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building_a_stronger_more_inclusive_and_responsive_wsmaBuilding a Stronger, More Inclusive and Responsive WSMALatest_NewsShared_Content/News/Membership_Memo/2021/July_23/building_a_stronger_more_inclusive_and_responsive_wsma<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/am-201910263-645x425px.jpg" class="pull-right" alt="WSMA Annual Meeting room with attendees" /> </div> <h5>July 23, 2021</h5> <h2>Building a Stronger, More Inclusive and Responsive WSMA</h2> <p>This fall at the WSMA Annual Meeting, delegates will consider a proposal to modernize and streamline the policymaking bodies of your WSMA. Prompted by a resolution passed by delegates in 2019 and reflecting months of diligence by the board of trustees and bylaws committee, the proposal seeks to make the House of Delegates stronger, giving all WSMA members an opportunity to have their voices heard during our policymaking process.</p> <p>The WSMA is <em>your</em> WSMA - and now's your chance to make your voice heard by weighing in on these proposed changes.</p> <h3>Why change WSMA's governing structure now?</h3> <p>To help inform this work, the WSMA engaged an external association strategy consulting firm to explore organizational directives, concerns, best practices, and market benchmarking. The following key drivers were identified:</p> <ul> <li>Attendance, participation, and engagement in the House of Delegates have declined in recent years.</li> <li>Intentional efforts are required to overcome systemic bias and help ensure more voices are at the table to effectively address inequities in health care.</li> <li>A streamlined and more representative House and board of trustees will be better positioned to meet the challenges posed by a rapidly changing health care environment.</li> </ul> <p><strong>Topline takeaway</strong>: The governance structure of an association is a key factor in its ability to achieve its mission. WSMA's current governance structure reflects what has existed for decades across many health care organizations and medical associations. While it may have served the organization well in the past, fundamental changes are needed to ensure that a variety of voices are represented in WSMA's policymaking setting.</p> <h3>Overview of proposed governance changes</h3> <p>These governance changes would be implemented through a set of proposed bylaws amendments which will go before the House of Delegates this fall at their annual meeting. Taken together, the proposed bylaws amendments would streamline the board and the House while expanding opportunities for diverse representation, allowing for a more nimble and diverse policymaking body.</p> <ul> <li><strong>WSMA board of trustees</strong> - The size of the WSMA board would be reduced from 44 to 29 members. Reducing the size of the board is needed to improve its ability to be nimble and responsive.</li> </ul> <ul> <li><strong>WSMA at-large delegates</strong> - WSMA members would be able to elect 14 at-large delegates to the House of Delegates. These new positions are intended to give more members a voice and to increase diversity in the House. These delegates would be voted on by the entire WSMA membership. A diversity, equity, and inclusion committee would be established to review at-large delegate candidates and provide candidate information to the membership. The DEI committee would also serve in other advisory capacities at the WSMA.</li> </ul> <ul> <li><strong>County medical societies</strong> - Component societies that meet the definition of being a functioning society will have one delegate and one alternate for every 100 WSMA members in the county, rather than one delegate and one alternate for every 50 WSMA members in the county. To be considered functioning, a component county society should conduct a business meeting at least once per year and have an elected governing body.</li> </ul> <p>Reducing delegate apportioning for county societies better reflects their historical participation in the House. Requiring societies to be functioning as defined helps ensure that delegates are representing active counties that have a process in place to select delegates.</p> <ul> <li><strong>Specialty delegates</strong> - No changes. Each specialty would remain as is with one delegate and one alternate per society.</li> </ul> <ul> <li><strong>Sections</strong> - With the proposed bylaws changes, both the senior section and osteopathic section delegates would be removed. Senior and osteopathic physicians and physician assistants are already sufficiently distributed and served throughout the delegate makeup of the House and board in both their current and proposed iterations.</li> </ul> <ul> <li><strong>Proposed resolution sponsorship</strong> - Proposed resolutions would need to be sponsored by two members of the House of Delegates instead of one. This change would help ensure proposed policy to the House is meaningful and actionable.</li> </ul> <ul> <li><strong>Proposed notification change</strong> - Reduce number of days required for resolutions to be furnished to delegates from 30 to 20 days prior to the annual meeting of the House. This change would allow adequate time for processing resolutions.</li> </ul> <h3>How to review these proposed governance changes and provide feedback</h3> <p>To review the bylaws amendments in full and discuss them with your WSMA member colleagues, visit virtual reference committee B in the <a href="[@]WSMA/Membership/Discussion_Forums/Virtual_Reference_Committees/WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx?hkey=d674a5ae-4fb5-48d6-b969-16aab9b63647">WSMA virtual reference committee forums</a>. These private, secure forums require sign-in and will remain available for member discussions in the runup to the 2021 Annual Meeting on Sept. 25-26 in Bellevue. All feedback posted in the forums will be collated and provided to the in-person reference committees during the meeting. If you'd like to attend the in-person reference committees, register for the Annual Meeting <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">on the WSMA website</a>.</p> </div>7/23/2021 12:00:00 AM1/1/0001 12:00:00 AM
A_closer_look__Gun_violence_policies_adopted_by_WSMA_House_of_DelegatesA closer look: Gun violence policies adopted by WSMA House of DelegatesLatest_NewsShared_Content/News/Membership_Memo/20181114/A_closer_look__Gun_violence_policies_adopted_by_WSMA_House_of_Delegates<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/gun_storage_645x425.jpg" class="pull-right" /> </div> <h5> November 14, 2018 </h5> <h2>A closer look: Gun violence policies adopted by WSMA House of Delegates</h2> <p>In the wake of two horrific mass shooting events - the killing of twelve people by a gunman in Thousand Oaks, Calif. and the massacre by a gunman of 11 congregants at a Pittsburgh synagogue - it's worth pausing a moment to consider the physicians and providers who have a front-row seat to the carnage created by gun violence. Physicians work tirelessly to reduce the impact of gun violence on bodies, and here in Washington state, they are also working to reduce the frequency of gun violence by seeking policy changes at the federal, state, and local level.</p> <p>During last month's WSMA Annual Meeting, the WSMA House of Delegates adopted a total of 10 new policies related to gun violence (Resolutions C-9 through 14). They are: </p> <ul> <li>RESOLVED, that the WSMA advocate for measures to reduce gun violence. </li> <li>RESOLVED, that the WSMA support the elimination of laws intruding on physicians’ and patients’ rights to discuss gun violence. </li> <li>RESOLVED, that the WSMA support encouraging physicians and health care workers to discuss safe storage of guns and the association of guns with risk of homicide, accidental shooting, and suicide, and counsel about risk. </li> <li>RESOLVED, that the WSMA support closing loopholes in gun purchases online and at unregulated gun shows. </li> <li>RESOLVED, that the WSMA support policy that creates weapons-free zones for medical practice settings, allowing exceptions for law enforcement. </li> <li>RESOLVED, that the WSMA support policy to address firearm-related violence and injury as a public health issue. </li> <li>RESOLVED, that the WSMA support policy that provides for background checks and waiting periods for the purchase of firearms. </li> <li>RESOLVED, that the WSMA support policy that will encourage and promote the safe storage of firearms in homes where those firearms are kept. </li> <li>RESOLVED, that the WSMA support policy that raises the minimum age to purchase a firearm to 21 years of age. </li> <li>RESOLVED, that the WSMA encourage its members to screen for risk factors of firearm injury and educate patients about prevention and safe storage. </li> </ul> <p>In addition to those new policies, WSMA delegates also reaffirmed existing policy that calls on the WSMA to support appropriate legislation that would restrict the sale and private ownership of large-clip, high-rate-of-fire automatic and semi-automatic firearms. Finally, WSMA delegates directed the WSMA to urge the state and federal government to fund research on the causes and prevention of firearm violence and injury and ensure that the databases and systems necessary for research and public health surveillance are available and publicly accessible.</p> <p>Washington's citizens are acting too: during this year's midterm election, voters passed Initiative 1639, which appears to largely align with WSMA policy requiring safe storage and restricting the purchase of firearms under certain circumstances.</p> <p>The creation of strong policy is at the heart of the WSMA's work, and reflects a commitment from Washington physicians to the health and welfare of patients and communities that extends beyond the exam room. Find all the new policies adopted by the 2018 WSMA House of Delegates on the <a href="[@]WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx">House of Delegates page</a>. For a comprehensive list of House of Delegates policy, review the WSMA Policy Compendium on our <a href="[@]WSMA/About/Policies/Policies.aspx">Policies page</a>.</p> </div>7/22/2021 3:21:58 PM1/1/0001 12:00:00 AM
building_a_new_legacyBuilding a New LegacyLatest_NewsShared_Content/News/Latest_News/2021/building_a_new_legacy<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/latest-news/2021/July/july-aug-2021-reports-cover-article-graphic-645x425.jpg" class="pull-right" alt="WSMA Reports July-August 2021 cover graphic" /></div> <h5>July 20, 2021</h5> <h2>Building a New Legacy</h2> <p> By Nathan Schlicher, MD, JD, MBA </p> <p> As we guide the activities of the Washington State Medical Association in 2021, we are building on the legacy of forward-thinking physicians stretching back to the late 1800s who were striving to make Washington the best place to practice medicine and receive care. </p> <p> When this was still - quite literally - the wild, wild West, our predecessors acted on a desire to meet the care needs of their communities. In those early meetings, an idealistic few cast a vision for the house of medicine: to encourage the unity and harmony of the profession, to advance its interests, and to promote the advancement of medical science. </p> <p> Today, we continue to build on that legacy and vision. We seek to create a sustainable medical association that reflects the times in which we live and practice medicine. We engage tomorrow's leaders today, as we create an association that reflects the population it serves. We look to the past - and the present - to realize a future that is relevant, nimble, and responsive. </p> <p> As with any undertaking, there are challenges. While the tradition of our House of Delegates remains strong, with passionate advocates driving good policy, attendance and engagement in our policymaking process have sharply declined. Reinvigorating our House is central to the work before us, to ensure our physician-driven strategies reflect engagement and diverse, informed perspectives. </p> <p> On identifying and engaging those diverse voices, our membership has spoken clearly and passionately through recent policy passed by our House. Overcoming systemic bias and institutionalized racism requires all voices at the table if we are to effectively address inequities in health care. Change is needed at all levels, including the makeup of our House and its leadership. </p> <p> Another challenge before our medical association is posed by the rapid changes that are a hallmark of today's health care environment. We must equip our WSMA with streamlined and modernized strategies to remain responsive to the fast-changing needs of our state's physicians and their patients, and to engender a culture of connectedness and trust in governance that is key for any healthy organization. </p> <p> The 2019 House of Delegates recognized these challenges and directed the WSMA to develop strategies that would help improve the value of the House. Since then, your WSMA has been hard at work doing just that. </p> <p> To develop these recommendations, the WSMA engaged an external association strategy consulting firm to explore our organizational directives and concerns and to review today's association best practices and market benchmarking. </p> <p> After stakeholder interviews, the recommendations were reviewed by our board of trustees in September and again in November 2020, then submitted to our bylaws committee for development. The board reviewed drafts in January and May and now the final amendments will be up for a vote during the 2021 House of Delegates meeting in the fall. </p> <p> In this issue, you'll find the proposed amendments to the WSMA bylaws (printed in the insert), which reflect the recommended restructuring of our governing bodies. We urge all members to review them prior to the September meeting of the 2021 House of Delegates, when they will be considered for adoption. Your feedback will be solicited via our secure and private online discussion forums. </p> <p> The changes proposed do not alter the policymaking process of the House of Delegates. Instead, the proposal seeks to make the House of Delegates stronger, giving all WSMA members an opportunity to have their voices heard during our policymaking process. </p> <p> These recommendations reflect a transformed path that builds on the best of our traditions, achieves a greater sense of community, ensures a diverse and equitable board of trustees and House of Delegates, and yields a sustainable and relevant association for the next 100 years. </p> <p> Our path forward is in view. Standing together, we can take a bold step into a future we have built that honors the best of who were yesterday, and who we are today. </p> <p> <em>Dr. Schlicher is president of the WSMA.</em> </p> </div>7/20/2021 12:00:00 AM1/1/0001 12:00:00 AM
by_the_numbers_getting_comfortable_with_discomfortBy the Numbers: Getting Comfortable With DiscomfortLatest_NewsShared_Content/News/Latest_News/2021/by_the_numbers_getting_comfortable_with_discomfort<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img alt="WSMA Reports July-August 2021 cover graphic" src="/images/Newsletters/latest-news/2021/July/july-aug-2021-reports-cover-article-graphic-645x425.jpg" class="pull-right" /></div> <h5>July 20, 2021</h5> <h2>By the Numbers: Getting Comfortable With Discomfort</h2> <p> During the 2021 WSMA Leadership Development Conference, keynote speaker Bill Eckstrom had this to say about change: “What makes you comfortable can ruin you, and only in a state of discomfort can we continually grow.” His talk about getting comfortable with discomfort rang true for attendees and speaks to us today as we consider a transformation of our House of Delegates. As these attendance numbers from recent House of Delegates meetings show, a reinvigorated House is needed to better position your WSMA for the future. To learn more about this transformation effort, read the “<a href="[@]Shared_Content/News/Latest_News/2021/building_a_new_legacy.aspx">Building a New Legacy</a>” column.</p> <p> <a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/by-the-numbers-wsma-july-aug-2021.pdf]">Click here to see the numbers</a>. </p> </div>7/20/2021 12:00:00 AM1/1/0001 12:00:00 AM
facing_the_demands_of_changeFacing the Demands of ChangeLatest_NewsShared_Content/News/Latest_News/2021/facing_the_demands_of_change<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/latest-news/2021/July/july-aug-2021-reports-cover-article-graphic-645x425.jpg" class="pull-right" alt="WSMA Reports July-August 2021 cover graphic" /></div> <h5>July 20, 2021</h5> <h2>Facing the Demands of Change</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> In the early days of the COVID-19 pandemic, WSMA's executive committee gathered weekly to strategize the association's response to the crisis. With Washington's "Stay Home, Stay Healthy" mandate in place, it wasn't long before we started hearing comments like "It's quiet, like on a Sunday," from a member describing his medical facility at the time. Another chimed in saying, "Same here, our hospital has the lowest census we've ever had in 20 years." Someone else noted that their emergency department had open beds and no waiting. </p> <p> We marveled at the slowdown of the pace at our members' practices and ambulatory settings. We collectively crossed our fingers, hoping this meant we did enough to have the capacity to care for COVID-19 patients. However, no one anticipated that our chronic or urgent care patients might delay care or necessary procedures. A member at Overlake was the first one to flag for us that the volume of stroke patients had plummeted at his stroke center. It was a harrowing harbinger of things to come, as we knew without a doubt that it wasn't because people weren't having strokes. It was because they weren't seeking care. Soon after, among other disturbing stories, we learned about a heart attack patient who delayed care so long that he died in the emergency clinic's parking lot before he could receive care. </p> <p> For all of us, the pandemic has taken so much. For some patients it took away the will to seek care or it caused critical care to be delayed. For some medical practices, it stole their financial viability, causing reductions in staff or worse, closures. </p> <p> The pandemic was a perfect storm for disastrously compromising the health of patients and practices. It may yet be years until we can assess the full extent of its impact. What we know for now is that the unforeseen consequences will be with us, much as long-haul COVID-19 will be as well. </p> <p> As we emerge on the other side of a pandemic, as well as a racial awakening, among the lessons learned is that we must recognize and face the demands of change head on. I've been reflecting on that lesson as your WSMA leadership contemplates how best to ensure a sustainable organization that reflects the times in which we live, all the people we represent, and the practice of medicine. It's time to look forward and create an opportunity for all voices to be at the table, now and into the future. </p> <p> I urge you to review the insert within this magazine, which outlines the bylaws updates that will be voted on at the annual meeting of our House of Delegates this September. Be sure to also read "<a href="@/Shared_Content/News/Latest_News/2021/building_a_new_legacy.aspx" name="Building a New Legacy"><a href="[@]Shared_Content/News/Latest_News/2021/building_a_new_legacy.aspx">Building a New Legacy</a></a>" for background into the transformational changes these bylaws amendments represent. </p> <p> I'm grateful to the bylaws committee for their diligence and thoughtfulness as they prepared these proposed amendments. Their work captures several months of debate at the WSMA board of trustees. To learn more or to share your thoughts, visit the virtual reference committee discussion forum at <a href="https://wsma.org/vrc">wsma.org/vrc</a>. </p> </div>7/20/2021 12:00:00 AM1/1/0001 12:00:00 AM
proposed_bylaws_amendments_for_2021Proposed Bylaws Amendments For 2021Latest_NewsShared_Content/News/Latest_News/2021/proposed_bylaws_amendments_for_2021<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/latest-news/2021/July/july-aug-2021-reports-cover-article-graphic-645x425.jpg" class="pull-right" alt="WSMA Reports July-August 2021 cover graphic" /></div> <h5>July 20, 2021</h5> <h2>Proposed Bylaws Amendments For 2021</h2> <p> Your state medical association - its governance and regulation of affairs - is defined by a set of bylaws. And each year a committee, consisting of volunteer WSMA members, convenes to consider changes to these bylaws. Those proposed amendments are then put before the WSMA House of Delegates for consideration. </p> <p> At the 2021 WSMA Annual Meeting this September, delegates will be asked to weigh in on five separate amendments to the bylaws. These proposed amendments reflect discussions at the WSMA board of trustees on restructuring our governing bodies in response to a resolution passed by the 2019 House of Delegates (see "<a href="[@]Shared_Content/News/Latest_News/2021/building_a_new_legacy.aspx">Building a New Legacy</a>" for details). WSMA Reports provides notice of these proposed amendments to members as required by Article XIX of the bylaws. </p> <h3>Summary of amendments</h3> <p> The proposed bylaws amendments would: </p> <ul> <li>Restructure the board of trustees <ul> <li>Remove the AMA alternates from the board of trustees;</li> <li>Reduce the number of the trustees-at-large from twenty-one (21) to fourteen (14); and</li> <li>Remove the finance committee chair and designate the secretary-treasurer to be the finance committee liaison to the board of trustees.</li> </ul> </li> <li> Restructure the House of Delegates <ul> <li>Require component county societies to be "functioning component county societies" when apportioning delegates to the Houses of Delegates;</li> <li>Define "functioning component county society;"</li> <li>Reduce the number of special sections that receive delegates (removes senior section and osteopathic section);</li> <li>Create "delegates-at-large" to the House of Delegates;</li> <li>Require all proposed resolutions be sponsored by two (2) members of the House of Delegates.</li> <li>Amend the number of days the secretary-treasurer must furnish each member of the House of Delegates and the secretary of each component society and section with a copy of each such resolution from thirty (30) days before the next meeting of the House of Delegates to twenty (20) days (to allow adequate time to process resolutions); and</li> <li>Add clarification to board of trustees composition regarding the AMA delegation.</li> </ul> </li> <li> Establish a diversity, equity, and inclusion committee, with responsibilities that include reviewing candidates for delegates-at-large to the House of Delegates. </li> </ul> <p> In the proposed amendments relating to the items listed above, those portions of the bylaws that are struck out are to be deleted and those colored and underlined are to be added. Bylaws text that remains unchanged and that has been omitted from this document in the interest of brevity is represented by an ellipsis [...]. A complete set of the current bylaws can be downloaded from the WSMA website at <a href="https://wsma.org/policies">wsma.org/policies</a>. </p> <p><a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/wsma-julyaug-2021-bylaws-final-amendments-only.pdf]">Download a PDF of all proposed amendments for 2021</a>. </p> </div>7/20/2021 12:00:00 AM1/1/0001 12:00:00 AM
2021_paying_for_value_survey_now_open2021 Paying for Value Survey Now OpenLatest_NewsShared_Content/News/Latest_News/2021/2021_paying_for_value_survey_now_open<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/physician-money-illustration-645x425px.png" class="pull-right" alt="Physician with money illustration" /> </div> <h5>July 8, 2021</h5> <h2>2021 Paying for Value Survey Now Open</h2> <p>The Health Care Authority is requesting physician and provider participation in its latest survey on the use of value-based payments in Washington. This survey will provide valuable insight into the challenges that practitioners face as they consider adopting new payment arrangements.</p> <p>The 2021 Paying for Value survey is designed to be filled out by an administrative leader, with consultation from clinicians as necessary. HCA is seeking only one response per organization. The survey should take no more than 30-45 minutes to complete. Surveys must be complete by 5 p.m. PDT, Friday, Aug. 31.</p> <p><a href="https://hca.servicenowservices.com/assessment_take2.do?sysparm_assessable_type=63e8e1d71b343810a6f9628ae54bcb37">Take the 2021 Paying for Value survey</a>.</p> <p>This survey helps inform HCA's strategic direction toward its goal of 90% of state-financed health care and 50% of the commercial market in value-based purchasing arrangements by the end of 2021. <a href="https://www.hca.wa.gov/about-hca/value-based-purchasing/tracking-success">More information and past survey results are available on the HCA website</a>.</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
cpt_codes_for_covid_19_vaccine_patient_conversationsCPT Codes for COVID-19 Vaccine Patient ConversationsLatest_NewsShared_Content/News/Latest_News/2021/cpt_codes_for_covid_19_vaccine_patient_conversations<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/istock-1296415706-645x425px.jpg" class="pull-right" alt="Masked physician talking to patients" /> </div> <h5>July 8, 2021</h5> <h2>CPT Codes for COVID-19 Vaccine Patient Conversations </h2> <p>Since Washington state announced a provider-based approach to its COVID-19 vaccine outreach, the WSMA has advocated for physicians and practices to be reimbursed for these important, and often necessary, conversations with their patients. On June 17, Gov. Jay Inslee, in conjunction with Insurance Commissioner Mike Kreidler and the Health Care Authority, announced that CPT consultation codes will temporarily be available for direct patient outreach.</p> <h3>About the billing codes</h3> <p>The new CPT codes, established via emergency order and in effect only until Aug. 21, are intended to facilitate direct outreach to patients to discuss the importance of getting vaccinated, as well as the safety and efficacy of a vaccine:</p> <ul> <li>CPT code 99401 for in-person consultation, and available for audio and visual telehealth visits.</li> <li>CPT code 99441 for audio-only (telephone) counseling for physicians.</li> <li>CPT code 98966 for audio-only (telephone) counseling for non-physicians (medical assistants, nurses, etc.).</li> </ul> <h3>Yes, but…</h3> <p>The emergency order does not dictate a reimbursement rate for these codes. The WSMA has reached out to the governor's office to confirm whether insurance carriers will be able to set their own payment rates and to clarify, if possible, the rates they are paying. We've made clear that without clarity on rates, it will be difficult for practices to determine if they have the resources to dedicate a provider to make this outreach.</p> <p>State officials have clarified that carriers will negotiate rates individually with their contracted providers. The WSMA advises that your practice review arrangements with insurance carriers to understand the contracted rate for these new billing codes.</p> <h3>For more information</h3> <p>You can review the <a href="https://www.hca.wa.gov/assets/billers-and-providers/apple-health-covid-vaccine-policy.pdf" target="_blank" rel="noreferrer">Apple Health COVID-19 vaccine billing policy</a> (starting on page 3) and the <a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-21-02_0.pdf?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=">OIC emergency order</a> for more information on the new CPT codes and what consulting conditions apply under this order.</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
hca_prepares_guidelines_for_new_pmp_check_requirementHCA Prepares Guidelines for New PMP-Check RequirementLatest_NewsShared_Content/News/Latest_News/2021/hca_prepares_guidelines_for_new_pmp_check_requirement<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/pharmacist-stock-lores-645x425.jpg" class="pull-right" alt="Pharmacist filling prescription bottles" /> </div> <h5>July 8, 2021</h5> <h2>HCA Prepares Guidelines for New PMP-Check Requirement</h2> <p>The Washington State Health Care Authority is finalizing guidelines for determining appropriate reviews of the state's prescription monitoring program consistent with federal SUPPORT Act requirements. As a reminder, starting Oct. 1 of this year, physicians must check an Apple Health (Medicaid) client's history in the PMP before prescribing controlled substances.</p> <p>This new requirement falls under sections <a href="https://www.congress.gov/bill/115th-congress/house-bill/6">subtitle E of the SUPPORT Act</a>, establishing the "Medicaid Providers Are Required to Note Experiences in Record Systems to Help In-need Patients Act" or the "Medicaid PARTNERSHIP Act." Physicians may delegate this task to anyone at the practice with authorization to access the PMP, so long as the physician reviews all of the client's prescriptions. The date and time of the retrieval and review of information must be documented in the patient record. Prior to writing and shortly after dispensing a prescription for a controlled substance to a Medicaid patient, providers will be expected to review the (most recent 12-month period) prescription drug history of a covered individual in the PMP for:</p> <ul> <li>The number and type of controlled substances prescribed and filled</li> <li>Who prescribed a controlled substance</li> </ul> <p>Outpatient pharmacists will also be required to review the PMP before dispensing a controlled substance. The Health Care Authority's finalized guidelines will be reflected in the agency's Oct. 1 prescription drug program billing guide.</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
july_16_deadline_to_weigh_in_on_scope_proposalsJuly 16 Deadline to Weigh in on Scope ProposalsLatest_NewsShared_Content/News/Latest_News/2021/july_16_deadline_to_weigh_in_on_scope_proposals<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/eye-exam-645x425px.jpg" class="pull-right" alt="Eye exam" /> </div> <h5>July 8, 2021</h5> <h2>July 16 Deadline to Weigh in on Scope Proposals</h2> <p>We recently reported on three sunrise reviews underway at the Washington State Department of Health that propose changes to the scope of practice for several health professions in our state. The WSMA will be providing feedback to the department on each of the scope proposals, and we encourage all WSMA members to do so as well. They are:</p> <ul> <li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/SunriseRequest-Midwives.pdf" target="_blank" rel="noreferrer">proposal</a> from the Midwives Association of Washington to increase the midwifery scope of practice. Submit your comments on the MAW proposal by emailing <a href="mailto:mwsunrise@doh.wa.gov">mwsunrise@doh.wa.gov</a>. </li> </ul> <ul> <li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/OptometrySunriseRequest.pdf" target="_blank" rel="noreferrer">proposal</a> from the Optometric Physicians of Washington to increase the optometrist scope of practice. Submit your comments on the OPW proposal by emailing <a href="mailto:optom-sunrise@doh.wa.gov">optom-sunrise@doh.wa.gov</a>. </li> </ul> <ul> <li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/SunriseRequest-AnesthesAssistants.pdf" target="_blank" rel="noreferrer">proposal</a> from the Washington State Society of Anesthesiologists to create a license for anesthesiologist assistants. Submit your comments on the WSSA proposal by emailing <a href="mailto:anesthesiology-sunrise@doh.wa.gov">anesthesiology-sunrise@doh.wa.gov</a>. </li> </ul> <p>See this Membership Memo article <a href="[@]Shared_Content/News/Latest_News/2021/sunrise_reviews_on_the_horizon_midwifery_optometrists_and_anesthesiologist_assistants">more information on sunrise reviews and WSMA policy regarding scope of practice</a>. Comments on these proposals are due by July 16 at midnight and should be sent to the email addresses provided above. If you have already submitted your comments to <a href="mailto:sunrise@doh.wa.gov">sunrise@doh.wa.gov</a>, originally provided by your WSMA in the last Memo, you should resubmit your comments to the correct email address. If the WSMA can be of any assistance, email our policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
nyt_bestselling_author_sheri_fink_md_phd_keynotes_the_2021_wsma_annual_meetingNYT Bestselling Author Sheri Fink, MD, PhD, Keynotes the 2021 WSMA Annual MeetingLatest_NewsShared_Content/News/Latest_News/2021/nyt_bestselling_author_sheri_fink_md_phd_keynotes_the_2021_wsma_annual_meeting<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/fink.sheri-645x425px.jpg" class="pull-right" alt="Sheri Fink MD" /> </div> <h5>July 8, 2021</h5> <h2>NYT Bestselling Author Sheri Fink, MD, PhD, Keynotes the 2021 WSMA Annual Meeting</h2> <p>Connect with your colleagues from around the state for a weekend of policy discussions and networking at the 2021 Annual Meeting of the WSMA House of Delegates, scheduled for Sept. 25-26 in at the Westin Bellevue Hotel.</p> <h3>Introducing our keynote presenter</h3> <p>This year's keynote speaker is Sheri Fink, MD, PhD, author of the critically acclaimed New York Times bestselling book "Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital," about choices made in the aftermath of Hurricane Katrina. During the COVID-19 pandemic, Dr. Fink has reported from more than two dozen hospitals in the U.S. and internationally. In her presentation at the Annual Meeting, Dr. Fink will share her observations from the COVID-19 pandemic and how it compares to the lessons learned from the New Orleans Memorial Medical Center's leadership response during Hurricane Katrina.</p> <h3>Other meeting highlights</h3> <p>Also on <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">this year's agenda</a> are returning favorites such as our welcome breakfast for first-time attendees and early career physicians, the WAMPAC luncheon (for those passionate about politics), a WSMA Foundation fundraising reception, and much more. More details will follow in the weeks ahead.</p> <h3>About the Annual Meeting</h3> <p>This annual two-day gathering is where your elected WSMA representatives (representing most specialties and counties in Washington state) gather to elect leaders and determine the policy that guides your association in its work to improve Washington medicine. All members are encouraged to attend the meeting to weigh in on the policies being considered, enjoy the presentations and networking, and celebrate the unity that comes when physicians from all backgrounds come together for a common purpose.</p> <p>The WSMA Annual Meeting is free for all WSMA members. For a full agenda and to register, <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">visit the WSMA website</a>. Discounted rooms are available at the Westin Bellevue. Reserve your room <a href="https://www.marriott.com/event-reservations/reservation-link.mi?id=1623091173085&key=GRP&app=resvlink">online</a> no later than Sept. 3 to receive WSMA's special meeting rate.</p> <p>See you in Bellevue!</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
oic_responds_to_carrier_non_payment_of_new_ppe_cpt_code_99072OIC Responds to Carrier Non-Payment of New PPE CPT Code 99072Latest_NewsShared_Content/News/Latest_News/2021/oic_responds_to_carrier_non_payment_of_new_ppe_cpt_code_99072<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/mask-mika-baumeister-645x425.jpg" class="pull-right" alt="Surgical mask" /> </div> <h5>July 8, 2021</h5> <h2>OIC Responds to Carrier Non-Payment of New PPE CPT Code 99072</h2> <p>The <a href="https://wsma.org/Shared_Content/News/Latest_News/2021/wsma_presses_oic_on_carrier_non_payment_of_new_ppe_cpt_code_99072">WSMA recently expressed concerns</a> to the Washington State Office of the Insurance Commissioner regarding carrier noncompliance under recently enacted Senate Bill 5169, which requires commercial carriers to reimburse for PPE costs during the pandemic. The OIC has taken a number of steps in response to our concerns.</p> <p>After receiving our letter on behalf of health care stakeholders, the OIC conducted outreach to plans it regulates, to clarify that the legislation applies to all fully insured health plans and to ensure they are paying CPT 99072 as per the legislation. A few carriers informed the agency that the IT changes necessary to process the claims were not in place when the legislation went into effect, but the programming has since been completed and claims initially denied/delayed are being successfully reprocessed. Additionally, the OIC has provided "<a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/oic-health-carrier-health-plan-status-061821-final.pdf]">How to determine health plan fully insured status</a>," a chart with instructions from carriers on how to identify what entity regulates their plans.</p> <p>If you are still having PPE claims denied by fully insured health plans, the OIC recommends you <a href="https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status">file a complaint using its online complaint form</a>.</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
parents_encouraged_to_get_a_jump_on_child_vaccinationsParents Encouraged to Get a Jump on Child VaccinationsLatest_NewsShared_Content/News/Latest_News/2021/parents_encouraged_to_get_a_jump_on_child_vaccinations<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img alt="Child getting a vaccination" src="/images/Newsletters/MembershipMemo/2021/July/cdc-immunization-645x425px.jpg" class="pull-right" /> </div> <h5>July 8, 2021</h5> <h2>Parents Encouraged to Get a Jump on Child Vaccinations</h2> <p>Over the past two weeks, families with children 4 to 6 years old received letters in the mail from the Department of Health with information about which vaccines their child may be missing. The outreach is part of an effort in health care organizations in Washington to encourage families to get up to date on vaccines ahead of the 2021-22 school year.</p> <h3>DOH outreach to parents</h3> <p>The DOH letter includes an important flyer on <a href="https://www.doh.wa.gov/Portals/1/Documents/Pubs/348-295-SchoolImmReqforParents2021-2022.pdf" target="_blank">Required Immunizations for School Year 2021-2022</a>. Along with a reminder that all students, including those learning remotely, must comply with immunization requirements for school, the DOH outreach encourages parents to contact their child's health care provider to schedule the catch-up vaccines. The letter is available in <a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/overdue-parent-letter-english-final.pdf]">English</a> and <a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/overdue-parent-letter-spanish-final.pdf]">Spanish</a>.</p> <h3>How primary care can help</h3> <p>The WSMA will join the Washington Chapter of the American Academy of Pediatrics to push public messaging to parents on routine child vaccinations in July and August, in anticipation of the school year. The WSMA continues to hear from members concerned about the crush of appointments in the weeks just preceding the school year. The message to parents will emphasize the urgency of getting their child protected now. Practices are encouraged to join us in this effort.</p> <ul> <li>WCAAP has developed <a href="https://immunitycommunitywa.org/covid-19-vaccine/">a toolkit with DOH, WithinReach, and Public Health - Seattle & King County with social media messages and images</a>.</li> <li>The <a href="https://www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization">DOH offers additional resources on school and child care immunization</a>.</li> </ul> <p>The WCAAP will also be supporting providers by creating a parent education piece/FAQ they can share with families and offering provider education. The WSMA will keep members in the loop as those efforts develop.</p> <h3>Promoting COVID-19 vaccination to parents</h3> <p>Children 12 and up are now eligible for a COVID-19 vaccine and younger children may be eligible by this fall. COVID-19 vaccines can now be given at the same time as any other vaccines-there is no longer a need to wait two weeks between COVID-19 vaccines and other routine childhood vaccines. Find resources at the links above and at <a href="http://www.covidvaccinewa.org/">CovidVaccineWA.org</a>.</p> <p>Thank you for all you do to keep Washington's families healthy.</p> </div>7/8/2021 12:00:00 AM1/1/0001 12:00:00 AM
covid_19s_unforeseen_consequencesCOVID-19's Unforeseen ConsequencesLatest_NewsShared_Content/News/Latest_News/2021/covid_19s_unforeseen_consequences<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2021/july-aug-2021-reports-cover-article-graphic-645x425.jpg" class="pull-right" /></div> <h5>June 25, 2021</h5> <h2>COVID-19's Unforeseen Consequences</h2> <h5> <em>Members only; sign-in required.</em> </h5> <p> By Rita Colorito </p> <p> It's been more than 18 months since Washington state reported its first case of COVID-19. During that time, and still today, the pandemic has had far-reaching effects on Washingtonians' health. Beyond those who battled the disease, countless others faced health consequences because the pandemic made them reluctant or unable to receive the care they needed. </p> <p> With the pandemic still not over, the true downstream effects on health care won't be evident for years to come. But preliminary tallies by public health agencies are sobering. </p> <p> Health care avoidance and delay may have contributed to excess deaths outside of COVID-19, according to a February 2021 report from Public Health - Seattle & King County. Age- adjusted death rates in King County were 12% higher in 2020 compared to the previous three years, including a 23% increase for both diabetes-related deaths and overdose deaths, and a 7% increase in cardiovascular deaths. </p> <p> <em>WSMA Reports</em> spoke with doctors from four specialties-pediatrics, general surgery, radiation oncology, and addiction medicine-to find out the impact of the pandemic on their patients. </p> <h3>Pediatrics</h3> <p> Of all the age groups, children have largely been spared from the devastating health effects of COVID-19. But they've been impacted in other ways, says Amy Carter, MD, chief medical officer for Allegro Pediatrics, which serves families in the eastern Seattle metropolitan area. </p> <p> In the early days of the pandemic, Allegro saw its total visits drop by 70%, says Dr. Carter. "Parents were very worried, so [they] did not want to come in." </p> <p> Data from the Washington State Department of Health show some children may be missing needed vaccinations. From the start of the pandemic through September 2020, DOH data show overall pediatric vaccinations down nearly 19%. </p> <p> Pre-pandemic, same-day appointments made up half of Allegro's daily schedule, with 30% of those dedicated to sick-child visits. Today, Allegro is still only at 80% of pre- pandemic volume. In a parent survey, 10% to 15% said they still don't feel comfortable bringing their children in for any reason. </p> <p> On the plus side, sick-child visits are nearly non-existent, says Dr. Carter. "The vast majority of normal kids would have colds in the winter, or get the flu, or have an ear infection. Those stopped happening because social distancing and masks work," she says. "While it was positive for kids that so few got sick this past year, it was hard for our outpatient pediatric business model to compensate for such a decrease in patient demand." </p> <p> In the pediatric population, the biggest impact was on mental health. "We've never had a higher volume and higher acuity for mental health issues," says Dr. Carter. "(We saw) every mental health diagnosis you can think of-more suicides and suicide attempts, more kids where it's impacting their functioning, or kids who need to go on medication." </p> <p> Parental mental health during the pandemic also affected children. As schools start to open back up, Dr. Carter says she's seen a spike in reports to child protective services-abuse hidden during the pandemic. </p> <p> The developmental fallout for newborns remains to be seen, says Dr. Carter. "We have children who haven't seen anyone outside their immediate family, or left their house, in a year. ...We don't really know long-term what it will do." </p> <p> The pandemic affected childhood physical growth. "Normally children follow their predicted growth line year over year. But this last year was remarkable because we saw a huge increase in weight gain," she says. </p> <p> The percentage of children ages 2 to 17 who are obese increased to 15.4% from June to December 2020, up from 13.7% in the year-earlier period, according to a May 2021 study in Pediatrics. </p> <p> Allegro also saw an increase in children with eating disorders. "This surprised us a little at first, but it shouldn't, in retrospect. For an anxious temperament, with no control over life, in general, eating is one of the few things that you can have control over," says Dr. Carter. </p> <h3>General surgery</h3> <p> Elective surgery was on the government- mandated cutting block early in the pandemic. As a result, total elective surgery dropped by about 60% to 70%, says Mika Sinanan, MD, PhD, medical director of contracting and value-based care for the general surgery clinic at the UW Medical Center - Montlake. </p> <p> Once those surgeries resumed, some patients further delayed surgery out of COVID-19 fear. Others delayed because of visitor restrictions, says Dr. Sinanan. "It made it harder for patients and their families to support each other. For many patients, that was unacceptable." </p> <p> In some cases, delaying surgery has caused disease conditions to worsen, says Dr. Sinanan, a board member of the Washington Chapter of the American College of Surgeons and president- elect of the WSMA. "I deal a lot with inflammatory bowel disease. And there were some people who were in pretty good shape a year ago who are more malnourished and more ill now. It will take more work to get them better and it will take them longer to recover." </p> <p> UW's general surgery clinic is now operating at full capacity, and then some-continuing to affect elective surgery in a different way. "We had a couple of days where we actually had to cancel or delay elective surgery for up to five days because we didn't have enough hospital beds for our staff to actually offer them surgery," says Dr. Sinanan. </p> <p> Those hoping to schedule their surgery have been frustrated by wait times caused by a backlog, says Dr. Sinanan. "By the time they get to the clinic, they want to have their surgery the next day or as quickly as possible. And sometimes it's not possible to get them scheduled in the time frame they want." </p> <h3>Radiation oncology</h3> <p> When you're facing cancer, time is often of the essence. </p> <p> "Cancer care is not really elective. We had to rapidly figure out how to safely treat our patients," says Edward Kim, MD, medical director for radiation oncology at the UW Medical Center and a physician at the Seattle Cancer Care Alliance. </p> <p> While current cancer patients continued to receive care, oncologists saw fewer people undergoing preventive screenings. Delayed screening and diagnosis remain the biggest concern for oncologists, says Dr. Kim, treasurer of the Washington State Radiological Society. </p> <p> "I'm starting to see in my practice patients that developed symptoms concerning for cancer last year, but for whatever reason-hesitancy or difficulty getting access to care-they didn't come in. Some of these patients ended up having later diagnoses, or more advanced disease by the time they were actually diagnosed," says Dr. Kim. </p> <p> Nationwide, screening for breast, prostate, and colorectal cancers dropped sharply from March through May of 2020, according to a study published in JAMA Oncology. And while screenings for breast and prostate cancer rebounded in July, the overall estimated COVID-19-associated screening deficit across those three cancers was 9.4 million in 2020 compared to 2019. </p> <p> Dr. Kim and his colleagues have observed a drop in patients presenting with early-stage breast and prostate cancers. "Those are cancers that are often diagnosed with screening. ... I think it's possible they will eventually be diagnosed. And the concern is that those patients may have more advanced disease," he says. </p> <p> More advanced disease means a longer treatment road ahead. "Even if we are able to cure a patient with a more locally advanced tumor, they still may have to go through more treatment and have different side effects than if the cancer been caught earlier," says Dr. Kim. </p> <p> The focus now is to convince people to resume cancer screenings, says Dr. Kim. "We have to reinforce the message that we have protocols to keep patients safe to deliver the care they need." </p> <h3>Addiction medicine</h3> <p> Pandemic mitigation measures exacerbated the social determinants of stability and recovery that many with substance use disorders contend with on a daily basis, including mental health issues, homelessness, and joblessness, says Lucinda Grande, MD, a family medicine physician with Pioneer Family Practice in Lacey. </p> <p> As a result, those with such disorders were especially hard hit. Not only was this already vulnerable population at 8.7 times higher risk of COVID-19 infection and at a higher risk of hospitalization and death, they also fared worse indirectly. </p> <p> More people died in Washington of drug overdoses in 2020 than any year in the last decade, according to preliminary data from the Department of Health. Overdose deaths from all drugs skyrocketed, up 38% during the first half of 2020 compared to the first half of 2019. </p> <p> "That's up from an average 3% increase over the previous four years," says Dr. Grande. </p> <p> Opioid overdose deaths also increased 36%, with the greatest increase among people of color and tribal communities, says Dr. Grande. If it weren't for previous measures in the state to ensure the availability of naloxone, overdose deaths may have been even higher, she says. </p> <p> The primary reasons for higher rates of substance use are increased social isolation and other stresses, says Dr. Grande. "It's a well-known saying that the opposite of addiction is connection." </p> <p> Though Pioneer never closed its facilities-early in the pandemic, its staff conducted patient visits outdoors- it saw a nearly 30% reduction in patient volume in mid-March, says Dr. Grande. "The most rapid acceleration in overdose deaths occurred between March and May of 2020, coinciding with the implementation of the mitigation measures," she says. </p> <p> Overdose deaths are the tip of the iceberg, says Dr. Grande. Among people who had previously been stable or in a fragile recovery state, she's has seen a significant increase in recurrence of substance use. </p> <p> "A patient stable on Suboxone lost his construction job due to the pandemic and was stuck at home, where long- brewing conflicts exploded," Dr. Grande says. "He turned to alcohol and ultimately, back to heroin to numb the emotional pain. After he got a new job, he finally developed the impetus to return to care." </p> <p> <em>Rita Colorito is a freelance journalist who specializes in writing about health care. She is a regular contributor to WSMA Reports.</em> </p> <p> <em>This article was featured in the July/August 2021 issue of WSMA Reports, WSMA's print newsletter.</em> </p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
financial_falloutFinancial FalloutLatest_NewsShared_Content/News/Latest_News/2021/financial_fallout<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2021/july-aug-2021-reports-cover-article-graphic-645x425.jpg" class="pull-right" /></div> <h5>June 25, 2021</h5> <h2>Financial Fallout</h2> <h5> <em>Members only; sign-in required.</em> </h5> <p> By John Gallagher </p> <p> On March 19, 2020, with Washington state on the front lines of the surging COVID-19 pandemic, Gov. Jay Inslee took the drastic step of halting all elective surgery. That effectively closed the practice of Seattle-based ophthalmologist Aaron Weingeist, MD. Almost all ophthalmic surgeries, including most cataract surgeries, were sidelined under the governor's initial guidelines. Dr. Weingeist's 18,000-square-foot office building, which includes a surgical center, was suddenly quiet. </p> <p> "It was pretty scary for a few months," says Dr. Weingeist, legislative affairs director for the Washington Academy of Eye Physicians and Surgeons. "We shut everything down and sent 30 employees home," while still keeping the employees on payroll. </p> <p> According to the American Medical Association, ophthalmology saw the biggest reduction in Medicare physician spending in the first half of 2020, with a 29% drop in payments. Without revenue, Dr. Weingeist's fixed costs loomed large. </p> <p> "We have a very large loan, which was a huge stressor," he says. Fortunately, the practice, Clearview Eye & Laser, was able to work out an interest-only payment plan with its bank. Still, he says, "it's a shockingly large amount of overhead when you don't have any revenue coming in." </p> <p> Dr. Weingeist's experience is far from unusual; the pandemic caused havoc for specialists across the state. A Commonwealth Fund study from February found "a substantial cumulative reduction in visits across all specialties over the course of the pandemic in 2020." </p> <p> The governor "definitely did the right thing" shutting down elective surgery, says Arooj Simmonds, MD, executive medical director of surgical services- anesthesia at Swedish Health Services, which serves the Seattle metropolitan area. Yet patient and provider safety came at a high cost. </p> <p> "There was a financial fallout," Dr. Simmonds notes. "You could talk to some surgical groups and they would say they were not paid for months." She notes that physicians tied to hospital groups were less likely to have been impacted. </p> <p> Anesthesiology practices saw "a lot of partners at home, working one day a week, getting a significantly smaller paycheck," she says. "Some practices laid off non-partner physicians." </p> <p> In addition to the elective surgery ban, many patients postponed care to avoid risking exposure to COVID-19. Samuel Lien, MD, president of the Washington State Society of Plastic Surgeons, says that more than half of his practice's business vanished overnight. </p> <p> "If a normal week was 50-60 hours, it was cut back to half or three-quarters of a day in clinic and the same for surgeries," says Dr. Lien, who practices at Providence Mill Creek Plastic and Reconstructive Surgery in Everett. Self- pay cosmetic surgery came to a halt. </p> <h3>A return to normalcy-somewhat</h3> <p> By the second half of the year, practices had adapted to the new reality and saw patients returning to pre-pandemic levels. "From a surgical perspective, things are getting back to normal," says Dr. Simmonds. "I'd say the same for anesthesiology." </p> <p> For some specialties, the return to normal was even more robust. </p> <p> "We saw a big uptick in elective surgery," says Dr. Lien. "People fortunate enough not to have lost their job were not vacationing and were having a relatively low cost of living, so they suddenly had money. If you can Zoom from home, then it's pretty easy to recover from cosmetic surgery while still performing your work duties. People saw that as a great opportunity." </p> <p> In other cases, however, the rebound is taking longer. "We've gradually ramped back up, but we're still at 75% to 80% of our normal volume," says Dr. Weingeist. </p> <h3>Reimbursement challenges ahead</h3> <p> This year, as specialty practices recover from the acute impacts caused by the pandemic, they face being squeezed by Medicare and well-meaning initiatives that threaten to divert resources away from them toward primary care. </p> <p> "Our state needs to adequately invest in primary care, that's for certain," says Jennifer Hanscom, executive director/ CEO of WSMA. "Yet we can't further compromise patients' access to care by reducing specialist payments to fund better primary care reimbursement. That's not in anyone's interests-not patients', not the profession's, not the community's." </p> <p> The tumult of the past year has brought those concerns into bright relief. Specialties that are still recovering are now faced with the prospect of a significant reduction in payments as legislators and government agencies look to redistribute money within health care. </p> <p> The pandemic paused many of those initiatives as attention was diverted to the public health response. Chief among the changes put on hold was a revision to the Medicare fee schedule that would have had an outsized impact on specialties. Now that the pandemic is fading, those initiatives will be returning to the fore. </p> <p> As the impact of the pandemic on specialties still lingers, efforts continue to reduce the total cost of health care in Washington state and at the federal level. </p> <p> "There are still a lot of headwinds for the practices, including reimbursement changes at the federal level," says Nathan Schlicher, MD, WSMA president. "It's the challenge of trying to maintain a practice while you're experiencing death by a thousand cuts." </p> <p> Those cuts include the 2021 Medicare fee schedule released late last year. The proposed schedule would have instituted payment cuts to specialties to increase primary care reimbursement. Organized medicine, including the AMA and the WSMA, successfully opposed the move, but the cuts have only been temporarily avoided. </p> <p> "Everyone breathed a huge sigh of relief this year," says Hanscom. "But we're in a situation where if and when the Medicare fee schedule does go into effect, it will be devastating to specialties. On average, the specialty community will be negatively impacted by at least 11%." </p> <p> Then there are Washington state initiatives that aim to bolster primary care. The Health Care Authority's primary care transformation project could be massively consequential as it seeks to reimagine primary care, including financing and how care is delivered, across all payers. Yet details are lacking on how the state intends to pay for that effort. </p> <p> "I'd say at the WSMA, we are feeling a little anxious and uneasy about this effort," Hanscom says. "They are working on a very rapid timeline and we don't know how HCA intends to pay for the transformation. Without a significant and stable long-term infusion of cash, which we are not counting on, then that leads me to believe they will be looking to shift costs. It's not clear if they are looking more broadly than physician reimbursement. I hope so, but if they follow Medicare's playbook, that's when things will get contentious. To date, we don't have these details." </p> <p> Specialists emphasize that they believe that primary care does deserve to be paid better. "Everybody thinks primary care should get more," notes Dr. Weingeist. </p> <p> Hanscom notes that many cost- control efforts focus solely on physicians. These include Cascade Care, which the state describes as a "higher value" health insurance option designed to increase access to care. However, its reimbursement structure often pencils out to be below the cost of delivering services. </p> <p> "I support things like Cascade Care," say Dr. Simmonds. "But we just need to make sure it pays physicians the appropriate rate for what they do." </p> <p> Recently, the governor appointed members to the state's new health care cost transparency board. One of its roles: setting a health care cost growth benchmark for providers and payers. </p> <p> "When we're looking at driving down the cost of care, we should really be looking at the total cost of care, not just physicians," adds Hanscom. "Policymakers can't ask physicians to unilaterally bear responsibility for cutting costs in the system. Our concern is they will try to force physician payments down without addressing any of the underlying cost drivers and overhead, like regulatory and other burdens, and significantly threaten practice viability." </p> <p> Ultimately, says Hanscom, it's the patient who suffers. </p> <p> "If a patient can't get access to specialty care in their community, where does the patient end up? Either the hospital emergency department or in worse condition in a hospital bed," she says. "That's not better, higher- value care. Preventative care is not only delivered by primary care physicians, but specialists as well." </p> <p> <em>John Gallagher is a freelance writer who specializes in covering health care. He is a regular contributor to WSMA Reports.</em> </p> <p> <em>This article was featured in the July/August 2021 issue of WSMA Reports, WSMA's print newsletter.</em> </p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
health_care_authority_finalizes_prescription_monitoring_program_ruleHealth Care Authority Finalizes Prescription Monitoring Program RuleLatest_NewsShared_Content/News/Latest_News/2021/health_care_authority_finalizes_prescription_monitoring_program_rule<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/April/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" alt="Doctor holding up a pill bottle while working at laptop" /> </div> <h5>June 25, 2021</h5> <h2>Health Care Authority Finalizes Prescription Monitoring Program Rule</h2> <p>The Washington State Health Care Authority has finalized a <a href="https://www.hca.wa.gov/assets/102-21-06-097.pdf" target="_blank" rel="noreferrer">rulemaking</a> that implements federal prescription drug monitoring program requirements per Section 5042 of the SUPPORT Act.</p> <p>Starting Oct. 1, 2021, physicians must check an Apple Health (Medicaid) client's history in the state's prescription monitoring program before prescribing controlled substances. Physicians may delegate this task to anyone at the practice with authorization to access the PMP, so long as the physician reviews all of the client's prescriptions. The date and time of the retrieval and review of information must be documented in the patient record.</p> <p>Outpatient pharmacists will be required to review the PMP before dispensing a controlled substance.</p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
join_wsmas_latinx_section_leadership_advisory_councilJoin WSMA's Latinx Section Leadership Advisory CouncilLatest_NewsShared_Content/News/Latest_News/2021/join_wsmas_latinx_section_leadership_advisory_council<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/latinx-physician-645x425.jpg" class="pull-right" alt="Latinx physician" /> </div> <h5>June 25, 2021</h5> <h2>Join WSMA's Latinx Section Leadership Advisory Council</h2> <p>Your leadership is needed to help us shape the goals and objectives for the development of the <a href="http://wsma.informz.net/z/cjUucD9taT0xMDA3MzE1OSZwPTEmdT0xMDc4MTEwNDgzJmxpPTg3NTAwMDU4/index.html">WSMA Latinx Section</a>. By serving on the section's leadership advisory council, you would help shape the work of the Latinx Section within the WSMA. This work is just getting started, so this is a great time to lend your voice. We'll be respectful of your time, as we gather virtually over the next several months.</p> <p>Here's what to do to be considered:</p> <ul> <li>Email a letter of interest and CV to Lauren Fielder at <a href="mailto:lauren@wsma.org">lauren@wsma.org</a> by Friday, July 9. In your letter, please address the following:</li> <ol> <li>Why do you want to serve in the leadership of the Latinx Section?</li> <li>Please share some of your professional experiences working in Latinx communities in Washington state.</li> <li>Please share your affiliations with any Latinx-serving organizations in Washington or nationally.</li> <li>Any other relevant information you would like to share.</li> </ol> </ul> <p>Learn more about the <a href="[@]WSMA/Membership/Latinx_Section/WSMA/Membership/Latinx_Section/Latinx_Advisory_Group.aspx?hkey=dcc8886a-b320-46f5-8adf-5103c9a18f15">Latinx Section</a> and get involved today!</p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
key_deadlines_for_the_2021_wsma_annual_meetingKey Deadlines for the 2021 WSMA Annual MeetingLatest_NewsShared_Content/News/Latest_News/2021/key_deadlines_for_the_2021_wsma_annual_meeting<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/am-201910128-645x425.jpg" class="pull-right" alt="People waiting in line to speak at a microphone" /> </div> <h5>June 25, 2021</h5> <h2>Key Deadlines for the 2021 WSMA Annual Meeting</h2> <p>The Annual Meeting of the WSMA House of Delegates is the WSMA's premier policymaking event, when the approximately 200 voting members of the WSMA House of Delegates gather to debate and determine policy for the association, elect officers, and network with colleagues. For WSMA members interested in proposing policy or serving as a delegate at the 2021 Annual Meeting, Sept. 25-26 at The Westin Bellevue, be sure to take note of the following guidance and key dates.</p> <h3>Deadlines for submitting resolutions</h3> <p>Good policy starts with a resolution-a proposal asking the WSMA to take a position or act on an issue. Resolutions are considered by delegates during the annual meeting and, if adopted, help guide the direction of the association and raise awareness of issues of importance to the practice of medicine in Washington. Resolutions must be sponsored by a WSMA delegate, alternate delegate, or member of the board of trustees. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to develop your resolution idea and help find a sponsor. <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136">Learn more about resolutions on the WSMA website</a> and be sure to mark your calendar for the following dates:</p> <p><strong>Aug. 6</strong> - Deadline to submit your resolution for publication in the delegate handbook, the compilation of resolutions and other business to be considered by the House of Delegates.</p> <p><strong>Aug. 26</strong> - Final deadline to submit your resolution. Resolutions received after this date must have consent of two-thirds of the House at the opening session to be considered. Delegate handbook will be available from the WSMA website for download.</p> <h3>How to serve as a delegate</h3> <p>The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county society or specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2021 WSMA Annual Meeting, please contact your local county society or state specialty society.</p> <h3>Annual Meeting registration and agenda</h3> <p>The WSMA Annual Meeting is free for members. See <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">the meeting webpage</a> for the meeting agenda and to register.</p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
physician_assistant_modernization_act_takes_effect_july_1Physician Assistant Modernization Act Takes Effect July 1Latest_NewsShared_Content/News/Latest_News/2021/physician_assistant_modernization_act_takes_effect_july_1<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/female-doc-patient-masks-645x425.jpg" class="pull-right" alt="Patient in exam room" /> </div> <h5>June 25, 2021</h5> <h2>Physician Assistant Modernization Act Takes Effect July 1</h2> <p>Major components of <a href="http://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Session%20Laws/House/2378-S.SL.pdf?q=20210524114451">House Bill 2378</a>, legislation introduced by the Washington Academy of Physician Assistants and supported by your WSMA, take effect on July 1. The bill makes a number of changes to delegation agreements (now referred to as practice agreements), PA to physician ratios (5:1 to 10:1), and removes the restrictions on PAs practicing at remote sites.</p> <h3>Putting HB 2378 into practice</h3> <p>Whether you're a PA, supervising physician, or a practice manager, it is a good time to review the legislation and make any necessary changes. For guidance on implementing changes at your practice and the creation of practice agreements, watch "<a href="[@]WSMA/Education/On_Demand_Webinars/WSMA/education/On_Demand_Webinars/Webinars_OnDemand.aspx?hkey=c3940e65-ff14-4c25-a05d-b85a147c9fa0">Putting HB 2378 into Practice</a>," an on-demand webinar featuring WSMA Policy Analyst Billie Dickinson and WAPA President Gabrielle Zecha, PA-C, MHA, available to members on the WSMA website.</p> <p>The Washington Medical Commission also offers resources, including:</p> <ul> <li><a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/implementation-of-house-bill-2378-pas.pdf]">A one-page brief on the implementation of HB 2378</a> </li> <li><a href="https://wmc.wa.gov/licensing/applications-and-forms/practice-agreements">Updated website information</a></li> <li><a href="https://wmc.wa.gov/sites/default/files/public/documents/Model%20Practice%20Agreement.pdf" target="_blank" rel="noreferrer">A model practice agreement</a></li> </ul> <p>Should you have questions on HB 2378 and what the changes mean for you, email WSMA's policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
spanish_speaking_provider_needed_for_caregiver_video_projectSpanish-Speaking Provider Needed for Caregiver Video ProjectLatest_NewsShared_Content/News/Latest_News/2021/spanish_speaking_provider_needed_for_caregiver_video_project<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/doctor-patient-masks-645x425.jpg" class="pull-right" alt="Doctor and patient reviewing chart, wearing masks" /> </div> <h5>June 25, 2021</h5> <h2>Spanish-Speaking Provider Needed for Caregiver Video Project</h2> <p>The Washington State Department of Health is developing two brief educational videos to help home caregivers talk to clients about COVID-19 vaccination. The videos will train nursing assistants, home care assistants, and other caregivers to approach these conversations and build confidence in these life-saving vaccines. In-home caregivers are trusted sources of information for the homebound population but may not yet be prepared to effectively discuss vaccination. The department has already developed these videos in English and would like to offer them in Spanish to reach Spanish-speaking in-home caregivers.</p> <p>The Department of Health is looking for a physician or other health care provider to deliver the scripts in Spanish. In the video, the provider will speak alone and do some scripted role playing with a department employee. Filming will be conducted remotely via videoconference, with a total time commitment of approximately 1-2 hours to film both videos. The scripts are translated, so the provider will not have to translate in real time.</p> <p>If you are willing to volunteer for this project, please reach out to <a href="mailto:emma.gossard@doh.wa.gov">emma.gossard@doh.wa.gov</a> by July 9.</p> </div>6/25/2021 12:00:00 AM1/1/0001 12:00:00 AM
 
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