| 2023-wsma-legislative-summit-features-panel-discussion-on-state-of-abortion-care | 2023 WSMA Legislative Summit Features Panel Discussion on State of Abortion Care | memo | Shared_Content/News/Membership_Memo/2023/january-27/2023-wsma-legislative-summit-features-panel-discussion-on-state-of-abortion-care | <div class="col-md-12">
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<h5>January 27, 2023</h5>
<h2>2023 WSMA Legislative Summit Features Panel Discussion on State of Abortion Care </h2>
<p>At the WSMA Legislative Summit next Friday, Feb. 3, we'll check in on the many legislative proposals regarding access to abortion currently being debated in Olympia during a robust panel discussion on the state of abortion care in Washington. Our guest panelists include Senator Karen Keiser (D-Des Moines), Nari Heshmati, MD, WSMA president elect and OB-GYN, and Courtney Normand, Planned Parenthood state director.</p>
<p>Protecting access to abortion and reproductive care is one of the priority legislative and budget items highlighted at this year's Legislative Summit. Other priorities include across-the-board Medicaid reimbursement rate increases, standardizing the prior authorization process, and preventing inappropriate scope-of-practice increases. If you are passionate about direct advocacy or have been looking for ways to engage with the work of the WSMA, next Friday's Summit is a great opportunity to come to Olympia, learn more about WSMA's legislative agenda, and help deliver our advocacy message directly to your elected representatives. The free event begins at 8 a.m. in the Columbia Room of the Legislative Building at 416 Sid Snyder Avenue SW, Olympia, WA 98504. A light breakfast and lunch will be provided. <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5&amp;_zs=A3aFd1&amp;_zl=soFk8">Register for the event online</a>.</p>
</div> | 1/26/2023 12:24:15 PM | 1/25/2023 3:47:23 PM | 1/27/2023 12:00:00 AM |
| apply-now-to-attend-the-physician-leadership-course-this-spring | Apply Now to Attend the Physician Leadership Course this Spring | memo | Shared_Content/News/Membership_Memo/2023/january-27/apply-now-to-attend-the-physician-leadership-course-this-spring | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/2023-plc-645x425px.png" class="pull-right" alt="WSMA Physician Leadership Course logo" /></div>
<h5>January 27, 2023</h5>
<h2>Apply Now to Attend the Physician Leadership Course this SpringHybrid distance, March 3-May 12, 2023</h2>
<p>The WSMA Physician Leadership Course, led by Ed Walker, MD, MHA, is an 11-week hybrid-distance leadership skills-development course for physicians and physician assistants who want to know more about health care leadership. Designed with a physician's busy schedule in mind, only three in-person classes, held at the Silver Cloud Hotel in Seattle, are required; the remainder of the course is conducted online. </p>
<p>In-person sessions will be held Friday and Saturday, March 3 and 4, followed by 11 weeks of online instruction and interaction and a final in-person session on Friday, May 12. The course is led by Edward A. Walker, MD, MHA, professor emeritus in the departments of psychiatry and behavioral sciences and health services at the University of Washington in Seattle. Dr. Walker is the senior advisor for WSMA's Center for Leadership Development.</p>
<p>For a course curriculum and application details, visit the <a href="[@]wsma/education/physician_leadership/physician_leadership_course/wsma/physician_leadership/physician_leadership_course/physician_leadership_course.aspx?hkey=efdc4ad1-ff20-4089-ab51-caafbe73572b">WSMA Physician Leadership Course</a> webpage, and learn more about other courses from WSMA's <a href="[@]wsma/education/physician_leadership/wsma/physician_leadership/physician_leadership.aspx?hkey=4a910f13-3bb1-4b95-853f-6f93e33637d2">Center for Leadership Development</a>. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢<em>.</em> </p>
</div> | 1/26/2023 12:33:20 PM | 1/26/2023 12:32:52 PM | 1/27/2023 12:00:00 AM |
| next-health-equity-m-and-m-webinar-is-friday-feb-10 | Next Health Equity M&M Webinar Is Friday, Feb. 10 | memo | Shared_Content/News/Membership_Memo/2023/january-27/next-health-equity-m-and-m-webinar-is-friday-feb-10 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/mm-equity-webinar-series-2023-645x425px.png" class="pull-right" alt="Health Equity M&amp;M Webinar Series logo" /></div>
<h5>January 27, 2023</h5>
<h2>Next Health Equity M&amp;M Webinar Is Friday, Feb. 10</h2>
<p>For members who haven't yet experienced these rich discussions, please join us for the next Health Equity M&amp;M Webinar on Friday, Feb. 10 at noon, facilitated by Edwin Lindo, JD. The webinar series, free for WSMA members, fosters a space conducive to building a community of professionals focused on achieving health equity, allowing for discussions of charged but necessary topics. Starting with this February session, members will now be able to submit patient cases for discussion. Verbal submission of cases is the safest approach for preserving the confidentiality of the information. If you would like to speak with professor Lindo directly, please email Kendra Peterson at <a href="mailto:kendra@wsma.org">kendra@wsma.org</a>. As an alternative, the WSMA has created a new <a href="http://wsma.informz.net/z/cjUucD9taT0xMDkxODM1NiZwPTEmdT0xMDc4MTA4MzYwJmxpPTk5NjQ0NTc3/index.html">online case submission form</a> for you to share patient cases. All case submissions are CQIP and HIPAA compliant. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. Register for the Feb. 10 webinar <a href="[@]wsma/education/upcoming_webinars/wsma/education/upcoming_webinars/Upcoming_Webinars.aspx?hkey=b760d6bd-1833-412d-b681-babf251792a8">online</a>.</p>
</div> | 1/26/2023 12:25:08 PM | 1/25/2023 3:47:25 PM | 1/27/2023 12:00:00 AM |
| updated-washington-practitioner-application-supports-physician-well-being | Updated Washington Practitioner Application Supports Physician Well-Being | memo | Shared_Content/News/Membership_Memo/2023/january-27/updated-washington-practitioner-application-supports-physician-well-being | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/smiling-docs-645x425px.jpeg" class="pull-right" alt="smiling doctors" /></div>
<h5>January 27, 2023</h5>
<h2>Updated Licensing and Credentialing Applications Support Physician Well-Being</h2>
<p>The WSMA is pleased to report that physicians and other licensed practitioners will now benefit from newly updated licensing and credentialing forms in Washington state. These widely used forms have been revised with input from the physician community, and reflect a growing awareness of the barriers to wellness that medical licensing and credentialing insurance applications were creating for physicians and practitioners. </p>
<h3>Updated Washington Practitioner Application&nbsp;</h3>
<p>This month, a streamlined <a href="https://www.wamss.org/resources/washington-credentialing-standardization-group/">Washington Practitioner Application</a>&nbsp;was introduced. The WPA is a standardized application that is accepted by most physician organizations, hospitals, and health plans and throughout the state. Changes to the application include:</p>
<ul>
<li>Updated attestation question regarding a practitioner's physical and mental health conditions. After years of discussions and input from numerous organizations, the credentialing committee overseeing the form revisions settled on a more streamlined question that still meets regulatory agency requirements to inquire about a practitioner's mental health status.</li>
</ul>
<ul>
<li>A new section that asks for contact details for the monitoring program the practitioner is enrolled in but does not ask for any details around the condition or circumstances that led to being admitted into the monitoring program or the practitioner's current status with the monitoring program. This ensures that no practitioner PHI ends up on the WPA.</li>
</ul>
<h3>Washington licensing applications newly updated</h3>
<p>The Washington Medical Commission has updated its <a href="https://wmc.wa.gov/licensing/applications-and-forms">licensing questions</a> to remove potentially invasive or stigmatizing language around mental health. The commission changed the question to an attestation and provided information about the Washington Physicians Health Program. These new updates follow changes in 2019 removing the requirement for applicants to disclose mental health or substance use disorder information resulting from new "safe haven" provisions.
</p>
<p>The WSMA gives special thanks to Washington Physicians Health Program Executive Medical Director Chris Bundy, MD, MPH, a strong physician advocate who helped provide guidance to both the Washington Medical Commission and the credentialing standardization committee on the changes to these forms.</p>
<p>These combined changes represent significant progress in decreasing barriers to help-seeking for physicians and physician assistants in our state and furthers WSMA's vision to make Washington the best place to practice medicine and receive care.</p>
</div> | 1/26/2023 4:29:41 PM | 1/25/2023 3:47:14 PM | 1/27/2023 12:00:00 AM |
| wsma-advocacy-critical-to-removal-of-buprenorphine-prescribing-barriers | WSMA Advocacy Critical to Removal of Buprenorphine Prescribing Barriers | memo | Shared_Content/News/Membership_Memo/2023/january-27/wsma-advocacy-critical-to-removal-of-buprenorphine-prescribing-barriers | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/buprenorphine-butrans10mcg-645px.jpeg" class="pull-right" alt="Butrans packets" /></div>
<h5>January 27, 2023</h5>
<h2>WSMA Advocacy Critical to Removal of Buprenorphine Prescribing Barriers </h2>
<p>The passage of the omnibus spending package in December included a significant policy priority of the WSMA and addiction treatment professionals: a provision to remove federal barriers to medications for opioid use disorder and increase access to life-saving treatment that prevents overdoses and supports recovery.</p>
<h3>About the Mainstreaming Addiction Treatment (MAT) Act</h3>
<p>The Consolidated Appropriations Act for 2023 included key provisions from the Mainstreaming Addiction Treatment Act (H.R. 1384/S. 445), legislation supported by the WSMA intended to address America's worsening overdose crisis. The MAT Act:</p>
<ul>
<li>Removes the X-Waiver registration requirement, so all physicians and nonphysician practitioners with a standard controlled medication license can prescribe buprenorphine for opioid use disorder just as they prescribe medications for other chronic conditions.</li>
<li>Removes the patient limits for prescribing buprenorphine for opioid use disorder.</li>
<li>Removes the special Drug Enforcement Administration "X" prescribing number. Physicians can use their standard DEA controlled substance license number to prescribe buprenorphine for opioid use disorder.</li>
<li>Removes the counseling referral and ancillary services requirement.</li>
<li>Removes the X-Waiver training requirement.</li>
<li>Removes the list of health care practitioners who can prescribe buprenorphine for opioid use disorder.</li>
</ul>
<p>See <a href="https://drive.google.com/file/d/1OwOAvy3oEs5DUtKAToS8irT4ZWApdezV/view">this brief for details</a> on these provisions.</p>
<h3>WSMA's critical early leadership and support</h3>
<p>The WSMA and a coalition of Washington stakeholders played a critical role in getting the MAT Act the attention it deserved at the federal level. Many stakeholders, including academic institutions, law enforcement, and other medical and recovery associations, signed on in support thanks to WSMA's early leadership on the policy, giving Washington state the broadest coalition of state-based organizations supporting the MAT Act.</p>
<p>This state coalition was pivotal in gaining federal support for the bill, in particular from the many Washington state lawmakers in Congress who have an outsized influence on health policy, including Sen. Patty Murray, Rep. Cathy McMorris Rodgers, and Rep. Kim Schrier, as well as Washington's key party leaders, Rep. Suzan DelBene, Rep. Pramila Jayapal, and Rep. Derek Kilmer, who have significant influence on legislation that passes the House. We are grateful to these lawmakers, each of whom supported and prioritized the MAT Act because they knew that it was important for physicians and health care professionals in the state.</p>
<p>The WSMA is especially grateful for the leadership and advocacy of Lucinda Grande, MD, Olympia addiction medicine physician, who authored Resolution C-15 on behalf of the Thurston-Mason County Medical Society, which called on the WSMA to support federal efforts to eliminate the buprenorphine waiver requirement. The resolution was passed by the 2019 WSMA House of Delegates and provided the policy underpinning for WSMA's advocacy on the issue.</p>
<h3>Resources for prescribing buprenorphine</h3>
<p>The Substance Abuse and Mental Health Services Administration has developed a <a href="https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf" target="_blank" rel="noreferrer">buprenorphine quick start guide</a> and <a href="https://www.samhsa.gov/sites/default/files/quick-start-pocket.pdf" target="_blank" rel="noreferrer">pocket guide</a> for all physicians and practitioners seeking to prescribe buprenorphine. We encourage physicians in active practice to familiarize themselves with this guidance and consider, when appropriate, prescribing buprenorphine to prevent painful withdrawal symptoms associated with opioid use disorder, just as you would prescribe medications for other chronic conditions.</p>
</div> | 1/26/2023 2:20:00 PM | 1/26/2023 2:19:23 PM | 1/27/2023 12:00:00 AM |
| apply-to-serve-on-the-board-of-osteopathic-medicine-and-surgery | Apply to Serve on the Board of Osteopathic Medicine and Surgery | memo | Shared_Content/News/Membership_Memo/2023/apply-to-serve-on-the-board-of-osteopathic-medicine-and-surgery | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/stethoscope-on-table-645x425px.jpeg" class="pull-right" alt="stethoscope laying on top of a wooden table" /></div>
<h5>January 13, 2022</h5>
<h2>Apply to Serve on the Board of Osteopathic Medicine and Surgery</h2>
<p>The Washington State Department of Health's Health Systems Quality Assurance Division is accepting applications to fill three vacancies on the Board of Osteopathic Medicine and Surgery. DOH is seeking osteopath candidates with diverse backgrounds and those who provide geographic representation throughout the state willing to study the issues and make decisions in the public's best interest. For details of the roles and responsibilities, visit the <a href="https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/osteopathic-physician-and-surgeon">board's information webpage</a>. To apply, use the <a href="https://govforms.dynamics365portals.us/application-form/">governor's application webpage</a>, selecting that you are applying for the Board of Osteopathic Medicine and Surgery, and include a current résumé along with the application.</p>
</div> | 1/12/2023 2:50:53 PM | 1/10/2023 3:18:07 PM | 1/13/2023 12:00:00 AM |
| cme-embed-the-covid-19-vaccine-into-your-practice-workflow | CME: Embed the COVID-19 Vaccine Into Your Practice Workflow | memo | Shared_Content/News/Membership_Memo/2023/cme-embed-the-covid-19-vaccine-into-your-practice-workflow | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/MembershipMemo/2023/january/covid-vaccines-doh-webinars-ondemand-645x425px.png" class="pull-right" /></div>
<h5>January 13, 2022</h5>
<h2>CME: Embed the COVID-19 Vaccine Into Your Practice Workflow</h2>
<p> If your practice or clinic does not yet offer the COVID-19 vaccine as part of its routine preventive care, the WSMA can help.</p>
<p>The WSMA has joined with the Washington State Department of Health to give physician practices and clinics the tools and information they need to incorporate the COVID-19 vaccines into their practice workflows and engage patients in conversations about the vaccine. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢.</p>
<p>The two-part WSMA/DOH COVID-19 Vaccines Webinar Series meets the following learning objectives:</p>
<h3>Strategies to Discuss the COVID-19 Vaccine with Your Most Reluctant Patients</h3>
<ul>
<li>Use effective strategies to engage patients in conversations about the COVID-19 vaccine by addressing their questions, fears, and concerns.</li>
<li>Review real-world examples of how to discuss the pediatric and adult vaccines, as well as booster vaccines.</li>
<li>Outline the key elements of Power of Provider (POP) and the resources included in the toolkit.</li>
</ul>
<h3>How to Embed COVID-19 Vaccines into Routine Preventive Care</h3>
<ul>
<li>Bill for COVID-19 vaccine counseling and administration.</li>
<li>Access small, more manageable quantities of COVID-19 vaccines from vaccine depots across the state.</li>
<li>Join the more than 65,000 Washington physicians, PAs, and health care professionals who have already committed to educating and empowering their patients to vaccinate.</li>
<li>Leverage the physician toolkit and public-facing resources to help protect the health and well-being of your community.</li>
</ul>
<p><a href="[@]wsma/education/on_demand_webinars/covid-19-vaccines-webinar-series.aspx">Begin CME activity</a>.</p>
</div> | 1/12/2023 3:00:25 PM | 1/10/2023 3:18:04 PM | 1/13/2023 12:00:00 AM |
| health-equity-m-and-m-webinars-to-continue-in-2023 | Health Equity M&M Webinars to Continue in 2023 | memo | Shared_Content/News/Membership_Memo/2023/health-equity-m-and-m-webinars-to-continue-in-2023 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/mm-equity-webinar-series-2023-645x425px.png" class="pull-right" alt="Health Equity M&amp;M Webinar Series logo" /></div>
<h5>January 13, 2022</h5>
<h2>Health Equity M&amp;M Webinars to Continue in 2023 </h2>
<p>The WSMA and the WSMA Foundation are pleased to announce the Health Equity M&amp;M Webinar Series will continue through 2023. Member registrations from last year will be carried over to this year, and members can use the same Zoom link as before to join each of the sessions. For members who haven't yet experienced these rich discussions, please join us for the next session on Friday, Feb. 10 at noon. The sessions are free, CME is available, and beginning this year, members will be able to submit patient cases for discussion.</p>
<h3>About the Health Equity M&amp;M Webinar</h3>
<p>Every other month, the WSMA and WSMA Foundation host health equity M&amp;M discussions (think "morbidity and mortality," but with a focus on health equity), to help provide a framework for conversations in which attendees are encouraged to recognize and examine biases and identify the ways systemic racism exists in our organizations. The series fosters a space conducive to building a community of professionals focused on achieving health equity, allowing for discussions of charged but necessary topics. Each webinar is protected under WSMA's coordinated quality improvement program (CQIP).</p>
<p>During each webinar, Edwin Lindo, JD, facilitates case-based discussions. Lindo is the assistant dean of social and health justice in the Office of Healthcare Equity, an associate teaching professor in the department of family medicine, and an adjunct associate teaching professor in the department of bioethics and humanities at the University of Washington School of Medicine. He teaches, presents, and writes on issues of race and racism within the field of medicine and greater society.</p>
<h3>New for 2023: How to submit a patient case for discussion</h3>
<p>WSMA members may now submit patient cases to discuss at a Health Equity M&amp;M session. Verbal submission of cases is the safest approach for preserving the confidentiality of the information. If you would like to speak with Professor Lindo directly, please email Kendra Peterson at <a href="mailto:kendra@wsma.org">kendra@wsma.org</a>. As an alternative, the WSMA has created a new <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=CgN5_wMfNU66xEvN3PBcAIl040VJfZtFmgd6Gl6BR-NUOVhWSlJaWVAyODJTUE9UVFVUTjc0ODZFUS4u">online case submission form</a> for you to share patient cases. All case submissions are CQIP and HIPAA compliant.</p>
<p>Register for the webinar <a href="[@]Shared_Content/Events/Event_Display.aspx?eventkey=hlthequimm">online</a> (members only; sign-in required). This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢.</p>
</div> | 1/12/2023 2:41:24 PM | 1/10/2023 3:17:55 PM | 1/13/2023 12:00:00 AM |
| scholarships-available-for-2023-leadership-development-conference | Scholarships Available for 2023 Leadership Development Conference | memo | Shared_Content/News/Membership_Memo/2023/scholarships-available-for-2023-leadership-development-conference | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/2022-ldc-campbells-lake-645x425px.jpeg" class="pull-right" alt="Campbell's Resort on Lake Chelan" /></div>
<h5>January 13, 2022</h5>
<h2>Scholarships Available for 2023 Leadership Development Conference </h2>
<p>The WSMA Leadership Development Conference is scheduled for May 19-20, 2023 at Campbell's Resort on Lake Chelan. This year's theme is on building strong teams, with a focus on wellness, diversity, and sustainability. The WSMA will offer up to five scholarships to members who have been identified as future leaders in medicine. </p>
<p>Scholarships cover registration fees, event meals, and lodging for two nights in one standard room. Travel to and from the conference is not covered by the scholarship. To be eligible for a scholarship, applicants must:</p>
<ul>
<li>Be a member of the WSMA in 2023.</li>
<li>Have not attended a WSMA Leadership Development Conference before.</li>
<li>Submit a complete application by Wednesday, Jan. 25.</li>
</ul>
<h3>Help us identify tomorrow's leaders</h3>
<p>Please encourage your WSMA member colleagues who may benefit from participating in this year's conference to apply for a scholarship. The scholarship application form is <a href="https://www.surveymonkey.com/r/2023LDCScholarship">available online</a>. The WSMA Executive Committee will select up to five scholarship recipients at its February meeting, with preference given to early career applicants (e.g., students, residents, fellows, those under 40, and those in their first 10 years of practice).</p>
<p>The one-and-a-half-day Leadership Development Conference is designed for physicians at all levels of leadership experience and their health care teams, providing practical information and skills that can be used in any setting-at work, in the community, or in organized medicine. The conference presents an excellent opportunity for physicians seeking leadership positions in their career, regardless of the type or size of their organization or practice.</p>
<p>Please save the dates and encourage all physicians involved in a leadership capacity in your organization to attend. Contact Brendan Cox at 206.956.3625 or <a href="mailto:brendan@wsma.org">brendan@wsma.org</a> if you have any questions.</p>
</div> | 1/12/2023 3:29:57 PM | 1/12/2023 3:17:40 PM | 1/13/2023 12:00:00 AM |
| medical-assistant-flexibilities-extended-to-flu-tests-and-vaccines | Medical Assistant Flexibilities Extended to Flu Tests and Vaccines | memo | Shared_Content/News/Membership_Memo/2022/december-30/medical-assistant-flexibilities-extended-to-flu-tests-and-vaccines | <div class="col-md-12">
<h5>December 30, 2022</h5>
<h2>Medical Assistant Flexibilities Extended to Flu Tests and Vaccines </h2>
<p>As a result of WSMA advocacy, Secretary of Health Umair A. Shah, MD, MPH, has issued a <a href="https://wsma.informz.net/WSMA/data/images/Attachments/PREP_Act_Authorization_Medical_Assistants_Tests_COVID_and_Flu_Vaccines_Final%20(003).pdf">Public Readiness and Emergency Preparedness Act authorization</a> to allow individuals with a medical assistant-certified or medical assistant-registered license to administer, without the on-site, physical presence of their supervising physician or practitioner, COVID-19 and influenza tests and vaccines as well as the products for treating or preventing serious conditions from their administration. With these flexibilities in place, practices and health systems may organize to reduce pressure on emergency departments and physician offices by, for example, establishing drive-through testing and vaccine sites like we saw earlier in the COVID-19 pandemic. The WSMA extends its gratitude to Secretary Shah for these latest flexibilities and will keep members apprised of further developments.</p>
</div> | 1/6/2023 12:20:51 PM | 1/3/2023 4:54:55 PM | 12/30/2022 12:00:00 AM |
| governor-releases-budget-proposal-for-2023-2025-biennium | Governor Releases Budget Proposal for 2023-2025 Biennium | memo | Shared_Content/News/Membership_Memo/2022/december-23/governor-releases-budget-proposal-for-2023-2025-biennium | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/spring-wa-capitol-645x425px.jpeg" class="pull-right" alt="Washington state capitol building in spring" /></div>
<h5>December 23, 2022</h5>
<h2>Governor Releases Budget Proposal for 2023-2025 Biennium</h2>
<p>Last week Gov. Jay Inslee released his budget proposal, kicking off negotiations around the next two-year state spending plan and signaling the approach of the legislative session that begins on Jan. 9. Spanning $70 billion in spending, the governor's proposal would increase state spending by around 12% and does not rely on new tax increases. </p>
<p>In announcing his budget, Inslee highlighted proposed investments in housing and homelessness, climate change, and behavioral health, including $50 million to address the opioid epidemic-including funding to support the <a href="https://wsma.org/wsma/resources/opioids/better_prescribing_better_treatment/wsma/resources/opioids/better_prescribing_better_treatment/better_prescribing_better_treatment.aspx?hkey=b6fb0ec0-8bc2-4e53-bf4c-9f148599cbeb">Better Prescribing, Better Treatment</a> program, the joint initiative of the WSMA and the Washington State Hospital Association to inform physicians' prescribing patterns.</p>
<p>The budget aligns with other WSMA priorities, including proposed funding and associated policies to ensure access to abortion services and to address gun violence, and proposed investments in our health care workforce, most notably the creation of 400 new nursing slots and a public health degree program at Washington State University.</p>
<p>Investments are also proposed to support access to health care coverage for undocumented immigrants ($19 million); fund public health and winding down COVID-19 services ($120 million); and to increase capacity in the health care system by raising Medicaid rates for long-term care facilities and facilitating discharge of patients from hospital settings (more than $300 million across multiple appropriations). </p>
<p>State revenues have remained strong in the wake of the COVID-19 pandemic, yielding around $1.5 billion more than was expected through 2025. Collective bargaining agreements the governor recently struck with state employee unions consumed some of that capacity, however, limiting investments in new programs. One of those agreements stipulates that for care delivered in state employee health plans, ARNPs will be reimbursed at the same rate as physicians. The WSMA has opposed this policy in recent years when it's been proposed as legislation and the collective bargaining agreement represents a potential end-run around the Legislature.</p>
<p>While Gov. Inslee's budget does not raise taxes, it does propose new spending in the form of bonding capacity to support $4 billion in investments in housing and to address homelessness. This would require a referendum to voters. The budget also relies on revenue from the state capital gains tax that was adopted in the 2021 session and is currently the subject of a legal challenge pending the state Supreme Court.</p>
<p>WSMA's top budget priority for the 2023-25 state fiscal cycle is an across-the-board rate increase for professional services delivered in the Medicaid program. Increasing Medicaid rates to Medicare levels would cost the state an estimated $134 million annually, leveraging $290 million in federal funds for a total annual investment of $423 million. While this funding was not included in the governor's budget, we will be advocating for its inclusion in legislative spending plans, which will likely be released in early April and finalized before session is scheduled to adjourn on April 26.</p>
<p>If you're interested in staying plugged in to the WSMA's work in Olympia, you <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/legislative_summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">can register for the 2023 Legislative Summit</a> taking place on Feb. 3, and receive our weekly Outreach and Advocacy Report by emailing WSMA's Legislative Coordinator Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a>. </p>
</div> | 12/22/2022 2:58:22 PM | 12/22/2022 2:58:00 PM | 12/23/2022 12:00:00 AM |
| l-and-i-payment-policy-updates | L&I Payment Policy Updates | memo | Shared_Content/News/Membership_Memo/2022/december-23/l-and-i-payment-policy-updates | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/physician-money-illustration-645x425px.png" class="pull-right" alt="physician pulling dollar sign arrow illustration" /></div>
<h5>December 23, 2022</h5>
<h2>L&amp;I Payment Policy Updates </h2>
<p>The Department of Labor &amp; Industries has made a few changes to its payment policies. Here are the latest updates: </p>
<ul>
<li>The CPT code updates for January 2023 should be ready by mid-December and will be published as soon as they are available. </li>
<li>The American Medical Association recently made changes to evaluation and management services. L&amp;I is reviewing these changes and will publish updates to its policies in June 2023. </li>
</ul>
<ul>
<li>The payment policy has been updated to allow sign language interpreters to provide services remotely. See <a href="https://lni.wa.gov/patient-care/billing-payments/marfsdocs/2022/UpdateSignlanguageteleinterpretation_final.pdf?utm_medium=email&amp;utm_source=govdelivery">Chapter 22 Update</a> for details. </li>
<li>Following review, <a href="https://www.lni.wa.gov/patient-care/billing-payments/marfsdocs/2022/Chapter15MedicalTestimony.pdf?utm_medium=email&amp;utm_source=govdelivery">Chapter 15: Medical Testimony</a> has several changes. In addition, the fee schedule is increasing. All changes are effective Jan. 1, 2023.  </li>
</ul>
<p>Contact L&amp;I at <a href="mailto:HPPM@Lni.Wa.Gov">hppm@lni.wa.gov</a> with questions.</p>
</div> | 12/22/2022 3:01:04 PM | 12/22/2022 2:58:30 PM | 12/23/2022 12:00:00 AM |
| omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut | Omnibus Bill in Congress Includes 2% Medicare Physician Payment Cut | memo | Shared_Content/News/Membership_Memo/2022/december-23/omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-barcode-645px.jpeg" class="pull-right" alt="Medicare barcode" /></div>
<h5>December 23, 2022</h5>
<h2>Omnibus Bill in Congress Includes 2% Medicare Physician Payment Cut</h2>
<p>Despite calls from the American Medical Association, the WSMA, and the physician community, the must-pass omnibus spending deal struck by congressional leaders this week will apply a 2% cut in 2023 and at least a 1.25% cut in 2024 to physician Medicare reimbursements.</p>
<p>As the WSMA recently <a href="https://wsma.org/Shared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship?_zs=Pimae1&amp;_zl=dV3k8">reported to our members</a> and to <a href="https://wsma.org/Shared_Content/News/Press_Release/2022/access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-reveals.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">the media and the public</a>, physician practices across the state are grappling with the economic hardship caused by workforce shortages and inflation. While the physician community was successful in staving off as much as an 8.5% cut in 2023, the WSMA is still deeply concerned about the impact a 2% reduction in Medicare reimbursement will have during a difficult time for practices and on the heels of a highly disruptive pandemic.</p>
<p>When adjusted for inflation, Medicare physician payments dropped by 22% from 2001 to 2021. With additional cuts in 2023, physicians simply cannot afford to operate under the current payment system. This latest disappointing news from Congress underscores the need for a comprehensive rethink of the Medicare payment system. The WSMA will be joining the AMA in seeking to reform the Medicare payment system in 2023 based on the principles of simplicity, relevance, alignment, and predictability. <a href="[@]wsma/advocacy/medicare_payment_reform/wsma/advocacy/medicare_payment_reform/medicare_payment_reform.aspx?hkey=d1a48c1c-af7b-4680-bd55-967338f3c977">Learn more about our plan for reforming Medicare</a>.</p>
</div> | 12/22/2022 2:50:50 PM | 12/22/2022 2:50:30 PM | 12/23/2022 12:00:00 AM |
| wsma-economic-impact-survey-of-physician-practices | WSMA Economic Impact Survey of Physician Practices | Membership_Memo | Shared_Content/News/Latest_News/2022/wsma-economic-impact-survey-of-physician-practices | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/july/doc-patient-exam-room-645x425px.jpg" class="pull-right" alt="physician treating a patient" /></div>
<h5>December 19, 2022</h5>
<h2>WSMA Economic Impact Survey of Physician Practices</h2>
<p>Over the last several years, the WSMA and Washington State Medical Group Management Association have periodically conducted surveys to better understand the economic challenges facing physicians, their practices, and patients resulting from COVID-19. Feedback has been vital to our advocacy at the state and federal levels as we secured regulatory and financial relief for medical practices. </p>
<p>With the recission of COVID-19 proclamations and regulatory waivers and the 2023 legislative session on the horizon, the WSMA and the WSMGMA conducted a sixth survey to better understand how these issues have affected physicians and patients to inform our advocacy.</p>
<p>Results from this latest round of surveying clearly demonstrate that inflation and workforce shortages, as well as the ongoing COVID-19 pandemic, are still adversely impacting outpatient physician practices, and hindering patient access to care across Washington. Respondents also note that administrative tasks, such as prior authorization remain burdensome to their practices and further strain their limited staffing resources.</p>
<p>If actions are not taken to shore up the medical practice community, access to outpatient care in our state will be severely diminished over the next year. Patients will no longer be able to get care, at the right time, at the right place, creating even more pressure on our already overwhelmed hospitals.</p>
<p>During the 2023 state legislative session, the WSMA will ask the Legislature to raise Medicaid rates to Medicare levels, as physician groups and practices overwhelmingly believe that doing so will help stabilize finances while maintaining access for current Medicaid panels and even increasing to include more patients. In addition, the WSMA will help introduce legislation to rein in insurance carrier prior authorization practices, which would also relieve staffing challenges currently felt by most of the medical practice community.</p>
<p>Download the <a href="javascript://[Uploaded files/News and Publications/Latest News/2022/inflation-survey-final.pdf]">November 2022 practice economic survey results</a>.</p>
<h3>About the respondents</h3>
<p>Eighty-two physician practices responded, representing more than a thousand physicians and health care professionals that provide care to millions of Washingtonians.</p>
<ul>
<li>26% of survey respondents were solo practitioners.</li>
<li>44% were in practices of 2-10 physicians and</li>
<li>7% were in practices of 11-20 physicians.</li>
<li>12% of respondents represented practices of 21-50 physicians, and</li>
<li>11% represented practices with over 51 physicians.</li>
</ul>
<p>These represent smaller outpatient practices that are not affiliated with a hospital system and are often the only care provided in some communities, especially rural areas.</p>
<h3>Medicaid patients </h3>
<p>Most of these practices serve Medicaid patients (75%) in addition to commercial and Medicare patients.</p>
<h3>Staffing shortages have led to practice closures and reduction in services</h3>
<p>Regarding staffing, 89% of respondents said are having experiencing shortages. Of the respondents experiencing staffing shortages, 77% are experiencing challenges filling administrative staff positions, 75% are experiencing challenges filling medical assistant positions, 40% are having trouble filling nursing positions, and 33% are having trouble hiring physicians.</p>
<p>Staffing shortages have meant 46% of practices have had to reduce patience access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients. One respondent noted that <em>"We will most likely close our Walla Walla office by the end of the year. We understand we are the only eye surgeon serving the low income."</em> If current staffing and financial trends continue, 51% of practices aren't confident they'll be able to provide the same level of patient access a year from now.</p>
<p>Other strategies to mitigate staffing challenges:</p>
<ul>
<li><em>Delayed well child care and chronic disease management.</em></li>
<li><em>Our waiting room is now where we see patients.</em></li>
<li><em>Limited number of new patients.</em></li>
<li><em>Closed on Friday, longer wait times for patients.</em></li>
<li><em>Delays in care and decreased access to services.</em></li>
<li><em>Cut back on clinic based testing and closed satellite office.</em></li>
<li><em>Increased workloads for staff which is causing burnout.</em></li>
</ul>
<h3>Inflation is impacting almost all practices </h3>
<p>Inflation is impacting practices: 51% of respondents said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation, 89% noted the rising cost of labor. To mitigate the impact of inflation, over 30% of practices have reduced office hours, patient access, and services and treatments offered to patients.</p>
<p>What physician groups said about inflation:</p>
<ul>
<li><em>Our staff are getting lured away for high cash compensation and forsaking our generous benefits package to keep up with their short-term financial stressors of rising rents/transportation/food.</em></li>
<li><em>Supply chain disruptions, we can't get flu test kits, off and on shortages or syringes or medications.</em></li>
<li><em>Payroll taxes, office equipment, supplies, malpractice insurance, property upkeep, and business taxes. Just to mention a few. I currently have my business for sale, it's become too much for a private practice to stay in business.</em></li>
<li><em>Inflation is going up. Payment from insurers is going down or staying flat. This trajectory in not sustainable to recruit and retain physicians to our specialty in the long term.</em></li>
<li><em>We raised our rates where we were able to, but insurance payments have not kept pace with inflation.</em></li>
<li><em>Stopped services where reimbursement did not keep up with cost of goods used.</em></li>
<li><em>Work harder and longer. Seeing 30+ patients per day per doctor at times.</em></li>
<li><em>Limiting Medicaid patients.</em></li>
</ul>
<h3>Ideally, practices should have 18 weeks' (roughly four months) worth of days "cash on hand"</h3>
<p>Defined as the number of days their organization can pay its operating expenses with current cash available, 93% of practices responded with having less than 4 months days cash on hand. Over half of practices report that their days cash on hand is down since November of 2021. Of those who reported that their cash on hand was down, 83% attributed it to staffing shortage or inflation.</p>
<h3>Access to care for Medicaid patients is threatened</h3>
<p>Of practices that see Medicaid patients, 46% have had to limit the number of Medicaid patients they see due to the practice's current financial statement. Furthermore, several respondents who haven't had to limit the number of Medicaid patients note it is a possibility in the future.</p>
<ul>
<li><em>We will have to limit should funding continue not to match inflationary increases.</em></li>
<li><em>Not yet, but soon going that route.</em></li>
<li><em>That could happen. That's what other practices are doing.</em></li>
<li><em>We had a much larger number of Medicaid patients, but due to very poor financial return, we had to stop taking any new Medicaid patients, as well as turning away others that once were patients, but we hadn't seen within a year. We were going broke and didn't want to close our clinic.</em></li>
<li><em>We have always had open access to all children, but for the first time in our 42-year history we are not taking new patients. We are unable to attract MDs to fill vacancies because we cannot compete with larger institutions that either do not take Medicaid or cap the number of Medicaid patients at a low rate.</em></li>
<li><em>We had to discontinue providing eyewear to our Medicaid patients through the state plan. The payment of $20 per pair of eyewear was resulting in a substantial net loss.</em></li>
<li><em>This remains the toughest population for us to see, primarily because the reimbursement is so low.</em></li>
</ul>
<h3>Without support patient access will suffer over the next year</h3>
<p>Medical practices were asked if they will be able to provide the same level of patient access a year from now if staffing and financial trends continue. Just over 50% said they are not confident.</p>
<h3>Medicaid rate increase a commonly cited solution</h3>
<p>When asked if raising Medicaid rates to Medicare levels would be sufficient to maintain current Medicaid patent caseload, 63% said that would be sufficient; 37% said they would be able to increase their Medicaid caseloads.</p>
<ul>
<li><em>If (Medicare and Medicaid) rates were the same, we would consider increasing our caseload.</em></li>
<li><em>Medicaid reimbursement has not increased in 20 yrs. Wages have changed dramatically.</em></li>
<li><em>Variance in reimbursement (between Medicaid and other payers) is no longer sustainable.</em></li>
<li><em>Increase in reimbursement for patient care would be helpful to keep on track with the other costs due to inflation.</em></li>
</ul>
<h3>Prior authorization an enormous burden for medical practices</h3>
<p>Without prompting by the survey, several respondents noted the toll administrative burden and prior authorization requirements contribute to economic and staffing challenges:</p>
<ul>
<li><em>Work to increase reimbursement and cut red tape. Prior authorizations are a killer for staff.</em></li>
<li><em>Help to improve prior authorization used as tactic to delay and deny care. Payer abuse in paying for approved services. Improve Medicaid rates to Medicare rates.</em></li>
<li><em>Decrease administrative burdens and barriers which add to cost of overhead and do not add value to practice, i.e., prior authorization, poor EHR interoperability, regular insurance audits, increasing reimbursement for primary care, reimbursement for nutritional counseling, improving access to MHP.</em></li>
<li><em>Commercial payers need to jump in and help by ending the onerous prior authorization processes. This alone would free up hours of precious staff time.</em></li>
</ul>
</div> | 12/19/2022 12:11:53 PM | 12/19/2022 12:11:28 PM | 12/19/2022 12:00:00 AM |
| wsma-economic-impact-survey-of-physician-practices | WSMA Economic Impact Survey of Physician Practices | memo | Shared_Content/News/Latest_News/2022/wsma-economic-impact-survey-of-physician-practices | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/july/doc-patient-exam-room-645x425px.jpg" class="pull-right" alt="physician treating a patient" /></div>
<h5>December 19, 2022</h5>
<h2>WSMA Economic Impact Survey of Physician Practices</h2>
<p>Over the last several years, the WSMA and Washington State Medical Group Management Association have periodically conducted surveys to better understand the economic challenges facing physicians, their practices, and patients resulting from COVID-19. Feedback has been vital to our advocacy at the state and federal levels as we secured regulatory and financial relief for medical practices. </p>
<p>With the recission of COVID-19 proclamations and regulatory waivers and the 2023 legislative session on the horizon, the WSMA and the WSMGMA conducted a sixth survey to better understand how these issues have affected physicians and patients to inform our advocacy.</p>
<p>Results from this latest round of surveying clearly demonstrate that inflation and workforce shortages, as well as the ongoing COVID-19 pandemic, are still adversely impacting outpatient physician practices, and hindering patient access to care across Washington. Respondents also note that administrative tasks, such as prior authorization remain burdensome to their practices and further strain their limited staffing resources.</p>
<p>If actions are not taken to shore up the medical practice community, access to outpatient care in our state will be severely diminished over the next year. Patients will no longer be able to get care, at the right time, at the right place, creating even more pressure on our already overwhelmed hospitals.</p>
<p>During the 2023 state legislative session, the WSMA will ask the Legislature to raise Medicaid rates to Medicare levels, as physician groups and practices overwhelmingly believe that doing so will help stabilize finances while maintaining access for current Medicaid panels and even increasing to include more patients. In addition, the WSMA will help introduce legislation to rein in insurance carrier prior authorization practices, which would also relieve staffing challenges currently felt by most of the medical practice community.</p>
<p>Download the <a href="javascript://[Uploaded files/News and Publications/Latest News/2022/inflation-survey-final.pdf]">November 2022 practice economic survey results</a>.</p>
<h3>About the respondents</h3>
<p>Eighty-two physician practices responded, representing more than a thousand physicians and health care professionals that provide care to millions of Washingtonians.</p>
<ul>
<li>26% of survey respondents were solo practitioners.</li>
<li>44% were in practices of 2-10 physicians and</li>
<li>7% were in practices of 11-20 physicians.</li>
<li>12% of respondents represented practices of 21-50 physicians, and</li>
<li>11% represented practices with over 51 physicians.</li>
</ul>
<p>These represent smaller outpatient practices that are not affiliated with a hospital system and are often the only care provided in some communities, especially rural areas.</p>
<h3>Medicaid patients </h3>
<p>Most of these practices serve Medicaid patients (75%) in addition to commercial and Medicare patients.</p>
<h3>Staffing shortages have led to practice closures and reduction in services</h3>
<p>Regarding staffing, 89% of respondents said are having experiencing shortages. Of the respondents experiencing staffing shortages, 77% are experiencing challenges filling administrative staff positions, 75% are experiencing challenges filling medical assistant positions, 40% are having trouble filling nursing positions, and 33% are having trouble hiring physicians.</p>
<p>Staffing shortages have meant 46% of practices have had to reduce patience access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients. One respondent noted that <em>"We will most likely close our Walla Walla office by the end of the year. We understand we are the only eye surgeon serving the low income."</em> If current staffing and financial trends continue, 51% of practices aren't confident they'll be able to provide the same level of patient access a year from now.</p>
<p>Other strategies to mitigate staffing challenges:</p>
<ul>
<li><em>Delayed well child care and chronic disease management.</em></li>
<li><em>Our waiting room is now where we see patients.</em></li>
<li><em>Limited number of new patients.</em></li>
<li><em>Closed on Friday, longer wait times for patients.</em></li>
<li><em>Delays in care and decreased access to services.</em></li>
<li><em>Cut back on clinic based testing and closed satellite office.</em></li>
<li><em>Increased workloads for staff which is causing burnout.</em></li>
</ul>
<h3>Inflation is impacting almost all practices </h3>
<p>Inflation is impacting practices: 51% of respondents said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation, 89% noted the rising cost of labor. To mitigate the impact of inflation, over 30% of practices have reduced office hours, patient access, and services and treatments offered to patients.</p>
<p>What physician groups said about inflation:</p>
<ul>
<li><em>Our staff are getting lured away for high cash compensation and forsaking our generous benefits package to keep up with their short-term financial stressors of rising rents/transportation/food.</em></li>
<li><em>Supply chain disruptions, we can't get flu test kits, off and on shortages or syringes or medications.</em></li>
<li><em>Payroll taxes, office equipment, supplies, malpractice insurance, property upkeep, and business taxes. Just to mention a few. I currently have my business for sale, it's become too much for a private practice to stay in business.</em></li>
<li><em>Inflation is going up. Payment from insurers is going down or staying flat. This trajectory in not sustainable to recruit and retain physicians to our specialty in the long term.</em></li>
<li><em>We raised our rates where we were able to, but insurance payments have not kept pace with inflation.</em></li>
<li><em>Stopped services where reimbursement did not keep up with cost of goods used.</em></li>
<li><em>Work harder and longer. Seeing 30+ patients per day per doctor at times.</em></li>
<li><em>Limiting Medicaid patients.</em></li>
</ul>
<h3>Ideally, practices should have 18 weeks' (roughly four months) worth of days "cash on hand"</h3>
<p>Defined as the number of days their organization can pay its operating expenses with current cash available, 93% of practices responded with having less than 4 months days cash on hand. Over half of practices report that their days cash on hand is down since November of 2021. Of those who reported that their cash on hand was down, 83% attributed it to staffing shortage or inflation.</p>
<h3>Access to care for Medicaid patients is threatened</h3>
<p>Of practices that see Medicaid patients, 46% have had to limit the number of Medicaid patients they see due to the practice's current financial statement. Furthermore, several respondents who haven't had to limit the number of Medicaid patients note it is a possibility in the future.</p>
<ul>
<li><em>We will have to limit should funding continue not to match inflationary increases.</em></li>
<li><em>Not yet, but soon going that route.</em></li>
<li><em>That could happen. That's what other practices are doing.</em></li>
<li><em>We had a much larger number of Medicaid patients, but due to very poor financial return, we had to stop taking any new Medicaid patients, as well as turning away others that once were patients, but we hadn't seen within a year. We were going broke and didn't want to close our clinic.</em></li>
<li><em>We have always had open access to all children, but for the first time in our 42-year history we are not taking new patients. We are unable to attract MDs to fill vacancies because we cannot compete with larger institutions that either do not take Medicaid or cap the number of Medicaid patients at a low rate.</em></li>
<li><em>We had to discontinue providing eyewear to our Medicaid patients through the state plan. The payment of $20 per pair of eyewear was resulting in a substantial net loss.</em></li>
<li><em>This remains the toughest population for us to see, primarily because the reimbursement is so low.</em></li>
</ul>
<h3>Without support patient access will suffer over the next year</h3>
<p>Medical practices were asked if they will be able to provide the same level of patient access a year from now if staffing and financial trends continue. Just over 50% said they are not confident.</p>
<h3>Medicaid rate increase a commonly cited solution</h3>
<p>When asked if raising Medicaid rates to Medicare levels would be sufficient to maintain current Medicaid patent caseload, 63% said that would be sufficient; 37% said they would be able to increase their Medicaid caseloads.</p>
<ul>
<li><em>If (Medicare and Medicaid) rates were the same, we would consider increasing our caseload.</em></li>
<li><em>Medicaid reimbursement has not increased in 20 yrs. Wages have changed dramatically.</em></li>
<li><em>Variance in reimbursement (between Medicaid and other payers) is no longer sustainable.</em></li>
<li><em>Increase in reimbursement for patient care would be helpful to keep on track with the other costs due to inflation.</em></li>
</ul>
<h3>Prior authorization an enormous burden for medical practices</h3>
<p>Without prompting by the survey, several respondents noted the toll administrative burden and prior authorization requirements contribute to economic and staffing challenges:</p>
<ul>
<li><em>Work to increase reimbursement and cut red tape. Prior authorizations are a killer for staff.</em></li>
<li><em>Help to improve prior authorization used as tactic to delay and deny care. Payer abuse in paying for approved services. Improve Medicaid rates to Medicare rates.</em></li>
<li><em>Decrease administrative burdens and barriers which add to cost of overhead and do not add value to practice, i.e., prior authorization, poor EHR interoperability, regular insurance audits, increasing reimbursement for primary care, reimbursement for nutritional counseling, improving access to MHP.</em></li>
<li><em>Commercial payers need to jump in and help by ending the onerous prior authorization processes. This alone would free up hours of precious staff time.</em></li>
</ul>
</div> | 12/19/2022 12:11:53 PM | 12/19/2022 12:11:28 PM | 12/19/2022 12:00:00 AM |
| action-alert-how-you-can-help-cancel-medicare-payment-cuts | Action Alert! How You Can Help Cancel Medicare Payment Cuts | memo | Shared_Content/News/Membership_Memo/2022/december-9/action-alert-how-you-can-help-cancel-medicare-payment-cuts | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-cta-1-645x425px.png" class="pull-right" alt="Protect patient access to care illustrated graphic" /></div>
<h5>December 9, 2022</h5>
<h2>Action Alert! How You Can Help Cancel Medicare Payment Cuts </h2>
<p>If Congress fails to act soon, physician Medicare payments will be cut by 4.5% on Jan. 1, 2023, due to regulatory changes enacted by the Centers for Medicare and Medicaid Services. Cuts of this magnitude would severely impede patient access to care and place further strain on an already stressed practice community. When adjusted for inflation, Medicare physician payments have dropped by 22% from 2001 to 2021. Physicians simply cannot afford to operate under the current payment system.</p>
<p>We have been raising the red flag over these cuts for months-and lawmakers are beginning to listen. But we need to keep the pressure on. The "lame duck" session of Congress is always a chaotic time with numerous priorities and interests vying to be included in the final must-pass package. It's urgent that the physician community push back on these cuts and ensure that physicians and patients don't get lost in the end-of-year shuffle.</p>
<p><strong>What can you do to help cancel the cuts:</strong></p>
<ol>
<li>Contact your lawmakers through this link and share it with your colleagues: <a href="http://www.bit.ly/PhysicianMedicare">www.bit.ly/PhysicianMedicare</a></li>
<li>Share this link with your patients: <a href="http://www.bit.ly/PatientMedicare">www.bit.ly/PatientMedicare</a></li>
<li>Reach out to your member of Congress to schedule a meeting/phone call.
<ul>
<li>Download the AMA'sCancel the Cuts Action Kit: <a href="http://www.bit.ly/MedicareActionKit">bit.ly/MedicareActionKit</a></li>
<li>Contact <a href="mailto:PoliticalAffairs@ama-assn.org">PoliticalAffairs@ama-assn.org</a> if you need help connecting with your member of Congress or need tips on how to effectively communicate your message and prepare for your meeting.</li>
</ul>
</li>
</ol>
<p>Time is running out. <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=/campaigns/96014/respond">Contact Congress now</a> and demand that they protect patients and practices by canceling these devastating Medicare cuts in their entirety before the clock strikes zero.</p>
</div> | 12/8/2022 2:18:40 PM | 12/8/2022 2:18:17 PM | 12/9/2022 12:00:00 AM |
| prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-priorities | Prior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative Priorities | memo | Shared_Content/News/Membership_Memo/2022/december-9/prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-priorities | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/ls-2018-01-245-straightened-645x425px.jpeg" class="pull-right" alt="Capitol building" /></div>
<h5>December 9, 2022</h5>
<h2>Prior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative Priorities</h2>
<p>WSMA's government affairs team will highlight these and other WSMA legislative priorities during a webinar on <a href="https://us06web.zoom.us/meeting/register/tZApc-ugqz4pE9IXUUHeiTCjN4q1HKfMfLvo">Tuesday, Dec. 13, at noon</a>. The hour-long session will serve as an opportunity for WSMA members to preview the 2023 state legislative session that begins in January and learn more about WSMA's legislative priorities and the health care policy landscape. Members are encouraged to participate-there will be time during the session for you to provide feedback on any concerns or issues you or your practice are facing. Register for the webinar <a href="https://us06web.zoom.us/meeting/register/tZApc-ugqz4pE9IXUUHeiTCjN4q1HKfMfLvo">online</a>.</p>
<p>Medicaid reimbursement, prior authorization, and ensuring access to abortion and reproductive health care services will also be among the priority fiscal and policy issues that will be the focus of the 2023 WSMA Legislative Summit, scheduled for Feb. 3, in person at the Capitol. We hope you will don your white coats and join us in Olympia to help advocate for these WSMA legislative priorities-<a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">registration for the Feb. 3 event is free</a> (lunch will be provided).</p>
</div> | 12/8/2022 11:32:39 AM | 12/8/2022 10:30:03 AM | 12/9/2022 12:00:00 AM |
| in-new-survey-practices-continue-to-grapple-with-economic-hardship | In New Survey, Practices Continue to Grapple with Economic Hardship | memo | Shared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship | <div class="col-md-12">
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<h5>November 23, 2022</h5>
<h2>In New Survey, Practices Continue to Grapple with Economic Hardship</h2>
<p>Results from a new survey from the WSMA and the Washington State Medical Group Management Association make clear that physician practices and clinics in Washington continue to face severe economic strain, putting at risk the ability of patients to access care in communities across the state.</p>
<p>Throughout the pandemic, the WSMA and the WSMGMA have jointly conducted economic impact surveys of physician clinics in Washington state to gauge the impact of the pandemic and pandemic-associated pressures on patient access to care and to help inform our advocacy on behalf of the physician community.</p>
<p>A few key highlights from the latest survey, which featured responses from 82 physician practices:</p>
<ul>
<li>89% have experienced staffing shortages due to COVID-19. Of those:
<ul>
<li>77% are experiencing challenges filling administrative staff positions.</li>
<li>75% are experiencing challenges filling medical assistant positions.</li>
<li>40% are having trouble filling nursing positions.</li>
<li>33% are having trouble hiring physicians.</li>
</ul>
</li>
<li>46% have had to reduce patient access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients.</li>
<li>93% have less than four months days cash on hand. Industry standard is 18 weeks.</li>
<li>51% said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation:
<ul>
<li>89% noted the rising cost of labor.</li>
<li>Over 30% have reduced office hours, patient access, and services/treatments offered to patients in response.</li>
</ul>
</li>
<li>Just over 50% are not confident they'll be able to provide the same level of patient access a year from now.</li>
<li>46% have had to limit Medicaid panels due to their financial situation. The most commonly cited solution: increasing Medicaid reimbursement rates to Medicare rates.</li>
</ul>
<p>Thank you to the practices that responded to the survey. The WSMA will use these data points as a snapshot of what is happening in practices across the state in its discussions with policymakers.</p>
</div> | 11/23/2022 11:22:22 AM | 11/23/2022 11:19:36 AM | 11/23/2022 12:00:00 AM |
| webinars-on-long-covid-and-health-care-worker-behavioral-health-support | Webinars on Long COVID and Health Care Worker Behavioral Health Support | memo | Shared_Content/News/Membership_Memo/2022/november-23/webinars-on-long-covid-and-health-care-worker-behavioral-health-support | <div class="col-md-12">
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<h5>November 23, 2022</h5>
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<h2>Webinars on Long COVID and Health Care Worker Behavioral Health Support </h2>
<p>The Washington State Department of Health is offering three upcoming sessions that may be of interest to some WSMA members.</p>
<h3>The Landscape of Post-COVID-19 Conditions - Where We Are Now?</h3>
<p>Dec. 2, noon<strong>-</strong>1 p.m. Free.</p>
<p>In this presentation, we will cover the known epidemiology and clinical considerations of post-COVID-19 conditions. We will review updates to case definitions, discuss the current understanding of the clinical spectrum, and explore possible underlying causes and risk factors.</p>
<p>Speaker: Dr. Eric J. Chow, MD, MS, MPH, chief of communicable disease epidemiology and immunization for Public Health-Seattle and King County and clinical assistant professor in the Division of Allergy and Infectious Diseases and in the Department of Epidemiology at the UW School of Medicine.</p>
<p><a href="https://register.gotowebinar.com/register/8047956050867195405">Find more information and register for the webinar</a>.</p>
<h3>Moral Injury and Personal Coping for Health Care Professionals</h3>
<p>Dec. 16, noon<strong>-</strong>1 p.m. Free.</p>
<p>Part 3 in the series: "Behavioral Health Support Refresher for Health Care Workers." Moral injury is a workplace term with origins in combat medicine that has recently been identified across work sectors with significant implications for physicians and health care professionals. This webinar will define and share more about how moral injury can "show up" at work, how some of the underlying causes can be effectively addressed, and how to recognize and divert unhealthy coping patterns to reduce symptoms of moral injury.</p>
<p>Speaker: Kira Mauseth, PhD, Washington State Department of Heath's Behavioral Health Strike Team.</p>
<p><a href="https://register.gotowebinar.com/register/5627802314613278219">Find more information and register for the webinar</a>.</p>
<h3>The Work Starts Here: Supporting Employees with Long COVID</h3>
<p>Jan. 13, noon<strong>-</strong>1p.m. Free.</p>
<p>This lecture serves to establish ways that employers can help identify, accommodate, and support employees with ongoing COVID-19 symptoms.</p>
<p>Speaker: Kyla Haggith, BSN, RN, PCCN-K, employee health services clinic and exposures team, Harborview Medical Center.</p>
<p><a href="https://register.gotowebinar.com/register/9123738018847843853">Find more information and register for the webinar</a>.</p>
</div> | 11/23/2022 11:06:31 AM | 11/22/2022 10:02:41 AM | 11/23/2022 12:00:00 AM |
| 2023-medicare-part-b-final-rule-features-expected-payment-reductions | 2023 Medicare Part B Final Rule Features Expected Payment Reductions | memo | Shared_Content/News/Membership_Memo/2022/november-11/2023-medicare-part-b-final-rule-features-expected-payment-reductions | <div class="col-md-12">
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<h5>November 11, 2022</h5>
<h2>2023 Medicare Part B Final Rule Features Expected Payment Reductions</h2>
<p>The Centers for Medicare &amp; Medicaid Services has released the <a href="https://www.federalregister.gov/public-inspection/current">final rule for the CY 2023 Medicare physician fee schedule</a>. As expected, the rule contains provisions that, when combined with other cuts to the program, amount to about a 10% reduction in Medicare physician payments starting Jan. 1. The WSMA, the American Medical Association, and much of organized medicine are strongly opposing these cuts and urging congressional intervention before the end of the year. Join your voice to ours by <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fcampaigns%2f96014%2frespond">contacting your congressional representatives today</a>.</p>
<p>In the rule, the 2023 Medicare conversion factor will be reduced by approximately 4.48% from $34.61 to $33.06. This incorporates the budget neutrality adjustments, which are required by law to ensure payment rates for individual services don't result in changes to estimated Medicare spending, the required statutory update to the conversion factor for 2023 of 0%, and the expiration of the 3% supplemental increase to physician fee schedule payments for 2022.</p>
<p>In addition to the final rule's 4.48% reduction for physician services, congressional Pay-As-You-Go rules require an automatic 4% cut in the program starting in 2023 as a result of new federal spending having nothing to do with physicians. Unless <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fcampaigns%2f96014%2frespond">Congress acts by the end of the year</a>, cuts in physician Medicare payments will total 8.42% in 2023, which would severely impede patient access to care due to the forced closure of physician practices and put further strain on those that remained open during the pandemic.</p>
<p>In other top lines, courtesy of the Medical Group Management Association, the final rule:</p>
<ul>
<li>Finalizes implementation of provisions of the Consolidated Appropriations Act, 2022 that extend the application of certain Medicare telehealth flexibilities for an additional 151 days after the end of the COVID-19 public health emergency, such as allowing telehealth services to be furnished to patients in their homes.</li>
<li>Extends flexibilities to permit split/shared E/M visits to be billed based on one of three components (history, exam, or medical decision-making) or time until 2024.</li>
<li>Expands access to behavioral health by permitting marriage and family therapists, licensed professional counselors, and others to furnish behavioral health services under general, instead of direct, supervision.</li>
<li>Maintains the MIPS performance threshold at 75 points for the 2023 MIPS performance year/2025 payment year.</li>
<li>Adds five new MIPS Value Pathways related to nephrology, oncology, neurological conditions, and promoting wellness for voluntary reporting beginning in 2023.</li>
<li>Creates an advanced incentive payment pathway for certain low-revenue, new entrant accountable care organizations to bolster participation in the Medicare Shared Savings Program.</li>
</ul>
<p>For more analysis of the rule's provisions, <a href="https://www.ama-assn.org/health-care-advocacy/advocacy-update/nov-5-2021-advocacy-update-spotlight-final-rule-2022-medicare?utm_source=SFMC&amp;utm_medium=email&amp;utm_term=1152021&amp;utm_content=21-9997+Advocacy+Update+Newsletter+110521&amp;utm_campaign=Advocacy_Email_Newsletter_AdvocacyUpdate&amp;utm_uid=8809453&amp;utm_effort=">see this AMA article</a>. Additional information about the final rule is available in the <a href="https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2023-medicare-physician-fee-schedule-final-rule?utm_source=email&amp;utm_medium=marketo&amp;utm_campaign=gov-washingtonconnection-oct-2022-regalert1031&amp;mkt_tok=MTQ0LUFNSi02MzkAAAGH1B53i5dWXBFoq6oxvHPyLpGNzdAQLASX61P5QkHiBNI8SoXosd1Z8l2xi4GQP6sqt18RwTR3U32mDW841r76RXp6PmAH2R_yonQD5eFwHQ">2023 Medicare Physician Fee Schedule Final Rule fact sheet</a>.</p>
</div> | 11/11/2022 9:44:54 AM | 11/8/2022 4:11:47 PM | 11/11/2022 12:00:00 AM |