VA Issues Addressed at AMA Meeting
The AMA Annual meeting in Chicago concludes today after nearly five days of networking and setting the agenda for organized medicine for 2017. The North Carolina delegation at the meeting made sure our state’s perspective was well represented.
North Carolina Medical Society (NCMS) CEO Robert Seligson brought NCMS members’ concerns about several Veterans Administration issues directly to Carolyn Clancy, MD, the VA’s Deputy Undersecretary for Health at the meeting.
Seligson spoke with Dr. Clancy, who was a speaker at the NCMS Annual Meeting in 2014, about payment delays for physicians seeing veterans under the Veterans Choice program. The NCMS has been helping over 30 practices resolve prior authorization and payment issues under this program. Seligson also has worked closely with US Senator Richard Burr (R-NC), who earlier this year introduced legislation to fix the problems with the Choice program.
The other concern Seligson addressed with Clancy centered on the VA’s recent announcement on May 25 of a proposed rule to grant independent practice for Advanced Practice Registered Nurses (APRN) within the Veterans Health Administration. The 60-day comment period on this proposal ends on July 25.
The NCMS and several specialty societies have long opposed local legislation granting expanded scope or independent practice for APRNs. The NC Society of Anesthesiologists is strongly opposed to this latest proposal and has mounted a campaign to encourage their members to comment via the American Society of Anesthesiologists website at SafeVACare.
To review the proposed rule and comment directly through the federal register, click here.
Clancy was open to his comments, and understood the concerns, Seligson said.
“Rest assured, the NCMS is going to continue to push the VA on these issues with VA administrators as well as our elected representatives to protect our members and our veteran patients,” he said.
Understanding MACRA – We Can Help
The Medicare Access and CHIP Reauthorization Act of 2015 – MACRA – is a massive piece of legislation that eliminated the Sustainable Growth Rate (SGR) formula, and set the stage for how doctors would be reimbursed under Medicare into the future. The North Carolina Medical Society (NCMS) is gearing up to educate our members on what MACRA will mean for them and their practices.
The Centers for Medicare and Medicaid Services (CMS) contend that MACRA will streamline quality reporting systems (e.g. the meaningful use program) and simplify the transition to value-based care. Physician groups have been skeptical of these claims, saying they are just as complicated as the programs they replace and will put an undue burden on small and solo practitioners.
MACRA sets out a detailed timeline for implementation and fee updates based on type of practice and quality scores earned under the Merit-Based Incentive Payment System (MIPS). As of 2019, MIPS combines existing Medicare quality reporting programs like the Physician Quality Reporting System (PQRS), meaningful use of electronic health records and the value-based payment modifier into a single MIPS score. This score would determine bonuses or penalties capped at a total of 9 percent of total Medicare fee-for-service payments. Practices that participate in risk-based or advanced alternative payment models could earn a lump sum bonus of 5 percent.
Many resources are available to explain what is contained in MACRA including the AMA’s website and CMS’ site. Information on several upcoming CMS webinars on MACRA are included in the Learning Opportunities section of this Bulletin.
The AMA, the NCMS and organized medicine as a whole are sorting through the many complex details of the legislation and are pushing to ensure that physicians do indeed remain in control over the quality metrics on which they will be assessed. The goal is to ensure that quality metrics capture those activities under the physician’s control and that have been shown to truly improve quality of care, enhance access to care and/or reduce the cost of care. Another goal is to allow physicians enough time to transition to value-based arrangements without financial damage to their practice.
Watch the Bulletin for ongoing educational resources and information on MACRA, and what we are doing to advocate for necessary changes in the law on your behalf.
Helping Practices Make the Move to Value
The North Carolina Medical Society (NCMS) and its Foundation are committed to helping physicians and physician assistants prepare for the new quality payment program under MACRA. The Centers for Medicare & Medicaid Services (CMS) have dedicated millions of dollars to support more than 140,000 clinician practices over the next four years in sharing, adapting and further developing their comprehensive quality improvement strategies through its Transforming Clinical Practice Initiative (TCPI).
The TCPI is one of the largest federal investments offering nationwide, collaborative and peer-based learning networks to facilitate practice transformation. The initiative is one part of a strategy advanced by the Affordable Care Act to strengthen the quality of patient care and spend health care dollars more wisely.
The NCMS Foundation is partnering with the National Rural Accountable Care Consortium (NRACC) a Provider Transformation Network (PTN) provide free training for practices in North Carolina as part of the TCPI.
This week the NCMS Foundation, in cooperation with the North Carolina Medical Group Management Association, hosted a webinar to demonstrate how NRACC can help providers prepare for the transition to value. Listen to the webinar here.
If you would like to become part of NRACC’s PTN, you may get more information and apply here. Once you are part of the PTN, you will be eligible to participate in training workshops throughout the state and have access to educational materials to help your practice make the transition to value. The first workshop for PTN members will be held July 15 in Raleigh. Register here. Another workshop is being planned in Asheville.
Learn more about the NRACC PTN click here. Please contact Melanie Phelps at the NCMS Foundation with questions or for more information on the Initiative.
Update From the NC Health Information Exchange Authority
The North Carolina General Assembly created the NC Health Information Exchange Authority (NCHIEA) last September to oversee and administer the state’s existing HIE. The legislation also requires that, as of February 1, 2018, all Medicaid providers be connected to the NC HIE in order to continue to receive payments for Medicaid services provided.
Since January, the NC HIEA has been working diligently to deliver a modernized HIE that will be more robust and of value to you as physicians and physician assistants and to the whole provider community.
"Physicians working in value-driven models right now have emphasized how important it is for them to have real-time access to clinical data for their own patients and population-level data to evaluate how they are doing compared to others,” said NCMS President Docia Hickey, MD.
The North Carolina Medical Society (NCMS) is in regular contact with NCHIEA staff to help communicate their progress to you and to represent your interests as this new HIE takes shape. The HIE is crucial to the successful transformation of our health care system and the move to value-based care. Please read this update from the NCHIEA, which includes a progress report as well as important information for those who were previously connected to the HIE via CCNC. Read the update. Visit the NCHIEA website.
You also may reach out to the NCHIEA team at any time for comments, questions or to introduce yourself. Phone: (919) 754-6912 or E-mail: [email protected].
Support for Medicare Audit Reform
Members of the US Senate Finance Committee, including Sen. Richard Burr (R-N.C.), highlighted a new report from the Government Accountability Office (GAO) detailing inefficiencies with the Medicare Audit and Appeals process and noted a bipartisan Finance Committee bill aimed to reform the process. The report details a dramatic increase in appeals at the Centers for Medicare & Medicaid Services (CMS), resulting in a backlog at the third and fourth levels of appeals where independent hearings are conducted. The bipartisan bill, Audit & Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015, S. 2368, would improve many of the deficiencies highlighted by GAO if approved by Congress.
The North Carolina Medical Society (NCMS) has been working closely with Sen. Burr to reform the RAC audit process including NCMS members meeting with Orrin Hatch (R-UT), chair of the Senate Finance Committee. The NCMS produced a video detailing the story of one North Carolina practice devastated by the faulty audit process. Watch the video “Guilty Until Proven Innocent: When Medicare Audits Cause Casualties.”
“Medicare’s audit and appeals processes are clearly not working,” said Sen. Burr. “GAO’s report echoes concerns raised by North Carolinians and is the latest wake-up call for the need for commonsense reforms. We must address the audit and appeals challenges so that doctors and hospitals can focus on what’s most important—providing quality care to Americans. I will keep working with my colleagues to fix this broken system.”
Additional information on the AFIRM Act can be found here. Read the GAO report.
BCBSNC Makes Progress on Claims Issues
The North Carolina Medical Society (NCMS) has been closely monitoring the claims problems members have been having with Blue Cross and Blue Shield of North Carolina (BCBSNC), meeting with BCBSNC representatives to better understand the issues and how the insurer is working to resolve the issues. BCBSNC reports they are making progress in processing individual member claims that were delayed due to difficulties with their new technology platform. As of June 2, claims for Affordable Care Act plans are processing normally, they said. They were hopeful that claims for their ‘grandfathered products’ would be released in early June.
Currently, more than 94 percent of all claims are processing normally, BCBSNC reports. Less than 6 percent of all claims are currently being held.
By mid-July, they expect to be current in processing new and first submission claims, as well as claims that normally suspend for additional review, manual intervention or may require medical records.
With the high volume of claims currently moving through the claims processing system, you may see an increase in claims activity during this month.
BCBSNC also advised that as you receive and reconcile claims payments, please check to see if you need to refund any advance payments you may have received from your BCBSNC patients as you waited for the claims to be processed.
Doctors facing financial hardship because of this delay should contact BCBSNC directly. They have a team in place to guide these requests for individual review and consideration. For more information about this process, please see the details and contact information.
If you need to check the status of a claim, please use Blue eSM to determine if they have received the claim in question. Any status that shows the claim is in the system is a reliable means of confirming that they have received it. If the claim has not yet been paid, that is an indicator that the claim is being held. You may also call the Provider Blue LineSM at 1-800-214-4844 for claims assistance.
This issue affects claims related to services for individual (under age 65) members, which constitutes a limited percentage of all claims. Please do not submit duplicate claims, as this will increase their inventory and potentially delay processing time.
Multi-Payer Expo in Fayetteville on June 23
Physicians, practice managers and staff are invited to attend an event that brings together multiple payers to answer your questions and provide information for your practice. This event is held in various locations throughout the state. On Thursday, June 23, it will be held at the Embassy Suites Fayetteville/Fort Bragg in Fayetteville. The doors open at 8 a.m. Look for the North Carolina Medical Society (NCMS) table and say 'hello'!
Blue Cross and Blue Shield of North Carolina, Humana, MedCost and UnitedHealthcare will all have representatives present. Guest speaker, Susan Richards of Humana will address “Improving Clinical Documentation and Why It Matters.”
More information and registration for this useful gathering is available here.
Inaugural Health Care Leadership and Management Class Graduates
The Kanof Institute for Physician Leadership’s inaugural Health Care Leadership and Management class concluded its year-long training on June 11 with a final meeting at the North Carolina Medical Society (NCMS) Center for Physician Leadership in Raleigh.
The nine members of this first class represent a variety of medical specialties and come from all parts of the state. Over the course of their year of study, they delved into topics like strategic planning, negotiation and financial literacy and learned how to apply their new knowledge to leadership roles in their organizations.
“A year of work paying off,” wrote graduate and NCMS Board Member Art Apolinario, MD, a family physician in Clinton on the NCMS Facebook page. “An amazing experience I recommend to any physician leader looking to make healthcare better.”
Health Care Leadership and Management is one of three leadership development tracks within the Institute. It provides participants with a critical framework based on economics, finance and leadership development along with the necessary business vocabulary to take on greater leadership positions in their career. The institute also offers more generalized leadership training through its Leadership College. The third track, CQ’U’, focuses on clinical quality initiatives.
Find out more about the Kanof Institute for Physician Leadership. If you are interested in applying to the Leadership College or the Health Care Leadership and Management program, applications are due July 15. Learn more here.
Unlock the Power of Data and Analytics – at the M3 Conference
How can data and analytics help unlock the value and true potential of your practice? Mikael Hagström, COO, McKinsey Analytics, offers the answer to this key question as the featured keynote speaker on Friday morning, Sept. 16, at the M3 Conference in Greensboro. Hagström brings extensive experience and expertise in harnessing high-performance analytics across industries to help companies reshape their business models, modernize their organizations, and unlock sustainable value from big data and advanced analytics.
Prior to joining McKinsey in 2015, Hagström was executive vice president at SAS Institute, a global analytics software company, for 25 years. Over the last decade he led SAS in Europe, Middle East, Africa, and Asia Pacific including more than 5,000 employees across 48 countries, overseeing a multibillion-dollar business.
This is just one of many engaging and important sessions at the Merging Medicine and Management – M3 conference – this fall. Each session is specially designed to address an issue of importance to both physicians and practice administrators. Don’t miss this historic opportunity to learn, share perspectives and socialize with your team and colleagues from across the state. Learn more and register here today.
Seeking Candidates to Serve on NC Commission for the Blind
The North Carolina Medical Society (NCMS) is seeking candidates to fill two board positions on the NC Commission for the Blind/Rehabilitation Council. The terms of the current two members will expire on June 30, 2016. The comission serves the Division on Services for the Blind in an advisory capacity on issues relating to services for persons with disabilities, especially independent living programs. The commission also develops and submits a state plan to monitor, review and evaluate such issues and programs. There are 13 members on the board, each serving a three-year term. The commission meets quarterly in Raleigh. For further information, please visit http://www.ncdhhs.gov/divisions/dsb/councils-commissions.
Interested physicians should contact Abbey Ruggiero at [email protected].
Nominations for NCMS Leadership Positions Due Monday, June 20
The North Carolina Medical Society (NCMS) Nominating and Leadership Development Committee is seeking nominations from physician members for NCMS leadership positions becoming vacant in 2016-2017. The deadline for receiving all nominations is June 20. If you are interested in serving in the following positions, please submit your nomination form and resume to Abbey P. Ruggiero, PO Box 27167, Raleigh, NC 27611-7167 or [email protected]. Download the nomination form.
Board of Directors:
Officers
- President-Elect (1-year term)
- Region and At-Large Members (3-year term)
- Region 2 Representative (1) (incumbent eligible for re-election)
- At-Large Member (1) (incumbent eligible for re-election)
Other Positions:
- AMA Delegates (3) (2-year term) (incumbents eligible for re-election)
- AMA Alternate Delegates (2) (2-year term) (incumbents eligible for re-election)
- Nominating and Leadership Development Committee (2-year term)
The Committee strives to identify, attract and develop the most competent physician leadership in the Society.
- Region 1 (2 representatives)
- Region 2 (1 representatives)
- Region 3 (1 representatives)
- Region 4 (1 representatives)
Region 1: Beaufort, Bertie, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Currituck, Dare, Duplin, Edgecombe, Gates, Greene, Halifax, Hertford, Hyde, Jones, Lenoir, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Tyrrell, Washington, Wayne, Wilson
Region 2: Alamance, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Franklin, Granville, Guilford, Johnston, Lee, Montgomery, Orange, Person, Randolph, Rockingham, Stokes, Vance, Wake, Warren
Region 3: Anson, Bladen, Cabarrus, Cleveland, Cumberland, Gaston, Harnett, Hoke, Lincoln, Mecklenburg, Moore, Richmond, Robeson, Sampson Scotland, Stanly, Union
Region 4: Alleghany, Alexander, Ashe, Avery, Burke, Buncombe, Caldwell, Catawba, Cherokee, Clay, Graham, Haywood, Henderson, Iredell, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rowan, Rutherford, Surry, Swain, Transylvania, Watauga, Wilkes, Yadkin, Yancey
For a nomination form for any of the above positions, please click here or contact Abbey P. Ruggiero at [email protected]
Please note: The historic 2015 conclusion of the House of Delegates prompted significant changes to how NCMS members can participate in the governance process. Last year, the NCMS Constitution and Bylaws were amended to require that voting in NCMS elections be reasonably accessible by all members, not just those attending the Annual Meeting. The NCMS is contracting with an outside technology vendor to conduct electronic elections, with the option to receive a paper ballot on request. Balloting will begin two weeks prior to the NCMS Annual Meeting, scheduled for Saturday, Sept. 17, 2016, at the Grandover Resort & Conference Center in Greensboro. Watch your email and upcoming issues of the Bulletin for more information.
CCME is Accepting Physician Nominations for 2016 Harris Award
The Carolinas Center for Medical Excellence (CCME) currently is accepting nominations for the 2016 T. Reginald Harris, MD, Memorial Award. Presented annually in conjunction with the fall meeting of the North Carolina Medical Society (NCMS). A plaque is given to a North Carolina physician for outstanding achievements in the areas of health care quality and service to the medical community.
“In memory of Dr. Harris, we continue to honor a deserving physician who has made a significant contribution to the practice of medicine and outstanding patient care,” said John B. Smith, MD, board chairman of CCME. “Dr. Harris devoted his career to improving the quality of health care for patients in North Carolina. He provided decades of service to the medical community through the North Carolina Medical Society, the American Medical Association, and many other professional, civic, and community activities.”
To nominate a physician, please complete and submit the nomination form for the physician leader you think is most deserving by Friday, July 15, 2016. The form can be downloaded here. For more information, contact Mani Markham at 800-682-2650, ext. 5537, or [email protected].
In the News
By Sharing Painkillers, Friends and Family Members Can Fuel Opioid Epidemic, Kaiser Health News, 6-13-16
Remove Pain As 5th Vital Sign, AMA Urged, MedPage Today, 6-13-16
AMA Seeks to Soothe MACRA Mania, MedPage Today, 6-12-16
AMA Prez Candidate Takes On VA Nurse Proposal, MedPage Today, 6-12-16
An ER Kicks the Habit of Opioids for Pain, The New York Times, 6-10-16
US Justice Department , NC Attorney General File Anti Trust Lawsuit Against Carolinas HealthCare System, The Charlotte Observer, 6-9-16
What We Know About Physician Assisted Death From Oregon, By the Numbers, The Los Angeles Times, 6-9-16
At This Medical School, Students Mix Science and Health Policy, Kaiser Health News, 6-9-16
New Opioid Limits Challenge the Most Pain Prone, The New York Times, 6-6-16
The Sobering Thing Doctors Do When They Die, The Washington Post, 6-6-16
Mosquito Repellents: Everything You Need to Tell Your Patients, MedScape, 6-3-16
Prince's Death By Opioid Overdose Is A Very Public Example of a Growing Cultural Problem, The Washington Post, 6-2-16
Medical Student Says Her Mental Health Issues Will Make Her A Better Doctor, NPR, 6-1-16
Learning Opportunities
The North Carolina Practice Improvement Collaborative Conference will focus on Prevention Strategies for Stemming the Prescription Drug Abuse Epidemic on Thursday, June 16 from 10 a.m. to 2:30 p.m. at the McKimmon Center in Raleigh. Get more information on the nationally known speakers and register here.
Providers’ Clinical Support System will offer a webinar on June 21 from noon to 1 p.m. on “Addiction, Overdose and Suicide: Preventing Deaths From Drug Self-Intoxication.” This webinar will review the proposed death sub-category, “death from drug self-intoxication,” as a surveillance strategy for improving accurate detection of a preventable death. Clinical translations of this concept, including empirical opportunities to elicit self-harm/suicide risk and to intervene with patients and families seeking treatment in a variety of clinical practice settings, will be presented. Register here.
Join the North Carolina Healthcare Information and Communications Alliance (NCHICA) on June 22 at the Research Triangle Foundation for a forum on Quality Reporting. The topics include: Leveraging Transparent Reporting for Quality Improvement, Transitioning to Electronic Clinical Quality Measures, and a MACRA overview. The registration fee is $50 NCHICA members/$75 non-members/$25 students. Click here for further details.
The Centers for Medicare & Medicaid Services (CMS) invites the public to join the final listening sessions in the ongoing webinar series about the Merit-Based Incentive Payment System (MIPS) proposed in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Notice of Proposed Rulemaking (NPRM).
- MIPS: Clinical Practice Improvement Activities (CPIA) Performance Category Overview, June 22, from noon to 1 p.m. Register here.
- MIPS Scoring Overview, June 17 and June 24, from noon to 1 p.m. Register by visiting the June 17 or June 24 registration webpages.
The 129th Annual Scientific Session of The Old North State Medical Society “Integrative Medicine: The Future of Healthcare” will be held June 24th-25th, 2016 at The North Raleigh Hilton in Raleigh. The Session provides ONSMS members, physicians and medical professionals with up-to-date education and peer networking opportunities. Included are a Pre-Conference Training Session to qualify for prescribing Buprenorphine and a broad selection of presentations and breakout sessions, providing an opportunity for up to 22 CMEs for participation at the Conference. For more information, visit the ONSMS website.
28th Annual Fall Foliage Cancer Conference, “Update on Melanoma and Gastrointestinal Cancers,” will be held Oct. 21-22 at the Grove Park Inn in Asheville. More information and registration available here.
MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid
Watch seven new MLN Connects videos on the Medicare Quality Reporting Programs, focusing on the requirements you need to meet in 2016. For those who participated in the webinars held in February, the information in these modules mirrors the information shared on those calls:
Introduction: Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016. Run time: 15 minutes.
Module 1: Medicare Access and CHIP Reauthorization Act (MACRA) Preview. Run time: 6 minutes.
Module 2: 2016 Incentive Payments and 2018 Payment Adjustments. Run time: 9 minutes.
Module 3: 2016 Physician Quality Reporting System (PQRS) Updates. Run time: 20 minutes.
Module 4: 2018 Value-Based Payment Modifier (VM) Policies. Run time: 17 minutes.
Module 5: Physician Compare Updates in 2016. Run time: 6 minutes.
Module 6: Meaningful Use of Certified Electronic Health Record Technology (CEHRT) in 2016. Run time: 16 minutes.
NC Senate Budget Addresses Use of CSRS
The North Carolina Senate released its proposed budget late Tuesday and various Senate committees started to review the $22 billion spending plan first thing this morning. Review the Senate’s budget bill here.
One significant provision for North Carolina Medical Society (NCMS) members in the North Carolina Senate’s recently released budget concerns the state’s Controlled Substance Reporting System (CSRS), which allows doctors to see previous controlled substance prescriptions filled by a patient. The Senate budget allocates nearly $1.5 million to upgrade the CSRS to connect it to the state’s Health Information Exchange and to the controlled substance reporting systems in surrounding states. The NCMS has supported these measures. The budget also includes money to enhance reports available through the database to identify unusual prescribing patterns or behavior indicative of abuse, addiction or criminal activity.
Legislators, faced with an opioid abuse epidemic, also have concerns that CSRS usage among physicians remains low. The Senate’s budget proposal seeks to mandate usage of the CSRS, requiring a physician to register for and check the database before prescribing an opioid or risk having their medical license suspended or revoked. The NCMS has opposed such mandates in the past and will continue to work with legislators to find ways to meaningfully address the opioid epidemic using all the tools available to legislators and physicians. We welcome physician input and viewpoints on this important issue.
The Senate’s vote on their budget is expected by the end of the week. House and Senate conferees then will begin to negotiate a compromise spending plan next week. Several legislators have predicted a final budget will be adopted and this short Legislative session should conclude by July 4.
Governor Signs Medicaid Waiver Application; Sent to CMS on June 1 Deadline
At a press conference at the Executive Mansion Wednesday morning, Governor Pat McCrory marked the next step in the state’s Medicaid reform process -- signing the cover letter that accompanied the state’s waiver application to the Centers for Medicare and Medicaid Services (CMS). CMS will now begin reviewing the proposal, which calls for shifting responsibility for the Medicaid program from the state to three statewide managed care organizations and up to 10 regional provider-led entities.
Earlier in the day, NC Department of Health and Human Services (DHHS) Secretary Richard Brajer presented an overview of the final application to the House Health Committee. He told legislators his department had worked with over 50 stakeholder organizations, held 12 public hearings across the state and received comments from over 750 organizations and individuals in developing this final waiver application.
“It’s a beautiful expression of democracy in process,” he said. He noted the strong physician representation at the hearings and among the commenters. Brajer cited their main concern with the proposal as increased administrative burdens in having to work with multiple pre-paid health plans for Medicaid patients rather than simply the state. He said the department was working to put in place approaches to minimize those burdens.
At the hearings and in the written comments, many advocated for expansion of Medicaid, Brajer told the legislators. The waiver application, however, does not include provisions for expanding Medicaid, he said, since the waiver must comply with the reform legislation passed last fall, which does not envision expansion.
While Brajer said the final waiver application submitted to CMS this afternoon is 95 percent similar to the one originally presented, all comments were carefully considered and incorporated where possible.
“I believe we were highly responsive to the comments,” he told the committee. “But we have to live within the same budgetary, legal and legislative restraints.”
CMS may take 18 months to review the waiver, during which time, Brajer said the department will continue to work with all stakeholder groups to revise and improve the application. The North Carolina Medical Society (NCMS) is working to ensure that reform plans fully address clinical priorities of Medicaid patients, ensure physicians have access to clinical and claims data to drive improvements in care, and integrate physician leadership system-wide.
NCMS Partners with National Rural Accountable Care Consortium to Help Practices Transition to Value
Is your practice ready for the transition to value-driven health care? If not, the North Carolina Medical Society (NCMS) Foundation is partnering with the National Rural Accountable Care Consortium (NRACC) to help practices make the transition to value-based health care delivery and payment. NRACC is a Provider Transformation Network (PTN), which is a CMS-funded program that is part of the Transforming Clinical Practice Initiative (TCPI).
Here are 10 Reasons to Choose the NRACC PTN.
To learn more about what the NRACC PTN offers, the NCMS Foundation, in cooperation with the North Carolina Medical Group Management Association, are sponsoring a webinar on Tuesday, June 14, 2016 from noon to 1 pm, [please note date change] to demonstrate how the TCPI Practice Transformation Networks (PTN) help providers prepare for the transition to value. To register for this free informational webinar, please click here.
For additional information about the NRACC PTN click here (see attached document: 2016 PTN Program Training). Quarterly workshops will be held in Raleigh and Asheville. The first workshop in Raleigh will be held at the NCMS Center for Leadership in Medicine on July 15 from 10 to 4 pm. Additional dates are to be determined.
Seeking Nominations for NCMS Leadership Positions
The North Carolina Medical Society (NCMS) Nominating and Leadership Development Committee is seeking nominations from physician members for NCMS leadership positions becoming vacant in 2016-2017. The deadline for receiving all nominations is June 20. If you are interested in serving in the following positions, please submit your nomination form and resume to Abbey P. Ruggiero, PO Box 27167, Raleigh, NC 27611-7167 or [email protected]. Download the nomination form.
Board of Directors:
▪ Officers
President-Elect (1-year term)
▪ Region and At-Large Members (3-year term)
Region 2 Representative (1) (incumbent eligible for re-election)
At-Large Member (1) (incumbent eligible for re-election)
Other Positions:
▪ AMA Delegates (3) (2-year term) (incumbents eligible for re-election)
▪ AMA Alternate Delegates (2) (2-year term) (incumbents eligible for re-election)
Nominating and Leadership Development Committee (2-year term)
The Committee strives to identify, attract and develop the most competent physician leadership in the Society.
- Region 1 (2 representatives)
- Region 2 (1 representatives)
- Region 3 (1 representatives)
- Region 4 (1 representatives)
Region 1: Beaufort, Bertie, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Currituck, Dare, Duplin, Edgecombe, Gates, Greene, Halifax, Hertford, Hyde, Jones, Lenoir, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Tyrrell, Washington, Wayne, Wilson
Region 2: Alamance, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Franklin, Granville, Guilford, Johnston, Lee, Montgomery, Orange, Person, Randolph, Rockingham, Stokes, Vance, Wake, Warren
Region 3: Anson, Bladen, Cabarrus, Cleveland, Cumberland, Gaston, Harnett, Hoke, Lincoln, Mecklenburg, Moore, Richmond, Robeson, Sampson Scotland, Stanly, Union
Region 4: Alleghany, Alexander, Ashe, Avery, Burke, Buncombe, Caldwell, Catawba, Cherokee, Clay, Graham, Haywood, Henderson, Iredell, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rowan, Rutherford, Surry, Swain, Transylvania, Watauga, Wilkes, Yadkin, Yancey
For a nomination form for any of the above positions, please click here or contact Abbey P. Ruggiero at [email protected]
Please note that the historic 2015 conclusion of the House of Delegates prompted significant changes to how NCMS members can participate in the governance process. Last year, the NCMS Constitution and Bylaws were amended to require that voting in NCMS elections be reasonably accessible by all members, not just those attending the Annual Meeting. The NCMS is contracting with an outside technology vendor to conduct electronic elections, with the option to receive a paper ballot on request. Balloting will begin two weeks prior to the NCMS Annual Meeting, scheduled for Saturday, Sept. 17, 2016, at the Grandover Resort & Conference Center in Greensboro. Watch your email and upcoming issues of the Bulletin for more information.
The Value of an NCMS Membership Made Clear Once Again
Fulcrum Strategies, a Raleigh firm that represents practices in managed care contract negotiations, recently alerted North Carolina Medical Society (NCMS) staff to a concern with some contractual language they were seeing. NCMS staff was able to resolve the problem after alerting the NC Department of Insurance. Here’s the update to his clients from Fulcrum CEO Ron Howrigon:
“Several of you who are in negotiations with Aetna have been struggling with some very concerning language in the new Aetna contract that would allow Aetna to penalize groups for the use of non-participating providers.
“Late last week I was informed by Conor Brockett, the Associate General Counsel of the North Carolina Medical Society, that he and the Medical Society on behalf of the physicians of North Carolina expressed their concerns about this language and questioned if it was in compliance with [state law]. The Department discussed the language with Aetna and Aetna agreed to remove the language from all contracts in North Carolina.
“This is another example of the value that the North Carolina Medical Society brings to physicians practicing in North Carolina. The Medical Society… continues to make sure that all payers continue to abide by that law and its requirements.”
5th Annual Skin Screening at the Legislature Raises Awareness
For the fifth year, North Carolina Dermatology Association (NCDA) members from throughout the state volunteered their time today to do free skin screenings at the NC General Assembly. Over the six hours of the event, 89 people were screened on Wednesday, June 1 from 9 am to 3 pm.
The dermatologists performed full- or partial-body skin screens for legislators, their staff members and others visiting the Legislative Building.
This popular and important event is part of the NCDA’s ongoing advocacy initiatives, and also is meant to raise awareness by sharing handouts and information on skin cancer, on how to find a dermatologist and teaching skin self-examinations.
The NCDA was instrumental in achieving passage of a new law last year prohibiting minors' access to commercial tanning beds in North Carolina.
New Accountable Care Toolkits Now Available
Two new specialty specific toolkits for those physicians interested in the accountable care organization (ACO) model of care are now available online. Now dermatologists and ophthalmologists can gain a better understanding of how their specialties may fit into an ACO with these guides.
These bring the total number of toolkits produced through the Toward Accountable Care (TAC) Consortium and Initiative to 26, with several more specialty specific guides on the way in the coming weeks. Review the list of all the guides and download those of interest to you here. Download the toolkit for dermatologists here and that for ophthalmologists here.
MSSP Council Convenes In Raleigh
It was another full house when close to 45 members of the Medicare Shared Savings Program (MSSP) Council came together for its first meeting of the year on May 19 at the North Carolina Medical Society (NCMS) Center for Leadership in Medicine in Raleigh. The Council meets twice a year and brings together representatives from medical organizations around the state that participate in the MSSP.
At its May meeting, Stephen Nuckolls, CEO of Coastal Carolina Health Care shared his group’s experience in establishing and maintaining a chronic care management program. The council members, all with varying degrees of experience in the program, use the meetings to share information as well as their insights and challenges as they navigate the MSSP.
The group also heard updates from NCMS staff on the new Medicaid rules and the proposal for implementation of MACRA and how this new legislation may impact their practices.
The MSSP Council meets in the second and fourth quarter each year, while the ACO Collaborative, which encompasses a larger group including Accountable Care Organizations that may not be part of the MSSP, meets in the first and third quarters. For more information on these vibrant groups, contact Melanie Phelps at the NCMS.
Learn About MACRA and the Quality Payment Programs
To help make sense of what implementation of the massive MACRA legislation might mean to you and your practice, check out the Centers for Medicare and Medicaid Services (CMS) webpages dedicated to this topic. Background information, fact sheets, press releases, a comprehensive list of upcoming webinars on the quality payment programs and how to comment on the proposed rule all are accessible here.
WIC Update on Infant Formula Availability
The federally funded Women, Infants and Children (WIC) program strongly supports physicians’ efforts to promote breastfeeding and offers breastfeeding coordinators available across North Carolina. WIC also provides infant formula, and receives many requests for special formulas. Recently, there have been a number of requests for certain standard milk or soy-based formulas that are not available through NC WIC.
If you have a WIC patient who is not tolerating the Similac Advance, Stage 1 or the Similac Soy Isomil, an alternative is to prescribe WIC Program Medical Documentation (using the WIC Program Medical Documentation form) an exempt infant formula best suited to the infant’s tolerance. Examples include but are not limited to Alimentum, Pregestimil or Nutramigen.
Please be advised that other standard milk- or soy-based infant formulas including, but not limited to, Enfamil Gentlease, Similac Sensitive, Similac Total Care and Similac for Spit Up are not available for issuance through NC WIC. The current contract infant formula in the WIC Program is with Abbott. Only the standard products that provide 20 calories per ounce from Similac are allowed, 19 calorie per ounce products are not approved for issuance.
If you run in to issues, contact the WIC Director at the office serving your community or the WIC State office at (919) 707-5800.
How Is Organized Medicine Helping to Combat the Opioid Epidemic?
Last October, the American Medical Association (AMA), the American Osteopathic Association (AOA) and the American Dental Association (ADA) along with many other medical, osteopathic, dental and health professional organizations were part of a public and private sector partnership announcement aimed at combating the prescription drug abuse epidemic.
Collectively the groups committed to raising awareness of the opioid abuse problem among their members and to encouraging their members to take action. The AMA has asked us to assess how many NCMS members have educated themselves on the issue, have prescribed naloxone or used the state’s Controlled Substance Reporting System (CSRS) since last October. Please take just a minute and answer these four ‘yes’ or ‘no’ questions, to help the AMA assess progress on this initiative.
Answer the questions here.
Thank you for all you do!
NCMS Member to Head Kate B. Reynolds Charitable Trust
Laura Gerald, MD, a pediatrician and market medical director for Evolent Health in Raleigh, has been named president of the Kate B. Reynolds Charitable Trust in Winston-Salem. A Lumberton native, Dr. Gerald will begin her new job in July.
She succeeds Karen McNeil-Miller, who stepped down in 2015 to become president and CEO of the Colorado Health Foundation. Allen Smart, vice president of programs, has been serving as interim president.
Gerald formerly served as state health director and director of the Division of Public Health for the NC Department of Health and Human Services.
Congratulations Dr. Gerald!
In the News
The Superbug That Doctors Have Been Dreading Just Reached the US, The Washington Post, 5-27-16
CVS Minute Clinics: A Cure for Long Wait Times At Veterans Affairs, Kaiser Health News, 5-25-16
Anthem CEO Expects US Regulatory Decision in July, Reuters, 5-24-16
Andy Slavitt Talks MACRA: Four Key Takeaways, Becker's Hospital Review, 5-23-16
Med Students Take Battle Against Opioid Epidemic Into Their Own Hands, Huffington Post, 5-23-16
Nearly 300 Pregnant Women In US Likely Have Zika, NEJM Journal Watch, 5-23-16
Relax, It's Only MACRA, MedPage Today, 5-21-16
The Days of Freely Prescribed Painkillers Are Ending. Here's What's Next, The Washington Post, 5-20-16
Health Insurance Companies Step Up To Fight the Opioid Epidemic, CNN, 5-19-16
Docs Say States Are Making Calculated Cuts to Medicaid Rates, Modern Healthcare, 5-18-16
Complain All You Want, But Your Busy Schedule May Help Your Brain, NPR, 5-18-16
Actions By Congress On Opioids Hasn't Included Limiting Them, The New York Times, 5-18-16
Hospitalizations for Depression on the Rise, MedPage Today, 5-18-16
Learning Opportunities
NC Medical Group Management Association and the North Carolina Medical Society are hosting Advocacy Day and White Coat Wednesday at the NCMS Center for Leadership in Medicine, 222 N. Person St., Raleigh on Tuesday and Wednesday, June 7-8. This is the 8th Annual NC MGMA Advocacy Day event, which this year includes sessions with the NC Insurance Commissioner and Blue Cross and Blue Shield of North Carolina’s CEO Brad Wilson. Free for NCMGMA members; $50 for non-members. Learn more and register here.
The NCMS Foundation and Get Social Health Academy offer you these upcoming workshops to Improve Your Social Media Skills on Tuesday, June 7. The morning session from 9 a.m. to noon, Practice Managers & Social Media Leads will cover content creation, how to evaluate social sites and tools and tips. The evening session from 6 to 8:30 p.m., Physicians & Thought Leaders will focus on online reputation management, LinkedIn profiles and thought leadership. Learn more and sign up here.
The last Regional NCTracks Seminar will be held on June 9, at the NC Cooperative Extension office in Dallas, NC. The purpose of the Regional NCTracks Seminars is to help educate new providers, educate new billing staff of existing providers, and serve as a refresher for current and experienced provider staff. Each of the seminars runs from 9 a.m. to 4 p.m. and they are being offered on different dates and locations across the state. There will also be a Provider Help Center at each location. For more information, including how to register, see the March 23, 2016, announcement.
NCTracks training on Friday, June 10 - 1 to 4 p.m. - ES User Role_Abbreviated MCR_Upload Documents (WebEx) will guide providers through the enhancements to the provider enrollment application processes. At the end of training, providers will be able to explain the Enrollment Specialist user role, identify the Abbreviated Manage Change Request (MCR) applications, and upload supporting documents. This course is taught via WebEx and can be attended remotely from any location with a telephone, computer and internet connection. The WebEx will be limited to 115 participants. Register for this course in SkillPort, the NCTracks Learning Management System.
The North Carolina Medical Society (NCMS) Foundation and the North Carolina Medical Group Management Association, is offering a webinar on Wednesday, June 15, from noon to 1 p.m. to demonstrate how the Practice Transformation Network (PTN) program helps providers transition from fee-for-service payment models to advanced payment models and succeed. Learn more and register here. This webinar is free but you must be registered to attend. Space is limited so register early!
The North Carolina Practice Improvement Collaborative Conference will focus on Prevention Strategies for Stemming the Prescription Drug Abuse Epidemic on Thursday, June 16 from 10 a.m. to 2:30 p.m. at the McKimmon Center in Raleigh. Get more information on the nationally known speakers and register here.
Join the North Carolina Healthcare Information and Communications Alliance (NCHICA) on June 22 at the Research Triangle Foundation for a forum on Quality Reporting. The topics include: Leveraging Transparent Reporting for Quality Improvement, Transitioning to Electronic Clinical Quality Measures, and a MACRA overview. The registration fee is $50 NCHICA members/$75 non-members/$25 students. Click here for further details.
The 129th Annual Scientific Session of The Old North State Medical Society “Integrative Medicine: The Future of Healthcare” will be held June 24th-25th, 2016 at The North Raleigh Hilton in Raleigh. The Session provides ONSMS members, physicians and medical professionals with up-to-date education and peer networking opportunities. Included are a Pre-Conference Training Session to qualify for prescribing Buprenorphine and a broad selection of presentations and breakout sessions, providing an opportunity for up to 22 CMEs for participation at the Conference. For more information, visit the ONSMS website.
MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid
Watch seven new MLN Connects videos on the Medicare Quality Reporting Programs, focusing on the requirements you need to meet in 2016. For those who participated in the webinars held in February, the information in these modules mirrors the information shared on those calls:
Introduction: Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016. Run time: 15 minutes.
Module 1: Medicare Access and CHIP Reauthorization Act (MACRA) Preview. Run time: 6 minutes.
Module 2: 2016 Incentive Payments and 2018 Payment Adjustments. Run time: 9 minutes.
Module 3: 2016 Physician Quality Reporting System (PQRS) Updates. Run time: 20 minutes.
Module 4: 2018 Value-Based Payment Modifier (VM) Policies. Run time: 17 minutes.
Module 5: Physician Compare Updates in 2016. Run time: 6 minutes.
Module 6: Meaningful Use of Certified Electronic Health Record Technology (CEHRT) in 2016. Run time: 16 minutes.
Board Meets With NCMS Leaders Past and Future
At its meeting last weekend in Cary, the North Carolina Medical Society (NCMS) Board of Directors met with current Leadership College scholars as well as with past NCMS presidents to ensure they are fully aware of the issues of concern to both past and future NCMS leaders.
Physician Wellness Initiative
Leadership College scholars and Board members heard a moving testimonial from Andrew Lamb, MD, vice president of medical affairs for Alamance Regional Medical Center about his own struggle with burnout and its larger toll on the physician, his or her family, colleagues and patients. He also described the innovative program he and his team at Cone Health have begun to implement to raise awareness of and address the problem. He provided the following statistics:
- 46 percent of physicians have experienced symptoms of burnout.
- Studies show to replace a burned out physician costs between $400,000 and $2 million.
- Only 5 percent of hospital programs in this country have any program to deal with physician burnout.
Joe Jordan, Interim Director of the Physicians Health Plan (PHP) introduced the newly formed NC Consortium for Physician Resiliency and Retention, of which the NCMS is playing an integral role. Started last summer, the consortium’s objective is to create a network of support through a consortium of likeminded individuals dedicated to addressing issue of physician burnout. Besides the NCMS, the consortium also includes representatives from the North Carolina Medical Board and is being spearheaded by PHP. A key component in tackling this problem is removing the stigma or “career fear” around burnout, Jordan said, and how to create a culture of acceptance, openness, understanding where it’s ok to ask for help.
The NCMS is working to develop resources to help physicians and is soliciting your input and ideas. Please contact Shawn Scott or Pam Highsmith at the NCMS, 919-833-3836 to learn more or get involved in this initiative.
Enduring NCMS Leaders Meet with Board
Eight former NCMS Presidents met jointly with the current Board of Directors to hear staff reports on current issues facing the Board and medical community including Medicaid reform, MACRA, opioid abuse, scope of practice issues and helping to initiate value-based models of care in rural and underserved communities in North Carolina. These enduring leaders offered their thoughts and insights on these and other topics.
BCBS CEO Meets with NCMS Board
Brad Wilson, the CEO of Blue Cross and Blue Shield of North Carolina (BCBSNC) spoke with the Board about the much publicized ‘operational challenges’ the state’s largest insurer has been facing since the first of the year. He told Board members that they had a major software failure that was bad, but never as bad as portrayed by the media. The problem was confined to those who enrolled through the Affordable Care Act or approximately 100,000 of the 3.9 million people served by BCBSNC.
“We’re cleaning it up. We’re not out of the woods yet, but we can see the edge,” Wilson said, noting that this month his staff is focusing on the claims issues and hopes that all held claims will have been moved through the system by the end of the month. “Thank you for your patience. We’ll stay at it until it’s right,” he said.
Stakeholder Meeting on CON
NCMS President Docia Hickey, MD, reported to the Board on her meeting with representatives from those specialties concerned about Certificate of Need (CON) changes. The meeting, which did not include any NCMS staff, was a chance for open and honest discussion between Hickey and a representative from radiology, ophthalmology, orthopedics, anesthesiology, ENT, plastic surgery, pathology, emergency physicians and the American College of Surgeons specialty organizations.
Overall there was a cordial exchange of views, Hickey said. Another meeting is planned to see if consensus can be reached on this hotly debated issue.
Since the first of the year, the Board has heard presentations from both sides in the issue and is grappling with how to formulate a policy stance that addresses everyone’s concerns.
In Other NCMS Board News
- The Durham Orange County Medical Society asked the Board for a resolution seeking changes to HB2, the controversial act passed by the General Assembly in March “to provide for single-sex multiple occupancy bathroom and changing facilities in schools and public agencies and to create statewide consistency in regulation of employment and public accommodations.” The Board unanimously voted to refer this request to the Legislative Cabinet for consideration since it refers to a specific bill. The NCMS’ Legislative Cabinet reviews legislation and makes recommendations to the Board.
- NCMS CEO Robert W. Seligson invited John Woodyear, Jr., MD, a family physician in Troy, NC, whom he had met through the Old North State Medical Society, to present his idea on how to decrease diversion of opioids to the NCMS Board of Directors. Dr. Woodyear explained his concept of Source Traceable Identification of Medication (STIM), which would entail printing a QR or scan code on each pill of a controlled substance, making it traceable to the person for whom it was prescribed. By putting this code, which would be printed with a harmless, FDA-approved food dye, on the pill, the pharmacist could electronically link the pill to the patient. If the pill was stolen or diverted to someone else, law enforcement could scan the pills to establish that it had been diverted. If someone tried to erase or adulterate the code, they could be held liable for tampering with a controlled substance, Dr. Woodyear told the Board. He showed the Board a video that he hopes to release soon to gain legislative and/or regulatory support for his idea.
- Staff is working to implement the new process for election of NCMS officers and board members now that the House of Delegates has been eliminated. Watch the Bulletin for updates on how to cast your vote.
- The NCMS annual business meeting will be held on Saturday, Sept. 17, during the M3 – Merging Medicine and Management – Conference at the Grandover Hotel and Spa in Greensboro. The business meeting is free and open to all NCMS members. Educational sessions including tracks on opioid prescribing, physician well-being and leadership development as well as social gatherings will be held as part of the larger conference and we hope everyone will participate in the entire weekend as well as the business meeting. Read more about the M3 Conference in the article in this issue of the Bulletin.
New Rule on CME on Opioid Abuse Open for Comment
The North Carolina Medical Board has published its proposed rule to implement the General Assembly’s legislation adopted last year requiring physicians to take CME on the abuse of controlled substances in order to renew a medical license. Read the proposed rule here.
A public hearing on the proposed rule will be held at 10 a.m. on July 14 at the NCMB building, 1203 Front St., Raleigh.
Comments also may be submitted to: Wanda Long, Rules Coordinator, NC Medical Board, P.O. Box 20007, Raleigh, NC 27619, fax (919) 326-0036, email [email protected]. The comment period ends on July 15, 2016, and the proposed effective date for the new rule is Sept. 1.
AMA President Posts Open Letter to Physicians on Opioid Abuse Epidemic
Steven Stack, MD, the president of the American Medical Association (AMA) and an emergency physician has published the following open letter to physicians concerning the opioid abuse epidemic.
The medical profession must play a lead role in reversing the opioid epidemic that, far too often, has started from a prescription pad.
For the past 20 years, public policies - well-intended but now known to be flawed - compelled doctors to treat pain more aggressively for the comfort of our patients. But today’s crisis plainly tells us we must be much more cautious with how we prescribe opioids.
At present, nearly 2 million Americans - people across the economic spectrum, in small towns and big cities - suffer from an opioid use disorder. As a result, tens of thousands of Americans are dying every year and more still will die because of a tragic resurgence in the use of heroin.
As a profession that places patient well-being as our highest priority, we must accept responsibility to re-examine prescribing practices. We must begin by preventing our patients from becoming addicted to opioids in the first place. We must work with federal and private health insurers to enable access to multi-disciplinary treatment programs for patients with pain and expand access for medication-assisted treatment for those with opioid use disorders. We must do these things with compassion and attention to the needs of our patients despite conflicting public policies that continue to assert unreasonable expectations for pain control.
As a practicing emergency physician and AMA President, I call on all physicians to take the following steps - immediately - to reverse the nation’s opioid overdose and death epidemic:
- AVOID initiating opioids for new patients with chronic non-cancer pain unless the expected benefits are anticipated to outweigh the risks. Non-pharmacologic therapy and non-opioid pharmacologic therapy are preferred.
- LIMIT the amount of opioids prescribed for post-operative care and acutely-injured patients. Physicians should prescribe the lowest effective dose for the shortest possible duration for pain severe enough to require opioids, being careful not to prescribe merely for the possible convenience of prescriber or patient. Physician professional judgment and discretion is important in this determination.
- REGISTER for and USE your state Prescription Drug Monitoring Program (PDMP) [in North Carolina this is the Controlled Substance Reporting System or CSRS] to assist in the care of patients when considering the use of any controlled substances.
- REDUCE stigma to enable effective and compassionate care.
- WORK compassionately to reduce opioid exposure in patients who are already on chronic opioid therapy when risks exceed benefits.
- IDENTIFY and ASSIST patients with opioid use disorder in obtaining evidence-based treatment.
- CO-PRESCRIBE naloxone to patients who are at risk for overdose.
As physicians, we are on the front lines of an opioid epidemic that is crippling communities across the country. We must accept and embrace our professional responsibility to treat our patients’ pain without worsening the current crisis. These are actions we must take as physicians individually and collectively to do our part to end this epidemic.
Together we can make a difference
Don’t Push the Panic Button on MACRA – Get Educated Instead
The recently released proposed rule to implement the Medicare Access and CHIPS Reauthorization Act (MACRA) is undoubtedly massive and complex, but don’t panic. The North Carolina Medical Society (NCMS) is working to glean what you most need to know from the rule’s 962-pages and gather resources to help you make sense of it all.
The AMA is constantly updating its MACRA webpage with information. Watch your Bulletin and the NCMS website for updates and links to resources – and don’t push the panic button.
Members Mix and Mingle
Over 100 North Carolina Medical Society (NCMS) and Durham Orange County Medical Society members gathered on a beautiful spring evening at the Umstead Hotel in Cary to mix and mingle with their colleagues and the NCMS Board of Directors at the Spring Leadership Mixer.
As part of the new governance structure adopted last year, the NCMS Board is holding each of their quarterly meetings in a different region of the state in order to better engage with physicians and physician assistants in that area.
Please let us know what you think of the ‘Mix and Mingle’ concept – whether you have attended one or not – with this 30-second ‘Mix and Mingle’ quiz.
The NCMS Board of Directors is always open to your thoughts on new or updated NCMS policies. Send them your ideas anytime through our online form.
Mark your calendar now for the Summer Leadership Mix and Mingle will be held in Charlotte on Friday, July 14 at The Lodge at the Ballantyne Resort, a special venue within the resort.
NC Medical Journal Delivers to Your Inbox
North Carolina Medical Society (NCMS) members are invited to sign up for electronic delivery of the North Carolina Medical Journal (NCMJ). A journal of health policy analysis and debate, the NCMJ covers a range of medical and public health topics each year. For example, 2015 topics included rural health, traumatic brain injury, patient and family engagement, evidence-based practice and military health. Sign up for the electronic edition of the journal here. Your email address will only be used for eTOC alerts. If you would prefer a paper copy of the journal, contact the NCMJ’s managing editor at [email protected] or 919-445-6155.
Have an Opinion About Health Care Today? Voice It!
The Physicians Foundation Biennial Physician survey is still open and collecting responses to how physicians view their role in today’s evolving health care system. The results of this nationwide survey are the basis for many media reports and policy papers, so your opinion is important to understanding the physician perspective. Results also are broken out by state, so the more North Carolina physicians who respond, the more data we will have about how you and your colleagues see physician trends in our state.
If that isn’t enough of an incentive, you also may win a $500 or $5,000 Amazon gift card. Click here to take just a few minutes to give your perspective on the health care trends affecting your practice.
Take the time now.
Another NCMS Plan Benefit – Healthy Employees
On Tuesday, June 7, from 11:30 am – 12:30 pm the NCMS Plan will present a webinar on the Eat Smart, Move More, Weigh Less Weight Management Solution. Kelly Nordby, MPH, RD, LDN, Eat Smart, Move More, Weigh Less Coordinator as she describes how your employees can participate for FREE if attendance and tracking requirements are met ($225 value) and how to market the program effectively. Rita Graves-Edwards, Practice Administrator, Cape Fear Center for Digestive Diseases, PA, will explain how the program was successfully launched as part of the practice’s culture of health.
All NCMS Plan members are eligible to enroll in Eat Smart, Move More, Weigh Less, a 15-week online weight management program delivered in an interactive real-time format with a live instructor. The program is based on mindfulness concepts and small steps to establish a healthy lifestyle – it is NOT a diet. The program has been offered successfully to more than 10,000 participants and the average weight loss is around 8 pounds. 70 percent of participants either maintain or lose additional weight six months after the program ends.
Register here. All attendees will be entered to win a $25 VISA gift card.
NCMS Logs Miles for Medicine
To benefit the NC MedAssist program, a nonprofit pharmacy program providing access to lifesaving prescription medications, patient support, advocacy and related services to poor, vulnerable and uninsured North Carolinians, the North Carolina Medical Society (NCMS) is a sponsor of the Miles for Medicine event on June 18 in Cary. Please consider joining the NCMS 5k run/walk team, volunteering on the day of the fundraiser or making a donation to this cause. Register here.
NC MedAssist began in 1997 through the efforts of the Mecklenburg Medical Society Alliance and with the assistance of a $55,000 grant from the employees of Presbyterian Hospital. NCMS Past President Darlene Menscer, MD, and NCMS Foundation President-elect Janice Huff, MD, were instrumental in the founding of the organization. Since its inception, NC MedAssist has dispensed over $30 million in free prescription medicines. It has been named one of the tip 25 non-profit organizations in Charlotte by the Charlotte Business Journal. For every $1 donated, $13 in donated medications is dispensed back to the community.
The NCMS staff will be out in force on June 18 to support NC MedAssist and enjoy the event with exercise – and the pancakes, bacon and beer that will be served. Please help us support this worthy organization. Get more information and register here.
NCMS In the News and Professional Journals
Be sure to check out this month’s issue of Business North Carolina. North Carolina Medical Society (NCMS) CEO Robert W. Seligson is featured prominently in the health care roundtable feature. Seligson along with other health care stakeholders reflect on the state of the state’s health care industry. Read the article here.
The NCMS also was mentioned in an NPR Morning Edition report on the problems with the Veterans Choice program. The NCMS has been working with 30 practices that are struggling to serve their veteran patients because of authorization and payment issues with Veterans Choice. We worked with a reporter from the local NPR affiliate in Charlotte to publicize the problems, which then became part of a larger national report. Listen here.
Kristina Natt och Dag, Ph.D, director of the NCMS Foundation’s Kanof Institute for Physician Leadership, recently had her scholarly article “Leadership Development: Emerging Models and Practices” published in the journal Advances in Developing Human Resources. Read the abstract here.
“I’m very proud of Dr. Natt Och Dag and honored to have her on our staff,” said NCMS CEO Seligson. “This article is just another example of the expertise we have in our leadership development programs as well as the high quality and professionalism of all our staff in advocating for the interests of physicians and physician assistants.”
Also, a shout out to longtime NCMS member Daniel B. Murrey, MD, MPP whose article “Creating Physician Owned Bundled Payments” was published in the New England Journal of Medicine’s Catalyst, a publication focused on practical innovations in health care delivery. See the case study in OrthoCarolina’s newsletter here.
In the News
For Loved Ones of Critically Ill Patients, Hope Often Trumps Understanding of Physician's Prognosis, The Los Angeles Times, 5-17-16
A Primer: How the Fight Against Zika Might Be Funded, Kaiser Health News, 5-17-16
Treating Opioid Abuse: Laws Passed, But Will They Work?, MedPage Today, 5-17-16
When the Addict Is A Doctor, Modern Healthcare, 5-14-16
HHS Finalizes Transgender Anti-Discrimination Rule, Modern Healthcare, 5-13-16
Medical School Enrollment Up 25 Percent, Becker's Hospital Review, 5-5-16
Don't Do This If Faced With A Crying Patient, MedPage Today, 5-5-16
You Want a Description of Hell? OxyContin's 12-hour Problem, The Los Angeles Times, 5-5-16
How Often Do You Go to the Doctor? It Depends On Where You Live, The Los Angeles Times, 5-5-16
Learning Opportunities
The Centers for Medicare and Medicaid Services will host a webcast on 2015 Mid-Year QRURs Webcast, Thursday, May 19 from 1:30 to 3 pm. The webcast will give an overview of the 2015 Mid-Year Quality and Resource Use Reports (MYQRURs) and explain how to interpret and use the information. The 2015 MYQRURs were recently released to groups and solo practitioners nationwide and are for informational purposes only. They contain interim information on a subset of the quality and cost measures used to calculate the 2017 Value Modifier (VM). Learn more on the 2015 QRUR and 2017 VM webpage. To register for the webcast visit MLN Connects Event Registration. Space may be limited, register early.
Third Annual National Plant-Based Prevention of Disease 2016 Conference will be held May 19-22 in Raleigh at the McKimmon Conference Center on the North Carolina State University campus. The conference will examine how clinicians may use nutritional measure in prevention and treatment of cardiovascular disease, cancer, diabetes, hypertension and other chronic conditions in their patients. More information and registration.
The 129th Annual Scientific Session of The Old North State Medical Society “Integrative Medicine: The Future of Healthcare” will be held June 24th-25th, 2016 at The North Raleigh Hilton in Raleigh. The Session provides ONSMS members, physicians and medical professionals with up-to-date education and peer networking opportunities. Included are a Pre-Conference Training Session to qualify for prescribing Buprenorphine and a broad selection of presentations and breakout sessions, providing an opportunity for up to 22 CMEs for participation at the Conference. For more information, visit the ONSMS website.
The NCMS Foundation and Get Social Health Academy offer you these upcoming workshops to Improve Your Social Media Skills on Tuesday, June 7. The morning session from 9 a.m. to noon, Practice Managers & Social Media Leads will cover content creation, how to evaluate social sites and tools and tips. The evening session from 6 to 8:30 p.m., Physicians & Thought Leaders will focus on online reputation management, LinkedIn profiles and thought leadership. Learn more and sign up here.
NCTracks training on Friday, June 10 - 1 to 4 p.m. - ES User Role_Abbreviated MCR_Upload Documents (WebEx) will guide providers through the enhancements to the provider enrollment application processes. At the end of training, providers will be able to explain the Enrollment Specialist user role, identify the Abbreviated Manage Change Request (MCR) applications, and upload supporting documents. This course is taught via WebEx and can be attended remotely from any location with a telephone, computer and internet connection. The WebEx will be limited to 115 participants. Register for this course in SkillPort, the NCTracks Learning Management System.
Join the North Carolina Healthcare Information and Communications Alliance (NCHICA) on June 22 at the Research Triangle Foundation for a forum on Quality Reporting. The topics include: Leveraging Transparent Reporting for Quality Improvement, Transitioning to Electronic Clinical Quality Measures, and a MACRA overview. The registration fee is $50 NCHICA members/$75 non-members/$25 students. Click here for further details.
MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid
Watch seven new MLN Connects videos on the Medicare Quality Reporting Programs, focusing on the requirements you need to meet in 2016. For those who participated in the webinars held in February, the information in these modules mirrors the information shared on those calls:
Introduction: Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016. Run time: 15 minutes.
Module 1: Medicare Access and CHIP Reauthorization Act (MACRA) Preview. Run time: 6 minutes.
Module 2: 2016 Incentive Payments and 2018 Payment Adjustments. Run time: 9 minutes.
Module 3: 2016 Physician Quality Reporting System (PQRS) Updates. Run time: 20 minutes.
Module 4: 2018 Value-Based Payment Modifier (VM) Policies. Run time: 17 minutes.
Module 5: Physician Compare Updates in 2016. Run time: 6 minutes.
Module 6: Meaningful Use of Certified Electronic Health Record Technology (CEHRT) in 2016. Run time: 16 minutes.
CMS Releases Two Landmark Directives on Medicaid and Medicare
Last week the Centers for Medicare and Medicaid Services (CMS) published the final rule on Medicaid (1,425 pages) and the proposed rule governing Medicare (962 pages), which was mandated by the Medicare Access and CHIP Reauthorization Act (MACRA). North Carolina Medical Society (NCMS) staff is carefully reading both pieces of rule-making and will be posting their full analysis and what these rules mean for you and your practice in the coming days and weeks.
MACRA Proposed Rule Outlines Vision for New Medicare Payment System
The MACRA proposal lays out CMS’ vision for the new Merit-Based Incentive Payment System (MIPS), which will replace the current quality programs as required by the MACRA legislation (i.e. PQRS, the Value Modifier and the Meaningful Use program). The proposed rule also outlines details regarding Alternative Payment Models (APMs). Certain qualifying APM participants will be eligible for 5 percent bonus payments in 2019-2024 and will be exempt from the MIPS program.
Part of the proposed restructuring of the current quality programs involves major changes to the physician EHR Incentive/Meaningful Use program, which will sunset in 2019. Instead, beginning in 2019 the MIPS program will incorporate the “advancing care information” performance category to address use of EHR technology to advance care, with an emphasis on interoperability and information exchange. CMS states this category will not include the all-or-nothing scoring currently utilized in the Meaningful Use program.
Watch the Quality Time with NCMS blog and the NCMS Bulletin for updates. The AMA also has information on their MACRA website with additional materials to assist physicians with the changes resulting from this landmark legislation. Another resource for information on these proposed changes is CMS’ listening session on the MACRA Quality Payment Program Proposed Rule on Tuesday, May 10, from 2-3 pm. To register for this session visit the MLN Connects Event Registration.
NCMS staff also recommends CMS’ new Quality Payment Program website, which includes:
- CMS Fact Sheet
- Fact sheet, Advancing Care Information (formerly Meaningful Use program)
- CMS MACRA timeline
Medicaid Rule Updates Medicaid Managed Care Requirements
This final rule, originally proposed last May, overhauls Medicaid managed care requirements for the first time in more than a decade, and will certainly guide North Carolina’s Medicaid reform efforts in the months ahead.
Among the provisions the rule caps insurer profits, with Medicaid managed care plans now subject to a national medical loss ratio standard of at least 85 percent, although it doesn't impose payment penalties if plans spend less than that share of premiums on care. The rule also requires states to more rigorously supervise the adequacy of plans' provider networks. It also encourages states to establish quality rating systems for Medicaid managed care systems. CMS will add a quality rating system for private Medicaid and CHIP plans; the program is expected to be similar to one utilized for Medicare Advantage plans. The agency plans to implement the rating system for Medicaid plans over five years and will seek feedback on its proposed methodology before moving ahead.
NCMS staff is reviewing the details of the rule and will post their analysis in the days and weeks ahead and how the new provisions will impact the state’s Medicaid reforms. Be sure to watch the Bulletin for these updates. In the meantime, CMS has put out a fact sheet under Final Rule on this website and an implementation timeline.
NC Legislative Session Now Underway -- What to Watch
North Carolina’s state senators and representatives returned to Raleigh on Monday April 25, to begin the 2016 short legislative session. Several items are worth noting as the session gets underway:
Medicaid reform: As the work to reform the state’s Medicaid program continues, the North Carolina Medical Society (NCMS) remains steadfast in advocating for sensible regulation of the program through Chapter 58 provisions. HB 967, Prepaid Health Plan Licensing by DOI, addresses this issue. HB 968, Medicaid Transformation Reporting, focuses on reporting requirements to the legislature by the NC Department of Health and Human Services and the new Department of Health Benefits. The recently released federal rule on Medicaid managed care will likely influence any state action in this area as well. [See story on the federal rule in this issue of the Bulletin.]
Opioid prescribing: The much publicized opioid abuse problem in North Carolina and nationally has prompted legislators to look more closely at prescribing practices and ways to stem what has been called an epidemic of opioid abuse and deaths from overdose. Legislation has already been introduced (SB 734, Statewide Standing Order/Opioid Antagonist) for a standing statewide order allowing anyone access to naloxone, the opioid antagonist used in the case of overdose. Legislators also currently are contemplating legislation to make enrollment in and/or use of the state’s Controlled Substance Reporting System (CSRS) mandatory.
The Governor’s 2016-17 Budget Proposal: Governor Pat McCrory announced his $22.3 billion proposed budget plan on April 22, and it reflects a 2.8 percent increase in total state spending. The major highlights for NCMS members include: No cuts to Medicaid rates are proposed. Funding for Medicaid is flat, although there $1 million in additional funds provided for Medicaid reform over the 2015-16 $5 million appropriation. Additional funds also are allotted for implementation of the Governor’s Task Force for Mental Health and Substance Use recommendations, including $9 million to address opioid addiction and substance abuse. The Governor budgets $2.5 million to expand Medicaid services for people with developmental disabilities through additional Medicaid Innovations Waiver slots. And he allocates $750,000 to respond to the Zika virus threat. Read McCrory’s proposal.
To hear the latest on these and other legislative issues directly from NCMS Director of Legislative Relations Chip Baggett, watch last Friday’s Bowtie Briefing. The 2015 NCMS Legislative Summary with details on the important bills introduced and adopted during last year’s long session is posted on the NCMS website. Download it.
Update on BCBSNC Payment Problems
Physicians throughout the state continue to encounter significant difficulties in their interactions with Blue Cross and Blue Shield of North Carolina (BCBSNC). Common complaints range from delays in claim and payment processing to long hold times for authorizations, eligibility checks and general support.
The North Carolina Medical Society (NCMS) is communicating with BCBSNC staff as we assist medical practices in need of support. We also continue to coordinate with NC Insurance Commissioner Wayne Goodwin and his staff at the NC Department of Insurance, who are closely monitoring BCBSNC's handling of these problems and have launched a formal investigation of the company. The Raleigh News & Observer recently published an article outlining the Commissioner's efforts on behalf of physician practices.
The Insurance Commissioner's office reports that BCBSNC's goal is to have delayed pending claims processed by May 27th, including any and all interest due to medical practices pursuant to the provisions of the Prompt Pay Law, N.C. General Statute 58-3-225.
NCDOI also sought and BCBSNC has established a fast-track payment process for those physicians presently facing financial hardship. Those medical practices facing financial hardship should contact Susan Menendez at BCBSNC via 919-765-4035 or [email protected]. BCBSNC has a team of Network Management staff in place to monitor phone and email messages from physician practices. All calls and emails will be rapidly triaged; those requiring additional research will be sent to the company's Strategic Provider Services unit for research with outreach to physicians within 1-2 business days.
Please continue reporting problems to NCMS at [email protected] or 919-833-3836 x142 and to the Department of Insurance at 855-408-1212 or to Commissioner Goodwin directly at [email protected].
Come ‘Hang’ with the NCMS Board of Directors
Next Friday, May 13, the North Carolina Medical Society (NCMS) Board of Directors and the Durham-Orange County Medical Society will host the Spring Leadership Mixer at the Umstead Spa & Hotel, Cary. Come to the Ballroom Terrace from 5:30-7:30pm to mix and mingle with the leadership of both of these organizations.
This is another opportunity to meet and discuss issues of concern to you with NCMS board members as part of the new governance structure, which makes the Board of Directors the NCMS’ policymaking body. The Board has been holding its meetings throughout the state, and their next meeting in July will be in Charlotte, offering a similar opportunity for physicians in that area to meet with the directors informally. Keep your eye on the Bulletin and NCMS website for details.
NCMS members always are welcome to submit ideas to the Board for new or updated policies through the online submission form available here.
Be sure to RSVP today to come ‘hang’ with us on May 13.
BCBS Offers Rewards for Practices Committed to Quality
Last month Blue Cross and Blue Shield of North Carolina (BCBSNC) began offering a Patient-Centered Medical Home (PCMH) incentive program to support independent primary care practices in achieving PCMH recognition. The program provides a financial incentive upfront to practices that commit to reaching this goal within 15 months. The reward is designed to defray costs associated with attaining PCMH recognition.
PCMH recognition is a mandatory component of the Blue Quality Physician Program (BQPP) that offers enhanced payment to participating practices. Learn more by visiting www.bcbsnc.com/pqpp.
To be eligible to participate in the PCMH incentive program practices must be independent primary care practices (pediatrics, internal medicine, family medicine and general practice) and also be on the BCBSNC standard fee schedule.
If you would like to learn more or have questions, contact BCBSNC at [email protected] or call 919-765-1292.
Registration Open for Physician Leadership Fall Programs
The North Carolina Medical Society Foundation and the Kanof Institute for Physicians Leadership (KIPL) invite you to register for one of two programs beginning this fall: Leadership College or the new Health Care Leadership & Management program.
KIPL started in 2002 with Leadership College, thanks to Elizabeth Kanof, MD, and Mike Brennan, MD, and their belief in the need and importance of physician leadership. Since its founding, additional programs addressing important needs such as clinical quality and business skills have been added. More than 250 physicians and PA-C’s are alumni of the programs, many of whom continue to be involved with the Medical Society and have advanced further in their individual careers!
The Leadership College 2017 and Health Care Leadership & Management 2017 programs are quite different, although both are year-long and are conducted in a small group-formats and are project-based. The Leadership College focuses on leadership fundamentals to enhance physicians’ and PA-Cs’ core aptitudes to excel as leaders within organized medicine, hospitals, health care systems, medical staffs, group practices and in the public policy arena. Health Care Leadership & Management provides a critical framework for physician leaders based on economics and finance as well as leadership development.
Both programs help build skills in critical areas of leadership and management and further equip graduates to become more influential and effective as individual leaders. Leadership College emphasizes advocacy, while Health Care Leadership & Management emphasizes business skills.
Learn more about the programs here.
Historic Merging of Medicine and Management This Fall
The North Carolina Medical Society (NCMS) and the North Carolina Medical Group Management Association (NCMGMA) are merging forces for the first time ever at the historic M3 Conference, Sept. 15-18, 2016 at the Grandover Resort in Greensboro.
An array of educational, networking and social opportunities for both groups will help you:
- Learn what it means to be an authentic leader.
- Discover how you can be healthier and happier.
- Demystify MACRA.
- Get the latest on important local legislation and political candidates.
- Connect with your colleagues – physicians and managers.
New speakers are being confirmed each day including, wellness expert Sean Foy who will speak on “What's Your Why: The Power of Purpose.” Last year’s NCMS Annual Meeting hit speaker, Wayne Sotile, will return to address “The Thriving Medical Family: New Challenge; New Solutions.” And Medical Mutual Insurance Company’s Chief Operating Officer and General Counsel David Sousa will help you address “Management of Your Digital Reputation.”
Watch the NCMS Bulletin and your email and snail mail for updates on speakers and the opening of registration later this month.
Learning Opportunities
The Centers for Medicare and Medicaid Services (CMS) is holding a listening session on the MACRA Quality Payment Program Proposed Rule on Tuesday, May 10, from 2-3 pm. This National Provider Call is an opportunity to provide CMS early feedback on proposed policy for the Quality Payment Program. Review the proposed rule here or visit the NCMS Quality Time page for a summary prior to the listening session. To register visit the MLN Connects Event Registration. Space may be limited, register early. Learn more about the proposed rule at the website and through the press release and fact sheet.
The NC MGMA will hold its Annual Conference, May 11-13, in Charleston, SC. This year’s conference, “Making Connections,” will tie together the various aspects of what health care administrators are challenges with every day featuring content on finance, customer service, legal, social media and human resources. The Practice of the Year Award also will be presented at this gathering. Learn more and register.
The Centers for Medicare and Medicaid Services will host a webcast on 2015 Mid-Year QRURs Webcast, Thursday, May 19 from 1:30 to 3 pm. The webcast will give an overview of the 2015 Mid-Year Quality and Resource Use Reports (MYQRURs) and explain how to interpret and use the information. The 2015 MYQRURs were recently released to groups and solo practitioners nationwide and are for informational purposes only. They contain interim information on a subset of the quality and cost measures used to calculate the 2017 Value Modifier (VM). Learn more on the 2015 QRUR and 2017 VM webpage. To register for the webcast visit MLN Connects Event Registration. Space may be limited, register early.
Third Annual National Plant-Based Prevention of Disease 2016 Conference will be held May 19-22 in Raleigh at the McKimmon Conference Center on the North Carolina State University campus. The conference will examine how clinicians may use nutritional measure in prevention and treatment of cardiovascular disease, cancer, diabetes, hypertension and other chronic conditions in their patients. More information and registration.
The 129th Annual Scientific Session of The Old North State Medical Society “Integrative Medicine: The Future of Healthcare” will be held June 24th-25th, 2016 at The North Raleigh Hilton in Raleigh. The Session provides ONSMS members, physicians and medical professionals with up-to-date education and peer networking opportunities. Included are a Pre-Conference Training Session to qualify for prescribing Buprenorphine and a broad selection of presentations and breakout sessions, providing an opportunity for up to 22 CMEs for participation at the Conference. For more information, visit the ONSMS website.
MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid
Watch seven new MLN Connects videos on the Medicare Quality Reporting Programs, focusing on the requirements you need to meet in 2016. For those who participated in the webinars held in February, the information in these modules mirrors the information shared on those calls:
Introduction: Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016. Run time: 15 minutes.
Module 1: Medicare Access and CHIP Reauthorization Act (MACRA) Preview. Run time: 6 minutes.
Module 2: 2016 Incentive Payments and 2018 Payment Adjustments. Run time: 9 minutes.
Module 3: 2016 Physician Quality Reporting System (PQRS) Updates. Run time: 20 minutes.
Module 4: 2018 Value-Based Payment Modifier (VM) Policies. Run time: 17 minutes.
Module 5: Physician Compare Updates in 2016. Run time: 6 minutes.
Module 6: Meaningful Use of Certified Electronic Health Record Technology (CEHRT) in 2016. Run time: 16 minutes.
Here’s Your Chance To Be Heard
The Physicians Foundation, a non-profit organization that seeks to empower physicians to lead in the delivery of high-quality, cost-efficient health care, has launched its fourth national Survey of America’s Physicians, one of the largest physician surveys ever undertaken in the United States. Please take a few minutes to complete this survey to add your voice to the thousands of other physicians nationally. The results will help lawmakers, influential health care policymakers and the media better understand your perspective and the challenges you face.
The survey will take approximately 10-12 minutes to complete and will allow you to share your thoughts on health reform, electronic medical records, new methods of physician reimbursement, ICD-10 and a variety of other topics. A full copy of the final survey report will be emailed to all physicians who participate. Participants also will be entered to win one of five $500 Amazon gift cards and one $5,000 Amazon gift card. The survey is being conducted by national physician search and consulting firm, Merritt Hawkins, and will be emailed to more than 650,000 physicians across the country from March-June of 2016.
“This is the one national survey that allows physicians to share their perspective on the state of the medical profession,” said Walker Ray, M.D., president of the Physicians Foundation. “We’d like to hear from as many physicians as possible so we can accurately understand – and share with the public – physicians’ perspectives on the most significant issues in medicine and healthcare today.”
Take the survey.
To access previous Physicians Foundation surveys, visit www.physiciansfoundation.org.
Landmark Proposed Rule Outlines Future For Our Health Care System
The Centers for Medicare and Medicaid Services (CMS) recently released their proposed rule implementing provisions of the Medicare Access and CHIP Reauthorization Act (MACRA). The proposal lays out CMS’ vision for the new Merit-Based Incentive Payment System (MIPS), which will replace the current quality programs (PQRS, the Value Modifier and the Meaningful Use program) as required by the MACRA legislation . The proposed rule also outlines details regarding Alternative Payment Models (APMs). Certain qualifying APM participants will be eligible for 5 percent bonus payments in 2019-2024 and will be exempt from the MIPS program.
Part of the proposed restructuring of the current quality programs involves major changes to the EHR Incentive/Meaningful Use program, which will sunset in 2019. Instead, beginning in 2019 the MIPS program will incorporate the “advancing care information” performance category to address use of EHR technology to advance care, with an emphasis on interoperability and information exchange. CMS states this category will not include an all-or-nothing scoring currently utilized in the Meaningful Use program.
The North Carolina Medical Society (NCMS) is reviewing the 962-page proposal, and will update this webpage with additional information about the MIPS and APM proposals shortly. The AMA also has updated their MACRA website with additional materials to assist physicians with the changes resulting from this landmark legislation. Be sure to visit our MACRA webpage and the Quality Blog often for updates!