Published 3/22/2017 

WSMA leadership responds to GOP release of American Health Care Act

The Republicans’ plan to “repeal and replace” the Affordable Care Act, titled the American Health Care Act, is scheduled for its first vote in the U.S. House of Representatives this Thursday. After reviewing the proposal, your state medical association has decided not to support the legislation in its current form (at the time of this writing). Both WSMA President Shane Macaulay, MD and WSMA Executive Director/CEO Jennifer Hanscom have spoken out on the Republican plan, outlining WSMA’s position.

In a statement issued last Tuesday before the Congressional Budget Office issued its analysis of the proposal, Dr. Macaulay notes:

“While the Congressional Budget Office analysis has yet to be released, as currently written, the AHCA puts our state’s Medicaid program at risk, reducing access to coverage for thousands of our most vulnerable patients. The act also shifts much of the Medicaid funding obligation onto Washington state. Sufficient funding of our state’s health care program is imperative to avoid damaging ripple effects throughout the entire health care system. Our state is already facing budgetary challenges, and is simply not able to fill the funding gap that would result from the policies proposed in this act.”

Read the WSMA president’s full statement. The WSMA reached its position after carefully conducting a section-by-section analysis of the American Health Care Act as compared to WSMA policy and Principles of Health Care Reform.

After the CBO issued its analysis, in her e-newsletter Weekly Rounds WSMA Executive Director/CEO Jennifer Hanscom pointed to other WSMA concerns with the proposal, including:

  • Reduced federal funding limiting our ability respond to changes in demand for Medicaid services, including mental health and substance abuse treatment as a result of the ongoing opioid crisis.
  • The impact on needed patient services from repeal of the Prevention and Public Health Fund.
  • Limits on services offered via Medicaid or in the nongroup market that eliminate the ability of patients to receive their care from qualified providers of their choice.

Read Jennifer’s full response, now posted on the WSMA DocTalk blog. With the debate just beginning at the national level, in state legislatures, the health care industry and elsewhere, the WSMA will continue to make sure the profession’s voice is heard above the din. Visit WSMA’s Legislative Action Center to keep abreast of developments.

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Published 3/22/2017

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Published 3/22/2017 

State budget battle on the horizon

This issue’s Olympia update will focus on upcoming budget negotiations as the Senate prepares (at the time of this writing) to release its budget proposal. To check the progress of policy bills the WSMA is tracking, visit the Legislative Action Center. More on WSMA’s budget priorities at the jump.

With the state legislature on the hook for resolving education funding as a result of McCleary, the debate to pass a 2017-19 biennial budget looks to be one of the most contentious in years (even considering the difficult budget battles of the last few sessions). If the Senate budget proposal is released this week, expect to see the House follow up with its proposal soon after. The WSMA will provide analysis of both chambers’ proposals in upcoming communications. Top-line budget priorities we will be looking for include:

Reimbursement
Raising the Medicaid pediatric reimbursement rate ($7 million).

Opioid crisis
Buildouts to the state’s prescription monitoring program ($800,000-$1 million).
UW Telepain provider clinical consults ($700,000).

Workforce
Mental health professional student loan repayment ($9.5 million).
Preserving gains in previous years to graduate medical education/residency funding.

Public health
Tobacco 21: Supporting Gov. Inslee’s ask of funds to address loss of revenue to the state ($16 million).
Supporting funding of Foundational Public Health Services.

WSMA oppose
1.5-2.5 percent increase in the business and occupations (B&O) tax affecting physician practices.

Other health care budget priorities include funds for mental health (Western State Hospital, Children’s Mental Health Workgroup), funds for the implementation of health-improvement projects passed by the legislature in 2016 (maternal mortality review panel, immunization portal), funds for Healthier Washington and more.

Once both chambers’ proposals are released, legislators then negotiate in the shadow of Gov. Inslee’s budget priorities, outlined in December. The goal for lawmakers is a final budget agreed upon by both parties and the governor by the scheduled end of session on April 23. If more time is needed, the governor can call as many “special” 30-day sessions as necessary, provided a final budget is passed and signed by the governor no later than June 30 to avoid a government shutdown.

The WSMA will be there at every stage of the budget-making process, providing strong advocacy on behalf of physicians and patients. We will fight to protect ground gained over the past few years and work hard to ensure funding necessary for pressing issues facing the practice of medicine. Stay tuned for more information on the budget negotiations—and potential calls to action—or visit WSMA’s Legislative Action Center for more in-depth analysis and breaking news.

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Published 3/22/2017

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Published 3/22/2017 

WSMA reduces impact of suicide CME requirement on physicians

Opposed by the WSMA, a bill mandating continuing education for physicians and physician assistants in suicide prevention was passed by state lawmakers in 2014. Since its passage, the WSMA has participated in the rulemaking process to minimize the new law’s impact on physicians and PAs with little or no patient contact. We are pleased to report that the Medical Quality Assurance Commission’s recently released final rule on the CME requirement includes our recommendations—a major win on behalf of those clinicians.

In its rule, the Commission clarifies the specific compliance requirements for physicians and PAs, and, as the WSMA strongly recommended, allows fair exceptions for physicians who have no, or limited, contact with patients. The Commission will also work with other professions within the Department of Health so that attestation language is consistent on all renewals.

For those physicians and physician assistants not exempted by the rule, the requirement to complete a one-time, six-hour training related to recognizing suicide risks in patients remains in effect.

To assist members required to complete the CME, the WSMA has partnered with several organizations to provide convenient training that meets the Commission’s approval. The Washington State Psychiatric Association offers a special discount to WSMA members to attend their suicide care workshops, jointly provided by the American Psychiatric Association. There are a number of workshops scheduled in Seattle throughout the year.

For those of you attending the WSMA Annual Meeting, we will be working with our longtime premiere partner Physicians Insurance to host a suicide prevention CME on Friday, Oct. 13, directly preceding the meeting.

For other options, including an online course, download the Commission’s list of approved suicide prevention trainings.

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Published 3/22/2017

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Published 3/22/2017 

Call the Question: Tell us about 2017 Match Week!

In the last Membership Memo, we introduced “Call the Question,” a new editorial item designed to prompt your feedback. This week we offer a new topic and new question: Last week was Match Week, and Friday, Match Day. Do you have a story to share about your experience with this year’s annual event? We know you are busy, but we hope you will take a few moments to tell your story and share your thoughts. Send your feedback to callthequestion@wsma.org. As we collect your stories, we’ll look to feature a summary of feedback in a future WSMA publication. Thank you!

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Published 3/22/2017

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Published 3/22/2017 

Theater of War featured at Leadership Development Conference

The WSMA is pleased to present Theater of War at this year's Leadership Development Conference, Friday, May 19 and Saturday, May 20 at Campbell’s Resort on Lake Chelan. This innovative public health project uses a dramatic reading from Sophocles’ Ajax—a 2,500-year-old play about the suicide of a warrior—to inspire dialogue and reflection on the unique challenges and stressors faced by medical professionals.

A theater event originally designed to help war veterans, Theater of War is increasingly performed before medical groups to allow for safe and compassionate exploration of difficult emotions such as grief, shock, failure and guilt. The performance of Sophocles’ play at this year’s conference in particular promises resonance as attendees are given the opportunity to reflect upon the emotional and ethical impact of loss as experienced by healers and caregivers.

Featuring American actor Tate Donovan among its cast members, Theater of War will kick off WSMA’s popular one-and-a-half-day conference dedicated to enhancing clinicians’ leadership skills. The WSMA Leadership Development Conference is a great event for physicians of all types and all levels of leadership as well as groups and physician-administrator teams. Come to learn, to network and to relax in Lake Chelan’s beautiful resort setting.

Visit the WSMA website for conference agenda and registration information. This activity has been approved for AMA PRA Category 1 Credit™. Be sure to book your accommodations soon—a limited number of rooms at the WSMA discounted rate are available at Campbell’s. Call the resort directly at 800.553.8225 to reserve your room.

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Published 3/22/2017

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Published 3/22/2017 

Safety initiatives considered for William O. Robertson Patient Safety Award

The yearly William O. Robertson Patient Safety Award gives the WSMA a chance to recognize innovative patient safety initiatives in the ambulatory care setting. The WSMA established the award in honor of its past-president, the late William O. Robertson, MD, who was a champion for patient safety, risk management and quality improvement throughout his long and distinguished career.

To have your patient safety initiative considered for the award, please submit information on your initiative online by Friday, June 30. The award winner will be announced at the 2017 WSMA Annual Meeting, Oct. 14-15 in Seattle. If you have any questions, contact Jessica Martinson at jessica@wsma.org or 206.956.3628.

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Published 3/22/2017

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Published 3/22/2017 

March 31 early-bird deadline for MGMA Washington/Oregon Spring conference

The Washington and Oregon Medical Group Managment Associations joint 2017 Spring Conference is scheduled for Sunday, April 30 through Tuesday, May 2 in Spokane. To receive the early-bird registration discount, attendees must register for the meeting and reserve their room at the Historic Davenport Hotel or Davenport Grand by March 31. Don’t wait to register—those registering before the deadline will also receive a complimentary ticket to a raffle for a king-sized Davenport bed, box spring and mattress topper.

The 2017 OR/WA MGMA Spring Conference is the largest educational and networking conference for medical practice leaders on the West Coast. Hundreds of practice administrators, CEOs, physicians and managers from various specialties and practice sizes attend the three-day event, which includes high-profile speakers, interactive sessions and expert-led breakouts.

This year’s conference theme is “Healthcare Community Interconnected: Building Relationships to Grow and Thrive.” Nationally renowned speaker Seth Mattison, an expert on workforce trends and organizational leadership, will keynote the event, presenting on cultivating meaningful relationships in the digital age.

The 2017 meeting combines fun and food with a pre-conference golf scramble and culinary tasting events in addition to the educational portion of the meeting. Physicians and their practice teams are encouraged to attend. Register at wsmgma.org/2017.

The conference is also seeking sponsors and exhibitors. Visit wsmgma.org/2017 for more information.

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Published 3/22/2017

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Published 3/22/2017 

New resources on Medicaid transformation, including video and webinar

The Medicaid demonstration project is a five-year agreement between Washington state and the Centers for Medicare & Medicaid Services that provides up to $1.1 billion in incentives to test and implement innovative approaches to providing care and $375 million for support services for Medicaid and other clients. The Health Care Authority has released a collection of new resources to educate physicians and other providers on the state’s efforts to transform Medicaid, including new and updated fact sheets, a new video in its “whiteboard” series, a revamped website and a new, free webinar on March 28.

As a wrap-up to its series of public forums across the state, HCA is offering a free webinar to discuss input received at the forums and to provide information on the state’s plan to test innovative approaches to providing care. The webinar is scheduled for Tuesday, March 28, 9:30-11 a.m. Participants will be able to pose questions to HCA staff during the webinar about these transformation efforts. Register for this free session online.

Under Initiative 1 (of the project’s three initiatives), the nine regional Accountable Communities of Health will work with their community partners to identify and conduct population health improvement projects. HCA’s latest video in its “whiteboard” series offers an overview of the state’s Initiative 1 Project Toolkit, a guide to how Accountable Communities of Health will carry out their work. Watch the video online.

HCA has also prepared a new resource, 10 Things You Need to Know about the Medicaid Demonstration, for those wanting a broad overview of the demonstration project. The agency has updated its fact sheets that provide more details about the demonstration and its three initiatives:

For Initiative 3 of the demonstration, HCA held a webinar on March 10; the recorded webinar is available on YouTube. For more information on the state’s Medicaid transformation project visit the Medicaid transformation webpages, which have been redesigned for easier use.

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Published 3/22/2017

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Published 3/22/2017 

MACRA: WSMA survey on “readiness” still open – your participation is needed!

Help us help you: Please invest a few minutes at your earliest opportunity to take our MACRA: Practice Assessment survey. The brief 20-question instrument should only take you about 10-15 minutes to complete, yet the findings will dramatically help guide our collective understanding of the “readiness” of physicians and practices to actively participate in MACRA.

WSMA and WSHA continue our collaboration with Qualis Health on MACRA materials. We jointly developed a guidance document on the transition of PQRS and “meaningful use” into the MACRA Quality Payment Program, available from WSMA’s MACRA webpage in the “Tools and Resources” section. For questions, contact Bob Perna at rjp@wsma.org.

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Published 3/22/2017

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Published 3/22/2017 

CMS launches Medicare Coordinated Care education campaign

To encourage physician practices to provide coordinated care to Medicare patients, CMS is conducting a new educational effort, including a webpage, Connected Care: The Chronic Care Management Resource, webinars, social media postings, display posters and postcards.

Starting in 2015, CMS approved chronic care management CPT code 99490 for payment under the Medicare program, paying physicians an average of $42 per patient per month for consulting with specialists and coordinating chronic-care services. This code allows eligible practitioners and suppliers to bill for at least 20 minutes of non-face-to-face clinical staff time, directed by a physician or other qualified health professionals each month, to coordinate care for Medicare patients who have two or more serious chronic conditions that are expected to last at least 12 months. CMS estimates that 70 percent of Medicare patients—about 35 million people—have two or more chronic conditions, making them eligible for these services.

In its final rule for 2017, CMS increased the payment amount for the care management code by $1.00 per use and approved three additional chronic care management codes (see below).

CPT Code and Description Seattle/King County   Rest of WA
99490 - Chronic Care Management Service, 20 min. or more per month     $45.79 $42.51
99487 - Complex CCM service, 1st hour per month $102.38 $93.72
99489 - Complex CCM Add-on, each add'l 30 mins. per month
           - CCM Initiating visit (use appropriate CPT visit code)
$51.40 $47.04
G0506 - Add on to CCM Initiating visit $68.68 $63.61

 

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Published 3/22/2017

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