NCMS Members Are Leaders
Several recent announcements highlight once again the accomplishments of many of our North Carolina Medical Society (NCMS) members and the leadership positions they hold.
Former NCMS President and Leadership College alumnus Dev Sangvai, MD, recently was named to a two-year term as vice-chair of The Joint Commission’s Ambulatory Care Professional and Technical Advisory Committee (PTAC). The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States.
Dr. Sangvai, a family physician, is Executive Director of Duke Connected Care, Duke’s accountable care organization, and medical director of DukeWELL, a population health program for Duke Employees and dependents. His administrative duties include serving as associate chief medical officer for Duke University Health System.
Governor Pat McCrory also just appointed Dr. Sangvai to serve on the North Carolina Medical Care Commission. The Governor also reappointed former NCMS President John Fagg, MD, of Forsyth County, who serves as chair of the Commission. Gov. McCrory also appointed longtime NCMS member Robert Alphin, MD, a Raleigh anesthesiologist, to the Commission. The Medical Care Commission is charged with adopting, recommending or rescinding rules for regulation of most health care facilities and administering the Health Care Facilities Finance Act. This enables the Commission to issue tax-exempt revenue bonds to finance construction and equipment projects for nonprofit and public hospitals, nursing homes, continuing care facilities for the elderly and facilities related to the foregoing.
Patients Show Their Gratitude Starting Monday
For the second year, the North Carolina Medical Society (NCMS) is spearheading the NC Doctors’ Day campaign built to put a spotlight on our state’s great doctors and their grateful patients. This homegrown celebration honoring physicians also is designed to remind you that what you do matters, and your patients are appreciative.
Our inaugural NC Doctors’ Day last year was a huge success, with over 140 doctors from across the state nominated for the NC Doctor of the Year Award. The Award is presented to the physician who garners the most online votes by March 30, and comes with a $5,000 check to be used to further a professional cause or project to help your community.
The nomination phase begins on Monday, Feb. 1. Encourage your staff and patients to nominate doctors in your practice – or nominate a colleague yourself. Visit the website at ncdoctorsday.org. Nominations close on March 4.
On March 18, the 10 finalists for NC Doctor of the Year will be posted on the ncdoctorsday.org website and online voting will begin and continue through March 27. On March 30, the winner will be announced and presented with their prize. Last year’s winner was Gloria Graham, MD, a dermatologist in Morehead City who has been practicing for over 50 years.
Check out the NC Doctors’ Day website today and be sure to like NC Doctors’ Day on FaceBook and follow the hoopla on Twitter #thxdocnc. And be sure to spread the word.
March Madness -- NCMS Board Meets in Wilmington March 18
For those who live in the eastern part of the state – or anyone who wants to make the trip -- the North Carolina Medical Society (NCMS) Board of Directors along with the New Hanover-Pender County Medical Society will be hosting the March Madness Mixer on Friday evening, March 18 in Wilmington at the Riverview Terrace, Hilton Wilmington Riverside. Mix and mingle with your colleagues and friends while taking in a game and getting to know the NCMS Board of Directors. This is a free event and spouses are welcome.
This is an opportunity to become more engaged with the NCMS leadership and have an impact on your Medical Society. For details and to register visit www.ncmedsoc.org/mixermadness.
NCMS Cares About Physician Job Satisfaction; Discussions Seek Resources to Share
Burnout is pervasive in the medical community and our state’s doctors are hurting as revealed at CME sessions during the North Carolina Medical Society's (NCMS) Annual Meeting and House of Delegates in October 2015. The programs and resulting discussions among attendees addressed physicians' career satisfaction and proved to be the beginning of a strong dialogue about burnout within the NCMS and with other organizations, employer groups and physicians to find ways the NCMS can help its members.
In early January, the NCMS Foundation announced the formation of the Mitchel D. Hardison, MD fund, created to support physician wellness activities. Named for the late Dr. Hardison, a Raleigh internist and longtime NCMS member, the fund will support initiatives addressing physician stress and burnout through the Kanof Institute for Physician Leadership (KIPL). To contribute to the fund, contact Pam Highsmith, NCMS Director of Development or call her at 919-833-3836 x122.
Activities are taking place across the state to address these growing concerns. The Western Carolina Medical Society (WCMS) has incorporated member wellness into their strategic plan and is providing ongoing education and resources in its newsletter. The WCMS is planning a Wellness Retreat in April 2016. For more information on their physician wellness efforts, visit www.mywcms.org.
In addition, the “North Carolina Consortium for Physician Resilience and Retention” is the new name for an informal group of interested stakeholders discussing ways to prevent and address burnout among physicians. Participating are the NCMS, NC Physicians Health Program, the NC Medical Board and representatives from various practices and health systems. With no formal structure or affiliation at this point, the group is simply a mechanism to keep the conversation going about burnout and to share information on programs currently underway. To be added to this group’s informal list serve, contact Shawn Scott, NCMS Deputy EVP for Operations and Administration or call her at 919-833-3836 x117.
AMA Launches Silicon Valley Health Technology Hub, Health2047
The American Medical Association (AMA) announced earlier this month that it is investing $15M to become founding partner of a health care innovation company - Health2047, Inc. The company, located in the Silicon Valley in California, will explore innovative solutions to the biggest technology challenges facing the nation’s physicians and the patients they serve.
A stand-alone, for-profit entity, Health2047 will work in partnership with leading companies, physicians and entrepreneurs to develop new products, tools and resources that improve the practice of medicine and the delivery of health care to patients. Health2047 will collaborate with AMA content experts across a wide range of medical, health policy and pragmatic practice areas. It will integrate health care companies, technology companies and entrepreneurs to co-develop, create and spin out offerings that can have large scale, systemic impact on health care and medical practice.
“Our investment in Health2047 tangibly underscores the AMA’s ongoing commitment to innovation and collaboration in health care. This dynamic new environment will include the physician perspective in every major innovation cycle, ensuring that physicians play a greater role in leading changes that will move health care forward,” said AMA Chief Executive Officer and Executive Vice President James L. Madara, M.D., who serves as board chair of Health2047.
Adulterated Heroin Alert
The Injury and Violence Prevention Branch of the North Carolina Division of Public Health is alerting providers to report of possible clenbuterol/heroin cases in central North Carolina. Scott Proescholdbell, MPH, an epidemiologist with the division has asked anyone dealing with overdose cases to be aware of this possibility. This product resulted in 20 hospitalizations last summer, he said.
Clenbuterol is a veterinary pharmaceutical used to boost muscle growth in cattle. The most common symptoms in those suspected of using clenbuterol sold as heroin were rapid heart rate, chest pain, palpitations, hypokalemia and hypotension. The researchers said cardiovascular effects are otherwise uncommon with heroin use.
If you suspect clenbuterol use, please contact Proescholdbell, [email protected] or by calling 919-707-5442.
Drug Diversion Serious Threat To Patients
The North Carolina Division of Public Health’s Healthcare Associated Infections Prevention Program recently sent a letter to local health department directors alerting them to the problem of drug diversion by health care providers and its consequences for patient safety.
Drug diversion is the act of illegally obtaining prescription medications by a health care worker for his or her own use. This can result in several types of patient harm, according to DPH, including:
- Substandard care delivered by an impaired health care provider,
- Denial of essential pain medication or therapy, or
- Risk of infection (e.g., with hepatitis C virus or bacterial pathogens) if a provider tampers with injectable drugs. Diversion involving injectable medications or injection equipment has been linked to multiple outbreaks of bacterial and viral infections nationwide, including six outbreaks between 2004 and 2014 that collectively resulted in more than 100 infections and 30,000 potential exposures. To date, no outbreaks or infections linked to drug diversion have been reported in North Carolina.
DPH has been working with medical, law enforcement and other partners to increase awareness about drug diversion and help health care facilities prevent, detect, and respond to it drug diversion.
Read the entire letter here. More information and resources are available at www.cdc.gov/injectionsafety/drugdiversion or by contacting the North Carolina Division of Public Health at 919-733-3419.
In the News
Location, Location, Location: 5 Cities Where Physicians Are Most in Demand; 9 States With Highest, Lowest Salaries, Becker's Hospital Review, 1-27-16
Let's Turn the Triple Aim Into the 'Quadruple Aim', MedPage Today, 1-26-16
Medical Mutual Insurance Co. of NC Completes Acquisition of Healthcare Providers Insurance Exchange Business, Triangle Business Journal, 1-26-16
State Certificate of Need Laws Weather Persistent Attacks, Modern Healthcare, 1-23-16
Cigna Temporarily Banned From New Medicare Plans, USA Today, 1-22-16
A New Era in Transparency in Clinical Trial Data, NEJM Journal Watch, 1-21-16
Interoperability Hurdles Impede ACOs, Modern Healthcare, 1-20-16
CDC Offers Zika Virus Guidelines, Docs Should Ask About Travel, Modern Healthcare, 1-19-16
What Qualities Make a Physician Leader?, MedPage Today, 1-15-16
Making the Most of Military Medics' Field Experience, NPR, 1-13-16
Meaningful Use Program is Ending, CMS Chief Says, MedPage Today, 1-13-16
Learning Opportunities
The Pain Society of the Carolinas invites you earn 3.5 CME at a free SAFE Opioid Prescribing Course on Saturday, Jan. 30, from 8 a.m. to 1 p.m., at the Medical University of South Carolina. To register click here.
The Centers for Medicare and Medicaid Services (CMS) is offering the following national provider call. For more information, click here.
- Thursday, Feb. 4, 1:30-3 PM ET: IMPACT Act: Connecting Post-Acute Care across the Care Continuum CMS subject matter experts and the Office of the National Coordinator for Health IT discuss the implications of the IMPACT Act for health information exchange across the care continuum.
2016 Emerging Issues Forum: FutureWork, Feb. 8-9 in Raleigh. Join leaders and learners from every North Carolina sector, region and point of view at the Institute for Emerging Issues 2016 Emerging Issues Forum, FutureWork. The forum seeks new models and strategies to position North Carolina as a leader in the global battle for good jobs for tomorrow’s diverse workforce. Focus on health care sector will be on day two when Thomas Aldridge, Manager, Public Consulting Group Health, and Carol Lewis Associate Director, UNC Innovation and Health Care System Transformation, will speak about how technology is transforming the health care landscape. Stakeholders and the general public are welcome. Register today.
NCTracks will offer the following training courses in February. Register for these courses in SkillPort, the NCTracks Learning Management System. Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort.
- Wednesday, Feb. 17 - 1 to 4 p.m. (WebEx) - Provider Web Portal Applications Webinar will guide providers through the process of submitting all types of provider applications found on the NCTracks Provider Portal. 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.
- Tuesday, Feb. 23 - 9:30 a.m. to noon - Prior Approval - Medical (Professional) will cover submitting Prior Approval (PA) Requests to help ensure compliance with Medicaid clinical coverage policy and medical necessity. It will also cover Prior Approval inquiry to check on the status of the PA Request. The course is being offered in-person at the CSC facility in Raleigh. It includes hands-on training and will be limited to 45 participants.
- Tuesday, Feb. 23 – 1 to 4 p.m. - Submitting a Professional Claim will focus on how to submit a Professional Claim via the NCTracks Provider Portal. The course is being offered in-person at the CSC facility in Raleigh. It includes hands-on training and will be limited to 45 participants.
- Friday, Feb. 26 - 1 to 3 p.m. - Recipient Eligibility Verification will cover how to use the Eligibility Verification System (EVS), which provides information regarding a recipient's eligibility for services in real time. This course will be taught at the CSC facility in Raleigh. The course includes hands-on training and will be limited to 45 participants.
Mark your calendar now for the Centers for Medicare and Medicaid Services (CMS) hosted series of one-hour webinars to discuss recent updates and the future of Physician Compare, including a publicly reported benchmark. The webinar will be conducted via WebEx at the following times. (All sessions will present the same information.):
- Tuesday, Feb. 23, 2016 at noon ET
- Wednesday, Feb. 24, 2016 at 4 pm ET
- Thursday, Feb. 25, 2016 at 11 am ET
Registration details will be posted at a later date.
The Carolinas Center and the Virginia Association for Hospices and Palliative Care are offering the 2016 Palliative Care Symposium, Support for a Lifetime: Palliative Care Across the Continuum, April 7 at the William and Ida Friday Center, University of North Carolina-Chapel Hill. More information here. The early registration deadline is March 17.
USF Health and i3 Health are hosting the 2nd Annual Hematologic Malignancies Symposium in Asheville on April 16 at the Asheville Renaissance Hotel. This live 1-day CME/CE-certified meeting is targeted towards medical oncologists, hematologists, oncology advanced practitioners, oncology nurses and other health care professionals involved in the treatment of gastrointestinal malignancies. Participants will receive expert insights from leading investigators in treatment selection and supportive care best practices for patients with hematologic malignancies. More information and register here. Early bird discount available until March 1.
USF Health and i3 health are hosting the 1st Annual Gastrointestinal Malignancies Symposium in Asheville on April 16 at the Asheville Renaissance Hotel. This live 1-day CME/CE-certified meeting is targeted toward medical oncologists, surgical oncologists, radiation oncologists, oncology advanced practitioners, oncology nurses and other health care professionals involved in the treatment of patients with gastrointestinal malignancies. More information and register here.
The Pain Society of the Carolinas (PSOC) urges you to save the dates for several other courses on pain management.
- DUKE Pain Meeting, on April 29-May 1, covering cancer pain, palliative care and end-of-life. To be held in Chapel Hill. Registration CLICK HERE to Register. Register early for discounted rates!
- Save the date for the PSOC Annual Meeting, Sept. 25, at The Omni Grove Park Inn, Asheville NC
NC Makes Strong Showing On CMS' List of New and Renewing ACOs
The Centers for Medicare and Medicaid Services (CMS) announced on Monday that three accountable care organizations (ACOs) in North Carolina had been selected to participate in the Next Generation ACO Model in 2016. Cornerstone Health Care in High Point, Triad HealthCare Network in Greensboro and WakeMed Key Community Care in Raleigh were among the 21 organizations nationwide that were chosen to join the new program.
These ACOs already have experience coordinating care for populations of patients through CMS’ Medicare Shared Savings Program (MSSP). CMS has recognized that these groups have the knowledge and expertise to assume higher levels of financial risk and reward as part of the Next Generation of ACOs.
“We are confident the model will continue to better align our efforts to ensure the needs of our patients and their families remain at the center of what we do every day,” Steve Neorr, chief administrative officer for Triad HealthCare Network, said in a statement.
North Carolina has proved fertile ground for this new, value-based model of care. On Monday, CMS also announced 100 new ACOs under the MSSP, and among those were five ACOs that will serve patients in North Carolina. They are: Physician Quality Partners, which is part of the New Hanover Regional Medical Center; Sandhills Accountable Care Alliance, part of Sandhills Physicians in Fayetteville; Tar River Health Alliance, part of the Boice-Willis clinic in the Rocky Mount area; and two organizations headquartered out-of-state -- Central Virginia Coalition of Healthcare Providers and National Rural ACO 3.
Tar River along with another North Carolina ACO, Carolina Medical Home Network ACO, also are participating in the Accountable Care Investment Model or AIM program. This program offers pre-paid shared savings to encourage new ACOs to form in rural and under served areas. NCMS is working with these practices and others as part of our Rural ACO Initiative to offer support and resources to help them succeed.
CMS also listed the 147 ACOs nationwide that are continuing in the MSSP for the coming year. This includes the well-established Coastal Carolina Quality Care in New Bern and Physicians Healthcare Collaborative (Wilmington Health) in Wilmington.
The North Carolina Medical Society (NCMS) has spearheaded the Toward Accountable Care Consortium and Initiative over the last three years, offering fledgling ACOs and those practices interested in this new model of care resources and a forum for exchange of best practices and ideas. Learn more and read a feature on Triad HealthCare Network and other North Carolina ACOs.
Medicare ACOs have grown to over 477 nationwide, currently serving nearly 8.9 million beneficiaries since the Medicare Shared Savings Program (MSSP) and Pioneer ACO Model began in 2012. The results over the past four years have demonstrated ACOs can provide better quality of care for beneficiaries while producing savings, according to CMS.
Last fall, CMS released the 2014 quality and financial performance results for ACOs that started the program in 2012, 2013, and 2014. Nationwide, 92 Shared Savings Program ACOs held spending $806 million below their targets and earned performance payments of more than $341 million as their share of program savings. The results showed that ACOS with more experience in the program were more likely to generate shared savings. The results also showed ACOs that reported on their quality in both 2013 and 2014 improved on 27 of the 33 quality measures, including patients’ ratings of clinicians’ communication, beneficiaries’ rating of their doctors, screening for tobacco use and cessation, screening for high blood pressure, and Electronic Health Record use. ACOs also outperformed group practices on 18 out of 22 reported quality measures, according to the report.
NCMS Board Begins New Year; Launches New Governance System
The 2016 North Carolina Medical Society (NCMS) Board of Directors held their initial meeting of the new year last Saturday, Jan. 9, at the NCMS Center for Leadership in Medicine in Raleigh. This was the first gathering since the 2015 Annual Meeting in October and adoption of a new governance system, which shifts policymaking authority from a House of Delegates to the NCMS Board.
This inaugural Board meeting offered an immediate example of how the new system will work. Matthew Olin, MD, an orthopedic surgeon from Greensboro, and current president of the North Carolina Orthopedic Association (NCOA), along with Richard Bruch, MD, former NCMS President and former NCOA President, appeared before the Board to request the NCMS adopt a policy on certificate of need (CON) reform.
Over the years, this issue has proved highly controversial among various specialty groups that make up the NCMS membership. CON reform legislation has been introduced in the past several legislative sessions, and came close to passing in this most recent session. The issue will most likely be debated by legislators again this year, according to Steve Keene, NCMS General Counsel and Deputy Executive Vice President for Government Affairs and Health Policy.
Drs. Olin and Bruch encouraged the Board to take action now with the possibility that the ‘house of medicine’ would be able to present a united front on this issue in the upcoming short session. Dr. Olin said that the current CON system is not fair and needs to be opened up to assist in achieving the ‘triple aim’– achieving better care for patients, better health for communities and lower costs -- as the health care system moves toward value-based medicine.
Board members questioned the guests and then debated the issue for nearly half an hour. Earlier in the meeting they had heard from North Carolina Department of Health and Human Services Secretary Rick Brajer, [see related article in this issue of the Bulletin] who told Board members that he foresees the state gradually moving away from CON. Several Board members agreed that CON no longer serves a purpose, and could be detrimental to achieving the 'triple aim' mentioned by Dr. Olin.
After a lively discussion the Board authorized NCMS CEO Robert Seligson to retain an outside and objective source to do a study on the ramifications of any changes to the CON law. The Board also is seeking comment from the larger NCMS membership. Please weigh in with your thoughts on this issue by posting a comment at the end of this article. Your comments and the results of the research study will be brought to an NCMS Task Force made up of representatives from all concerned specialties within the membership to make a definitive recommendation to the Board on a policy change.
Under the new governance structure, if you have a policy issue you would like the Board to consider, please complete the online form. In addition, the Board of Directors will be holding their meetings throughout the state this year to make them more accessible to the entire membership. The next meeting will be held in Wilmington in March. An evening ‘Mix and Mingle’ event will be held before the meeting on Friday, March 18. This is an opportunity to speak with Board members in a casual setting. Watch the Bulletin and your email for more details on this eastern NC meeting.
Audit of ACA Enhanced Payments for Primary Care Begun
Last week, NC Medicaid began the process of auditing physicians, physician assistants and nurse practitioners who attested and received enhanced payments under the ACA for certain primary care services provided in 2013 and 2014. The audit is required by federal law and is meant to confirm that those who attested and received the enhanced payment rates were eligible to receive them.
For Physicians
A sample of 100 physicians who attested that they qualified to receive the enhanced payments will be randomly selected for audit. For those selected, the Division of Medical Assistance (DMA) will independently confirm that the physician was EITHER board certified in one of the applicable specialties/subspecialties OR that at least 60 percent of his/her Medicaid paid CPT codes were the ACA eligible codes for E&M and vaccine/toxoid codes. No work will be required on the part of those selected. In fact, if the audit confirms that an individual physician was eligible, the physician will likely never know he/she was audited.
However, if DMA believes that the physician was ineligible, DMA will contact the physician with a mailed notice that the supplemental portion of his her 2013-2014 Medicaid payments (not the entire claim payment) will be recouped. Furthermore, if a physician is deemed ineligible and also supervises a PA or NP that attested, the supplemental payments to that PA or NP could be recouped as well. DMA’s notice will describe how a physician may dispute the findings and pursue an appeal.
For PAs and NPs
Because CMS requires a “paper trail” for the attested PAs and NPs, the process DMA has created for these providers is different. Last week DMA mailed certified letters to every PA and NP who self-attested for the enhanced payments. The letter was sent to the address tied to the person’s record in NCTracks.
The letter directs the PA or NP to complete and return the enclosed Midlevel Provider Confirmation form within 30 days. The short form requests the name of the PA’s or NP’s supervising physician, the physician’s NPI, and a signed statement that the physician accepts professional responsibility for the services rendered. Completed forms can be mailed (we suggest certified) or faxed (as a last resort – and please call to confirm receipt) to DMA. Review a draft of the DMA letter and Confirmation form.
DMA stresses that the form is only meant to generate documentation for each attested PA and NP. We understand that a PA’s or NP’s eligibility will only be scrutinized in this audit if DMA finds the supervising physician ineligible in the sample of 100 physicians outlined above.
But it is still essential that PAs and NPs return the requested paperwork within the 30-day timeframe. Please watch for this letter from DMA and handle immediately upon receipt.
Our goal is to inform you as early as possible when issues like this arise. Please continue to watch the North Carolina Medical Society Bulletin and website for updates.
Physician Groups Continue to Press DOJ to Reject Insurance Mergers
The Physicians Advocacy Institute (PAI) continues to press the US Department of Justice (DOJ) to reject the proposed mergers of insurance giants Cigna with Anthem and Humana with Aetna. In his role as President of PAI, Robert Seligson, CEO of the North Carolina Medical Society (NCMS) recently sent a letter to William Baer, the Assistant Attorney General for the DOJ, Antitrust Division, detailing why these proposed mergers would be harmful to the health care system. Read the letter.
“The gravity of the decision before the DOJ and its lasting impact on the nation’s health care system cannot be overstated,” Seligson wrote. “For all of the reasons set forth in this letter, PAI opposes the proposed acquisition of Cigna by Anthem and the proposed acquisition of Humana by Aetna and would urge the Antitrust Division to use its authority to block the mergers. It should be abundantly clear from our comments that 'big is not better,' and drastically reducing the number of competitive health insurers will create a 'too big to fail' scenario in the health insurance industry.”
Other organizations like the AMA and The Physicians Foundation also have been pressing the DOJ to reject the merger proposal due to the detrimental effects this type of consolidation would have on patients and their doctors. The NCMS also has encouraged North Carolina’s Commissioner of Insurance, Wayne Goodwin, to use his platform with the National Association of Insurance Commissioners to voice opposition to the mergers.
Likely, no decision on the mergers will be made until late 2016.
Room Dedicated in Honor of Bob Seligson and His Personal Physician
The conference room at the North Carolina Medical Society (NCMS) Center for Leadership in Medicine in Raleigh was dedicated last week in honor of NCMS Executive Vice President and CEO Robert W. Seligson and in memory of his personal physician Mitchell D. Hardison, MD, who passed away last year.
At a dedication and ribbon cutting ceremony at the Center on Friday evening, Jan. 8, nearly 150 NCMS members, supporters, family, friends and colleagues of Seligson and Dr. Hardison turned out to honor both men for their commitment to the profession of medicine.
“Bob insisted that the dedication include his late personal physician. Including Dr. Hardison is a fitting way to call attention to the very heart of what the Medical Society seeks to promote and protect – the doctor-patient relationship,” said Robert “Charlie” Monteiro, MD, former NCMS President, in speaking about the dedication. “Emphasizing this central principle also highlights the importance that Bob places on building relationships – with members, with his staff, within the larger health care community, with policy makers and, through his filmmaking, with many individuals unrelated to his role at the Medical Society. Bob is a master relationship builder in any setting.”
Seligson has served as executive vice president and CEO of the Medical Society for 21 years. Over his tenure he has assembled a top-notch staff and has helped mold the NCMS into a progressive, highly regarded and respected organization, wielding considerable clout at the General Assembly and supporting and serving thousands of physicians and physician assistants across the state, Dr. Monteiro noted.
In his remarks, Seligson recalled several funny anecdotes from his time as Dr. Hardison’s patient. He spoke about the importance of physician wellness in the face of the many stresses and challenges doctors must cope with in today’s health care environment.
He also announced the establishment of the Mitchell D. Hardison Fund.
“I am pleased to announce that the NCMS Foundation will establish the Mitchell D. Hardison, MD Fund to support our Institute for Physician Leadership in developing a wellness curriculum and initiatives for physicians and physician assistants,” Seligson revealed at the dedication gathering. “When I spoke with Marianne [Dr. Hardison’s widow] about establishing this fund, without hesitation, she agreed to match my personal gift – providing a $10,000 dollar foundation on which to build and grow this fund.”
If you are interested in learning more about the fund or would like to make a contribution, please contact NCMS Director of Development Pam Highsmith at 919-833-3836, x122.
DHHS Secretary Brajer Meets NCMS Board
North Carolina Department of Health and Human Services Secretary Rick Brajer told the North Carolina Medical Society (NCMS) Board of Directors at their meeting on Jan. 9, that he is committed to thoughtful and inclusive Medicaid reform for the state.
“We’re going to take our time on this,” he said. He shared that he has been meeting with hundreds of representatives from health care stakeholder organizations since he took office in August 2015, to gather their thoughts and insights on implementation of the Medicaid reform legislation passed last fall. The waiver to the Centers for Medicare and Medicaid Services (CMS) is due on June 1, and Brajer described his process thus far as “crowd-sourcing the waiver.” Once the waiver is approved, Brajer estimated it will take two and a half years to complete the implementation of the new Medicaid program.
NCMS staff has met several times with the Secretary – once at 6 a.m. at the NCMS Center for Leadership in Medicine -- to discuss aspects of the reform.
Another important focus for Brajer is mental health, and he has pushed training programs to help identify and help those with mental illness through a mental health first aid program – it’s like CPR training for mental health, he said.
Before his appointment to Secretary by Governor Pat McCrory, Brajer served as CEO of ProNerve, LLC, in Denver, Colo., an intraoperative neurophysiologic monitoring company providing services to health care facilities and professionals throughout the US. Much of his career he served as the CEO and director of LipoScience in Raleigh, a personalized diagnostics company that established a new clinical standard of care in cardiovascular management. He has held various leadership roles at the medical technology and manufacturing company Becton Dickinson in Europe and in the US, ultimately serving as Executive Officer and President of the company’s diagnostics sector.
Sec. Brajer earned his bachelor’s degree in chemical engineering from Purdue University and an MBA from the Stanford Graduate School of Business.
NCMS Board Welcomes Dr. Phil Brown
The North Carolina Medical Society (NCMS) Board of Directors welcomed Philip Brown, MD, to its ranks at its first meeting of the year on Saturday, Jan. 9. Dr. Brown is a vascular surgeon in Wilmington and was recently named Chief Physician Executive at New Hanover Regional Medical Center where he had been serving as Chief of the NHRMC Medical Staff. In his new role at the medical center, which started Jan. 1, he oversees care quality, care transformation and physician leadership.
A longtime NCMS member, Dr. Brown serves as co-chair of the Kanof Institute for Physician Leadership, a program of the NCMS Foundation. He is an alumnus of the Leadership College, class of 2003.
Dr. Brown has been practicing in Wilmington since 2004. He earned his undergraduate degree at UNC-Wilmington in 1988, then his MD at the Brody School of Medicine at East Carolina University in Greenville in 1995. He completed a residency at Pitt Memorial Hospital in Greenville, then a fellowship at Johns Hopkins Hospital in 2001-02. He also served on the academic faculty at East Carolina University. He is a former president of the New Hanover-Pender Medical Society.
The next NCMS Board of Directors meeting in March will be held in Wilmington, Dr. Brown’s hometown. All physicians and PAs in the eastern region are invited to join Dr. Brown and the other Board members at a Mix and Mingle on Friday, March 18. Watch the Bulletin and NCMS website for details.
Save the Date for M3
Be sure Sept. 15-18 is blocked out on your calendar so you can be part of the new M3: Merging Medicine and Management conference at the Grandover Resort in Greensboro that weekend. The North Carolina Medical Society (NCMS) has partnered with the North Carolina Medical Group Management Association (NCMGMA) to launch a new educational conference, bringing together physicians, physician assistants and other health care providers along with medical group managers for three days of learning, inspiring discussions, networking and fostering the team mentality that is the future of health care.
Speakers are still being finalized, but the agenda will include several tracks in areas such as wellness and work-life balance, leadership development, advocacy, value-based initiatives and opioid prescribing. NCMS also will hold its annual business meeting over this weekend to install our new president and officers. Watch the Bulletin and your email for updates about this exciting event.
NCMS Seeks Faculty for Opioid Prescribing CME
The North Carolina Medical Society (NCMS) has received funding support from The Physicians’ Institute for Excellence in Medicine to conduct up to three CME events this year on best practices in opioid prescribing. The NCMS and the Physicians' Institute are committed to addressing the epidemic of opioid abuse by helping to educate prescribers. This educational activity will be supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies (RPC).
Next year, continuing education on the abuse of controlled substances will be required by the NC Medical Board and other licensing authorities as a condition of license renewal for health care providers who prescribe controlled substances. This new requirement is the result of legislation supporting the use of the Controlled Substance Reporting System (CSRS) and the critical need to address this nationwide health issue.
Sessions are being planned for summer 2016 in Charlotte and potentially Asheville and Greenville. In September, a session will be offered in Greensboro as part of the NCMS Annual Meeting and the M3 Conference. If you are interested in learning more about serving as faculty for the “Opioid Prescribing: Safe Practice, Changing Lives” CME activities, please contact Shawn Scott ([email protected]) or Jennifer Gasperini ([email protected]) at the NCMS, or by phone (800) 272-8772.
In the News
AMA Launches Company In Silicon Valley, MedPage Today, 1-12-16
Medicare Expands Coordinated Care for 8.9M Beneficiaries, The New York Times, 1-11-16
State Attorneys General Joining Probe Of Health Insurance Mergers, The New York Times, 1-11-16
Doctors Unionize to Resist the Medical Machine, The New York Times, 1-9-16
Doctors Question How CDC's Voluntary Opioid Guidelines Would Really Work, Modern Healthcare, 1-7-16
CMS Eyes 'Nuture' As Key to Health Costs, MedPage Today, 1-5-16
Four Critical Trends Physicians Must Keep Top of Mind in 2016, Forbes, 1-4-16
Doctors Can Report Some Mentally Ill Patients To FBI Under New Gun Control Rule, Politico, 1-4-16
Insurance Mergers, ACA Exchanges' Sustainability Will Be Issues to Watch in 2016, Modern HealthCare, 1-1-16
Most Doctors Will Be Required to Use Prescription Database, The Dispatch (Davidson County, NC), 12-31-15
As Home Births Grow in US, A New Study Examines the Risks, The New York Times, 12-30-15
UNC-Chapel Hill Starts Physician Assistant Program with Military Veterans in Mind, WFAE, 12-30-15
Learning Opportunities
NCTracks is offering the following course this week. Providers can register in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort.
Friday, Jan. 15 - 9 to 10:30 a.m. - Using the Provider Message Center Inbox (WebEx) will guide authorized users on how to use the Provider Inbox within the Provider Message Center of NCTracks. 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.
The North Carolina Medical Society Foundation, in cooperation with the North Carolina Medical Group Managers, invites you to a discussion of social media in health care through a free webinar titled “Managing Online Reputation in a Busy Health Care Practice” on Tuesday, Jan. 19 from noon to 1 p.m. There’s more to reputation management than having a LinkedIn profile (although that’s important). In this webinar, Get Social Health social media coach Janet Kennedy will walk you through the basics of establishing, maintaining and protecting the online reputation of your practice and providers. Register here. You must be registered to attend. Space is limited so register early!
The Centers for Medicare and Medicaid Services (CMS) is offering the following national provider calls. For more information about each of them, click here.
- Tuesday, Jan. 19, 2-3 PM ET: ESRD QIP: Payment Year 2019 Final Rule CMS subject matter experts discuss the final rule that operationalizes the ESRD QIP for Payment Year (PY) 2019. The performance period for PY 2019 will begin on Jan. 1, 2017.
- Wednesday, Jan. 20, 2:30-4 PM ET: Collecting Data on Global Surgery as Required by MACRA: Listening Session This listening session provides an opportunity for CMS to learn from stakeholders about how to conduct the data collection required under Section 523 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
- Thursday, Feb. 4, 1:30-3 PM ET: IMPACT Act: Connecting Post-Acute Care across the Care Continuum CMS subject matter experts and the Office of the National Coordinator for Health IT discuss the implications of the IMPACT Act for health information exchange across the care continuum.
Registration is now open for the next Great Lakes and Mid-Atlantic Violence and Injury Prevention (GLMA) Webinar "Prescription Drug Overdose - The Truth about Opioids: Treating Pain in the United States" on Jan. 21, from 3- 4 PM, EST. Read more about it. Register here. After registering, you will receive a confirmation email containing information about joining the webinar.
A Neuromuscular Review Course will be held on Jan. 23, in Raleigh at the Renaissance Raleigh North Hills. The faculty include Dr. Richard Barohn, University of Kansas Medical Center, Dr. Mazen Dimachkie, University of Kansas Medical Center, Dr. Jonathan Katz, California Pacific Medical Center and Dr. Todd Levine, Phoenix Neurological Associates and University of Arizona. The course provides 6.0 hours of AMA PRA category I CME. All healthcare professionals interested in neuromuscular disorders are invited to attend including physicians of all disciplines, physicians in training, fellows, RNs, NPs, PAs, therapists, etc. For more information and registration, click here.
The 2nd Annual Bundled Payment Implementation Forum: How to Make Your Bundled Payment Program Work will be held Jan. 25-26, 2016 at the Wyndham Orlando Resort in Orlando, FL. Learn more about the program and register here. For questions, call 866-676-7689.
The Pain Society of the Carolinas invites you earn 3.5 CME at a free SAFE Opioid Prescribing Course on Saturday, Jan. 30, from 8 a.m. to 1 p.m., at the Medical University of South Carolina. To register click here.
NCHICA Thought Leader Forum: How Telehealth is Transforming Patient Care, Jan. 27, 9:30-11:30 am, Research Triangle Foundation Headquarters. Learn how telehealth is transforming patient care in North Carolina from Mary Foster, Telehealth Program Manager at the VA Mid-Atlantic Health Care Network, and Patty Upham, Director of Care Transitions at FirstHealth of the Carolinas. The registration fee is $50 for NCHICA members, $75 for non-members. Click here to register.
2016 Emerging Issues Forum: FutureWork, Feb. 8-9 in Raleigh. Join leaders and learners from every North Carolina sector, region and point of view at the Institute for Emerging Issues 2016 Emerging Issues Forum, FutureWork. The forum seeks new models and strategies to position North Carolina as a leader in the global battle for good jobs for tomorrow’s diverse workforce. Focus on health care sector will be on day two when Thomas Aldridge, Manager, Public Consulting Group Health, and Carol Lewis Associate Director, UNC Innovation and Health Care System Transformation, will speak about how technology is transforming the health care landscape. Stakeholders and the general public are welcome. Register today.
Mark your calendar now for the Centers for Medicare and Medicaid Services (CMS) hosted series of one-hour webinars to discuss recent updates and the future of Physician Compare, including a publicly reported benchmark. The webinar will be conducted via WebEx at the following times. (All sessions will present the same information.):
- Tuesday, Feb. 23, 2016 at noon ET
- Wednesday, Feb. 24, 2016 at 4 pm ET
- Thursday, Feb. 25, 2016 at 11 am ET
Registration details will be sent at a later date.
USF Health and i3 Health are hosting the 2nd Annual Hematologic Malignancies Symposium in Asheville on April 16 at the Asheville Renaissance Hotel. This live 1-day CME/CE-certified meeting is targeted towards medical oncologists, hematologists, oncology advanced practitioners, oncology nurses and other health care professionals involved in the treatment of gastrointestinal malignancies. Participants will receive expert insights from leading investigators in treatment selection and supportive care best practices for patients with hematologic malignancies. More information and register here. Early bird discount available until March 1.
USF Health and i3 health are hosting the 1st Annual Gastrointestinal Malignancies Symposium in Asheville on April 16 at the Asheville Renaissance Hotel. This live 1-day CME/CE-certified meeting is targeted toward medical oncologists, surgical oncologists, radiation oncologists, oncology advanced practitioners, oncology nurses and other health care professionals involved in the treatment of patients with gastrointestinal malignancies. More information and register here.
The Pain Society of the Carolinas (PSOC) urges you to save the dates for several other courses on pain management.
- DUKE Pain Meeting, on April 29-May 1, covering cancer pain, palliative care and end-of-life. To be held in Chapel Hill. Registration Coming soon!
- PSOC Annual Meeting, Sept. 25, at The Omni Grove Park Inn, Asheville NC
The NCMS Year in Review
In retrospect, 2015 has been a year of notable accomplishments for the North Carolina Medical Society (NCMS) and it marked the next leap forward in the enormous project of Medicaid reform. The following look back at the past year gives you a brief glimpse of the breadth of the NCMS’ work on your behalf. We look forward to working with you and for you in the coming year.
Medicaid reform remains a top priority for the NCMS, and this year saw reform legislation enacted. The new law, passed during one of the longest legislative sessions on record, invites managed care organizations and provider-led entities to administer the state’s Medicaid program. This shifting of risk from the state to other entities is a long and complex process that will unfold over the next several years with enrollment estimated to begin in the first quarter of 2018. The NCMS is working diligently to protect the interests of patients and their physicians and to ensure the reforms result in a sensible system that leads to healthier communities, better care for patients and smarter spending.
- What the State’s Compromise Medicaid Reform Bill May Mean to Your Practice
- NCMS Working to Ensure Sensible Medicaid Reform
A new governance structure was adopted by the NCMS in 2015, moving policy making authority from the House of Delegates to the NCMS Board of Directors. Now, any member may bring a concern directly to the Board for consideration. Also, Board meetings in 2016 will be held throughout the state to encourage more participation among members.
- Delegates Vote to Change NCMS Governance Structure. What Does This Change Mean to You?
- NCMS Begins Implementation of New Governance System
For the first time in 20 years, North Carolina’s physician fee schedule for workers’ comp was updated and implemented. The NCMS was instrumental in bringing together various specialties and community stakeholders to reach a compromise fee schedule, which promises better access to care for injured workers.
- Huge Win on Workers’ Comp Medical Fee Schedule Workers’ Comp
- New Workers’ Comp Physician Fee Schedule Takes Effect Today
- Workers’ Comp Study Reveals Positive Trend for Physician Fees
The NCMS and its members through their grassroots efforts helped push to repeal the long-hated sustainable growth rate (SGR) formula for Medicare. After nearly a decade of trying, the SGR was repealed in 2015. The new legislation, the Medicare Access and CHIP Reauthorization Act (MACRA), gives us a new acronym and many new provisions to understand. The NCMS Director of Health Policy Jennifer Gasperini has been analyzing what MACRA may mean to you. Follow her on the ‘Quality Time with the NCMS’ blog for the latest information.
- The SGR Has Been Repealed. Now What?
- What MACRA Means to You. A Detailed Summary of the Historic SGR Repeal Bill
Also at the federal level, NCMS helped convince several North Carolina congressional representatives to introduce and support legislation to reform the RAC Audit process.
Much sound and fury occurred leading up to the transition to the ICD-10 codes on October 1, 2015, but a major claims processing meltdown never materialized.
The NCMS continued to support the move to value-based health care models through spearheading resource guides and the hugely popular NC ACO Collaborative and MSSP Council, which brings together those in North Carolina interested in this model of care and those who are actively pursuing it. More guides are coming in 2016, and the meetings for the Collaborative and Council have been set for the coming year.
- New Resources From the Toward Accountable Care Consortium
- More Resources Available for Specialists Interested in ACOs
- NC Medicare Shared Savings Program Council Members Share Best Practices
While the move to a value-based model of care is being encouraged at the federal level, those practices in rural areas have unique challenges. The NCMS Foundation began the Rural ACO Initiative in 2015 to help rural providers successfully form or participate in accountable care organizations. The Kate B. Reynolds Charitable Trust granted nearly $500,000 to help accomplish this goal.
- NCMSF Receives Grant to Improve Access to Health Care for Those In Rural NC
- NCMS Foundation’s Rural ACO Initiative Pioneering New Territory
The NCMS Practice Consulting Services also helped practices navigate the often complicated process of attaining Patient Centered Medical Home or Patient Centered Specialty Practice recognition among other quality designations. Many practices benefitted from our Consulting Services in 2015, with medical groups across the state achieving the highest quality and meaningful use recognition. Designations from the National Committee for Quality Assurance (NCQA) serve as a quality ‘seal of approval’ and can lead to incentive payments for the practice.
- NCMS Helps Dozens of Practices Improve Care and Increase Revenue
- NCMS Practice Consulting Services Offers Help Statewide
The Kanof Institute for Physician Leadership expanded to include three tracks – the Leadership College, Clinical Quality or CQ’U’ and a new pilot program on Health Care Leadership and Management began in 2015. These leadership development programs continue to grow in popularity as hundreds of program alumni are found in many key health care leadership positions throughout the state and beyond.
Opioid abuse is a national epidemic, and a problem here in North Carolina. The NCMS has been vocal about how physicians can help alleviate this problem. Read an editorial by our 2015 President Robert Schaaf, MD, published in the Raleigh News & Observer. At the General Assembly, the NCMS has pushed for the Controlled Substance Reporting System (CSRS) for physicians and pharmacists to better track patients who may be abusing opioids. Improvements to the CSRS were enacted this year make it easier to use.
Four years after the NCMS was successful in passing tort reform legislation, the positive impact of this historic legislation is just now becoming clear through data collected over the intervening years.
Thanks to help from the NCMS, physician assistants now have a dedicated seat on the NC Medical Board.
To remind doctors their patients appreciate them, the NCMS helped update and localize the annual celebration of Doctors’ Day with an online “NC Doctor of the Year” contest. Dr. Gloria Graham, a Morehead City dermatologist was named 2015 NC Doctor of the Year.
What’s Ahead for Your Medical Society in 2016?
No one can foretell the future, but we can say with certainty that the North Carolina Medical Society (NCMS) will be working on your behalf in the following areas among many others in 2016.
Medicaid reform -- making sure the reform legislation is implemented in a sensible manner that best serves Medicaid patients and those who care for them.
MACRA – our policy experts will continue to analyze and inform you about how this massive new legislation might impact your practice. Our practice consultants will be standing by to help you implement the changes to your best advantage.
M3 Conference – we are joining forces with the NC Medical Group Managers to present the Merging Medicine and Management Conference (M3) on Sept. 15-18 at the Grandover Resort in Greensboro. Mark your calendar now and join us for thought-provoking keynote speakers, cutting-edge educational seminars on everything from opioid prescribing to leadership development and informative legislative updates as well as the latest political news as Election Day will be just around the corner.
Physician wellness initiatives – Many say the trend toward physician burnout has been made worse with increased regulatory pressures and the rapid pace of change. Your medical society is dedicated to providing the resources to help you stay healthy and happy in your chosen profession. Watch for more about this initiative in the coming months.
Help with the move to value-based models of care – the NCMS and its Foundation remain committed to helping you understand and navigate a value-based model of care. In 2016, we will add to our collection of Toward Accountable Care Consortium and Initiative toolkits; we will continue to bring together Accountable Care Organizations (ACOs) through our NC ACO Collaborative or MSSP Council and to offer educational seminars to enhance understanding of this growing model.
Continued refinement of leadership development opportunities – the Kanof Institute for Physician Leadership will continue to refine and enhance its programming. We also welcome opportunities to form customized leadership programs for organizations.
Be sure to read your eBulletin (published every other Wednesday, starting Jan. 13, 2016) and watch your email for special video updates and other announcements. To access topical blogs or update your email address or profile, please register on our website (www.ncmedsoc.org) by clicking ‘Login’ on the upper right portion of the homepage and following the prompts.
NCMS meets with Office of Rural Health on Prescription Drug Abuse
Earlier this month, North Carolina Medical Society (NCMS) staff met with Office of Rural Health representatives to discuss how to partner to combat the state’s prescription drug abuse problem. In the meeting, the NCMS discussed the 2015 budget legislation, which requires the state to create a Prescription Drug Abuse Advisory Committee charged with developing a strategic plan for combatting prescription drug abuse in North Carolina. The state will hold open public meetings to discuss this strategy going forward. Watch the Bulletin for information in these meetings.
The budget law also will require continuing education on the abuse of controlled substances as a condition of license renewal for health care providers who prescribe controlled substances. The NCMS will work with the NC Medical Board to ensure this requirement is implemented in a fair and transparent manner and will educate members on availability of CME courses to fulfil this new requirement.
The state also will be working on improvements to the Controlled Substances Reporting System (CSRS) in the near future. If you would like to provide feedback on improvements that could be made to the CSRS, please email us at [email protected]. The NCMS will continue to work with the state, legislature and the NC Medical Board to address this important issue.
CMS Will Expedite 2015 Meaningful Use Stage 2 Exemption Applications
From AMA reports
Prior to adjourning for the holidays, Congress adopted legislation, S. 2425, the “Patient Access and Medicare Protection Act,” which included a provision granting the Centers for Medicare and Medicaid Services (CMS) the authority to expedite applications for exemptions from Meaningful Use Stage 2 requirements for the 2015 calendar year.
In order to avoid a penalty under the meaningful use program, eligible professionals must attest that they met the requirements for meaningful use Stage 2 for a period of 90 consecutive days during calendar year 2015.
However, CMS did not publish the Modifications Rule for Stage 2 of meaningful use until Oct. 16. As a result, eligible professionals were not informed of the revised program requirements until fewer than the 90 required days remained in the calendar year.
CMS has previously stated that it will grant hardship exemptions for 2015 if eligible providers are unable to attest due to the lateness of the rule. However, under current law, CMS can only grant such exemptions on a case-by-case basis. This means that many eligible professions will be required to apply for exemptions and that CMS will have to act on each application individually.
A provision of the legislation adopted by Congress would grant CMS the authority to process requests for hardship exemptions to physicians through a more streamlined process, alleviating burdensome administrative issues for both providers and the agency.
Many members of Congress played key roles in advancing this provision, including Rep. Tom Price, MD (R-GA), Sens. Orrin Hatch (R-UT) and Ron Wyden (D-OR), and numerous members of the House and Senate leadership, both Republicans and Democrats, went to extraordinary lengths to ensure that this provision was considered prior to the end of the 2015 Congressional session.
2015 Attestation Begins Monday, Jan. 4, 2016
The Centers for Medicare and Medicaid Services (CMS) has updated the EHR Incentive Programs Attestation Batch Upload page with the Attestation Batch Upload Specifications for 2015 program year attestation.
Attestations for the 2015 program year will be accepted for all Medicare eligible professionals from Jan. 4, 2016 through February 29, 2016. All Medicaid program participants should refer to their State Medicaid offices for more information on attestation timeframes for the 2015 program year.
Eligible professionals or surrogates for multiple eligible professionals have the option to upload attestations using a batch file. For detailed instructions, visit the Attestation Batch Upload page on the EHR Incentive Programs website.
And don’t forget that the NCMS Practice Consulting Services are here to help. Contact Director of Practice Improvement Terri Gonzalez or 919-833-3836 x123 for more information.
NCTracks Ends ICD-10 Outreach
From NCTracks
With ICD-10 working normally, the NCTracks ICD-10 Crosswalk and the NCTracks ICD-10 Inbox will shut down by year end.
You can continue to find help with ICD-10 after December 31 here:
- If you need to know what an ICD-9 code corresponds to in ICD-10, you can look it up on the crosswalk or GEMS maintained by the Centers for Medicare and Medicaid Services.
- Check DMA policies or documents for the specific codes used by NCTracks at
- You can refer to the NCTracks ICD-10 webpage for FAQs, fact sheets, and the Help Kit. Also, review the Issues List, where we will continue to post any issues that arise and their resolution.
- Computer-based provider training for NCTracks ICD-10 can be accessed at your convenience on the secure provider portal.
- If you have any questions, you can, as usual, contact the NCTracks Call Center at 800-688-6696 or [email protected]. Please note that the NCTracks Call Center agents cannot determine what the right diagnosis code is for any particular situation. Determining the correct diagnosis code can only be done by the medical professional treating the patient.
WHO Declares Guinea Ebola-Free
Effective yesterday, Dec. 29, 2015, state and local public health officials have discontinued active monitoring of travelers from Guinea arriving in North Carolina in light of the World Health Organization’s (WHO) declaration that Guinea is free from Ebola. Active monitoring was discontinued for travelers from Liberia on June 17, 2015 and for travelers from Sierra Leone on Nov. 10, 2015.
Health care providers should continue to screen patients for recent international travel. A thorough travel history is essential to identify potential exposures to diseases of concern globally and to direct appropriate laboratory and diagnostic testing. The importance of obtaining a travel history has been reaffirmed by recent and ongoing travel-associated outbreaks of Middle East Respiratory Syndrome (MERS), measles, avian influenza, and other emerging infections. The North Carolina Division of Public Health encourages health care providers and facilities to post notices in waiting rooms and triage areas encouraging patients to report recent international travel. Examples are available in English, Spanish and French at http://www.ncdhhs.gov/ebola.
Read the NC Department of Health and Human Services, Division of Public Health memo to learn more.
In the News
Hands Off That Frozen Pizza; Doctors Advise Customers As They Shop, Kaiser Health News, 12-23-15
Veterans Suffering Poor VA Care Despite Washington Fixes, USA Today, 12-22-15
Beyond FitBit: The Quest to Develop Medical-Grade Wearables, The New York Times, 12-18-15
Can the EHR Be Our Friend?, MedPage Today, 12-17-15
Broader Strategies Urged to Counter Painkiller Over Prescribing, MedPage Today, 12-16-15
Physicians Are Jaded, But This is What Keeps Them In Medicine, MedPage Today, 12-15-15
Learning Opportunities
NCTracks is offering the following courses in January. Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort.
Tuesday, Jan. 12 - 9:30 a.m. to noon - Submitting a Claim/Recipient Eligibility Verification DPH ITP (WebEx) will cover how to submit a Professional (1500/837P) claim within the NCTracks system with an emphasis on claim level adjustments. This course also will show authorized users how to use the Eligibility Verification System (EVS), which provides information regarding a recipient's eligibility for services in real time. Providers will also be able to submit an Individual Recipient Eligibility Inquiry, submit a Batch Eligibility Inquiry, and view an Eligibility Response. 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.
Tuesday, Jan. 12 - 1 to 2 p.m. - Prior Approval Inquiry DPH ITP (WebEx) will cover how to inquire about previously submitted Prior Approval (PA) requests for Division of Public Health (DPH) ITP recipients. 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.
Friday, Jan. 15 - 9 to 10:30 a.m. - Using the Provider Message Center Inbox (WebEx) will guide authorized users on how to use the Provider Inbox within the Provider Message Center of NCTracks. 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.
A video recording of the "PQRS/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015" presentation has been posted to the CMS MLN Connects® page on YouTube. This presentation is the same as the webinars that were delivered on March 31, 2015 and April 7, 2015 by the Philadelphia Regional Office. View the video.
The 2nd Annual Bundled Payment Implementation Forum: How to Make Your Bundled Payment Program Work will be held Jan. 25-26, 2016 at the Wyndham Orlando Resort in Orlando, FL. Learn more about the program and register here. For questions, call 866-676-7689.
Mark your calendar now. The Centers for Medicare and Medicaid Services (CMS) will host a series of one-hour webinars to discuss recent updates and the future of Physician Compare, including a publicly reported benchmark.
The webinar will be conducted via WebEx at the following times. (All sessions will present the same information.):
- Tuesday, Feb. 23, 2016 at noon ET
- Wednesday, Feb. 24, 2016 at 4 pm ET
- Thursday, Feb. 25, 2016 at 11 am ET
Registration details will be sent at a later date.
NCMS Working to Ensure Sensible Medicaid Reform
The North Carolina Medical Society (NCMS) is meeting regularly with state officials charged with constructing the new capitated Medicaid framework mandated by the General Assembly as well as with other stakeholders and the managed care entities likely to be pursuing a contract with the state. We are monitoring and working to influence their objectives to make sure they are in keeping with our core values and principles.
Key principles guiding our work include ensuring that the new system:
- Puts the patient at the center, making certain that the whole person is cared for, factoring in community services as necessary to sustain the person’s health.
- Is led by physicians with the clinical knowledge to understand what constitutes excellent patient care.
- Uses meaningful quality performance measures that are consistent across all entities, are clinically relevant and not an additional burden to physicians.
- Is transparent in reporting data, quality measures, costs and savings.
- Strives for administrative simplicity during this transition period leading to sensible and streamlined procedures once the system is in place.
- Establishes network adequacy standards to ensure access to care based on federal law or regulations.
The NCMS was an integral part of the process as the state’s Medicaid reform legislation was being developed, and we successfully advocated to incorporate patient and physician protections into the final law.
“This is a lengthy and complex process with myriad details to attend to before the new system is operational and patients are being seen within it,” said NCMS CEO Robert W. Seligson. “We are knee deep in those details and will continue to report progress to our members. And we encourage our members to let us know their concerns as we continue our work at the highest levels.”
The most immediate signpost on this pioneering trek is Secretary of the North Carolina Department of Health and Human Services, (DHHS) Rick Brajer’s report to the General Assembly in March 2016 outlining his progress toward implementing the Medicaid reform legislation. Other markers on the timeline include DHHS’ application to the Centers for Medicare and Medicaid Services for approval of the state’s Medicaid reform plans. It is unknown how long the federal approval process will take, but once approved the General Assembly has allowed 18 months to select the managed care organizations or provider led entities to serve patients and begin enrollment. Many observers expect enrollment to begin as early as January 2018.
Watch for updates in the Bulletin as well as our Director of Legislative Relations Chip Baggett’s video blog (aka Bowtie Briefing) on Fridays. Please comment on this blog or contact us directly at [email protected] or 800-722-1350.
PAI Pushes for RAC Audit Reform
The Physicians Advocacy Institute (PAI) submitted additional comments this month on the Audit & Appeal Fairness, Integrity and Reforms in Medicare (AFIRM) Act to Senator Orrin Hatch, Chairman of the Senate Finance Committee, which passed the AFIRM Act earlier this year. There is growing consensus that significant reforms are needed to address the serious problems in the Medicare audit and appeals processes to address inaccurate audit findings and the costly, time-consuming appeals process. The letter, which was from North Carolina Medical Society (NCMS) CEO Robert W. Seligson, who also is the President of PAI outlines specific ways to revamp the Medicare audit process. Read the letter.
The NCMS has been pushing for such legislation for years. Working closely with Sen. Richard Burr (R-NC), NCMS Past President Robert Monteiro, MD, testified in March 2014 before a special meeting of key Senate Finance Committee staff hosted by Sen. Hatch. Dr. Monteiro detailed his practice’s experience with a flawed RAC audit and the financial hardship it caused.
In the US House of Representatives, Rep. George Holding (R-NC) introduced a RAC reform bill called “The Fair Medical Audits Act of 2015.” The bill reflects years of effort by the NCMS working with the PAI to address many concerns physicians throughout the country have with the extraordinary lack of transparency and expensive, time-consuming and often unfair processes plaguing the current Medicare audit program.
2014 Health Care Spending Report Released
The Centers for Medicare and Medicaid Services (CMS) recently published a study by the Office of the Actuary detailing 2014 health care spending. The report found that in 2014, U.S. health care spending increased 5.3 percent, slightly higher than the 2.9 percent growth in 2013. Here are some highlights from the report:
- Physician services- Spending on physician services increased 4.6 percent in 2014, compared to 2.5 percent growth in this category in 2013. The report also states that spending on prescription drugs grew by 12.2 percent in 2014, compared to 2.4 percent in 2013. This dramatic increase is due in large part to increased spending on new specialty drugs like those used to treat hepatitis C.
• Medicare spending- Medicare spending grew 5.5 percent in 2014 according to the study, compared to 3 percent growth recorded for 2013. This increase was attributed to a growth in spending on retail prescription drugs and in the Medicare Advantage program.
• Medicaid spending- Medicaid spending grew 11 percent in 2014, compared to 5.9 percent in 2013 due in large part to the coverage expansion under the Affordable Care Act.
After a year of historically low health care spending in 2013, U.S. health care spending reached $3 trillion in 2014. As a share of Gross Domestic Product, health spending accounted for 17.5 percent, emphasizing the need for continued focus on ways to reduce health care costs. You can read the full report here.
More Physician Data Available Online in 2016
As required by the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) will be expanding the amount of information available publicly on physicians’ quality and cost data via the Physician Compare website. In 2016, Physician Compare will display quality measure performance for individual providers for the first time. The website will also continue to display information on group practices and Accountable Care Organizations (ACOs). The information displayed in 2016 will contain 2014 performance information on certain quality and cost measures. CMS has been increasing the amount of data displayed on Physician Compare since its creation in February 2014. It began with information regarding a physician’s specialty, practice location and contact information and each year has expanded the amount of quality and cost data displayed. Take a look at the information displayed for you as an individual and the group practice you are affiliated with to ensure the accuracy of the data. If you see any errors, CMS recommends contacting them at [email protected].
Keep up to date on all the latest on quality reporting at the Quality Time with the NCMS blog. Sign in today on our website.
Frustrated with Summary of Care Documents? Give Your Feedback Here
The AMA is assisting the Office of the National Coordinator (ONC) with gathering information to improve the summary of care documents that include discharge summaries and consult notes. This is the document produced to meet the Transfer of Care objective in Stage 2 of Meaningful Use. To gather feedback from those who are actually using these documents, please take this short survey (5-10 minutes) to help ONC create a new standard that will reduce the number of pages in the summary of care, and make it easier to find relevant information.
Reminder of Meaningful Use Program Penalties
The NCMS Foundation’s Director of Practice Improvement Terri Gonzalez encourages practices to review the EHR Incentive program’s basic information sheet to be aware of any penalties you may be facing.
The Center for Medicare and Medicaid Services (CMS) recently released a final rule that specifies criteria that eligible professionals (EPs) must meet in order to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The final rule’s provisions encompass 2015 through 2017 (Modified Stage 2) as well as Stage 3 in 2018 and beyond.
Click here to find out what you need to know about meeting EHR Incentive Programs requirements in 2015. Other CMS resources include:
Eligible Professionals What You Need to Know for 2015
Overview of the EHR Incentive Programs in 2015-2017
What’s Changed for the EHR Incentive Programs in 2015-2017
CMS will continue to update the EHR Incentive Programs website to include additional information and resources. If you would like help from the NCMS Practice Consulting Services, contact Terri Gonzalez or call 919-833-3836 x123.
CDC Draft Opioid Prescribing Guideline Now Available for Comment
The Centers for Disease Control and Prevention (CDC) is developing an opioid prescribing guideline to help primary care providers offer safer, more effective care for patients with chronic pain and help reduce misuse, abuse and overdose from these drugs. The guideline will provide recommendations to primary care providers about the appropriate prescribing of opioid pain medications to improve pain management and patient safety. Recommendations focus on the use of opioids in treating chronic pain (i.e., pain lasting longer than three months or past the time of normal tissue healing). The guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.
CDC’s draft Guideline for Prescribing Opioids for Chronic Pain, 2016 is now available at www.Regulations.gov for review and comment. The public comment period opened Dec. 14, 2015 and closes Jan. 13, 2016. Please submit all comments and feedback at www.Regulations.gov. Enter the docket number (CDC-2015-0112) to access the docket.
CDC will also convene the National Center for Injury Prevention and Control’s Board of Scientific Counselors (BSC), a federal advisory committee, to review the draft guideline. At a public conference call on January 7, 2016, CDC will ask the BSC to appoint a workgroup to review the draft guideline and comments received on the guideline, and present recommendations about the guideline to the BSC.
More information:
- Federal Register Notice of public comment on the draft CDC Guideline for Prescribing Opioids for Chronic Pain, 2016
- Federal Register Notice of the January 7, 2016 phone meeting of the NCIPC Board of Scientific Counselors
What Would You Like to Learn About in 2016?
The North Carolina Medical Society (NCMS) Foundation offers Lunch and Learns each month and is always interested in hearing what topics you would find interesting. Now is your chance to tell us – list the webinar topics you’d like to see in 2016 here.
North Carolina’s Health Ranking Improves
North Carolina improved its overall public health ranking more than any other state in this year’s report released by the UnitedHealth Foundation. North Carolina moved up six places from last year, and ranks second highest state in the country for child immunizations. This year’s report marked North Carolina’s highest ranking since the report’s first publication in 1990. Overall, North Carolina ranks 31st. Learn more about the report and North Carolina’s overall state of health.
Burke County Medical Society Celebrates the ‘Festive Five’
Pam Highsmith
In keeping with the holiday theme of the Burke County Medical Society’s recent meeting, North Carolina Medical Society (NCMS) Director of Development Pam Highsmith spoke to the group about the NCMS Foundation’s ‘Festive Five.’
Highsmith focused on five key NCMS Foundation programs during her presentation –
- The Toward Accountable Care Consortium and Initiative, which offers resources and support for Accountable Care Organizations and those practices looking to make the move to a value-based, model of care.
- The Community Practitioner Program, which helps place health care providers in underserved areas of the state.
- NCMS Practice Consulting Services, which offers practices help with EHRs and Meaningful Use, achieving Patient Center Medical Home status, quality reporting and financial and practice management analysis and consultation.
- The Kanof Institute for Physician Leadership, which offers three tracks of leadership development courses.
- The ‘festive morsels,’ which don’t quite rise to the level of a key program, but are important nonetheless. For instance, our Merging Medicine and Management (M3) Conference, Sept. 15-18 at the Grandover Resort in Greensboro or our Doctors’ Day celebration of doctors in February and March culminating with the naming of the NC Doctor of the Year as well as our annual calendar photo contest and our ever-growing Marketplace of partner organizations to help our members.
All five programs Highsmith described at the meeting have the same ‘festive’ elements.
Foundation funded
Elevate the profession of medicine
Support NCMS members in their pursuit of patient-centered care
Transformation – our programs/services assist members during this era of transformation from fee-for-service to value-based care.
Innovative
Valuable
Engage – invite you to engage with the NCMS and Foundation.
Visit the NCMS Foundation webpage to learn more about the ‘Festive Five’ this holiday season.
In Memory of Dr. Bill Hardaker
Longtime North Carolina Medical Society (NCMS) member, William Thomas Hardaker, MD, died on Dec. 4, 2015 at the age of 73. An orthopaedist practicing in Durham, Dr. Hardaker was a 31-year member of NCMS, serving on the Sports Medicine Committee since 1998, and a 30-year member of the NC Orthopaedic Association.
He received a BA degree in 1963from the University of Pennsylvania, where he was a four-year starter/letterman on the football team, serving as its captain his senior year. He was an aviator in the United States Marine Corps, flying over 285 combat mi
ssions in Vietnam and Laos.
He attended Duke University School of Medicine from 1969 to 1973 and completed his orthopaedic residency training at Duke in 1979. Dr. Hardaker became a member of the Duke orthopaedic faculty where his diverse clinical/teaching interests included pediatric orthopaedics/scoliosis surgery, spine trauma and sports medicine. . In this capacity as the Duke Orthopaedic Resident Program Director, he recruited and trained more than 250 orthopaedic residents and his unwavering dedication to the program earned him the endearing nickname “The Rock.”
Dr. Hardaker was active in the community, serving as team physician for a wide variety of college sports, including Duke football, lacrosse and basketball teams and serving as an attending orthopaedic surgeon for the American Dance Festival. Dr. Hardaker was an active participant in Pediatric Outreach Clinics throughout North Carolina, including in Lumberton (Robeson County), Carteret, Sampson and Columbus counties. For his service, he was twice named Robeson County Physician of the Year.
We extend our sympathies to his family.
In the News
States Hold Key Role in Big Insurer Mergers, Modern Healthcare, 12-12-15
Policing the Ethics Police: Research Review Boards Face Scrutiny As Fed Propose New Rules, Modern Healthcare, 12-12-15
CMS Posts New Quality Data For Individual Doctors Over AMA Protests, Modern Healthcare, 12-10-15
Small Violations of Medical Privacy Can Hurt Patients and Corrode Trust, ProPublica/NPR, 12-10-15
Ob-Gyns, Surgeons Most Likely to Be Sue, Survey Finds, Modern Healthcare, 12-9-15
Why Hospital-Owned Health Plans Are Big Like Cheese in Wisconsin, Modern Healthcare, 12-9-15
Small Practices Can Avoid Selling Themselves to Hospital, MedPage Today, 12-8-15
Burnout Increasing Among US Doctors, The Washington Post, 12-8-15
Medical Training So Dark Students Depict Supervisors as Monsters -- Literally, Kaiser Health News, 12-8-15
Physicians at San Bernadino Hospital Recount Aftermath of Deadly Shooting, Modern Healthcare, 12-7-15
Should Medical Residents Work 30-hours Straight?, NPR, 12-7-15
Doctors Prescribe Old-Fashioned House Calls When Treating the Old and Frail, The Washington Post, 12-6-15
As Aging Population Grows, So Do Robotic Health Aides, The New York Times, 12-4-15
Is Prescription Opioid Abuse a Crime Problem or a Health Problem?, NPR, 12-3-15
Understanding Health Care Costs: Patients Talk $$ With Providers, MedPage Today, 12-3-15
Learning Opportunities
NCTracks is offering the following courses in December. Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort.
Friday, Dec. 18 – 9 to 11:00 a.m. - Recipient Eligibility Verification learn to use the Eligibility Verification System (EVS), which provides information regarding a recipient's eligibility for services in real time. This course will be taught at the CSC facility in Raleigh. The course includes hands-on training and will be limited to 45 participants.
Friday, Dec. 18 - 1 to 2:30 p.m. - Managed Care Referrals and Overrides shows authorized users how to submit Managed Care Referrals and inquire about Managed Care Referrals and Overrides. This course will be offered at the CSC facility in Raleigh. It involves hands-on training and will be limited to 45 participants.
The Mountain Area Health Education Center (MAHEC) fall course schedule is out. Find out what is being offered July through December 2015 and register today.
A video recording of the "PQRS/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015" presentation has been posted to the CMS MLN Connects® page on YouTube. This presentation is the same as the webinars that were delivered on March 31, 2015 and April 7, 2015 by the Philadelphia Regional Office. View the video.
The 2nd Annual Bundled Payment Implementation Forum: How to Make Your Bundled Payment Program Work will be held Jan. 25-26, 2016 at the Wyndham Orlando Resort in Orlando, FL. Learn more about the program and register here. For questions, call 866-676-7689.
Mark your calendar now. The Centers for Medicare and Medicaid Services (CMS) will host a series of one-hour webinars to discuss recent updates and the future of Physician Compare, including a publicly reported benchmark. (See related article in this issue of the Bulletin.)
The webinar will be conducted via WebEx at the following times. (All sessions will present the same information.):
- Tuesday, Feb. 23, 2016 at noon ET
- Wednesday, Feb. 24, 2016 at 4 pm ET
- Thursday, Feb. 25, 2016 at 11 am ET
Registration details will be sent at a later date.
Palmetto Posts 2016 Medicare Physician Fee Schedule Files
Palmetto’s 2016 Medicare Part B Physician Fee Schedules (MPFS) are now available in their Medicare Physician Fee Schedule tool. The 2016 Medicare Physician Fee Schedule conversion factor is $35.8279, a slight decrease from the 2015 conversion factor of $35.93. This reduction is a result of the Protecting Access to Medicare Act of 2014 and Achieving a Better Life Experience Act of 2014, which both required CMS to set annual targets for reductions in physician fee schedule spending from adjustments to relative values of misvalued codes. The .5 percent increases included in the Medicare Access and Chip Reauthorization Act (MACRA) all but offset the misvalued code target reductions for 2016.
Additionally, the Centers for Medicare and Medicaid Services (CMS) has sent notifications to physicians who will see reductions in Medicare payments due to penalties resulting from the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier and Meaningful Use programs for 2016. Penalties applied as a result of these programs will be in place for the duration of the calendar year, and will be applied to Medicare paid amounts for covered professional services. The penalties will be accompanied by a reason/remark code specifying the program penalty on the remittance advice. If you feel you are being penalized in error, CMS is accepting requests for “informal reviews” to contest these penalties. PQRS informal review requests must be received by Dec. 11, while Value-Based Payment Modifier informal review requests must be received by Dec. 16. According to CMS, requests must be submitted electronically via the Communication Support Page under the Related Links section of the Physician and Other Health Care Professionals Quality Reporting Portal. See the CMS fact sheet on the informal review request process for more information.
M3 Conference Marks Dawn of New Era for NCMS
Next fall you will have the opportunity to participate in an exciting new conference, marking a new era in the 166-year history of the North Carolina Medical Society (NCMS). The NCMS has partnered with the North Carolina Medical Group Management Association (NCMGMA) to launch a new educational conference, bringing together physicians, physician assistants and other health care providers along with medical group managers for three days of learning, inspiring discussions, networking and fostering the team mentality that is the future of health care. To emphasize the partnership between organizations and the collaborative nature of health care, the conference is titled “M3: Merging Medicine and Management.”
Save the date now -- Sept. 15-18 for the M3 Conference at the Grandover Resort in Greensboro.
“The M3 Conference represents what is most relevant to our membership today,” said NCMS CEO Robert W. Seligson. “The fresh educational tracks at this meeting address the topics our members told us were of most concern to them. These are the crucial issues of our day in health care and this conference provides the forum for meaningful and robust dialogue. Partnering with the Medical Group Managers, an integral part of the transition health care is undergoing, will ensure a lively and vibrant atmosphere. I’m confident you’ll return to your practice recharged and ready to succeed in the rapidly changing health care landscape.”
The agenda will include a significant number of CME-accredited hours in educational tracks covering payment reform, health care innovations taking place in North Carolina now, work life balance issues, leadership training seminars, data management and opioid prescribing. Over the course of the conference, NCMS members may bring issues of concern to the Board of Directors at the NCMS Annual Meeting, which will include a business meeting, open dialogue on issues, the election of officers and the inauguration of the new NCMS President.
Watch your email for continuing updates on the agenda, including keynote speakers and prominent thought- leaders who will inspire you. See you Sept. 15-18 in Greensboro at the M3 Conference!
Primary Care Bonus for Medicare Patients Ends With New Year
The 10 percent bonus that many primary care practitioners have been receiving to care for Medicare patients will end on Dec. 31. This incentive program, which began in 2011, was meant to address disparities in Medicare reimbursements between primary care physicians and specialists. Medicare generally pays lower fees for primary care visits to evaluate and coordinate patients' care than for procedures that specialists perform. Doctors who specialize in family medicine, internal medicine, and geriatrics were eligible for the bonuses, as were nurse practitioners and physician assistants.
Since the program began, roughly 170,000 primary care providers have received bonus payments averaging $3,938, according to a 2014 report by the Medicare Payment Advisory Commission (MedPAC). In North Carolina, approximately $26 million in incentive payments were made under this program in 2012.
Not all primary care practitioners will miss the incentive program, according to a national survey of primary care providers by the Commonwealth Fund and the Kaiser Family Foundation. Only 25 percent of those surveyed said they received a bonus payment; half didn't know the program existed. Of physicians who were aware of and received Medicare bonus payments, 37 percent said it made a small difference in their ability to serve their Medicare patients, and 5 percent said it made a big difference. However, nearly half – 48 percent -- said it made no difference at all.
The majority of primary care doctors, aside from pediatricians, accept Medicare patients, according to the survey. While 93 percent of those practitioners nationwide take Medicare, a smaller percentage, 72 percent, accept new Medicare patients.
Deadline Extended for Value-Based Payment Modifier and PQRS Informal Review
The Centers for Medicare and Medicaid Services (CMS) has extended the deadlines for Physician Quality Reporting System (PQRS) informal review requests, which now must be received by Dec. 11, and for Value-Based Payment Modifier informal review requests, which now must be received by Dec. 16.
If you believe you have been incorrectly assessed the 2016 PQRS, Value-Based Payment Modifier and Meaningful Use program penalties for 2016, you may submit an informal review request. CMS will investigate incentive eligibility and/or make a payment adjustment determination. All informal review requestors will be contacted via email of a final decision by CMS within 90 days of the original request for an informal review. All decisions will be final and there will be no further review.
All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP). For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or [email protected] Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number (TIN), in e-mail inquiries to the QualityNet Help Desk.
What Are Your Media Consumption Habits?
Do you get your news in print or online? Do you read a daily newspaper, website or magazine? Please take our 30-second survey to help us reach you and your colleague better. We’ll report our findings in the next issue of the Bulletin.
Take the survey.
NC’s "Talk It Out" Initiative Makes Progress Against Underage Drinking
One year ago, the North Carolina Alcoholic Beverage Control (ABC) Commission launched “Talk It Out,” a statewide campaign designed to raise awareness about the dangers of underage drinking, and to give parents the tools they need to speak with their children openly, honestly and often. The North Carolina Medical Society (NCMS) has proudly supported this initiative since the beginning.
In the first year, the percentage of parents who believe that underage drinking is a serious problem rose significantly (from 37 to 44 percent), as did the percentage of parents who frequently speak about the dangers of alcohol with their children (from 33 to 43 percent).
But significant challenges remain. One of the ways we can support this effort is to share Talk It Out’s “Conversation Starters” with NCMS members and the families they serve. Please use these materials and visit the website as resources to help open the dialogue with your patients and their families around the dangers of underage drinking.
NC Medicare Shared Savings Program Council Members Share Best Practices
Last month, representatives from North Carolina medical groups that participate in the Medicare Shared Savings Program (MSSP) came together at the NCMS Center for Leadership in Medicine in Raleigh to share their successes and the challenges they face as they strive to move to a value-based model of care within the MSSP. The group calls itself the NC MSSP Council and meets twice a year.
At the Council’s Nov. 19 meeting, Mission Health Partners gave an overview of their experiences as part of the Centers for Medicare and Medicaid Services (CMS) MSSP. The goal of the MSSP is to facilitate coordination and cooperation among providers to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs. The Shared Savings Program will reward Accountable Care Organizations (ACOs) that lower their growth in health care costs while meeting performance standards on quality of care and putting patients first.
Mission Health described their process of forming an ACO and their experiences in the MSSP. The bottom line, according to Amanda Gerlach, Mission Health’s Director of Operations, was that “this is the best thing for patients.”
The NC MSSP Council represents a diverse group from across the state, each with a different set of opportunities and challenges within their communities. Some issues are common to each organization including physician buy-in, effective data sharing and analytics and care coordination. Discussion is lively and often members leave with new insights and ideas gleaned from other members’ experiences.
The Council also heard from Sheree Vodicka, executive director of the NC Alliance of YMCAs about ways to partner with community Y’s to help patients stay fit as well as manage chronic conditions like diabetes. See the slides from this presentation.
The NC MSSP Council is a subset of the NC ACO Collaborative, a larger group that includes ACOs and other interested organizations from across the state. The next NC ACO Collaborative meeting will be held March 3, 2016 in Raleigh. If you are interested in learning more, please contact Melanie Phelps at the North Carolina Medical Society, 919-833-3836.
NCMS Employee Benefit Plan Expands Offerings
North Carolina Medical Society (NCMS) and MMIC Agency, LLC, a Medical Mutual Group Company, have partnered to provide expanded insurance products to the physician community. MMIC Agency has had a long-standing relationship with the NCMS as the exclusive insurance agency for the NCMS Employee Benefit Plan (NCMS Plan), a health, dental and life insurance program that insures approximately 650 medical practices in North Carolina. Beginning Jan. 1, 2016, MMIC Agency will be NCMS's endorsed insurance agency for the following personal, commercial property, and casualty insurance products:
EMPLOYEE BENEFITS: Health Insurance, Dental Insurance, Life Insurance, Vision Insurance, Disability Insurance, Long-Term Care, Accident, Cancer, Critical Illness and Hospital Confinement.
COMMERCIAL PRODUCTS: Cyber Liability, Workers' Compensation, Business Owners Policy, Employment Practice Liability, Fidelity Bonds (ERISA), Directors and Officers Liability, Commercial Umbrella.
For more information go to the MMIC website or call 800-662-7917.