for the October/November 2019, article, "Actor Dash Mihok on How Tourette Syndrome Shaped His Career," and for Feature Writing for the August/September 2019 article, "Why MS Patients May Benefit from Aggressive Early Treatment." Midway through 2020, the AAN released a compelling compilation of heartfelt video messages from numerous celebrities who have graced the covers of Brain & Life, including musician Peter Frampton and actors Emilia Clarke and Blair Underwood. Themselves touched by neurologic disorders, these stars inspired viewers with how they were coping with the crisis and meeting each day with strength and courage to persevere. The number of individual digital subscribers to Brain & Life more than doubled to 43,229 compared to 21,185 in 2019. With each issue of Brain & Life estimated to reach 1.6 million readers, and each quarterly copy of Brain & Life en Español shared by more than 100,000 readers, it should not be surprising that the award-winning patient magazine and its companion online website BrainandLife.org became the centerpiece of the Patient-Public Strategy Task Force recommendations that were accepted by the Board of Directors in September.

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