Published 8/9/2017 

The 2017 WSMA Annual Meeting: Deadline for submitting resolutions is Aug. 18

This fall, WSMA members from across the state will gather to debate and determine the policy direction of your medical association at this year’s Annual Meeting of the House of Delegates. Participating in the policymaking process is a powerful benefit of WSMA membership. If you are interested in authoring a resolution, the WSMA will work with you to develop your resolution idea and find a board member or delegate sponsor (contact hod@wsma.org or 206.441.9762 for assistance). Don’t delay: Board members or delegates/alternates must submit their resolutions by email to hod@wsma.org by next Friday, Aug. 18 for distribution prior to the meeting.

All are welcome to attend the WSMA’s annual conference, scheduled for Oct. 13-15 at the Hilton Seattle Airport & Conference Center in Seattle. The meeting is free for WSMA members, members of the Medical Group Management Association Washington State, and for all residents and medical students. Meeting registration is also free for members of the Washington State Radiological Society, which will be holding its annual meeting on Saturday morning, Oct. 14, concurrent with the WSMA meeting. For a full agenda and to register, visit the WSMA website.

WSMA members interested in serving as a delegate/alternate delegate at the meeting can contact us at hod@wsma.org (learn more about being a delegate).

The WSMA would like to thank our corporate partners for helping make the 2017 WSMA Annual Meeting possible: Exclusive Premier Partner Physicians Insurance A Mutual Company, Diamond Partner Cordant Health Solutions, and Silver Partners Premera Blue Cross, First Choice Health and Hall Render.

Published 8/09/2017

Published 8/9/2017 

Improving Value in Health Care: The 2017 Choosing Wisely Summit, Friday, Oct. 27

Join health care leaders, stakeholders and national Choosing Wisely® representatives in Seattle on Friday, Oct. 27 for a day-long, in-depth look at how the Choosing Wisely initiative in Washington state is moving from education to implementation.

The full-day conference is designed to give practices and organizations of all sizes the tools and inspiration to integrate Choosing Wisely recommendations into daily operations. Conference highlights include:

  • Keynote address: Choosing Wisely: A National Campaign, presented by Richard Baron, MD, president and CEO of American Board of Internal Medicine and ABIM Foundation.
  • Implementation Science, presented by Matt Handley, MD, medical director of clinical improvement and prevention at Kaiser Permanente Washington.
  • Connecting the Dots: Choosing Wisely and MACRA's QPP, presented by Paul McGann, MD, chief medical officer of quality improvement at the Centers for Medicare & Medicaid Services.
  • Clinical Education Strategies: Leveraging CME to Change Physician Behavior, presented by Graham McMahon, MD, president and CEO of the Accreditation Council for Continuing Medical Education.

Several breakout sessions will be available, with options including medical group implementation, hospital and health system implementation, sharing physician- and clinic-level results for measuring success, and much more. Learn more about the Choosing Wisely Summit and register on the WSMA website. This activity has been approved for AMA PRA Category 1 Credit™.

Published 8/09/2017

Published 8/9/2017 

WSMA and WSHA guidance for Medicaid demonstration opioid projects

With the opioid epidemic in Washington and the rest of the nation showing no signs of abating, state agencies and provider communities continue to explore strategies to combat the crisis, with the WSMA at the ready to assist with clinician-driven expertise and solutions. Together with our partners at the Washington State Hospital Association, the WSMA is excited to announce a set of strategies that can help hospitals, health systems, independent/group practices and the state’s Accountable Communities of Health target the opioid crisis. These strategies offer promising interventions that can be implemented as part of the Medicaid demonstration opioid project.

Each Accountable Community of Health, the regional vehicles for Medicaid transformation, is required to submit a targeted strategy this November to address the opioid crisis. To assist the ACHs and their providers, the WSMA and WSHA have convened subject matter experts to identify promising strategies focused on prevention, appropriate prescribing and access to treatment. The strategies are:

  1. Overdose prevention – Implementing protocols and policies in the emergency department and primary care setting for overdose education and take-home naloxone for at-risk individuals.
  2. Expanding access to treatment – Initiating medication-assisted treatment in emergency departments and coordinating outpatient treatment for at-risk individuals.
  3. Integrating PMP data into clinical workflows – Furthering utilization of the prescription monitoring program and integration of PMP data into the electronic medical record.
  4. Expanding access to treatment – Developing and implementing a toolkit to support providers in increasing the number of patients treated with MAT.
  5. Improving opioid prescribing practices – Leveraging data and guidelines to support appropriate opioid prescribing practices.
  6. Develop low-barrier methadone and buprenorphine access (under development).

For details on the opioid strategies, including expected outcomes, implementation approach and timeline, required system capacity and more, click here.

We hope that hospitals, health systems and providers will discuss these strategies with their ACHs and that ACHs will implement many of these approaches. We believe the impact will be stronger by having work aligned across regions. If you have questions or wish to partner with WSMA or WSHA on any of these strategies, contact Jeb Shepard, jeb@wsma.org or Ian Corbridge, ianc@wsha.org.

Published 8/09/2017

Published 8/9/2017 

Changes to Joint Commission accreditation standards, Medicare HCAHPS pain scores on the horizon

The Joint Commission and the Centers for Medicare & Medicaid Services recently announced respective changes to how pain should be assessed and managed in the hospital setting. Both new policies go into effect on Jan. 1, 2018.

Following a public comment period in January, the Joint Commission released new and revised standards for its accredited hospitals regarding pain assessment and management. The standards include the following new requirements:

  • Identifying a leader or leadership team that is responsible for pain management and safe opioid prescribing.
  • Involving patients in developing their treatment plans and setting realistic expectations and measurable goals.
  • Promoting safe opioid use by identifying high-risk patients.
  • Monitoring high-risk patients.
  • Facilitating clinician access to prescription drug monitoring program databases.
  • Conducting performance improvement activities focusing on pain assessment and management to increase safety and quality for patients.

The standards are posted on the Joint Commission website and will be included in the upcoming edition of the Comprehensive Accreditation Manual for Hospitals.

And in a long-anticipated move intended to eliminate incentives for hospital staff to prescribe more opioids, CMS announced in its recently released Hospital Inpatient Prospective Payment System final rule that Medicare will remove from hospital surveys questions asking patients how well their pain was managed. Revised questions will be used to form the composite measure “Communication About Pain,” which will seek to encourage better communication with patients about their pain during a hospital stay.

Published 8/09/2017

Published 8/9/2017 

Feedback due Aug. 21 on proposed changes to MACRA Quality Payment Program

The Centers for Medicare & Medicaid Services has released a proposed rule to update MACRA’s Quality Payment Program for 2018 and beyond, with the goal of simplifying the program, decreasing administrative burden and increasing flexibility, particularly for small, independent and rural practices. Comments on the proposed rule are due to CMS by 5 p.m. on Aug. 21. To help physicians and practices provide feedback to CMS, the WSMA is offering education on the proposed rule and the changes under consideration.

The proposed rule would amend some existing requirements and introduce new policies that would encourage participation in either of MACRA’s two payment pathways: advanced alternative payment models or the Merit-based Incentive Payment System. One key proposal is the introduction of “virtual groups” as a participation option, composed of solo practitioners and groups of 10 or fewer eligible clinicians who come together “virtually” with at least one other solo practitioner or group to participate in MIPS for a performance period of a year. WSMA staff is currently preparing a summary of these proposals for members’ review.

To help you understand the changes being proposed by CMS, WSMA recently joined the Oregon Medical Association, the Idaho Medical Association and CMS Region 10 to present a one-hour webinar, featuring Dr. Nancy Fisher, chief medical officer of CMS Region 10, as lead presenter. The webinar will be available on demand from the WSMA website shortly.

Published 8/09/2017

Published 8/9/2017 

Update: State’s Clinical Data Repository

As noted in our last update, WSMA and the Medical Group Management Association Washington State proposed to Health Care Authority leadership that a “summit” be convened. The goal would be to give provider organizations an opportunity to meet with leadership from the HCA and OneHealthPort and reach an understanding of the status of the state’s implementation of the Clinical Data Repository and how to move forward. However, as a more immediate action, we are encouraging HCA to convene a provider-centric “users group” that would help identify concerns and potential solutions to technical, administrative and clinical issues. That body would include WSMA, the Washington State Hospital Association, MGMA-WA, HCA and OHP, as well as a representative cohort of small-to-mid-sized physician practices, large physician practice organizations and hospital/health care system organizations.

We’ll keep you apprised as details develop. For questions, contact Bob Perna, director of the WSMA Practice Resource Center at rjp@wsma.org or 206.441.9762.

Published 8/09/2017

Published 8/9/2017 

New tool helps estimate costs of behavioral health integration

A cornerstone of the state’s Healthier Washington initiatives is the integration of primary care and behavioral health, as well as finding a sustainable way to finance those services. To help clinicians and staff in primary care practices better understand the ongoing costs and revenues associated with integrated strategies, the University of Washington AIMS Center (Advancing Integrated Mental health Solutions) created the Financial Modeling Workbook in collaboration with the Institute for Family Health and the American Psychiatric Association.

The workbook can help practices more accurately estimate revenues and expenses for providing collaborative care and other integrated services by:

  • Estimating visit volume and the number of patients served.
  • Defining and analyzing how much time staff engage in key integrated care tasks.
  • Estimating fee-for-service and BHI/CoCM G-code potential revenues more accurately.

The workbook also assists in evaluating practice parameters to better understand their impact on the practice’s bottom line. For example, you can vary the length of appointment times, the percentage of time staff spends on the different components of collaborative care work or other factors to start to better understand how to build or revise clinical workflows.

The workbook is free with registration and can be downloaded via the Healthier Washington Practice Transformation Support Hub Portal, where you can also find many other tools, resources and webinar recordings on physical and behavioral health integration.

Published 8/09/2017

Published 8/9/2017 

Medical records: Permissible fees for records reproduction

The Washington statute that sets the maximum fee that physicians and other providers can charge for health records expired as of June 30. The WSMA is engaged in ongoing discussions with the Washington State Department of Health and the federal Office for Civil Rights regarding permissible fees that physician practices can charge for record reproduction. While a number of points are still unresolved, DOH has provided some guidance.

DOH reports that the final stage of the rulemaking is scheduled for early August, with rules typically becoming effective 30 days after filing. Given the June 30 expiration of the statute (WAC 246-08-400), DOH advised that physicians can continue to charge the fees found in the expired WAC as it is still under the maximum set in the proposed amended rule. DOH fees can only be used when applicable; otherwise, the limitations placed on charging fees established by HIPAA must be followed. For questions, contact Bob Perna at rjp@wsma.org.

Published 8/09/2017

Published 8/9/2017 

CMS rebrands “New Medicare Card”

As reported previously, CMS is removing Social Security numbers from Medicare cards to help fight identity theft and safeguard taxpayer dollars. Previously referred to as the Social Security Number Removal Initiative (SSNRI), CMS now calls this initiative the “New Medicare Card.” On the WSMA Practice Resource Center’s Health Insurers webpage, you’ll find information for educating practice staff and your Medicare patients about this coming change.

By April 1, 2018, Medicare patients and their health care practitioners can start using each patient’s randomly generated Medicare Beneficiary Identifier (the new Medicare number). Your practice’s data systems must be ready to accept the MBI by April 1, 2018. For those patients who are newly eligible for Medicare, only the new MBI will be issued.

CMS and Medicare contractors (Noridian for Washington) will continue to accept the old health insurance claim number until the end of the transition period on Jan. 1, 2020. During the transition period, Medicare contractors will be able to process claims using either the HICN or the MBI. For questions, contact Michelle Lott at mml@wsma.org.

Published 8/09/2017