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Weekly Rounds
Jennifer Hanscom, WSMA Executive Director/CEO
News and insights from WSMA CEO Jennifer Hanscom.

Weekly Rounds

A newsletter from WSMA CEO Jennifer Hanscom, sent to health care industry leadership and WSMA members.

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weekly_rounds_november_23_2020_the_wsma_mattersto_youWeekly Rounds: November 23, 2020 - The WSMA Matters...to YouWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_november_23_2020_the_wsma_mattersto_you<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>November 23, 2020</h5> <h2>The WSMA Matters...to You</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> During times of chaos and change, WSMA is your steady hand. </p> <p> As you grapple with trying to treat your patients, contain a virus, and protect your own health and well-being, the WSMA is behind the scenes working to protect your interests. We are: </p> <ul> <li>Working with the governor's office and Department of Health to ensure that we can continue to provide care to patients when it is needed.</li> <li>Amplifying a science- and evidence-based approach to combatting this virus.</li> <li>Working to ensure that policymakers understand the benefits of telemedicine payment parity and that carriers are complying with the law.</li> <li>Giving a voice and a face to a medical community that is sacrificing its own financial viability in order to protect their staff and patients, while complying with new orders.</li> </ul> <p> I could go on and on about the ways in which WSMA supports you, advocates for you, and influences change for you…but I know you're busy, so I'll keep this short. </p> <p> What I do want to say is whether we are working behind the scenes or front and center, the work we do directly benefits every single physician in this state. </p> <p> Ever since 1996 when I joined the WSMA, my job has been to convince you to <a href="[@]WSMA/Membership/Join_Renew/Join_Renew.aspx?hkey=37a820cf-9d05-4812-b9dd-c29b9a75356d&WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&_zs=B3aFd1&_zl=pN6G7">renew your membership</a> in WSMA. After the year we've had and all the work we've done together, my hope is that WSMA's value proposition is more clear than ever! </p> <p> This is about survival. The survival and well-being of your patients, your practice, your profession, and your sanity. It is about preserving science, evidence, and public health. It is about keeping your doors open - literally - and preserving your ability to practice your craft while keeping your patients and community safe. </p> <p> It's also about partnership. The work we do is enabled by the membership investment you make with us. And when you partner with us, we are enabled to raise up your voice with the clout carried by being the largest physician association in this state. We are part of the highest-level health care conversations because of our size, our credibility, our influence, and our stature within the community. </p> <p> And our work is far from over. We need your support and engagement as Washington eventually moves from the combat zone to recovery. Soon the Legislature will convene, and COVID-19 recovery and the state's budget will be the primary topics of debate. We must be ready to advance an agenda for medicine's recovery, to ensure that patients have access to a physician when they need one, and to take lessons learned and apply them in a meaningful way to improve care delivery, efficiency, a better public health system, and financially viability for all practices regardless of size or specialty. </p> <p> Thank you in advance for your continued support of WSMA. </p> </div>11/23/2020 10:01:32 AM11/23/2020 9:49:55 AM11/23/2020 12:00:00 AM
weekly_rounds_november_5_2020_2020_election_update_excitement_but_no_immediate_resolutionWeekly Rounds: November 5, 2020 - 2020 Election Update: Excitement, but No Immediate ResolutionWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_november_5_2020_2020_election_update_excitement_but_no_immediate_resolution<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-Sean-Graham-645x425px.jpg" class="pull-right" alt="Weekly Rounds with Sean Graham" /></div> <h5>November 5, 2020</h5> <h2>2020 Election Update: Excitement, but No Immediate Resolution</h2> <p> Sean Graham, Director of Government Affairs </p> <p> Election Day has come to a close, but the race that's at the top of the ticket and the front of everyone's mind remains unsettled, with the presidential election looking like it will take time to untangle. It's not the clean resolution that the record number of Americans who turned out for the election were hoping for, but it's also no surprise given the multiple modes of voting and ballot counting and reporting utilized across the country. </p> <p> The pandemic that has permeated all aspects of our lives has played a significant part in the election, both in terms of who folks voted for and how they cast their votes. Washington state transitioned to all-mail voting nearly 10 years ago, but other states have had to make significant changes to allow for more early and absentee voting. A number of swing states chose to tabulate ballots received before Election Day after the fact, leaving pundits to guess at how those votes will ultimately trend. </p> <p> Democratic presidential nominee Joe Biden was preaching "patience" on election night, saying he expects to win the race as votes are counted in the coming days. President Donald Trump spoke later, lamenting the delay in victory being declared for his campaign, making unsubstantiated allegations of voter fraud, and threatening to pursue legal action to halt additional votes from being counted. </p> <p> The picture at the state level is clearer—if anything, it's more complete than we're accustomed to seeing on Election Day due to early turnout. Results have already been tabulated for more than 68% of our state's registered voters, representing an increase of one million votes more than the number tabulated at this point in the process in 2016. Many votes have yet to be counted and things will surely shift, but here's a look at where things stood in our state at the end of Election Day. </p> <p> There were no surprises in statewide races, with most incumbents cruising to reelection by wide margins. That includes Gov. Jay Inslee and Attorney General Bob Ferguson, both of whom are garnering nearly 60% of the vote, and Insurance Commissioner Mike Kreidler, at nearly 68%. Denny Heck looks poised to win the open-seat race for lieutenant governor that was a contest between two Democrats. The lone incumbent likely to be upset is Treasurer Duane Davidson, a Republican who is trailing Democratic challenger Mike Pellicciotti 56-44. </p> <p> Of Washington's 10 congressional seats, WSMA's focus was on the reelection campaign of Rep. Kim Schrier, the Issaquah Democrat who, as a pediatrician, is the only physician in higher office in our state. Rep. Schrier is staked to a solid 54-46 lead in the 8th Congressional District, a swing district that spans I-90 from Issaquah to Ellensburg. In the intraparty open-seat race for the 10th Congressional District centered on Olympia, Democrat Marilyn Strickland is handily winning. Incumbents lead in the rest of the state's congressional races. </p> <p> The dynamic in the state Legislature will likely be similar to what we've seen over the last two years, where Democrats have enjoyed wide majorities in the Senate and House of Representatives. As things stand, Democrats would increase their Senate majority by one seat to 29-20 and would pick up two more seats in the House to move to 59-39. </p> <p> A number of state legislative races are too close to call, however, particularly given how sky-high turnout may disrupt the voting patterns we're used to seeing. While pre-election predictions varied considerably based on who you talked to, Olympia insiders who follow campaigns closely were projecting results in line with how things are shaping up. Key legislative races WSMA is watching include: </p> <ul> <li>Senate <ul> <li>28th District: Republican Sen. Steve O'Ban is trailing Democratic challenger T'wina Nobles by around 2,000 votes in this Pierce County contest that will likely tighten as late votes are counted. O'Ban is the lead Republican on the Senate Health Care Committee.</li> <li>5th District: An intraparty contest in the Issaquah area has moderate Democrat Sen. Mark Mullet trailing more progressive challenger Ingrid Anderson by less than 1,000 votes. While the seat will remain in the hands of Democrats either way, the outcome will influence the tenor of the Senate.</li> </ul> </li> <li>House of Representatives <ul> <li>The state's few remaining "split" districts where each party controls one state House seat all look to be consolidating into single-party rule. Democrats are poised to pick up a seat in Whatcom County's 42nd District and the 10th District centered on Stanwood, turning both districts blue. Conversely, Republicans will add a seat in southwest Washington's 19th District.</li> <li>One new split district may be created in Clark County's 17th Legislative District where Republican Rep. Paul Harris looks likely to be reelected, but a Democratic challenger is leading the Republican incumbent in the other seat. Rep. Harris was named WSMA's legislator of the year in 2019 for leadership on immunization legislation.</li> </ul> </li> </ul> <p> With so much at stake for patients, physicians, and health policy, WSMA will continue to monitor election results closely and will provide continued analysis on the implications for the house of medicine in the weeks to come. Through engagement in campaigns via our non-partisan political arm, WAMPAC, we have already made connections with many of the elected officials who will be new to office in 2021. We'll also be looking to the physician community to engage directly with your state legislators, as next year's session is likely to be held remotely, precluding many of the traditional avenues for access in Olympia. </p> <p> For more information on election returns, visit the <a href="https://results.vote.wa.gov/results/20201103/">website for the Secretary of State</a>. If you have questions about anything related to the election or would like to learn more about how you can engage with your elected officials, please contact WSMA's Director of Government Affairs, Sean Graham, at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> </div>11/5/2020 3:49:11 PM11/5/2020 9:24:59 AM11/5/2020 12:00:00 AM
weekly_rounds_october_30_2020_let_the_physician_voice_be_heard_vote_todayWeekly Rounds: October 30, 2020 - Let the Physician Voice be Heard: Vote TodayWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_october_30_2020_let_the_physician_voice_be_heard_vote_today<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>October 30, 2020</h5> <h2> Let the Physician Voice be Heard: Vote Today </h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> With election day looming next Tuesday, it feels like there's a lot that's up in the air. How will our country respond to the pandemic? Will the Supreme Court overturn the Affordable Care Act? What's next in terms of health care reform? Every four years we hear that this is the most important election of our lifetime, but if there ever was a time that was true, 2020 has to be the year. </p> <p> I was surprised and frankly dismayed by a <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2772243">report in JAMA last week</a> that found that less than 50% of physicians vote. Granted, they were only looking at data from New York, Texas, and California, so I'd like to think that our state's participation rates would be higher. But based on the report, physicians in those states vote at a rate that's 14% lower than the general public, so we'd have to be doing quite a bit better for me to feel good about physician participation in elections! </p> <p> If you haven't voted or even registered to vote yet, the good news is it's not too late. You can check whether you're registered and find more information about how to vote on the <a href="https://www.sos.wa.gov/elections/register.aspx">secretary of state's website</a>. If you're interested in information about how your state legislators voted on the bills most important to the house of medicine, check out our 2020 Legislator Report Card (available here under 2020 Legislative Report). And if you've got questions about anything pertaining to elections, you can contact WSMA's Director of Government Affairs Sean Graham at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> <p> As the returns come in on Tuesday, everyone's focus will understandably be on the presidential election. WSMA engages in races down the ballot and across the state through WAMPAC, our non-partisan political arm, so we'll be looking at things through a broader lens. Here are a few of the races we'll be watching closely: </p> <ul> <li><strong>8th Congressional District</strong> <ul> <li>This is the first reelection campaign for Rep. Kim Schrier, MD (D-Issaquah), a Virginia Mason pediatrician who is the only physician holding state or federal office in Washington. She faces a Republican challenger who is not well known, but the 8th is very much a swing district and pundits figure this race will be close.</li> </ul> </li> </ul> <ul> <li><strong>10th Congressional District </strong> <ul> <li>When the 10th Congressional District was created in 2012, it was designed to be a swing seat. But by a confluence of factors things have shifted so dramatically that this open seat race is an intraparty affair, with two Democrats facing off. Former Tacoma Mayor Marilyn Strickland is running against state Rep. Beth Doglio, whose husband is a family physician.</li> </ul> </li> </ul> <ul> <li><strong>Lieutenant governor </strong> <ul> <li>Another intraparty contest where Rep. Denny Heck (D-Olympia) is squaring off against state Sen. Marko Liias (D-Mukilteo). The lieutenant governor office is largely a ceremonial post, presiding over the state Senate and filling in for the governor when they're out of state. But it's drawn more focus this year due to speculation that Gov. Jay Inslee may find himself appointed to a federal position should Joe Biden be elected, hence the lieutenant governor would ascend, at least temporarily, to serve as governor.</li> </ul> </li> </ul> <ul> <li><strong>State Legislature </strong> <ul> <li>Democrats will likely retain control of the state House and Senate in Olympia, but what those majorities will look like and focus on is not yet clear. With 126 legislative races on the ballot across the state this year, it's difficult to distill things down to a digestible size. But there are two state Senate races that will have outsized influence on how things look in Olympia next year. <ul> <li>In the Issaquah-area 5th Legislative District, moderate Democrat state Sen. Mark Mullet (D-Issaquah) is being challenged by Ingrid Anderson, a nurse who is a more progressive Democrat. Millions of dollars will be spent on the seat before all is said and done, with business groups favoring Mullet and labor unions supporting Anderson.</li> <li>In Pierce County's 28th Legislative District, state Sen. Steve O'Ban (R-University Place) is being challenged by T'wina Nobles, a Democrat who is president of the Tacoma Urban League. Health care policy has featured prominently in the race, in part due to O'Ban's position as the lead Republican on the Senate Health Care Committee.</li> </ul> </li> </ul> </li> </ul> <p> I know some people feel as though their voice and vote don't matter, but the reality is, every vote counts. Sometimes a race is decided by the casting of just one vote. Let the physician voice be heard at the ballot box—take action to vote today! </p> </div>10/30/2020 9:49:33 AM10/30/2020 9:47:17 AM10/30/2020 12:00:00 AM
weekly_rounds_october_16_2020_together_we_are_an_oceanWeekly Rounds: October 16, 2020 - Together We Are an OceanWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_october_16_2020_together_we_are_an_ocean<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>October 16, 2020</h5> <h2>Together We Are an Ocean</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> While there are tempered signs of hope for a COVID-19 vaccine, we are far from out of the woods from the economic destruction that the pandemic has inflicted on our communities and our practices. As we move into fall, the WSMA continues to make financial stability a primary focus of our work. We need your help. As Ryunosuke Satoro wrote, "individually we are one drop, together we are an ocean." This message of unity concluded our <a href="https://vimeo.com/459169630">2020 year in review</a>, recently shown during our annual House of Delegates meeting, and serves as a précis of our work on behalf of the house of medicine: By bringing together the voices of Washington state's physicians, we can move forward policies and actions that make Washington the best place to practice medicine and to receive care. </p> <p> In the weeks ahead, we will be conducting a new practice financial health survey, as well as meeting with lawmakers in Olympia to discuss how the physician community is faring. More to come on those items, but for now, we need your help on the following: </p> <h3>Contact your congressional representatives to stop payment cuts</h3> <p> We <a href="[@]Shared_Content/News/Weekly_Rounds/2020/weekly_rounds_august_7_2020_the_good_and_the_bad_of_proposed_new_cms_rule">shared in August</a> that the Centers for Medicare & Medicaid Services published the 2021 Medicare physician fee schedule proposed rule, comprising numerous payment policy proposals - some of which are deeply concerning to the house of medicine. </p> <p> Most notably, CMS is restructuring and revaluing the office-based evaluation and management codes following broad changes made in 2019. While the proposal provides an increase in payments for primary care and other office-based services, the effect will result in drastic cuts - as high as 11% - to certain physician specialties. This is due to current law requiring any changes to the physician fee schedule to be budget neutral. </p> <p> H.R. 8505, introduced in Congress by Representatives Michael Burgess, MD, and Bobby Rush, would prevent pending Medicare payment cuts by waiving the budget neutrality requirements stipulated in the Social Security Act for the finalized E/M code proposal slated for implementation in January 2021. We understand other pieces of legislation are also in the works. </p> <p> The WSMA continues to express our concerns that adhering to existing budget neutrality requirements for implementing the new policy will generate sizeable cuts for various specialties. We urge you to join us in <a href="https://takeaction.wsma.org/urge-congressional-action-to-halt-medicare-payment-cuts/">contacting your member of Congress now</a>. Share with them that given the financial pressures many practices and medical groups are facing due to COVID-19, now is the time to implement any payment reductions. </p> <p> According to the AMA, nearly 200 members of the House of Representatives have indicated their support for mitigating the forthcoming payment cuts. Please contact your congressional representative today and urge continued collaboration and support of H.R. 8505 or another legislative remedy to stop forthcoming payment reductions generated by budget neutrality requirements. </p> <p> CMS is expected to release its final 2021 fee schedule rule by Dec. 1. </p> <h3>HHS announces additional Provider Relief Fund payments</h3> <p> The U.S. Department of Health and Human Services announced that $20 billion in new funding will be available for physicians and providers on the front lines of the coronavirus pandemic. Eligible practitioners may apply for funding now through Friday, Nov. 6. </p> <p> Under this Phase 3 General Distribution allocation, physicians who have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. HHS is making a large number of previously ineligible practitioners eligible for Phase 3 General Distribution funding, including: </p> <ul> <li>Physicians and providers who previously received, rejected, or accepted a General Distribution Provider Relief Fund payment. Physicians who have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.</li> <li>Behavioral health practitioners, including those who previously received funding and new providers.</li> <li>Physicians and health care providers who began practicing Jan. 1, 2020 through March 31, 2020. This includes Medicare, Medicaid, CHIP, dentists, assisted living facilities, and behavioral health providers.</li> </ul> <p> HHS is urging all eligible practitioners to apply early; do not wait until the last day or week of the application period. Applying early will help to expedite HHS's review process and payment calculations, and ultimately accelerate the distribution of all payments. For more information on the methodology and application process, read the <a href="https://www.hhs.gov/about/news/2020/10/1/trump-administration-announces-20-billion-in-new-phase-3-provider-relief-funding.html">press release</a>. </p> <h3>Premera PPE policy</h3> <p> Premera Blue Cross and its subsidiaries have made a determination to follow Centers for Medicare & Medicaid Services guidelines and have been allowing for separate reimbursement for personal protective equipment over the past several months when billed appropriately. Premera will be following this practice through the end of October 2020. This policy applies to dates of service on or before Nov. 1, 2020. </p> <ul> <li>For dates of service after Nov. 1, Premera will consider such supplies to be included in the standard office visit reimbursement. Premera will no longer pay separately for such equipment but will resume the prior policy of considering such equipment to be part of the services covered under standard office visit codes. PPE will no longer be reimbursed as of dates of service on Nov. 1, 2020 and after.</li> <li>Practices should correctly code for PPE using HCPCS codes (A-series of codes) for coverage of gowns and masks. Premera notes that the "A" codes typically billed for such miscellaneous supplies are: <ul> <li>A4927 - Gloves, non-sterile</li> <li>A4928 - Surgical masks</li> <li>A4930 - Gloves, sterile</li> </ul> </li> </ul> <p> Practices should submit their standard charges or acquisition costs for each visit, and each contract will either have a set fee (not to exceed billed charges) or a default percentage. All other "miscellaneous codes" billed will potentially incur a "denial," not for PPE, but for other reasons. Providers can access a copy of the policy on the <a href="https://identity.onehealthport.com/EmpowerIDWebIdPForms/Login/PREMERA/">OneHealthPort website</a> (registration is required). </p> <p> Practices that were not aware of Premera's policy can be reimbursed for those PPE expenses if those charges were not included in claims already submitted. They would need to rebill per the above guidance for dates of service prior to Nov. 1, 2020. For any further clarifications, please contact your Premera provider service. Thank you to the Washington State Medical Group Management Association for providing this information. </p> <h3>Urge local legislators to support payment parity for virtual and audio visits</h3> <p> The Legislature has granted a brief extension - through Nov. 9 - of Gov. Jay Inslee's proclamation temporarily requiring telemedicine payment parity. While the WSMA was glad to see the proclamation extended, we continue to advocate for the policy to be extended through the end of the year, which is when the provisions of Senate Bill 5385, permanently requiring payment parity from state-regulated health plans, take effect. </p> <p> Similarly, the Office of the Insurance Commissioner has extended its emergency order to health insurers expanding telehealth and other coverages until Nov. 13, including requiring all state-regulated carriers to permit and reimburse for care provided over non-HIPAA-compliant platforms, including video chat applications and telephones. </p> <p> We need you to act: Please write your local legislators and urge them to: </p> <ul> <li>Extend the governor's telemedicine parity proclamation through Dec. 31, 2020.</li> <li>Call on the OIC to extend its emergency telemedicine order for the duration of the public health crisis.</li> <li>Share how both video visits and audio visits benefit your patients. Once the Legislature convenes WSMA will advocate for further permanent expansion of telehealth parity, including the use of audio-only visits.</li> </ul> <p> <a href="https://takeaction.wsma.org/urge-your-state-lawmakers-to-support-telemedicine-payment-parity-policies/">Send a message to your legislators today</a>. </p> <h3>Don't forget to vote</h3> <p> Ballots for the general election on Nov. 3 are in the mail. As a reminder, online and mail registrations must be received eight days before Election Day on Oct. 26. At the end of every legislative session, the WSMA prepares a legislator "report card" to show how each legislator voted on WSMA's top-priority bills. Make sure to check out the <a href="[@]WSMA/Advocacy/WAMPAC/WSMA/Advocacy/WAMPAC/WAMPAC.aspx">2020 Legislator Report Card</a>, which includes bills from both the 2019 and 2020 legislative sessions, while you are filling out your ballot to see how your local state legislators fared. </p> <p> In closing, please urge your patients to get their flu shots (and get one yourself). Facing a "twindemic" of flu plus COVID-19, WSMA has launched the Be Smart, Be Safe, Get Your Flu Shot campaign. The campaign is initially focusing on early vaccination, with <a href="https://www.yakimaherald.com/opinion/editorials/guest_editorials/guest-opinion-flu-combined-with-covid-19-could-mean-double-trouble-for-many-patients/article_ee0e4545-9d8a-53f4-835f-1dca1804e916.html">several</a> <a href="https://www.seattletimes.com/opinion/flu-or-covid-19-dont-guess-this-fall-get-your-flu-shot/">op-eds</a> and <a href="https://www.spokesman.com/stories/2020/sep/18/providers-public-health-officials-stress-the-impor/">news stories</a> published, and a partnership with the Department of Health to offer patient awareness materials (in English and Spanish) for immunization partners to promote through their own communication channels. The WSMA has also been working with the DOH to alert practices on the availability of additional adult flu doses available this year for un- and under-insured individuals. It's not too late to enroll to receive these doses for your practice or clinic. Visit our new flu webpages at <a href="[@]flu">wsma.org/flu</a> to learn more, and to find resources to help your practice get the word out on the importance of getting vaccinated. </p> <p> In the coming weeks, we'll introduce new PSAs on the topic and we're continuing to work on getting media traction in communities throughout the state. More to come. </p> <p> With that, I'll conclude by sending warm wishes to you all here at the start of fall, and a heartfelt thank you to the extraordinary work you all do every day on behalf of Washington's patients. We are all in this together - and it is our unity that gives us strength. It's from that deep well that I draw courage, compassion, and hope, and I hope you do as well. Thank you </p> </div>10/16/2020 9:35:44 AM10/16/2020 9:26:20 AM10/16/2020 12:00:00 AM
weekly_rounds_september_29_2020_a_beacon_of_light_in_the_darknessWeekly Rounds: September 29, 2020 - A Beacon of Light in the DarknessWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_september_29_2020_a_beacon_of_light_in_the_darkness<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-Schlicher-645x425px.jpg" class="pull-right" /></div> <h5>September 29, 2020</h5> <h2>A Beacon of Light in the Darkness</h2> <p> <em>On Saturday at the virtual 2020 Annual Meeting of the WSMA House of Delegates, we inaugurated our incoming president, Nathan Schlicher, MD, JD. For those of you who couldn't be with us, we wanted you to have the opportunity to read an amended version of his speech, so he is our guest columnist this week for Weekly Rounds. You can also watch a video of <a href="https://vimeo.com/461645025">Dr. Schlicher's speech here</a>.<br /> - Jennifer Hanscom, WSMA CEO</em> </p> <p><strong>Nathan Schlicher, MD, JD, WSMA 2020-2021 incoming president's speech, Saturday, Sept. 26, 2020.</strong></p> <p> Good morning colleagues and friends. It is a privilege to serve as your president of the Washington State Medical Association. I am honored to assume the post from my friend Bill Hirota and all the WSMA presidents with whom I’ve worked over the past nine years. </p> <p> In 2009, when I joined the WSMA as a newly minted emergency medicine physician, we were mired in the Great Recession. It seemed an inhospitable place for a young doctor as there were few jobs, existential threats of governmental regulation, and of the march of corporatization in health care. </p> <p> Those were uncertain times. </p> <p> But this year we faced a threat not seen for a hundred years. The coronavirus pandemic upended the practice of medicine and the broader world in unimaginable ways. Where we once happily gathered at concerts and theme parks, we now socially distance. Where we once shared hugs, smiles, and handshakes, now our facial expressions are masked. In a time when Snapchat and text messaging are preferred modes of communication, COVID compounded our isolation, increasing the distance between us, and eroding personal connections. And as COVID took so much away, it left many of us wondering where the light had gone. </p> <p> When the darkness overwhelmed the nation—it was health care heroes, physicians and nurses who stepped up to care for those in need. We provided care, we held the hands of the dying, we answered the call of our profession, in spite of the risk we faced. </p> <p> To all of you let me say this: Well done, heroes! In those moments of great challenge, I hope fear was met with hope and a sense of purpose. </p> <p> Now it’s time to look ahead. I see four key things that will make a difference in our future, and with WSMA’s help, we can make it happen. </p> <p> First, if we take anything from this pandemic, it’s that physicians must lead our health care system. As Peter Drucker said, “Management is doing things right; leadership is doing the right thing.” We have too much management and not enough leadership in health care today. </p> <p> Physicians can serve in administration, while also working clinically. We can be both CEO and physician, medical director and doctor, CMO and practitioner. More than 50% of us are now employed by large groups—now is the time for the employed to lead. </p> <p> Here’s an example—during the early days of COVID, the medical executive committee met to discuss how to face this epidemic. A physician shared the challenges and fears his team faced as they wrestled with caring for their patients, while striving to keep their families safe. He described a plan to open tents, eliminate hallway beds, and encouraged cancelling of surgeries to make the space he needed to combat a pandemic. </p> <p> But the ever-present business impact of such decisions overrode the innovation. A non-physician leader noted the idea would be taken under consideration, but in that moment the feeling in that room was clear, we were not essential, we were expendable. </p> <p> That kind of thinking demonstrates perfectly the “iceberg of ignorance.” If you’re not familiar with the concept, it’s a knowledge gap study that reveals the higher up you are on the leadership ladder, the less you know. </p> <p> Physicians must lead the future and straddle the chasm of ignorance from the front line to the C-suite. Through the WSMA you can make this a reality by attending our Center for Leadership Development programming that promotes leadership development, governance education, and courses to help train the future generation. You are already leaders by being here today with the WSMA, but lets not stop here. Let’s take it to the top! </p> <p> Second: As we lead, let’s care for those we lead. An emergency physician who survived a near suicide event said: “When we witness trauma and death among the innocent, a little piece of my soul died. We’re never offered counseling and in the end, you get the jaded emergency doctor who struggles to care. My psychologist says it wasn’t just the last girl. It was trauma after trauma after trauma.” </p> <p> Like you, the patients I have lost remain with me. I can still close my eyes and feel room #12 where Haley died. I was a brand-new attending, three months out of residency, full of confidence, ready to conquer the world in another pandemic, the H1N1 pandemic. I remember intubating her while pulmonary edema filled her lungs and obscured my view, but I managed to sneak the tube in near blind. The cheers of the nurses faded as I saw her heart rate drop from 180 to 60. Her pulse was gone. I well remember those three hours, on and off again coding her, talking to her mom in the hall as she sat motionless in a hard-plastic chair, texting family on her old flip phone. We would get her to Mary Bridge for ECMO, but she would never make it, arresting one last time upon arrival. To this day, 12 years into my practice, it still brings tears to my eyes. </p> <p> With this pandemic we’ve seen death on a scale not seen in decades. Add its risk to us, to our families, add the moral injury of what we’re facing, and the stress on physicians is profound. Moral injury is the suffering people experience when we are in high-stakes situations, things go wrong, and harm results that challenges our deepest moral codes and ability to trust in others or ourselves. The harm may be something we did, something we witnessed, or something that was done to us. It results in moral emotions such as shame, guilt, self-condemnation, outrage, and sorrow. </p> <p> It is the type of sorrow and guilt that we know has resulted in the suicide death of colleagues, such as Dr. Lorna Breen, an emergency physician in Manhattan. She was one of the dedicated front-line workers who put her own health at risk, having contracted COVID personally, but going back to work 10 days later to help, once more, caring for those in need. Despite her training, her leadership as a medical director, and her supportive family, she could not reconcile the world in which she worked with the world in which she wanted to live. Her story is tragically not unique. </p> <p> We can’t simply yoga our way out of this problem. The WSMA is working hard to combat the epidemic of burnout and moral injury. We are pushing for real change by looking at the drivers of the problem. Administrative simplification and easing the work of running a practice remains a high priority of our Olympia team. The WSMA Foundation is leading a wellness initiative with PDSA cycles to improve the practice of medicine. And when we take our rightful place as the leaders of our health system, we will be the drivers of change that builds a robust and holistic system that cares for its doctors as well as its patients. </p> <p> Third: As we lead our way into a healthier future, we must reinvigorate passion for professionalism. When I started law school, our civil law professor, standing in the deep well of the auditorium of new 1L students, spoke in the deep baritone of professors past about the three learned professions: religion, law, and medicine. He noted how each held an important role not just because of the job they did, but because of their leadership in the community and the example they set through their actions. </p> <p> Each of the professions cared about the forgotten before themselves, seeking to serve rather than be served. They cared for parts of the human condition: the body (medicine), the soul (religion), and society (law). I believe that medicine has the power, and obligation, to work on body, soul, and society. </p> <p> I’m disillusioned with many in our profession when I see what they write on social media or how they speak to a colleague with whom they disagree. Civil discourse has gotten lost. We’ve become subject to the echo chamber effect of politics, religion, and science denialism. </p> <p> As the learned profession of medicine, we should be able to discuss the challenges of racism and acknowledge the differential experience of our African American colleagues, patients, and citizens, while respecting that most police officers are good people doing hard work in a challenging environment, as are we. As physicians we should be willing to speak about the increasing economic disparity in our communities and the risk it poses to our patients if they cannot afford care even while working two jobs. </p> <p> The WSMA is a beacon of civility in an uncivil world. Our Olympia efforts are not flashy, making threats or big burns in testimony. We do not rage or tweet against a bill, no matter how much it upsets us (can you say: naturopath scope of practice?). </p> <p> We will continue that standard of educated dialogue and reflect well on our profession. We will advocate to address the social determinants of health including racial disparities this year by supporting a Health Equity Continuing Medical Education Program. We will, with your approval today, start a Latinx Section in the WSMA to increase the representation of Latinx members and give a new conduit to their voice. </p> <p> If we are going to heal a divided nation that is far too isolated, we must lead through our actions together. I hope today as we discuss some of these challenging resolutions we will rise to that occasion as the first step on building a better future. </p> <p> Fourth: As we advocate for a more civil world, we must be scientists first. The American author Jim Butcher once wrote “The human mind isn't a terribly logical or consistent place. Most people, given the choice to face a hideous or terrifying truth or to conveniently avoid it, choose the convenience and peace of normality. That doesn’t make them strong or weak people, or good or bad people. It just makes them people.” </p> <p> In these times of COVID, it seems easier to accept illogical truths. I’ve been shocked to see physicians argue against masks, ignoring observational studies and mountains of historical evidence from other diseases. We’ve seen physicians trying to profiteer by minimizing the risk. Now there’s a neuroradiologist pushing debunked theories over the objection of the world class expert Dr. Anthony Fauci. Others on the front lines have given in to fatalism, believing that there is nothing we can do to prevent the disease, so why even try? </p> <p> Physicians must help lead a course correction. We understand the scientific method that guides trial and error, the ethical standards that limit our ability to certain types of studies, and how to review the quality of source materials. The WSMA provides Continuing Medical Education and promotes valid science. We advocate for sound public policy like the elimination of the personal exemption from the MMR vaccine and support DOH rules on mandatory masking in schools. We continue to advocate for the health and welfare impacts of climate change and the social determinants of health. But it is imperative that we lead these conversations with our patients, organizations, and colleagues in an honest, respectful way. </p> <p> If we do not confront the half-truths and mistruths with compassionate advocacy, we give them room to grow and breed. </p> <p> So this… my mentor in life was a wily old Methodist preacher whom I met when he was 77 and I was 11. He never shied away from controversial topics, choosing to lead with compassion and respect. When he gave a controversial sermon at Seattle’s First United Methodist Church in the ’80s and received hundreds of letters from “Christians” who wrote some of the most vile language you could imagine, he responded to each of them with compassion and love. When I gave my first homily at 13 and upset a church member who demanded a swift rebuke of this young man, Big David graciously said all were welcome in the church and when they threatened to leave, he wished them luck on their journey. </p> <p> He led by example, giving generously to those in need and challenging his privileged congregation to host Seattle’s Tent City on their church grounds. When the neighbors complained, at the age of 85 he limped around in his Ultrasuede jacket and bicycle socks, knocking on their doors, inviting them to sit in the pews with those they had condemned. And when he died at the age of 94, his closing lines on his life were simple, “I love you, thank you, I love you.” </p> <p> Like David, we must step forward to lead our health system, with professionalism and compassion, seeking the wellness of those we serve, and encouraging the pursuit of knowledge. I believe when we rise to this calling and become the beacon of light and embrace our professionalism, we give our life’s work purpose. </p> <p> It is not easy, it is not simple. We must choose to care for our neighbors and go the extra mile. We must choose to lean into leadership rather than be led. I believe that our future is bright if we stand together, defend our trade, and reinvigorate our profession. </p> <p> This is my pledge because I love what I do as a physician and I love you for what you do to care for our neighbors. </p> <p> Thank you. </p> </div>9/29/2020 9:35:11 AM9/29/2020 9:24:45 AM9/29/2020 12:00:00 AM
weekly_rounds_september_18_2020_your_voice_your_vote_it_all_mattersWeekly Rounds: September 18, 2020 - Your Voice, Your Vote - It All MattersWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_september_18_2020_your_voice_your_vote_it_all_matters<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>September 18, 2020</h5> <h2>Your Voice, Your Vote - It All Matters</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> As my middle son turns 18 on Monday, I can't help but wonder...where has the time gone? In some ways, it seems like only yesterday that instead of heading to the 2002 WSMA House of Delegates, I was on my way to Swedish to deliver my son. It's the only WSMA Annual Meeting I've missed in 24 years! </p> <p> Obviously, with the impact of COVID-19, this year's annual gathering will look different than years' past, as we move to an online meeting format. Even so, that hasn't tempered delegates' enthusiasm for discussing new policy at the WSMA. Thirty-eight resolutions will be debated during the annual meeting on Sept. 26-27. While only delegates can vote, all members are encouraged to share their opinions. You can do that in two ways: either by adding your comments to our password-protected <a href="[@]WSMA/Membership/Discussion_Forums/Virtual_Reference_Committees/WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx">virtual reference committees</a> or by participating in the online event. Be sure to <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">register in advance</a> to gain access to the special meeting platform. </p> <p> In addition to resolutions, several reports also have been submitted for review. Some of the reports are internal to the association, others are from external stakeholders. All can be viewed in the Delegate Handbook at <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">wsma.org/annual-meeting</a>. </p> <p> If you are a voting delegate, note that this year we are showcasing all candidates nominated for office. To be as well-informed as possible, I urge you to review their materials in advance, in addition to watching their video speeches which are available via the WSMA <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">Annual Meeting webpage</a> (look under BOT Elections). The House of Delegates will vote on candidates for office on Sunday, Sept. 27 </p> <p> Speaking of candidates, as my soon-to-be 18-year-old comes of age on Monday, he will also gain the right to vote. I hope he will duly embrace his civic duty, research candidates that reflect his values, views, and desires for leadership, and cast his vote effectively. </p> <p> That's my hope for you as well! I encourage you to research who you plan to support. And remember, WAMPAC produced a legislator report card (downloadable <a href="[@]WSMA/Advocacy/Legislative___Regulatory/WSMA/Advocacy/Legislative_Regulatory/Legislative_Regulatory.aspx">here</a>) that can help inform you about how your state legislators voted on issues that impact the profession and patients. This information is key to your decision-making as you strive to elect representatives who support the house of medicine. </p> <p> WSMA's government affairs and policy team is also hosting an Advocacy Council meeting to provide updates on the legislative and campaign landscape at noon on Friday, Sept. 25. We're excited to be joined by Senate Democratic Leader Andy Billig and House Republican Leader JT Wilcox, who will provide their insights on all things 2020. We will also share an update on WAMPAC's campaign activities and preview how the election may impact WSMA's 2021 legislative priorities. </p> <p> The meeting will be held via Zoom and <a href="https://zoom.us/webinar/register/WN_-NWTv-qpQAu6Sn8xU8dLsA">registration is required</a>. You will receive a confirmation email containing the Zoom information after completing the registration. </p> <p> Another way to help ensure that the profession has solid representation in the state Legislature is to support our political action committee. WAMPAC is the nonpartisan campaign arm of WSMA that builds relationships and connections between our members and their elected officials. The start of that connection is via a donation - whether a one-time donation or an ongoing commitment, we urge you to give today so that we can advance an advocacy agenda that bolsters the profession and improves patient care throughout Washington. Your contribution really does make a difference. I hope you'll consider <a href="[@]WSMA/Advocacy/WAMPAC/Give_to_WAMPAC/WSMA/Advocacy/WAMPAC/Give_to_WAMPAC.aspx">joining the Diamond Club or contributing to our $20 for 2020 campaign</a>. </p> <p> At the congressional level, WSMA's priority race is Rep. Kim Schrier, the Issaquah pediatrician who's running for re-election for the first time. Rep. Schrier bested a crowded field in the primary election and has advanced to the general against a challenger who is not well-known; however, the 8th Congressional District is a swing district and the race will likely be close. Rep. Schrier needs the continued support of the physician community and has received contributions from the AMA's political action committee and several other physician organizations. You can support Rep. Schrier by visiting her <a href="https://www.drkimschrier.com/">campaign website</a>. </p> <p> In the 10th Congressional District seat currently held by Rep. Denny Heck, former Tacoma mayor Marilyn Strickland and current state House Rep. Beth Doglio are facing off in the general election. Rep. Doglio is married to WSMA member Dr. Eddy Cates. </p> <p> The governor's race is at the top of the ticket for statewide campaigns. Gov. Jay Inslee will go up against Loren Culp, a conservative Republican from Ferry County. In other statewide races of interest to WAMPAC, Attorney General Bob Ferguson and Insurance Commissioner Mike Kreidler will be heavy favorites in the general election. And in the race for lieutenant governor, the aforementioned Denny Heck will face off against fellow Democrat Marko Liias in November. </p> <p> With all the unexpected events this year, there is a lot to consider as we all head to the polls on Nov. 3. If you have questions about anything related to campaigns or would like to get more involved, contact WSMA Government Affairs Director Sean Graham at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> <p> Most importantly, remember to vote early and get those ballots in the mail. Every vote matters! </p> </div>9/18/2020 9:07:45 AM9/18/2020 9:06:13 AM9/18/2020 12:00:00 AM
weekly_rounds_september_5_2020_contact_congress_this_labor_day_weekendWeekly Rounds: September 5, 2020 - Contact Congress This Labor Day WeekendWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_september_5_2020_contact_congress_this_labor_day_weekend<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>September 5, 2020</h5> <h2>Contact Congress This Labor Day Weekend</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> Are you feeling a little nostalgic this Labor Day weekend, remembering past family barbeques, local street fairs and markets, or attending a local pancake breakfast fundraiser for your local legislators or members of Congress? Regardless of many of these events being cancelled, it's still important to use this time to raise up your voice on issues that impact you and your profession. </p> <p> Your congressional representatives are now in your area and they need to hear from you on two critical issues before they return to Washington, D.C., after the holiday weekend. </p> <h3>COVID-19 relief package</h3> <p> With Congress currently gridlocked over the next relief package, they need to hear from you about what you need in order to keep your practices open so patients can continue to receive care. The American Medical Association Physician Grassroots Network has provided tools for arranging meetings via phone or videoconferencing technology —see this <a href="https://www.ama-assn.org/practice-management/sustainability/get-facetime-congress-hit-key-pandemic-relief-measures">AMA advocacy update</a>. Here are the messages that need to be communicated: </p> <ul> <li>Continue the expansion of, and add flexibility to, the Medicare Accelerated and Advanced Payments Program.</li> <li>Better address Medicare and Medicaid payment policy to account for the lack of positive updates.</li> <li>Include direct financial support to help sustain physician practices through the COVID-19 crisis.</li> <li>Permanently lift the geographic and site restrictions on telehealth technologies so all Medicare beneficiaries have access to telehealth services.</li> <li>Institute broader liability protection for physicians.</li> <li>Provide federal assistance for the purchase of PPE.</li> </ul> <h3>Urge congressional action to halt Medicare payment cuts</h3> <p> The Centers for Medicare & Medicaid Services has published the 2021 Medicare physician fee schedule proposed rule, comprising numerous payment policy proposals—some of which are deeply concerning to the house of medicine. </p> <p> Most notably, CMS is restructuring and revaluing the office-based evaluation and management (E/M) codes, following broad changes made in 2019. While the proposal provides an increase in payments for primary care and other office-based services, the effect will result in drastic cuts—as high as 11%—to certain physician specialties. This is due to current law requiring any changes to the physician fee schedule to be budget neutral. </p> <p> This weekend, take a moment to urge your congressional representative to waive the budget neutrality requirements stipulated in Section 1848(c)(2) of the Social Security Act before the final E/M code proposal is implemented on Jan. 1, 2021. This much-needed action by Congress, for inclusion in any forthcoming legislative package, will provide a critical reprieve for physicians and a broad scope of health care professionals facing substantial payment reductions in the coming months. </p> <p> <a href="https://takeaction.wsma.org/urge-congressional-action-to-halt-medicare-payment-cuts/">Learn more and take action</a>. </p> <p> In honor of the Labor Day holiday, just a few brief words of gratitude. As your professional society, we are deeply grateful for the sacrifices each of you has made, and continue to make each day, on behalf of Washington's patients and Washington state communities. Your work is valued, respected, and upheld in every moment of our work on your behalf—it's why we do what we do. </p> <p> Respect for the value of the work you do motivates and informs our work, and also helps create good health care policy at both the state and national levels. As we head into the long weekend, we hope you find some much-needed respite and relaxation. </p> </div>9/8/2020 9:08:15 AM9/8/2020 9:05:58 AM9/5/2020 12:00:00 AM
weekly_rounds_august_21_2020_its_back_to_school_timeWeekly Rounds: August 21, 2020 - It's Back-to-School TimeWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_august_21_2020_its_back_to_school_time<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>August 21, 2020</h5> <h2>It's Back-to-School Time</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> Recently, I had to share the news with my boys that their school will be remote through the end of the first quarter, if not longer. They were pretty devastated. The novelty of not attending school has worn off and they're eager to reconnect with friends and do normal high school activities. </p> <p> I know the launch of this new school year is on the minds of many of us, <a href="https://www.wbur.org/hereandnow/2020/08/12/doctor-kids-school-pandemic">doctors included</a>. With most of Washington's schools utilizing a remote learning environment, parents are not only grappling with the logistics of having their kids at home, they're also concerned about the long-term ramifications, as well as the social isolation. </p> <p> We asked child psychiatrist Avanti Bergquist, MD, to tackle the topic in our latest WSMA public service announcement. In the video, she offers tips on how best to cope as parents and school-age children experience anxiety at the start of the school season. <a href="[@]WSMA/Resources/COVID-19_Response/COVID-19_Patient_Education/WSMA/Resources/COVID-19/COVID-19_Patient_Education/covid_19_patient_education.aspx">Click here</a> to see the PSA and share it with your friends. </p> <p> Since the onset of COVID-19, we've been producing these PSAs as part of our mission to provide the best care for patients. We encourage you and/or your medical group to share these messages via your personal or practice's social media channels. </p> <p> We've also produced a number of COVID-19-related resources, including graphics for your use to help encourage patients to mask up. Take a moment to download these resources <a href="[@]WSMA/Resources/COVID-19_Response/COVID-19_Patient_Education/WSMA/Resources/COVID-19/COVID-19_Patient_Education/covid_19_patient_education.aspx">here</a> and feel free to make them available as posters or social media graphics. </p> <p> While you're on our website, don't miss the various educational offerings we offer to our members. These continuing professional development opportunities are convenient and readily available for your lifelong learning journey. </p> <h3>WSMA education on COVID-19 and health equity</h3> <p> Given that COVID-19 will impact the medical community for the foreseeable future, we convened a Virtual Grand Rounds mini-series to focus on the evolution of the disease, management of COVID-19 patients, and our state's response to the pandemic—with an emphasis on what front-line physicians need to know. WSMA brings you the state's public health leaders—Vice Adm. Raquel Bono, MD, Kathy Lofy, MD, and Charissa Fotinos, MD—for free sessions that will offer the latest information on COVID-19 that directly impacts you, your practice, and your patients. Guest speakers will share their expertise as well. The format includes 45 minutes of content and 30 minutes for a Q&A discussion with the speakers. Catch our recent COVID-19 sessions on demand <a href="[@]WSMA/Education/Webinars_OnDemand/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx">here</a>; details on future sessions will be available on our website <a href="[@]WSMA/Education/Upcoming_Webinars/WSMA/education/Upcoming_Webinars/Upcoming_Webinars.aspx">here</a>. </p> <p> The WSMA also recently launched a new <a href="[@]WSMA/Education/Upcoming_Webinars/WSMA/education/Upcoming_Webinars/Upcoming_Webinars.aspx">webinar series on health equity</a>. The first in the series is titled "Cultural Agility: Creating Sustained Systemic Change in Health Care." This Continuing Professional Development webinar will educate physicians and physician assistants on the current state of health inequity, describe how the systems that were created impact patient care, and outline strategies to create lasting change within health care organizations. </p> <p> The second webinar, "LGBTQ Health Care," will educate physicians and physician assistants on strategies to align care delivery with existing evidence-based, culturally sensitive standards of care for LGBTQ people in Washington state to decrease health disparities. </p> <p> To register for our health equity sessions, visit the <a href="[@]WSMA/Education/Upcoming_Webinars/WSMA/education/Upcoming_Webinars/Upcoming_Webinars.aspx">WSMA website</a>. </p> <h3>Leadership development</h3> <p> You may be aware of our popular <a href="[@]WSMA/Education/Physician_Leadership/Physician_Leadership_Course/WSMA/Physician_Leadership/Physician_Leadership_Course/Physician_Leadership_Course.aspx">physician leadership</a> and <a href="[@]WSMA/Resources/Physician_Leadership/Dyad_Leadership_Course/Dyad_Leadership_Course.aspx">dyad courses</a>. These in-depth leadership courses continue this fall via a live online learning environment. You can learn more <a href="[@]WSMA/Education/Physician_Leadership/WSMA/Physician_Leadership/Physician_Leadership.aspx">here</a>. </p> <p> We are also launching several leadership seminars designed for graduates of the WSMA Physician Leadership Course. Seminars will provide in-depth exposure to the topics that were covered in the PLC, with an emphasis on skill development and practical application of leadership principles using role-playing, demonstrations, and case studies. All seminars will be held via Zoom and will range between half-day and full-day sessions depending on the seminar topic. </p> <p>Topics include:</p> <ul> <li>Communication is a Two-way Street: Tips on Shaping Your Message and Listening Effectively.</li> <li>The Art of Persuasion and Influence in Medical Leadership.</li> <li>Harness Your EQ to Change Culture and Influence Colleagues.</li> <li>Your Personal Leadership Style: The Key to Unlocking Versatility.</li> <li>Beyond the Basics: Building High Performing Teams.</li> <li>A Leader's Guide to Providing Feedback and Managing Conflict.</li> <li>Lessons from a CFO: How to Increase Your Financial I.Q.</li> </ul> <p> We intentionally design these efforts to support our members in their work and lives. I trust you'll find these resources helpful, and I hope you're surviving these back-to-school days in good health. </p> </div>8/21/2020 10:27:11 AM8/21/2020 10:22:34 AM8/21/2020 12:00:00 AM
weekly_rounds_august_7_2020_the_good_and_the_bad_of_proposed_new_cms_ruleWeekly Rounds: August 7, 2020 - The Good and the Bad of Proposed New CMS RuleWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_august_7_2020_the_good_and_the_bad_of_proposed_new_cms_rule<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>August 7, 2020</h5> <h2>The Good and the Bad of Proposed New CMS Rule</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> No matter how unusual things have been over the last several months, one thing we can count on every summer is the release of proposed updates to Medicare's physician fee schedule. This year, the Centers for Medicare & Medicaid Services published its proposed rule, comprised of more than <a href="https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy-2021-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other">1,300 pages of fee and policy proposals for 2021</a>, on the evening of Aug. 3 - the latest the agency has released the document in over a decade. </p> <p> The uncertainty and associated anxiousness created by the late release has given way to concerns around several controversial proposals. Most notably, CMS is overhauling the evaluation and management (E/M) office visit, documentation, and payment system, which will require an 11% budget neutrality reduction in the conversion factor, pitting the house of medicine against itself. </p> <p> While supportive of CMS's proposal to implement reforms and substantial payment increases for office visits, the WSMA is concerned by the <a href="https://www.cmadocs.org/Portals/CMA/files/public/CY%202021%20PFS%20Estimated%20Impact%20on%20Total%20Allowed%20Charges%20by%20Specialty.pdf" target="_blank">associated cuts to the non-primary care specialties</a> that will have a negative impact on many physician practices. </p> <p> Due to the community response to COVID-19, Washington's physician practices of all specialty types have <a href="[@]Shared_Content/News/Press_Release/2020/washingtons_physician_practices_in_financial_crisis_new_wsma_survey">experienced severe financial difficulty</a>. Instead of compounding these challenges, the WSMA supports the growing <a href="https://www.mgma.com/getattachment/764a1f8b-32b3-4975-85b9-54fa4703a644/E-M-Sign-on-letter-to-HHS-Budget-Neutrality.pdf.aspx">chorus</a> of medical associations and societies calling on the U.S. Department of Health and Human Services to use its authority under the public health emergency declaration to preserve patient access to care and mitigate financial distress due to the pandemic by implementing the office visit increases as planned while waiving budget neutrality requirements for the new Medicare office visit payment policy. </p> <p> Other notable proposed policies include: </p> <ul> <li>Annual updates to the MIPS quality program, including gradually implementing MIPS in 2021 and postponing the MIPS Value Pathways participation option until 2022.</li> <li>Permanently keeping several codes that were temporarily added to the Medicare telehealth list during COVID-19, including the prolonged office or outpatient E/M visit code and certain home visit services. These policies were included, in part, because of WSMA advocacy with CMS officials.</li> <li>Implementing the Appropriate Use Criteria program, which will require, starting Jan. 1, 2021, physicians to consult AUC using clinical decision support tools prior to ordering advance imaging services for Medicare beneficiaries.</li> </ul> <p> You can find a copy of the proposed rule <a href="https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17127.pdf" target="_blank">here</a>, RVU files and other downloads <a href="https://www.cms.gov/medicaremedicare-fee-service-paymentphysicianfeeschedpfs-federal-regulation-notices/cms-1734-p">here</a>, and a CMS fact sheet overviewing the rule <a href="http://wsma.informz.net/z/cjUucD9taT05NTA1NTY2JnA9MSZ1PTEwNzgxMDgzNjEmbGk9Nzk0MzcwOTE/index.html">here</a>. CMS is taking comments on its proposals until 5 p.m. on Oct. 5. We encourage you to review the rule and submit your comments at its <a href="https://beta.regulations.gov/document/CMS-2020-0088-0001">regulations.gov webpage</a>. </p> <p> The Medicare physician fee schedule, in a normal year, is finalized in early November. The WSMA will keep members apprised of developments. If you have any questions, email WSMA's policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> </div>8/7/2020 9:55:05 AM8/7/2020 9:52:56 AM8/7/2020 12:00:00 AM
weekly_rounds_july_31_2020_wsma_zooms_into_its_virtual_futureWeekly Rounds: July 31, 2020 - WSMA Zooms Into Its Virtual FutureWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_31_2020_wsma_zooms_into_its_virtual_future<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>July 31, 2020</h5> <h2>WSMA Zooms Into Its Virtual Future</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> One of my favorite things about the WSMA being a member-driven organization is when we come together in person, whether in small meetings or large, to connect, to share, and to get to know one another. But now that COVID-19 has derailed such gatherings for the foreseeable future, I'm grateful for the technology that enables us to come together - even if virtually - to build and sustain community, even as our need to distance continues. </p> <p> Just like most other organizations, your WSMA team is hard at work transitioning two upcoming events from in-person to virtual. And the silver lining to making that change? Even more of you will be able to participate! So read on and be sure to mark your calendars. </p> <h3>Join our Virtual Road Trip</h3> <p> Last year we launched our first road shows, hitting the road to Spokane, Vancouver, and Bellingham so we could meet with our members face to face. This year, on Aug. 27 from 6 - 8 p.m., we'll make that a virtual trip, without the pesky limitations of geography! </p> <p> Members are welcome to join us as we offer an update on WSMA's advocacy and policy work, with an emphasis on our work during the COVID-19 outbreak. We'll want to hear from you too, so we'll "Zoom" into virtual breakout rooms where you'll have an opportunity to share your thoughts with staff and members of the executive committee about how we can amplify our work in representing the profession or improving patient care. </p> <p> Lest you think this Zoom meeting will be just one more regular ol' meeting or webinar…think again! We'll make it fun, interactive, and there will be prizes. Beyond that, the first 25 folks to register will be the lucky recipients of a dandy "Road Trip Snack Box," shipped to their home just in time for the Virtual Road Trip. Our Zoom space will be limited, so sign up quickly once registration goes live. If the Aug. 27 event becomes over-subscribed, stay tuned as we'll add another date to the schedule if needed. </p> <p> <a href="[@]WSMA/Events/Virtual_Road_Trip/WSMA/Events/Virtual_Road_Trip/WSMA_Virtual_Road_Trip.aspx">Click here</a> for the event webpage. Stay tuned - registration will be announced shortly. </p> <h3>WSMA Annual Meeting goes virtual</h3> <p> The WSMA House of Delegates was formed back in 1889. Ever since, we've taken pride that this structure allows policies to spring from our members - staying true to our member-driven roots. Despite COVID-19, your WSMA leadership decided that this year's annual HOD meeting will carry on - albeit virtually. </p> <p> Several deadlines are fast approaching. The deadline for submitting resolutions is Aug. 10. If you have new policy you'd like to propose, consider submitting a resolution through your local county medical society or specialty society. More details about how to structure a resolution can be found <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">here</a>. </p> <p> When the time comes to vote on resolutions during the meeting, remember that only delegates can vote. If you want to serve as a delegate, let us know, and we will put you in touch with your county medical society or state specialty society (see our <a href="[@]WSMA/About_Us/Policies/WSMA/About/Policies/Policies.aspx">bylaws on who is eligible to vote</a>). If you feel frustrated that you don't have a formal vote except through these societies, consider getting engaged and <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">advance a change to the process</a>. </p> <p> If you are curious to know more about our work, be sure to visit our website at <a href="[@]">wsma.org</a>. There you can also access our <a href="[@]WSMA/About_Us/Who_We_Are/WSMA/About/Who_We_Are/Who_We_Are.aspx#strat">current strategic plan</a>, find an <a href="[@]WSMA/About_Us/Leadership/House_of_Delegates/WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx">update on last year's official actions from the House of Delegates</a>, or review <a href="[@]WSMA/About_Us/Policies/Whats_Our_Policy/WSMA/About/Policies/Whats_Our_Policy/Policy_Index.aspx">current WSMA policy</a>. </p> <p> Another way to inform us about issues of concern to you is to engage with us via our members-only <a href="[@]WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx">virtual reference committees</a> and general discussion forum in advance of the WSMA Annual Meeting on Sept. 26-27. It's easy to post your ideas or comment on the ideas of others. </p> <p> All of this to say…as a member-driven organization, your views and opinions matter, regardless of specialty, geography, and/or whether you are working within a large integrated group or small private practice. You matter. </p> <p> Let us hear from you, and I hope I'll see you online at our Road Trip in August or at the virtual <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">WSMA House of Delegates</a> in September. </p> <p> If you can't make either event but would like me to speak to your medical staff or group, write me at <a href="mailto:jen@wsma.org">jen@wsma.org</a>. I'm happy to provide an update on our work, live or virtually. </p> </div>7/31/2020 4:17:17 PM7/31/2020 4:15:47 PM7/31/2020 12:00:00 AM
weekly_rounds_july_20_2020_even_covid_19_cant_keep_the_wsma_from_its_missionWeekly Rounds: July 20, 2020 - Even COVID-19 Can't Keep the WSMA From Its MissionWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_20_2020_even_covid_19_cant_keep_the_wsma_from_its_mission<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>July 18, 2020</h5> <h2>Even COVID-19 Can't Keep the WSMA From Its Mission</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> The onset and disruption of COVID-19 has shaken us all, to be sure. But even in the midst of it, I'm grateful that the WSMA's vision, mission, and strategy remain relevant and appropriate for the times. The pillars of our strategic plan focus on advocacy through strong, thoughtful policy; physician-directed quality improvement; physician education and development; and organizational stewardship. </p> <p> This framework continues to serve us well as we raise up the interests of physicians at the highest levels of influence and unite our members to make a difference. We know a robust and healthy professional and practice environment is necessary to ensure that patients and communities have access to high-quality care when they need it. We achieve this by advancing strong physician leadership and advocacy to shape the future of medicine and advance quality care for all Washingtonians. Working together, we are building a vibrant medical profession and a healthy population. </p> <p> That effort doesn't stop or change even during a pandemic. Still, we press on. Here are five highlights of some of the ways we are doing just that. </p> <h3>Seeking clarity as hospital COVID-19 data redirected from CDC to HHS</h3> <p> Several physicians have inquired about the <a href="https://www.seattletimes.com/seattle-news/health/coronavirus-data-is-funneled-away-from-cdc-sparking-worries/">news that hospital data on COVID-19 will be redirected</a> from the Centers for Disease Control and Prevention to the Department of Health and Human Services. </p> <p> Our understanding based on informal discussions with American Medical Association staff is that since April, hospitals have been reporting COVID-19 data to two federal databases: CDC and TeleTracking. The principle purpose of reporting is to allocate federal resources among the hospitals; however, concerns have been raised regarding the burden of the dual reporting. Additionally, the Coronavirus Task Force has needed to periodically change the reporting requirements to coincide with developments. It seems the CDC data collection has been more robust than TeleTracking, but not capable of adapting as quickly to changing requirements. Consequently, the administration decided to require hospitals to report only toTeleTracking. The CDC will remain on the Coronavirus Task Force Data Group. </p> <p> Currently, the CDC helps states analyze and understand the data. While the CDC will continue to have access to the data, it is unclear how that will be operationalized, so the implications of the change in data collection are not clear to us at this time. </p> <p> The AMA continues to stress to officials that data collection is vital to combatting COVID-19. The data needs to be accurate and transparent so it can be actionable and inform the health care community's response. It will closely monitor the situation and weigh in as issues arise. </p> <h3>Speaking up about barriers to COVID-19 testing</h3> <p> State officials recently expanded criteria for who should be tested for COVID-19 to include the mildly symptomatic and their close contacts (for the full criteria, download the <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Interim-2019NovelCoronavirusQuicksheetProviders.pdf" target="_blank">DOH testing guidance for health care providers</a>, updated June 28). Along with expanding testing criteria, Gov. Jay Inslee delivered a message directly to physicians and medical providers: If a patient comes to you with symptoms, get them tested. As the guidance states, symptomatic patients should be tested within 24 hours or referred to another testing site and provided guidance on the need to isolate (for ill persons) and self-quarantine (for exposed contacts). </p> <p> In our role as advocates for the physician community, the WSMA is helping state officials identify barriers faced by physicians and practices seeking to provide or ramp up testing. We need to hear from you: What is your experience with testing, and are you facing any barriers to increasing testing in your office or practice? <a href="https://www.surveymonkey.com/r/XR6QQ5J">Take this brief WSMA survey on testing and PPE supply</a> and let us know. </p> <h3>Supporting candidates that support physicians and their patients</h3> <p> The primary election is just around the corner on Aug. 4, with the general election to follow on Nov. 4. WSMA leaders and staff have been meeting virtually with candidates and providing financial support for those whose priorities align with ours. </p> <p> As you consider how to cast your vote, you can see how your state legislators voted on WSMA's priority issues last session by checking out the "WAMPAC Report Card" in the <a href="https://wsma.informz.net/WSMA/data/images/Attachments/wsma_2020_legislativereport_printers_final.pdf" target="_blank">2020 WSMA Legislative Report</a>. And if you're disappointed with how your legislator voted, remember that one of the best ways to send a message is by <a href="[@]WSMA/Advocacy/WAMPAC/Give_to_WAMPAC.aspx">supporting WAMPAC</a> and helping physicians speak with a loud, unified voice on campaigns. </p> <h3>Equipping the front lines with information they need to know</h3> <p> Given that COVID-19 will impact the medical community for the foreseeable future, WSMA is launching a Virtual Grand Rounds webinar series to provide you the latest on local developments. The series will focus on the evolution of the disease, management of COVID-19 patients, and our state's response to the pandemic - with an emphasis on what front-line physicians need to know. </p> <p> We will be joined by state public health leaders - Vice Adm. Raquel Bono, MD; Kathy Lofy, MD; and Charissa Fotinos, MD - on July 22, Aug. 5, Aug. 19 and Sept. 4 for sessions that will offer the latest information on COVID-19. This series is free to all WSMA members. The format will include 45 minutes of content and 30 minutes for a Q&A discussion with the speakers. This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢</em>. <a href="[@]WSMA/Education/Upcoming_Webinars/WSMA/education/Upcoming_Webinars/Upcoming_Webinars.aspx">Click here to learn more and to register</a>. </p> <h3>Influencing policy, shaping the future</h3> <p>The <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">2020 Annual Meeting of the WSMA House of Delegates</a> will be held virtually on Sept. 26 and 27 via Zoom. If you are interested in proposing policy or serving as a delegate at the meeting, be sure to take note of the following guidance and key dates. Resolutions, one of the key policy drivers for the association, are considered for adoption by the House of Delegates at its annual meeting each fall. 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">Learn more about resolutions on the WSMA website</a> and be sure to mark your calendar for the following dates:</p> <ul> <li>Aug. 10 - Deadline to submit your resolution for publication in the WSMA Delegate Handbook, the compilation of resolutions and other business to be considered by the House of Delegates.</li> <li>Aug. 21 - Delegate Handbook will be available on the <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">WSMA website</a>.</li> <li>Aug. 27 - Final deadline to submit your resolution. Resolutions received after this date must have consent of two-thirds of the House to be considered.</li> </ul> </div>7/20/2020 10:06:13 AM7/20/2020 9:41:10 AM7/18/2020 12:00:00 AM
weekly_rounds_july_3_2020___six_things_to_know_while_planning_your_virtual_july_4th_celebrationWeekly Rounds: July 3, 2020 - Six Things to Know While Planning Your Virtual July 4th CelebrationWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_3_2020___six_things_to_know_while_planning_your_virtual_july_4th_celebration<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>July 3, 2020</h5> <h2>Six Things to Know While Planning Your Virtual July 4th Celebration</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> It's hard to believe it's already time for July 4th celebrations - such as they will be, without the usual fireworks displays and crowded gatherings. As I plan how best to celebrate the Fourth with my immediate household, I do feel increasingly better equipped to cope and adapt as needed. My growing collection of face masks is at least one indication that our new reality is becoming more familiar! </p> <p> It's also been heartening to see some of our WSMA team back in the office, with staff alternating days and schedules. Things are far from the way they used to be, but seeing team members occasionally around the office is certainly encouraging. </p> <p> We all press on, and there is plenty of news to share with you this week. Here are several things you need to know about. </p> <h3>HHS will renew public health emergency</h3> <p> On Monday, U.S. Department of Health and Human Services spokesperson Michael Caputo tweeted the news that the agency intends to extend the COVID-19 public health emergency that is set to expire July 25. The extension would prolong the emergency designation by 90 days. This is welcome news for physicians because several payment policies and regulatory adjustments are attached to the public health emergency. </p> <p> Some <a href="https://www.modernhealthcare.com/law-regulation/how-ending-covid-19-public-health-emergency-will-impact-healthcare-industry">notable policies</a> attached to the public health emergency are the <a href="https://www.modernhealthcare.com/politics-policy/covid-19-economic-stimulus-deal-passes-senate-billions-hospital-funding">Medicare inpatient 20% add-on payment for COVID-19 patients</a>, increased federal <a href="https://www.modernhealthcare.com/politics-policy/trump-signs-second-major-covid-19-relief-package">Medicaid matching rates</a>, requirements that insurers cover COVID-19 testing without cost-sharing, and <a href="https://www.modernhealthcare.com/politics-policy/cms-use-glide-path-when-removing-covid-19-waivers">waivers of telehealth restrictions</a>. </p> <p> Even if HHS maintains the public health emergency, some changes the Trump administration has made to help health care practitioners also depend on a separate <a href="https://www.modernhealthcare.com/politics-policy/trump-declares-covid-19-emergency-asks-hospitals-activate-emergency-plans">Stafford Act national emergency declaration</a> staying active (the emergency declaration is effective until March 13, 2021, or until the president issues a proclamation terminating the declaration, whichever comes first). These changes include <a href="https://www.modernhealthcare.com/medicaid/cms-grants-new-york-5-other-states-medicaid-waivers-respond-coronavirus">CMS Medicaid waivers</a> that allow bypassing some prior authorization requirements, temporarily enrolling out-of-state providers, delivering care in alternative settings, and pausing fair hearing requests and appeal times. </p> <h3>Governor to announce extension of telemedicine parity proclamation to Aug. 1</h3> <p> Earlier this week, we received word that the Legislature has approved extending Gov. Jay Inslee's proclamation requiring payment parity for telemedicine services through Aug. 1. No formal announcement has been made yet, but we will let you know once the governor's office officially confirms. </p> <p> Payment at parity is critical for patients and physicians. The WSMA will continue to advocate that this important policy be extended through the end of the year when the provisions of parity legislation Senate Bill 5385 take effect. </p> <h3>$15 billion being distributed to Medicaid providers by HHS: Has your practice received its share?</h3> <p> The federal CARES Act appropriated $175 billion to health care providers and facilities through a variety of mechanisms. The most recent distribution that was <a href="https://www.hhs.gov/about/news/2020/06/09/hhs-announces-enhanced-provider-portal-relief-fund-payments-for-safety-net-hospitals-medicaid-chip-providers.html">announced by HHS</a> is $15 billion dedicated for eligible physicians and providers who participate in Medicaid and the Children's Health Insurance Program. To be eligible for this funding, clinicians must have billed their state's Medicaid/CHIP programs or Medicaid managed care plans between Jan. 1, 2018 and Dec. 31, 2019. Additionally, they must not have received payments from the earlier $50 billion Provider Relief Fund general distribution based on Medicare utilization. </p> <p> Our state's Medicaid agency has raised concerns with HHS about the Medicaid distribution, asserting the funds allotted are insufficient and that it's administratively burdensome for practices to tap into. Perhaps most concerningly, practices were not aware that accepting the Medicare general distribution would preclude them from receiving Medicaid funds where the latter may have been financially advantageous for a practice. Further, there is no mechanism for a practice to return the Medicare funds to create eligibility for the Medicaid distribution. </p> <p> If you believe you're eligible for a payment under the Medicaid distribution, HHS provides an <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html">Enhanced Provider Relief Fund Payment Portal</a> that allows you to report your annual patient revenue, as well as information such as the number of Medicaid patients you serve, which will be used as factors in determining your payment. Distributions to eligible physicians will equal to at least 2% of reported gross revenues from patient care. </p> <p> If you have concerns pertaining to the Medicaid distribution or anything related to the Provider Relief Fund under the CARES Act, the WSMA wants to know. Share your perspective by emailing our policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <h3>WSMA advocates for flexibility as state grapples with COVID-19</h3> <p> The WSMA continues to advocate on several fronts related to COVID-19, including with the Centers for Medicare & Medicaid Services. In recent correspondence, we shared with CMS the need to make permanent, or continue for a reasonable duration of time after the public health emergency is declared over, the following regulatory flexibilities: </p> <ol> <li> Continue telehealth flexibilities so that the Medicare population, which is particularly vulnerable to COVID-19, may access appropriate remote care. Audio-only coverage is particularly important for those who may not feel comfortable with or are unable to navigate audio/visual platforms or cannot afford or do not live in an area that has access to the broadband required to use the platforms. <ol style="list-style-type: lower-alpha; margin-left: 40px;"> <li> Continue coverage for audio-only telephone evaluation and management when necessary. </li> <li> Continue coverage of video and telephone E/M for patients who could make an office visit. </li> <li> Continue coverage of telehealth treatment services to patients at home. </li> <li> Maintain payment parity between audio-only E/M claims and their in-person equivalents, as well as between all telehealth and in-person visits. </li> <li> Establish clear telehealth billing guidance. Maintain the increased payment rates for these codes to equal Medicare's established in-person codes (99212-99214) to ensure that patients without advanced video-sharing capabilities can access care. </li> <li> Change the definition of "originating site" to allow for patients to receive telehealth services in any location/permanently extend the policy to lift geographical and originating-site restrictions. This will allow patients who cannot or should not make office visits and for whom such services are safer or more feasible. </li> <li> Continue coverage for remote patient monitoring services. </li> <li> Permanently remove frequency limitations on telehealth utilization. </li> <li> Continue the reduction or waive cost-sharing requirements for telehealth service. </li> <li> Continue to allow direct supervision to be performed via audio-video real-time communications when necessary, especially in rural and underserved areas. </li> </ol> </li> <li> Allow multimedia communication equipment, such as smartphones, to provide telehealth, and release practical examples of the technologies and devices that Medicare beneficiaries are permitted to use so that the public can have a better understanding of what is allowed. </li> <li> Cover inpatient hospital services in patients' homes to accommodate socially distanced services for this high-risk population. </li> <li> Continue to cover emergency department, critical care, and other telehealth services to patients at sites outside their homes, and do so without frequency limits, especially in rural and underserved areas, to facilitate access to this high-risk population. </li> <li> CMS should not reinstate the once-per-lifetime limit for Medicare Diabetes Prevention Program services and should allow these services to continue to be provided virtually, including allowing the first core session to be provided virtually. </li> <li> Continue to permit durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items except for powered medical devices (PMDs) to be provided via a verbal order. </li> <li> Continue to permit physician assistants to order home health services. </li> <li> We urge CMS to further reduce burden by enabling the use of telemedicine and remote patient monitoring services to satisfy the face-to-face requirement in certifying eligibility for Medicare home health services. </li> </ol> <p> If we are missing anything, please contact our policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <h3>Tell your patients to mask up</h3> <p> The mandatory use of face masks is now in effect statewide. The order applies to anyone who is: </p> <ul> <li>Inside of, or in line to, enter any indoor public space.</li> <li>Seeking health care services.</li> <li>Waiting for or riding public transportation.</li> <li>Outdoors and unable to keep six feet away from others not in their household.</li> </ul> <p> There are exceptions to this order for children under the age of five and people with a medical condition, mental health condition, or disability that prevents them from wearing a face covering. In no case should children under two years of age wear a face covering due to the risk of suffocation. </p> <p> Washington state purchased 3.6 million cloth face masks to provide two masks to every person in Washington below 200% of the federal poverty level (which means, for example, a family of four earning $52,400 or less). They have already sent 2.8 million masks to local emergency management programs that are working with various community organizations and service providers to deliver to people who need them. </p> <p> If you have patients in need, masks are available through your <a href="https://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions">local public health department</a> and other community organizations. </p> <p> If you need masks for your medical practice, the WSMA is partnering with the Washington State Hospital Association, and its subsidiary Washington Hospital Services, to supply FDA-approved disposable ASTM Level 1 simple procedural masks to medical groups and physician practices throughout the state at bulk pricing. Orders will be filled on a first-come, first-served basis. Submit your order by 9 a.m. each Monday to be included in that week's distribution. <a href="[@]WSMA/Resources/COVID-19_Response/PPE/WSMA/Resources/COVID-19/PPE/PPE.aspx">Learn more and place your order</a>. </p> <h3>Gaining a better understanding of cultural diversity</h3> <p> In our <a href="[@]Shared_Content/News/Press_Release/2020/wsma_statement_on_the_death_of_george_floyd">statement on the death of George Floyd</a>, the WSMA noted that physicians and health care professionals wield power, privilege, and responsibility for dismantling structural racism in medicine, and we have an obligation and opportunity to contribute to health equity through legislative action and advocacy. The disparate health outcomes of Black Americans in the United States are an extension of a historical context where Black lives and the lives of people of color have been devalued. </p> <p> We are shaken by these racist and unjust events, and we join the many voices calling out the connectedness between these issues and health equity. As a health care community, we know well that racism is detrimental to public health and must be addressed. </p> <p> We are renewing our efforts to contribute to health equity and are examining what steps we can take to make a difference. As always, we seek to reflect the voices of our members, and we'd like to hear from you about this - write me at <a href="mailto:jen@wsma.org">jen@wsma.org</a>. We will continue to keep members apprised about opportunities to learn, reflect, and improve the house of medicine. </p> <p> In the meantime, here are some opportunities we encourage you to take advantage of: </p> <ul> <li> View AMA's recent virtual meeting: "<a href="https://www.ama-assn.org/delivering-care/health-equity/time-tackle-hard-questions-root-causes-health-inequities">Time to tackle hard questions on root causes of health inequities</a>." </li> <li> Access the online CME multicultural care and cultural diversity courses offered by Physicians Insurance via their <a href="https://www.phyins.com/education/all-courses">online education portal</a>.<br /> Titles include: </li> <ul> <li>Building a Multicultural Care Environment (1.25 credits)</li> <li>Individual and Organizational Approaches to Multicultural Care (1.25 credits)</li> <li>Culture Responsiveness in Clinical Practice (1.50 credits)</li> <li>Culture Competence (.50)</li> </ul> <li>Add your voice to the "<a href="http://thenocturnists.com/blackvoices">Black Voices in Health Care</a>," a new audio documentary series created by <a href="http://thenocturnists.com/whoweare">The Nocturnists</a>, an independent medical storytelling community. They've issued an "open call" for voices, recognizing that more needs to be done to create equity and erase racism in our society.</li> </ul> <p> With all that's happening in our world these days, I'm actually grateful for what I anticipate will be a quiet Fourth of July. I want to reflect about what more I can do as an individual - and what we can do as an organization - to bring health and healing to a world that sorely needs it. </p> </div>7/8/2020 5:07:31 PM7/2/2020 2:27:12 PM7/3/2020 12:00:00 AM
weekly_rounds_june_5_2020_standing_in_solidarity_and_supportWeekly Rounds: June 5, 2020 - Standing in Solidarity and SupportWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_june_5_2020_standing_in_solidarity_and_support<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>June 5, 2020</h5> <h2>Standing in Solidarity and Support</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> As our nation continues to be shaken by racism and injustice, the WSMA joins the many voices that are calling out the connectedness between these issues and health equity. As a health care community, we know well that racism is detrimental to public health and must be addressed. We join our communities of color in solidarity and support. Your WSMA leadership issued a statement earlier this week and wanted to ensure that all WSMA members received it directly. That statement is below. </p> <p> If, as a member of the physician and PA community, you are seeking to take action, we've learned about health-care-specific events today and tomorrow in which you may wish to participate. Both events are urging mindfulness about social distancing and best protection practices in light of the COVID-19 pandemic.</p> <ul> <li>Join health care professionals across the county for a <a href="https://twitter.com/search?q=%23WhiteCoatsForBlackLives&src=typeahead_click">#whitecoatsblacklives</a> moment of remembrance for George Floyd and countless others at 10 a.m. today, Friday, June 5. Join in at your clinic, hospital, or virtual site.</li> <li><a href="https://twitter.com/EdwinLindo/status/1268007582146285570/photo/1">Time for Change event</a> in Seattle, Saturday at 9 a.m.</li> </ul> <h3>WSMA's Statement on the Death of George Floyd</h3> <p> The Washington State Medical Association, like the rest of the U.S. and the world, is shocked and saddened by the needless loss of life resulting from the use of excessive force and violence, the latest in a long line of many such incidents in our country. </p> <p> In the midst of a pandemic that is disproportionately impacting our communities of color, the death of George Floyd serves as a harsh reminder that the responsibility for dismantling structural racism is incumbent upon all of us, particularly those in positions of leadership. </p> <p> Racism is a social determinant of health. The disparate health outcomes of black Americans in the U.S. can be seen as an extension of a historical context where non-white, and specifically black, lives have been devalued. Physicians and other health care professionals wield power, privilege, and responsibility for dismantling structural racism, and we have an obligation and opportunity to contribute to health equity through legislative action and advocacy. </p> <p> Just as COVID-19 has revealed the disparate impact on communities of color, the death of George Floyd has shown how too easily persons of color in our culture can become victims of racist acts of violence. We urge our political leaders at this time to join us as we repay our obligation to contribute to health equity, here in Washington state and across the U.S., through stronger public policy, so that George Floyd's death—and those of the thousands of victims disproportionately impacted by COVID-19—will not have been in vain. </p> </div>6/5/2020 10:08:25 AM6/5/2020 9:16:18 AM6/5/2020 12:00:00 AM
weekly_rounds_may_22_2020_five_things_to_know_while_staying_home_for_memorial_dayWeekly Rounds: May 22, 2020 - Five Things to Know While Staying Home for Memorial DayWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_may_22_2020_five_things_to_know_while_staying_home_for_memorial_day<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>May 22, 2020</h5> <h2> Five Things to Know While Staying Home for Memorial Day </h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> While there continues to be a lot of activity at the state and federal levels in response to COVID-19, it feels to me as though we're shifting from the urgent onset reactive phase into a more intentional and thoughtful phase. </p> <p> We know we're in this for the long haul, and along with our COVID response, your WSMA team continues to advocate on the things that impact your ability to practice in today's challenging times. Hopefully you've benefitted from our intensive communications efforts as we work to bring you the latest information in nearly real time across all of our channels, including our social media feeds, our website, our biweekly e-newsletter Membership Memo, and, of course, Weekly Rounds, my personal missive to you. </p> <p> As we ready ourselves for a well-deserved long Memorial Day weekend, I offer a few brief updates you'll want to know about. </p> <h3>Deciding to meet virtually for the WSMA House of Delegates</h3> <p> At its lengthy Zoom meeting last Sunday, the WSMA board of trustees made the difficult decision to transition our usual in-person Annual Meeting in Spokane to a virtual one-day House of Delegates meeting on Saturday, Sept. 26. Out of an abundance of caution for the health and well-being of all concerned, they directed that the meeting be condensed to focus solely on the business of the House of Delegates. </p> <p> In the weeks preceding the meeting, we will open our online reference committee forums in order to give all members an opportunity to provide feedback on resolutions. In addition, we will hold virtual reference committee meetings so that members will have an opportunity to provide verbal testimony. On Sept. 26, the House will act on the reports of the reference committees, vote on the slate of candidates for the board of trustees, and conduct other business of the House. Your WSMA staff is currently working on the new schedule and will share more information soon. </p> <h3>Taking action to say "no" to psychologists' scope expansion</h3> <p> The Washington State Department of Health will hold a sunrise review hearing on psychologists' prescriptive authority. The WSMA opposes efforts to expand non-physician practitioners' prescriptive authority and any scope of practice increase that does not stipulate commensurate education and training to what a physician receives, and thus we oppose this expansion. </p> <p> By way of some background, late in the 2020 legislative session, <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/HB2967.pdf" target="_blank">House Bill 2967</a> was introduced to grant psychologists prescriptive authority. While this bill was not considered during session (i.e. no public hearings were held), it served as the catalyst for this sunrise review. Sunrise reviews are the process by which the DOH considers proposals that would amend practices of regulated health professions in the state. </p> <p> <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/SunriseRequest.pdf" target="_blank">Requested by the Legislature</a>, DOH will now review the <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2020-Sunrise-PsyScope.pdf" target="_blank">proposal submitted by the Washington State Psychological Association</a> and provide opportunities for stakeholders to engage and provide comments as the department drafts its report. At the end of the review process, DOH will issue a final report with their recommendations to the Legislature. While these recommendations are technically advisory, they often serve as the basis for future legislation. </p> <p> Comments on the initial proposal are due by June 17 at midnight and should be emailed to <a href="mailto:sunrise@doh.wa.gov">sunrise@doh.wa.gov</a>. Once the WSMA has compiled our draft comment we will share it with you. In the meantime, should you have any questions, concerns, or feedback, or if the WSMA can be helpful to your organization on this issue, email Alex Wehinger, WSMA's associate director of legislative and political affairs, at <a href="mailto:alex@wsma.org">alex@wsma.org</a>. </p> <h3>Reporting out to improve opioid prescribing practices</h3> <p> The latest round of the Washington Opioid Reports, the key feature of our <a href="[@]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&_zs=B3aFd1&_zl=KQ4o6">Better Prescribing, Better Treatment</a> initiative, will arrive in your inboxes next week. This feedback reporting program provides data compiled from the state's prescription monitoring program to physicians and other prescribing providers that allows them to see how their opioid prescribing practices compare to others in their health care system and specialty. </p> <p> There are two levels of reports: organizational and prescriber. The organization-level reports are sent quarterly to CMOs and QI leaders and summarize the prescribing practices in their organization by specialty. The prescriber-level reports are sent quarterly to each individual prescriber and summarize how an individual's prescribing practices compare to other prescribers in the same specialty and organization. </p> <p> For more information, please contact Monica Salgaonkar, WSMA's continuing professional development manager, at <a href="mailto:monica@wsma.org">monica@wsma.org</a>. </p> <h3>Developing tomorrow's leaders today</h3> <p> The WSMA <a href="[@]WSMA/Education/Physician_Leadership/Physician_Leadership_Course/WSMA/Physician_Leadership/Physician_Leadership_Course/Physician_Leadership_Course.aspx?hkey=30a53472-d3c0-4d7d-bd0c-cf09b4bea7f5&_zs=B3aFd1&_zl=LQ4o6">Physician Leadership Course</a> is a 40+ hour course for physicians and physician assistants who want to develop their health care leadership skills. Online virtual sessions will be held on Sept. 18-19 and Dec. 11, with eight weeks in between of self-guided online learning. The deadline to register is Aug. 18. </p> <p> Taking your leadership journey deeper, the WSMA <a href="[@]WSMA/Education/Physician_Leadership/Dyad_Leadership_Course/WSMA/Physician_Leadership/Dyad_Leadership_Course/Dyad_Leadership_Course.aspx?hkey=f6387317-48e4-44f1-b623-4b00fcba57ab&_zs=B3aFd1&_zl=MQ4o6">Dyad Leadership Course</a> is a 24+ hour educational workshop for physicians and their administrative dyad partners that helps improve team function and achieve greater operational success within their clinical system. Online virtual sessions will be held on Oct. 16-17 and Nov. 13, with four weeks in between of self-guided online learning. The deadline to register is Sept. 16. </p> <h3>Restarting health care in Washington state</h3> <p> Gov. Jay Inslee issued <a href="https://www.governor.wa.gov/sites/default/files/20-24.1%20-%20COVID-19%20Non-Urgent%20Medical%20Procedures%20Ext%20.pdf" target="_blank">a new proclamation regarding non-urgent procedures</a> this week that allows non-urgent health care services and surgeries to be provided once again. The proclamation emphasizes the importance of a health care provider's clinical judgment, stipulating that physicians and other providers should consider the needs of patients in the broader context of the pandemic, as well as adequate PPE, and urges providers to act with good judgment in delivering care. </p> <p> For more information on the criteria and how to comply with the proclamation, <a href="https://www.informz.net/WSMA/data/images/Attachments/Guidance-Document-Non-Urgent-Procedures-FINAL.pdf" target="_blank">download the WSMA's new guidance and physician practice checklist</a>. And be sure to check out WSMA's <a href="[@]WSMA/Resources/COVID-19/COVID-19_Clinical_Guidance_and_Testing/covid_19_clinical_guidance_and_testing.aspx?_zs=B3aFd1&_zl=NQ4o6">COVID-19 Resource</a> pages for more practice information to help assist you during the pandemic. </p> <p> With that, here's wishing you a restful Memorial Day weekend. As we reflect on the sacrifices of military heroes past and present, I know I'll also be thinking about the sacrifices of the medical heroes who are serving on the front lines of this pandemic. </p> </div>5/22/2020 10:20:02 AM5/22/2020 10:10:03 AM5/22/2020 12:00:00 AM
weekly_rounds_may_1_2020_during_covid_19_advocacy_more_important_than_everWeekly Rounds: May 1, 2020 - During COVID-19, Advocacy More Important Than EverWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_may_1_2020_during_covid_19_advocacy_more_important_than_ever<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>May 1, 2020</h5> <h2> During COVID-19, Advocacy More Important Than Ever </h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> We often describe what we do at the WSMA under the umbrella of one simple word: advocacy. With the onset of the COVID-19 crisis, I've found that to be true more than ever. Since early March, most of my time has been spent doing just that on behalf of our members. </p> <p> In doing that work, I've experienced that the meaning of advocacy is more than its Latin origins - "to call out for support" - though it is surely that. I happened across <a href="https://www.culturepartnership.eu/en/publishing/advocacy-course/what-is-advocacy">this quote</a>, which I think deftly describes our efforts during this pandemic: "To fulfill its aspirations advocacy requires coordination, strategic thinking, information, communication, outreach and mobilization." </p> <p> Each of those aspects is key to the work the WSMA has been doing. You can find out more about our specific efforts <a href="[@]WSMA/Resources/COVID-19/WSMA_Advocacy_for_Physicians_During_COVID_19/wsma_advocacy_for_physicians_during_covid_19.aspx">here</a> , and, in addition, I want to highlight a few activities here as well. </p> <p> We will soon shift to helping prepare our state to move into recovery mode by reopening our health system in total. We'll continue our work at the highest state levels with Gov. Jay Inslee, COVID-19 Health Systems Response Director Vice Adm. Raquel Bono, MD, Secretary of Health John Wiesman, and State Health Officer Kathy Lofy, MD. </p> <p> We will continue to advocate for a recovery plan that <a href="https://www.seattletimes.com/business/doctors-practices-are-hurt-by-coronavirus-pandemic-just-when-theyre-most-needed/?utm_source=facebook&utm_medium=social&utm_campaign=article_inset_1.1&fbclid=IwAR0uEI2kZ_dtFHqbmoIy3bKFwrQfEnPcOVcMjhv3J03fKcQfXaY8zvG0xJo">addresses the care of all of our patients</a>, <a href="https://www.heraldnet.com/news/how-will-it-end-testing-testing-testing-tracing-and-time/?fbclid=IwAR0r0H3JoDa-Vn0Upok8T9gAcwMgBt33gGw_jOXYzcd2C9QpQI3FWEhXZuE">the safety of our patients and health care workers</a>, and the <a href="https://stateofreform.com/news/washington/2020/04/wsma-ceo-jennifer-hanscom-discusses-the-financial-impact-of-covid-19/?fbclid=IwAR3x5RUTQwb0NJkQ98uuslr92qQ--5x3413qgHwlbY2rGDV2iCKIwWraSL0">viability of medical clinics</a> of all sizes and specialties. </p> <p> Currently, we are assessing the impact of COVID-19 on the financial state of practices, as well as the state of PPE and supplies. To that end, we have been gathering intel from our community on how the pandemic is impacting you. I hope you will take a moment to complete <a href="https://wsma.informz.net/informzdataservice/onlineversion/pub/bWFpbGluZ0luc3RhbmNlSWQ9OTI4ODk4NA==" target="_blank">our most recent survey</a>, as acquiring this data is critical to our advocacy work. While your anecdotal stories do help us humanize the issues, it's data that speaks most loudly to legislators. </p> <p> In other behind-the-scenes efforts, along with our partners, I've been working with the state's health leaders to advocate for clarity on the governor's proclamation regarding elective procedures, particularly around the proclamation's definition of "harm" and the intent of physicians using their medical judgment when determining whether a medically necessary procedure or surgery should be postponed. </p> <p> At the urging of the WSMA and others in the health care community, Gov. Inslee issued on Wednesday an <a href="https://www.governor.wa.gov/sites/default/files/Non-Emergent%20Procedure%20Interpretive%20Statement%204.29.20%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery">interpretive statement</a> providing clarification on his <a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-24%20COVID-19%20non-urgent%20medical%20procedures%20%28tmp%29.pdf" target="_blank">proclamation issued March 19</a> that imposed restrictions on "non-urgent" medical procedures. That document also outlines prerequisites for performing procedures and surgeries, such as maintaining appropriate PPE supplies and following <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/ConservationStrat-PPE.pdf" target="_blank">Department of Health guidance on the use of PPE</a>. </p> <p> As a reminder, the original March proclamation (still in effect) does not apply to outpatient clinics. As stated in the interpretive statement, "The proclamation permits outpatient clinic visits, both in hospital-based clinics and other outpatient clinic settings. While not addressed in the proclamation, the department encourages clinicians to weigh the benefits and risks of such visits to patients given the active presence of COVID-19 in our communities. It also encourages clinicians to use telehealth visits where possible." </p> <p> At the same time, WSMA's policy team swiftly worked to create a checklist to help practices adjust workflows and comply with the governor's proclamation. The checklist can be used manually or to build prompts into your electronic health record (e.g. Epic dot phrase). Find the checklist on our COVID-19 <a href="[@]WSMA/Resources/COVID-19_Response/COVID-19_Clinical_Guidance_and_Testing/WSMA/Resources/COVID-19/COVID-19_Clinical_Guidance_and_Testing/covid_19_clinical_guidance_and_testing.aspx?hkey=5236cdd9-90b5-46fe-9cbd-d9bf9ad4831e&_zs=B3aFd1&_zl=I97k6">Clinical and Professional Resources page</a>. </p> <p> During his press conference on Wednesday, Gov. Inslee also reviewed the <a href="https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard">dashboard</a> he uses to help assess next steps on recovery. He uses five key statistical areas including: COVID-19 disease activity, the readiness of the health care system, the availability of testing, the capacity for contact tracing after people have been infected, and the risk to vulnerable populations. </p> <p> The governor also noted that he will announce more information about his plans for recovery today at 2:30 p.m. Watch the announcement at <a href="https://www.tvw.org">tvw.org</a>. </p> <p> Meanwhile, just as your work never ceases, neither does ours. We will continue our efforts, advocating for you and your concerns without ceasing. </p> </div>5/1/2020 4:28:58 PM5/1/2020 2:42:34 PM5/1/2020 12:00:00 AM
weekly_rounds_april_17_2020_advocacy_and_answers_in_the_time_of_covid_19Weekly Rounds: April 17, 2020 - Advocacy and Answers in the Time of COVID-19Weekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_april_17_2020_advocacy_and_answers_in_the_time_of_covid_19<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>April 17, 2020</h5> <h2>Advocacy and Answers in the Time of COVID-19</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> As hard as this COVID-19 crisis is, I'm heartened to see the community expressing appreciation for Washington's physicians, physician assistants, and other health care workers who are right there on the front lines. When I walk around my neighborhood to get a bit of exercise, it's encouraging to see "thank you" scrawled in sidewalk chalk and craft paper mural messages in business windows. During calls this week with several members of Washington's congressional delegation, all have expressed their thanks for your tireless efforts and dedication to patients in the state. </p> <p> The WSMA is working daily to represent medicine's interests during this pandemic. I wanted to alert you to three key updates. This is not a comprehensive list, and we'll continue to update you via our Membership Memo as well as our COVID-19 pages on our website. </p> <h3>WSMA advocates to ease restrictions on non-urgent procedures and surgeries</h3> <p>Last Friday, the WSMA, the Washington State Hospital Association, and the Association of Washington Healthcare Plans wrote to Gov. Jay Inslee urging him to modify his proclamation on elective surgeries and non-urgent procedures, knowing we are no longer projecting that Washington's health care system will be overwhelmed. WSHA has shared that hospitals across the state are 50-70% full and have capacity to care for many more people. The ambulatory surgery center community also has supplies and capacity to add back procedures. WSMA and WSHA have outlined a framework by which to allow some scheduled surgeries and non-emergency procedures in phases. Following our outreach, a broader community of health care organizations and other stakeholders sent a <a href="https://www.informz.net/WSMA/data/images/Attachments/Forum-COVID-return-to-usual-care-FINAL-20-0415.pdf" target="_blank">letter to the governor</a> that mirrored our request and added context for the dental and long-term care communities. </p> <p> With this week's new understanding that Gov. Inslee is working with California and Oregon on a roadmap to recovery, the WSMA is working with our medical association counterparts in those states to outline a West Coast recovery plan. I hope to update you very soon about the specifics of that work. </p> <h3>Stay Home, Stay Healthy…unless you're not</h3> <p>In mid-March, I heard from Abhineet Chowdhary, MD, from Overlake Neuroscience Institute, who flagged his concerns about patients overlooking their stroke symptoms for fear of contracting COVID-19 at the emergency department. We took Dr. Chowdhary's warning to heart and created a <a href="https://vimeo.com/405908032">PSA video</a> and social media campaign to specifically address the topic. </p> <p> And just this week, we heard his concerns validated in a <a href="https://www.knkx.org/post/washington-state-doctors-puzzled-drop-heart-attack-stroke-patients-amid-covid-19">story on KNKX</a> as they reported on a puzzling drop in stroke/heart attack cases. </p> <p> The WSMA will continue to connect with the public via our communications channels to urge them to seek care when they need it. And we also encourage all physicians to do the same - let your patients know that the "Stay Home, Stay Healthy" mandate does not apply when people are sick or need care. In the case of accessing health care, sometimes you need to leave home to stay healthy! </p> <p> Remember that the <a href="https://www.governor.wa.gov/sites/default/files/20-24%20COVID-19%20non-urgent%20medical%20procedures%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery">governor's proclamation</a> applies to hospitals, ambulatory surgery facilities, dental, orthodontic and endodontic offices in Washington state, and only applies to those entities listed in the proclamation. While hospital outpatient clinics are referenced, it is to distinguish them from the hospital setting. Clinics - hospital-based or otherwise - are not included in this proclamation. If a clinic operates as an ASC, they should follow the proclamation's guidance and cancel or postpone elective or non-urgent procedures unless in their medical judgment a condition will be made worse. The DOH has affirmed that it wants patients to continue to receive care in their communities, whether in person or virtually. </p> <h3>WSMA answers questions on financial assistance available to practices</h3> <p>Earlier this week, the WSMA convened a webinar with attorneys from K&L Gates who presented guidance on two of the financial assistance programs authorized through the federal CARES Act - the Paycheck Protection Program, with loans available through the Small Business Administration, and the Provider Relief Program, with funds from the Department of Health and Human Services. </p> <p> There was a lot of interest in the webinar - more than 200 people participated - and we were glad to be able to help provide information to practices about how to tap into these new programs. If you didn't participate in the webinar, we've archived it on our website along with associated materials <a href="[@]WSMA/Resources/COVID-19_Response/Financial_Viability_During_COVID-19/WSMA/Resources/COVID-19/Financial_Viability_During_COVID-19/financial_viability_during_covid_19.aspx?hkey=59bdde18-196d-479e-bfab-10b7ddd7b227&_zs=B3aFd1&_zl=k9sg6">here</a>. </p> <p> If you have questions about these programs or something that was covered in the webinar, write the WSMA's policy department (<a href="mailto:policy@wsma.org">policy@wsma.org</a>) so that we can help find answers. </p> <p> We're here for you. Take good care. </p> </div>4/21/2020 10:21:15 AM4/17/2020 9:03:23 AM4/17/2020 12:00:00 AM
weekly_rounds_april_6_2020_using_our_voices_in_defense_of_good_care_or_healthWeekly Rounds: April 6, 2020 - Using Our Voices in Defense of Good Care (or Health)Weekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_april_6_2020_using_our_voices_in_defense_of_good_care_or_health<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>April 6, 2020</h5> <h2>Using Our Voices in Defense of Good Care</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> When disasters strike, it's not long before the compelling stories of heroism emerge. Thankfully, the best of humanity does seem to show up at the worst of times, right when we need it the most. </p> <p> We're in such a time right now, as the COVID-19 pandemic makes its way around the globe and knocks at our very own door. Since the very beginning of its advance, we've seen heroes in action - the physicians, physician assistants, and other health care workers who are on the front lines of this crisis. We've heard the stories of those professionals who offer care no matter the cost, those first responders who answer the 911 calls, those caregivers who rush in against this invisible enemy. </p> <p> And in this worst of times, it is a time for unity, for the health care community in our state to work together to defeat this common enemy. </p> <p> It's also a time for transparency, a time to speak up. We cannot be silent about our need for supplies and personal protective equipment in our state and in our communities. </p> <p> It is well past time for the Trump administration to turn its full attention to federal coordination of PPE acquisition and distribution, and ensure that supplies are delivered - in full - to the places where it is most needed, not where it buys the most political good will. It is time for the White House to take every measure to ensure that facilities capable of manufacturing PPE are doing so at the maximum capacity possible. </p> <p> The dire need for health care supplies and PPE in our state is well known and documented. Masks, gowns, and gloves are in extremely limited supply, and the news out of the other Washington <a href="https://www.msn.com/en-us/news/us/protective-gear-in-national-stockpile-is-nearly-depleted-dhs-officials-say/ar-BB122cFl?ocid=spartanntp">about the national stockpile</a> is disturbing. </p> <p> Showing the steady leadership that's been on display throughout this crisis, Gov. Jay Inslee held a press conference on Wednesday urging Washington state manufacturers to <a href="https://www.rev.com/blog/transcripts/washington-governor-jay-inslee-covid-19-briefing-transcript-april-1">repurpose their plants to produce needed supplies</a>. </p> <p> "In World War II, the people of Washington state built B-29s in Seattle, they built minesweepers on Bainbridge Island in Kitsap County, and now it is time for all of us to turn to manufacturing the equipment we need in this fight, in this war." </p> <p> If we do not take urgent action, PPE won't be the only items in limited supply. Our most critical resources that must be protected and preserved are the people who don this garb and care for us. </p> <p> So rather than silencing their voices, let's embrace them. Let's work together to ensure that their stories are used to advocate for what we all need: more PPE. </p> <p> Washington state officials and its health care system have worked tirelessly to tackle this unprecedented and crushing pandemic in spite of the most challenging of circumstances. So has this state's brave heath care workforce. </p> <p> Together we all must demand the federal government urgently delivers the protection and supplies needed to stop this coronavirus and protect our strongest line of defense: health care workers. </p> </div>4/16/2020 8:24:52 AM4/6/2020 9:00:09 AM4/6/2020 12:00:00 AM
weekly_rounds_march_23_2020_alarming_shortage_of_ppe_continuesWeekly Rounds: March 23, 2020 - Alarming Shortage Of PPE ContinuesWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_march_23_2020_alarming_shortage_of_ppe_continues<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>March 23, 2020</h5> <h2>Alarming Shortage Of PPE Continues</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> No doubt you have heard about the alarming shortage of PPE in our state. The governor announced today (Friday) that Washington state will receive a shipment from the national stockpile this weekend. Our understanding is that the Northwest Regional Health Care Network and Department of Health will be <a href="https://www.informz.net/WSMA/data/images/Attachments/PPE_prioritization_DOH_3-11-20.pdf" target="_blank">prioritizing supplies based on COVID-19 cases</a>. The City of Seattle <a href="https://durkan.seattle.gov/2020/03/city-of-seattle-leading-coordinated-effort-to-collect-critically-needed-personal-protective-equipment-for-first-responders-medical-professionals-on-the-frontlines-of-covid-19-response/">has announced a donation drive in partnership with Goodwill</a>. The WSMA is in conversations with the City and others to see how we can get supplies to clinics in need. </p> </div>3/23/2020 10:37:17 AM3/23/2020 10:31:04 AM3/23/2020 12:00:00 AM
weekly_rounds_march_23_2020_caring_for_the_caregiver_during_the_outbreakWeekly Rounds: March 23, 2020 - Caring for the Caregiver During the OutbreakWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_march_23_2020_caring_for_the_caregiver_during_the_outbreak<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>March 23, 2020</h5> <h2>Caring for the Caregiver During the Outbreak</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> Responding to the COVID-19 crisis is already taking toll on physicians and the health care team. Remember that this is a marathon, not a sprint. We know how critical it is that you can access the support you need and practice self-care while you strive to meet your calling to provide medical care to patients. </p> <ul> <li><a href="https://www.psychologytoday.com/us/therapists/cognitive-behavioral-cbt/washington?sid=5e73e0fcbaa71">Find a licensed cognitive behavioral therapist near you</a>. Many therapists provide online and phone sessions. You can either private pay or bill your insurance.</li> <li>Access your employer's Employee Assistance or Physician Assistance Program. Services are 100% confidential and provided by skilled mental health professionals. Online and phone sessions are available through most EAPs. Search your inbox for emails from your "EAP" or "PAP" provider for instructions on how to connect with them directly. Tell your HR department if you need additional on-site support.</li> <li>Quick resources:</li> <ul> <li>Center for the Study of Traumatic Stress: <a href="https://www.cstsonline.org/assets/media/documents/CSTS_FS_Sustaining_Well_Being_Healthcare_Personnel_during.pdf.pdf" target="_blank">Sustaining the Well-Being of Healthcare Personnel during Coronavirus</a></li> <li>CDC: <a href="https://emergency.cdc.gov/coping/responders.asp">Emergency Responders: Tips for taking care of yourself</a></li> <li>Ten Percent Happier: <a href="https://www.tenpercent.com/coronavirussanityguide">Free app and online resources for health care workers</a></li> </ul> </ul> <p> Finally, child care. If you are struggling with child care, know that according to the governor each school district is supposed to come up with a plan to offer child care to health care workers. We are working with the Washington Office of Superintendent of Public Instruction (OSPI) to see if we can get more details to share. I know last night my local district sent out an email announcing their child care location and hours. If you have a moment, check in with your local district. In the meantime, we will try to compile this information for your easy access.</p> </div>3/23/2020 10:48:05 AM3/23/2020 10:42:13 AM3/23/2020 12:00:00 AM
weekly_rounds_march_23_2020_doh_distributes_8000_tests___we_need_moreWeekly Rounds: March 23, 2020 - DOH Distributes 8,000 Tests - We Need MoreWeekly_RoundsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_march_23_2020_doh_distributes_8000_tests___we_need_more<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>March 23, 2020</h5> <h2>DOH Distributes 8,000 Tests - We Need More</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> It's been incredibly frustrating and upsetting to hear from so many of our members who are unable to access the supplies necessary to test for COVID-19 - along with the equipment necessary to protect themselves and their staff from infection. </p> <p> While a lack of both testing supplies and protective equipment remains a major issue, we have learned that the Washington State Department of Health received <a href="https://coronavirus.wa.gov/news/washington-receives-8000-additional-covid-19-test-kits">8,000 additional COVID-19 test kits</a> on Thursday from the U.S. Department of Health and Human Services. </p> <p> DOH is working to distribute the new supplies to local health agencies in the areas hardest hit by the COVID-19 virus thus far - King, Pierce, and Snohomish counties. These additional test kits are intended to increase capacity for testing of high-risk populations, including elderly people, those with pre-existing conditions, and the health care providers and first responders who are caring for others during this crisis. </p> <p> FEMA and the U.S. Department of Health and Human Services plan to provide additional test kits and related equipment to Washington state as these materials become available. </p> <p> The WSMA is conducting surveys of independent docs/clinics to determine need, to help advocate for testing supplies in our rural and non-Puget Sounds impacted areas.</p> </div>3/23/2020 10:58:09 AM3/23/2020 10:26:50 AM3/23/2020 12:00:00 AM
 
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