In this issue:

Register for our complimentary program on the governance of physician organizations

The transformation of health care toward more integrated and accountable delivery systems has brought physicians and hospitals together as collaborators in ever increasing numbers. With this shift has come a need to rethink and engage physician leaders in new roles, including governance.

 

To understand how the governance of physician-led organizations is different, and similar, to that of health care systems, the AHA’s Center for Healthcare Governance and Physician Leadership Forum, with generous support from Hospira, Inc., undertook a study to examine governance structures and functions in a diverse set of physician organizations.

 

Join your physician and hospital executive colleagues on Saturday, July 25 from 11:30 a.m. – 5:00 p.m. at the Marriott Marquis in San Francisco for this half-day complimentary program, in conjunction with the Health Forum/AHA Leadership Summit, to hear the highlights of the study, including case study presentations from three leading-edge physician organizations. Attendance is limited to ensure opportunity for dialogue.

 

To learn more or register for this complimentary program, click here.

AHA-AMA offer new guiding principles on integrated leadership

Yesterday the American Hospital Association (AHA) and the American Medical Association (AMA) released new guidance on best practices for reimagining traditional relationships between physicians and hospital executives. The six principles, the result of more than two years of work between the associations, provide a framework for physicians and hospitals that choose to create an integrated leadership structure but are unsure how to best achieve the engagement and alignment necessary to collaboratively prioritize patient care and resource management. “The changing landscape of health care requires hospitals and physicians to become true partners, providing the best care for their patients,” said Jonathan Perlin, MD, chairman of the AHA Board of Trustees and president of clinical services and chief medical officer at HCA. “Care coordination is critical as health care continues to evolve, all leading to better outcomes for patients and providers alike. As health care is fundamentally a team-based activity, we believe that organizational collaboration models the increasing necessity for inter-professional collaboration.”

 

In October 2013, the AHA and AMA, in conjunction with Health Affairs, initiated their collaboration through a meeting where 10 organizations discussed different examples of care models focusing on the financing, operations and cultural consideration. Proceedings from that meeting can be found here.

Next PLF webinar will explore the SGR fix and implications for physician payment

The passage of a permanent repeal of the deeply flawed Sustainable Growth Rate formula fixes the most critical physician payment problem and includes policy changes that move to a value-based payment system that rewards quality and the ability to accept alternative payment models such as bundled payments and accountable care organizations. But understanding the implications of these payment changes and how to prepare is essential.

 

Please join the AHA’s Physician Leadership Forum on Wednesday, July 1 beginning at 3:30 p.m. ET for a webinar to review the policy changes and hear how one organization is preparing for alternative payment models and value-based payment. In this 90-minute webinar, Akin Demehin and Melissa Jackson, senior associate directors, AHA Policy, will provide an overview of the policy changes and measures that will make up the new payment system. Dr. Bryan Gamble, president and CEO, Florida Hospital Medical Group, will share the work they’ve done to prepare their medical group to manage the clinical and financial risk in alternative payment models.

 

To register, click here.

CMS: Participation in Physician Quality Reporting System rose 47 percent in 2013

Nearly 642,000 physicians and other professionals participated in the Physician Quality Reporting System (PQRS) in 2013, a 47 percent increase from 2012 and about half of those eligible to participate, according to a new report by the Centers for Medicare & Medicaid Services. About four in 10 eligible professionals (EPs) earned a PQRS incentive payment, up from 31 percent in 2012, with payments averaging $443 for EPs and $4,531 for practices (prior to a 2 percent reduction required under sequestration). Incentive payments for the PQRS and Electronic Prescribing (eRx) Incentive Program totaled $390.7 million in 2013. About 32 percent of EPs earned an eRx incentive, up from 29 percent in 2012. Nearly 470,000 EPs who did not meet PQRS reporting requirements for 2013 are subject to a 1.5 percent reduction in their Part B Medicare Physician Fee Schedule payments in 2015; all but 2 percent of them did not submit 2013 data. Nearly 50,000 EPs were subject to a 2014 eRx payment adjustment, 80 percent of whom did not participate in the program. The eRx program ended in 2013, but e-prescribing is required to achieve “meaningful use” of electronic health records (EHR) under the Medicare and Medicaid EHR Incentive Programs.

Three ways organizations can help physicians improve care and efficiency

A recent blog post from Health Affairs outlines what physicians want and need from their organizations to improve efficiencies in their practices. Over the last several years, the authors have been conducting focus groups with primary care and specialty physicians located in the Midwest who mostly worked for non-profit organizations. Three overarching themes emerged among the groups. They were:

Pioneer ACO model saved Medicare $385 million

During the first two performance years, Pioneer Accountable Care Organizations (ACOs) saved a total of $385 million, according to a recent article (abstract only) published in JAMA. Researchers looked at fee-for-service Medicare beneficiaries aligned with 32 Pioneer ACOs and compared them to a group of eligible, but not-aligned beneficiaries in the same markets. They modeled expenditures and outcomes over a two-year performance period (2012-13) and a two-year baseline period (2010-11). They found total spending for beneficiaries aligned with Pioneer ACOs in 2012 or 2013 increased less compared to the non-aligned beneficiaries. Utilization of physician services also increased less for the ACO-aligned group. In addition, the ACO-aligned beneficiaries reported higher scores for timely care and clinician communication.

AHA takes part in White House forum on antibiotic stewardship

The American Hospital Association (AHA) recently participated in a White House forum on ways to improve responsible antibiotic use, where more than 150 stakeholders committed to help thwart the public health and national security threat posed by antibiotic-resistant bacteria. The AHA and six national partners last year released a toolkit to help hospitals and health systems develop and enhance their antimicrobial stewardship programs. Representing AHA at the White House event was Roberta DeBiasi, MD, chief of the Division of Pediatric Infectious Diseases at Children’s National Medical Center in Washington, DC, and professor of pediatrics and microbiology, immunology and tropical medicine at The George Washington University School of Medicine. Hospital and health system representatives at the event included Jonathan Perlin, MD, president of clinical services and chief medical officer for Hospital Corporation of America and AHA chairman. In related news, the Department of Health and Human Services announced a $20 million competition to develop rapid point-of-care diagnostics to combat antibiotic-resistant bacteria.

CMS to transition Physician Quality Reporting System to Enterprise Portal

The Centers for Medicare & Medicaid Services (CMS) will transition the Physician Quality Reporting System (PQRS) to its Enterprise Identity Management System on July 13. Existing PQRS users, their data and roles will be moved to a new “PQRS Portal” portion of the CMS Enterprise Portal at portal.cms.gov, where they can then submit data, access reports and conduct other administrative and maintenance activities. For a smooth transition, they should ensure that their Individuals Authorized Access to CMS Computer Services (IACS) account is active, current and accessible. New PQRS users will need to register for an EIDM account. For additional assistance regarding IACS or EIDM, contact the QualityNet Help Desk at 866-288-8912 or [email protected].

ED physicians say visits continue to rise

Three-quarters of emergency physicians say the volume of emergency department visits has increased since January 2014, when the Affordable Care Act required all Americans to have health insurance or pay a tax penalty, according to a new survey by the American College of Emergency Physicians (ACEP). About 90 percent of respondents say the severity of illness or injury among emergency patients has either increased or remained the same. “The reliance on emergency care remains stronger than ever,” said ACEP President Michael Gerardi, MD. “It’s the only place that’s open 24/7, and we never turn anyone away.” Asked what would happen if federal subsidies for health insurance coverage were eliminated in their state, 42 percent of respondents said they would expect emergency visits to increase and 65 percent said they would expect reimbursement for emergency care to decrease. The U.S. Supreme Court is expected to soon rule in King v. Burwell, which asks whether subsidies are available for patients in the 34 states whose health insurance exchanges are federally facilitated.

New apps are delivering doctors to patients’ doorsteps

A recent well blog post from The New York Times profiles a number of new smartphone apps that can help deliver a doctor to your home. One such app is called Heal. Users download the app, type in an address and reason for the visit, add a credit card, and request either a primary care physician or pediatrician. After paying the $99 fee, a physician will arrive at the user’s doorstep in 20-60 minutes. Heal is currently available in the Los Angeles and San Francisco areas with plans to expand to 15 additional cities by the end of the year. Similar services are available in New York City ( Pager), Philadelphia ( Curbside Care) and in Chicago and Milwaukee ( Go2Nurse). For those interested in virtual visits, a number of apps exist including Doctor on Demand ($40 for a physician or pediatrician consult via video; $50 for a 25-minute psychology webcam visit; or $40-70 for a lactation consultation), Teladoc, and MDLIVE. The author notes these apps aren’t meant to replace the traditional doctor appointment, but can be useful and save money for users with non-life-threatening injuries and ailments.

ABMS/AAMC call for MOC activities

The American Board of Medical Specialties (ABMS) in partnership with the Association of American Medical Colleges (AAMC) is developing the ABMS MOC Directory powered by MedEdPORTAL (ABMS MOC Directory), an online repository of competency-based MOC activities.

 

Phase One of this partnership is the ABMS/AAMC Call for MOC Activities. All members of the continuing professional development and continuing medical education communities are invited to submit relevant educational activities for review and inclusion in the ABMS MOC Directory by July 31, 2015. This is an opportunity for all stakeholders to engage in the development of Lifelong Learning and Self–Assessment (Part II) and Improvement in Medical Practice (Part IV) activities designed to improve the quality of patient care.

 

To submit an activity for review and inclusion in the ABMS MOC Directory, fill out the Common MOC Activity Submission Form at www.mededportal.org/abms.

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