| 2023-legislative-session-update-an-update-on-wsma-policy-priorities | 2023 Legislative Session Update: An Update on WSMA Policy Priorities | Latest_News | Shared_Content/News/Latest_News/2023/2023-legislative-session-update-an-update-on-wsma-policy-priorities | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/812098090"><img src="/images/Newsletters/latest-news/2023/march/legislative-update-wk-12.png" alt="WSMA Legislative Update Week of March 27, 2023" /></a></div>
<h5>March 27, 2023</h5>
<h2>2023 Legislative Session Update: An Update on WSMA Policy Priorities</h2>
<p>With just under one month left in the state legislative session, WSMA Director of Government Affairs Sean Graham provides an update on four of WSMA's policy priorities: access for abortion and reproductive health care services, addressing gun violence, prior authorization modernization and standardization, and scope of practice.
<a href="https://vimeo.com/812098090">Watch the video</a>.
</p>
</div> | 3/27/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| department-of-health-advisory-regarding-the-buprenorphine-x-waiver | Department of Health Advisory Regarding the Buprenorphine X Waiver | Latest_News | Shared_Content/News/Membership_Memo/2023/march-24/department-of-health-advisory-regarding-the-buprenorphine-x-waiver | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/march/buprenorphine-butrans10mcg-645px.jpeg" class="pull-right" alt="Buprenorphine Butrans" /></div>
<h5>March 24, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>Department of Health Advisory Regarding the Buprenorphine X Waiver</h2>
<p>In December, the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Agency eliminated the requirement for physicians and other prescribers to have a DATA 2000 (X) waiver to prescribe buprenorphine-containing medication products for the treatment of opioid use disorder. SAMHSA has additionally dropped the limit on the number of patients physicians may prescribe buprenorphine medications to. The removal of these barriers to treatment represents a significant victory in the battle to reduce opioid addiction and overdose, one in which the <a href="[@]Shared_Content/News/Membership_Memo/2023/january-27/wsma-advocacy-critical-to-removal-of-buprenorphine-prescribing-barriers.aspx?_zs=A3aFd1&amp;_zl=9qFn8">WSMA and a coalition of Washington stakeholders played a critical role</a>.</p>
<p>The medication buprenorphine effectively treats opioid use disorder by manage craving and withdrawal, reducing illicit opioid use, and decreasing the risk of overdose. This week, Washington's Chief Science Officer Tao Sheng Kwan-Gett, MD, MPH, issued the following health advisory for physicians and prescribing clinicians to encourage the prescribing of buprenorphine for OUD:</p>
<ul>
<li>If you have a current DEA registration number that includes Schedule III authority, effective immediately you may now prescribe buprenorphine formulations for opioid use disorder.</li>
<li>There are no longer limitations on the number of patients a prescriber can treat for opioid use disorder with buprenorphine.</li>
<li>There are no medication-specific training requirements at this time.</li>
<li>With this provision, waiver applications from SAMHSA are no longer needed.</li>
</ul>
<p>If you have not prescribed buprenorphine or Suboxone (buprenorphine/naloxone) and would like additional education, there are many resources available to support safe and effective treatment of opioid use disorder:</p>
<ul>
<li><a href="https://pcssnow.org/">Providers Clinical Support System</a></li>
<li><a href="https://www.learnabouttreatment.org/for-professionals/">Learn About Treatment</a></li>
<li><a href="https://www.acep.org/patient-care/bupe/">American College of Emergency Physicians</a></li>
<li><a href="https://pcl.psychiatry.uw.edu/">University of Washington Consultation Line</a>
<ul>
<li>Phone: 877.927.7924</li>
</ul>
</li>
<li>Clinician Peer Support for physicians treating pregnant or parenting patients with SUD
<ul>
<li>Phone: 833.937.9326 (Yes-WeCAN)</li>
</ul>
</li>
</ul>
<p>More information:</p>
<ul>
<li><a href="https://www.deadiversion.usdoj.gov/pubs/docs/A-23-0020-Dear-Registrant-Letter-Signed.pdf" target="_blank" rel="noreferrer">DEA announcement</a></li>
<li><a href="https://www.samhsa.gov/medications-substance-use-disorders/removal-data-waiver-requirement">SAMHSA Removal of DATA Waiver Requirement </a></li>
<li><a href="https://www.hca.wa.gov/billers-providers-partners/program-information-providers/medications-opioid-use-disorder-moud">Health Care Authority medications for opioid use disorder</a></li>
</ul>
<p>For any additional questions, contact <a href="mailto:Hannah.Carmichael@doh.wa.gov">Hannah.Carmichael@doh.wa.gov</a>.</p>
</div> | 3/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| medpac-recommends-tying-physician-payment-update-to-inflation | MedPAC Recommends Tying Physician Payment Update to Inflation | Latest_News | Shared_Content/News/Membership_Memo/2023/march-24/medpac-recommends-tying-physician-payment-update-to-inflation | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/march/medicare-barcode-645px.jpeg" class="pull-right" alt="Medicare barcode" /></div>
<h5>March 24, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>MedPAC Recommends Tying Physician Payment Update to Inflation </h2>
<p>In a historic first, the Medicare Payment Advisory Commission called for a physician payment update tied to the Medicare Economic Index in its <a href="https://www.medpac.gov/document/march-2023-report-to-the-congress-medicare-payment-policy/">yearly report to Congress</a>. The American Medical Association was quick to praise the nonpartisan commission's recommendation, calling it a first step toward reforming the Medicare payment system and, together with the support of the WSMA and organized medicine, has urged Congress to go even further.</p>
<p>In a <a href="https://www.ama-assn.org/press-center/press-releases/ama-commends-medpac-move-recognize-costs-practicing-medicine">statement</a>, AMA President Jack Resneck Jr., MD, said, "MedPAC recognized that physician pay has not kept up with the cost of practicing medicine. Yet, we feel strongly that an update tied to just 50% of MEI will cause physician payment to chronically fall even further behind increases in the cost of providing care."</p>
<p>The WSMA has joined with the AMA and 133 other health organizations to <a href="https://searchlf.ama-assn.org/letter/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2Flfdr.zip%2FAMA-Inflation-Payment-Update-MEDPAC-sign-on-letter-FINAL-3-15-23.pdf" target="_blank" rel="noreferrer">send a letter to congressional leaders</a> urging the adoption of a 2024 Medicare payment update that recognizes the full inflationary growth in health care costs. The letter points out the real-life impact of the eroding value of Medicare payments. According to MedPAC, among those looking for a new primary care physician, half of Medicare patients had difficulty in finding one. And among Medicare patients looking for a new specialist, one-third struggled to find one. Finding specialists in rural and historically underserved areas is particularly difficult, and the payment system is creating even bigger barriers for patients in those communities.</p>
<p>Visit the WSMA website for <a href="[@]wsma/advocacy/medicare_payment_reform/wsma/advocacy/medicare_payment_reform/medicare_payment_reform.aspx?hkey=d1a48c1c-af7b-4680-bd55-967338f3c977">more on organized medicine's efforts to reform the Medicare payment system</a>.</p>
</div> | 3/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| services-announced-for-tom-curry-wsma-ceo-1986-2013 | Services Announced for Tom Curry, WSMA CEO 1986-2013 | Latest_News | Shared_Content/News/Membership_Memo/2023/march-24/services-announced-for-tom-curry-wsma-ceo-1986-2013 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/march/remembering-tom-curry-no-ceo-645x425px.png" class="pull-right" alt="Tom Curry" /></div>
<h5>March 24, 2023</h5>
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<h2>Services Announced for Tom Curry, WSMA CEO 1986-2013</h2>
<p>Earlier this week in a <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2023/weekly-rounds-march-20-2023-remembering-tom-curry.aspx">heartfelt tribute</a>, WSMA CEO Jennifer Hanscom shared the news of the passing of her predecessor and mentor, former WSMA CEO Tom Curry. Tom was the executive director and CEO of the WSMA from 1986 to 2013, working diligently during those 27 years to help build a forward-leaning and progressive professional society. From working with the Legislature in the 1990s to help create the Basic Health Plan, to being the voice for needed tort reform in the early 2000s, Tom was an ardent supporter of Washington state physicians and patients, a sentiment many WSMA members will undoubtedly share. <a href="https://www.gaffneyfuneralhome.com/obituary/Thomas-Curry">Services</a> will be held at 9 a.m. on March 31 at St. Charles Borromeo Catholic Church, 7112 S. 12th St; Tacoma, WA 98465. In lieu of flowers, donations are encouraged to the <a href="http://www.parkinson.org/">Parkinson's Foundation</a>, <a href="http://www.michaeljfox.org/">Michael J. Fox Foundation</a>, or <a href="http://www.trm.org/">Tacoma Rescue Mission</a>. Tom is survived by his loving wife Deedle; his three children Ian (Becci) Curry, Jennifer Curry-Hahn (Michael Murphy), and James Curry (Sara Arsenault); his eight grandchildren Emma and Edie Curry, Isaac, Alice, Lily Hahn and Owen Murphy, and Aden and Lane Curry; and his sister Christine (Ray) Baker.</p>
</div> | 3/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| starting-june-2023-theres-a-new-education-requirement-for-dea-registration-or-renewal | Starting June 2023, There's a New Education Requirement for DEA Registration or Renewal | Latest_News | Shared_Content/News/Membership_Memo/2023/march-24/starting-june-2023-theres-a-new-education-requirement-for-dea-registration-or-renewal | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/march/doctor-at-desk-645x425px.png" class="pull-right" alt="doctor at desk writing on a pad" /></div>
<h5>March 24, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>Starting June 2023, There's a New Education Requirement for DEA Registration or Renewal</h2>
<p>The Consolidated Appropriations Act of 2023 requires a new training for physicians, physician assistants, and health care professionals who need U.S. Drug Enforcement Administration registration as a condition of employment or to prescribe controlled substances in Schedule II-V.</p>
<p>Starting in June, upon registration with the DEA or renewal of a DEA number, physicians will be required to complete an eight-hour training on substance use disorder treatment. The DEA and the Substance Abuse and Mental Health Services Administration are in the process of creating and releasing guidance around this new requirement.</p>
<p>The American Medical Association reviewed these changes and submitted a comment letter to the DEA and SAMHSA outlining various concerns. With a focus on patient access, the AMA raised concerns that physicians and health care professionals may struggle meeting the new training requirement in such a short timeframe, resulting in a potentially dangerous lapse in patient care. In addition, the AMA called on the DEA and SAMHSA to allow for broad interpretation of SUD training and provide a one-year grace period for physicians to fulfill the new requirement.</p>
<p>The WSMA will keep you apprised of updates to help you understand and comply with this new federal requirement, which goes into effect on June 21. With any questions or comments please email <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 3/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsma-signs-on-in-support-of-fair-access-in-residency-act | WSMA Signs On in Support of Fair Access in Residency Act | Latest_News | Shared_Content/News/Membership_Memo/2023/march-24/wsma-signs-on-in-support-of-fair-access-in-residency-act | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/march/shutterstock-619039964-web-645x425px.jpeg" class="pull-right" alt="stethoscope resting on clipboard" /></div>
<h5>March 24, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>WSMA Signs On in Support of Fair Access in Residency Act </h2>
<p>This month, the physician leadership of the WSMA voted to <a href="https://www.aacom.org/docs/default-source/public-statements/final---coalition-support-letter-for-fair-act---9-15-22.pdf?sfvrsn=4c641f97_26">sign on in support of the Fair Access in Residency Act</a>&nbsp;currently before Congress, legislation supporting equitable treatment of osteopathic medical students and increased access to high-quality, patient-centered health care in rural and underserved areas. The WSMA is the first non-osteopathic medical association to sign on in support of the legislation.</p>
<p>Many federally funded graduate medical education programs exclude or impose burdensome requirements on osteopathic medical student residency applicants, resulting in discriminatory treatment. According to the 2022 National Resident Matching Program survey, 32% of residency program directors report never or seldom interviewing DO candidates, and for those who do, 56% require the USMLE, the MD licensing exam. As a result, the proportion of DO students taking the USMLE as well as the COMLEX-USA has increased by 26% since 2015.</p>
<p>The FAIR Act requires Medicare-funded graduate medical education programs to do the following as a condition for participation:</p>
<ol>
<li>Report annually the number of applicants for residency from osteopathic and allopathic medical schools and how many such applicants were accepted from each respective type of school.</li>
<li>Affirm annually that they accept applicants from osteopathic and allopathic medical schools, and that if an examination score is required for acceptance, the COMLEX-USA and USMLE will be equally accepted.</li>
</ol>
<p>Read the <a href="https://www.congress.gov/bill/118th-congress/house-bill/751/text?s=1&amp;r=11">full text of the FAIR Act (H.R. 751)</a>.</p>
</div> | 3/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2023-legislative-session-update-wsmas-budget-priorities-for-2023 | 2023 Legislative Session Update: WSMA's Budget Priorities for 2023 | Latest_News | Shared_Content/News/Latest_News/2023/2023-legislative-session-update-wsmas-budget-priorities-for-2023 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/809588260"><img src="/images/Newsletters/latest-news/2023/march/legislative-update-wk-11.png" alt="WSMA Legislative Update for March 20, 2023 graphic" /></a></div>
<h5>March 20, 2023</h5>
<h2>2023 Legislative Session Update: WSMA's Budget Priorities for 2023</h2>
<p>As the Legislature's focus shifts toward budget negotiations, WSMA's Director of Government Affairs Sean Graham gives an update on WSMA's budget priorities for 2023. Watch the video.
<a href="https://vimeo.com/809588260">Watch the video</a>.
</p>
</div> | 3/20/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| weekly-rounds-march-20-2023-remembering-tom-curry | Weekly Rounds: March 20, 2023 - Remembering Tom Curry, Former WSMA CEO | Latest_News | Shared_Content/News/Weekly_Rounds/2023/weekly-rounds-march-20-2023-remembering-tom-curry | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div>
<h5>March 20, 2023</h5>
<h2>Remembering Tom Curry, Former WSMA CEO</h2>
<p>Jennifer Hanscom, CEO</p>
<p>
It is with a heavy heart that I share the news of the passing of Tom Curry. Tom was the executive director and CEO of the WSMA from 1986 to 2013, in addition to being a dear friend, mentor, and supporter not only to me, but to many in organized medicine and the physician community.
</p>
<p>
During his 27 years at the WSMA, Tom had many achievements that centered on building a forward-leaning and progressive professional society. From working with the Legislature in the 1990s to help create the Basic Health Plan, to being the voice for needed tort reform in the early 2000s, Tom was an ardent supporter of Washington state physicians and patients. He helped incorporate and secure stable funding for the Washington Physicians Health Program and supported Physicians Insurance's evolution into a national professional liability insurance company leader.
</p>
<p>
During his tenure at the WSMA, Tom served as a member of the board of directors of Physicians Insurance a Mutual Company, the state's largest professional liability insurance company. He was also a member of the board of directors of the Washington Physicians Health Program, the Association of Washington Business, the Washington Health Care Forum, and the Foundation for Health Care Quality.
</p>
<p>
Prior to joining the WSMA, Tom was the executive director of the Pierce County Medical Society and manager of corporate relations at Blue Cross of Washington and Alaska.
</p>
<p>
Tom was deeply respected by all in organized medicine-both within Washington state as well as throughout the U.S. His charming wit and engaging sense of humor will be deeply missed.
</p>
<p>
On behalf of all of the staff and members of the WSMA, we extend sincerest condolences to Tom's wife, Deedle, sons Ian and James, daughter Jennifer, and grandchildren.
</p>
</div> | 3/20/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| weekly-rounds-march-17-2023-five-ways-were-representing-our-members | Weekly Rounds: March 17, 2023 - Five Ways We're Representing Our Members | Latest_News | Shared_Content/News/Weekly_Rounds/2023/weekly-rounds-march-17-2023-five-ways-were-representing-our-members | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div>
<h5>March 17, 2023</h5>
<h2>
</h2>
<h2>Five Ways We're Representing Our Members</h2>
<p>Jennifer Hanscom, CEO</p>
<p>
As I write this, I've just finished watching the 95th Academy Awards. That's not something I typically do, but with nothing else on my schedule, there I sat. Watching the production, it dawned on me that I was watching an association's award show. Just like the WSMA, the Academy of Motion Picture Arts and Sciences, which, according to Google, has 10,000-plus members, exists to represent its members and celebrate their achievements.
</p>
<p>
The academy is best known, at least outside of Hollywood, for the Oscars. Similarly, outside of our most engaged members, the WSMA is best known for our advocacy work in Olympia. In addition to representing your voice in the Legislature, the WSMA represents you in other contexts: in Congress, in the media, in conversations with stakeholders, and in the regulatory arena. The WSMA also helps equip you professionally, with leadership development courses, quality improvement programs, and other opportunities for continuing education and networking. And we have our own Oscars: the WSMA Apple Awards, by which we celebrate our members' achievements during our annual gathering, the Annual Meeting of the WSMA House of Delegates (<a href="[@]wsma/events/annual_meeting/wsma/events/annual_meeting/annual_meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f&amp;_zs=B3aFd1&amp;_zl=BRRs8">this year's meeting</a> will be held in Bellevue Sept. 23-24).
</p>
<p>
Just in case you aren't up to speed on all that the WSMA is working on, here are five examples of the ways we are engaged today in representing your interests and achieving the goals of our <a href="[@]wsma/about_us/who_we_are/strategic-plan/wsma/about/who_we_are/strategic-plan.aspx?hkey=cc3b2e8d-f7ff-49ac-95a7-fb5e6052b967&amp;_zs=B3aFd1&amp;_zl=CRRs8">strategic plan</a>.
</p>
<h3>New education requirement to register for or renew your DEA number effective June 2023</h3>
<p>
The Consolidated Appropriations Act of 2023 requires a new training for physicians, physician assistants, and health care professionals who need U.S. Drug Enforcement Administration registration as a condition of employment or to prescribe controlled substances in Schedule II-V.
</p>
<p>
Starting in June, upon registration with the DEA or renewal of a DEA number, physicians will be required to complete an eight-hour training on substance use disorder treatment. The DEA and the Substance Abuse and Mental Health Services Administration are in the process of creating and releasing guidance around this new requirement.
</p>
<p>
The American Medical Association reviewed these changes and submitted a comment letter to the DEA and SAMHSA outlining various concerns. With a focus on patient access, the AMA raised concerns that physicians and health care professionals may struggle meeting the new training requirement in such a short timeframe, resulting in a potentially dangerous lapse in patient care. In addition, the AMA called on the DEA and SAMHSA to allow for broad interpretation of SUD training and provide a one-year grace period for physicians to fulfill the new requirement.
</p>
<p>
The WSMA will keep you apprised of updates to help you understand and comply with this new federal requirement, which goes into effect on June 21.
</p>
<h3>DEA proposed rulemaking regarding prescribing controlled substances via telemedicine</h3>
<p>
The U.S. Drug Enforcement Administration has proposed rulemaking to expand telemedicine flexibilities adopted during the COVID-19 public health emergency. The proposed rule would provide safeguards for a narrow subset of telemedicine and audio-only consultations: those by a medical practitioner who has never conducted an in-person evaluation of a patient and that result in the prescribing of a controlled substance.
</p>
<p>
For these types of consultations, the proposed telemedicine rules would allow a physician or other prescriber to prescribe:
</p>
<ul>
<li>A 30-day supply of <a href="https://www.dea.gov/drug-information/drug-scheduling">Schedule III-V</a> non-narcotic controlled medications or a combination of such drugs that have been approved for use in continuous medical treatment or withdrawal management treatment.</li>
<li>A 30-day supply of buprenorphine for the treatment of opioid use disorder.</li>
</ul>
<p>
The DEA has also released a proposed rule to expand the induction of buprenorphine via telemedicine encounter. WSMA staff is reviewing the rulemaking for potential comments.
</p>
<h3>Quality improvement regarding safe prescribing habits with the sharing of prescribing reports</h3>
<p>
The Better Prescribing, Better Treatment program, a collaboration started several years ago by the WSMA along with the Washington State Hospital Association, Washington State Department of Health, and the Washington State Health Care Authority, continues to help ensure proper utilization of controlled substances and encourage safe prescribing habits.
</p>
<p>
Each quarter, the WSMA sends feedback reports on acute opioid prescribing to more than 10,000 prescribers and sends organization-level reports to medical group chief medical officers. At the same time, WSHA sends organization-level reports to hospital CMOs. Reports are derived from state prescription monitoring program data. Currently, reports are only sent to CMOs who actively enroll their hospital, health system, or medical group in the program.
</p>
<p>
This quarter, however, the program is expanding to enable all medical groups and individuals to enroll and receive these quarterly reports. This includes groups who do not have an approved CQIP plan with the state.
</p>
<p>
To enroll your medical group, practice, or individual physicians into the program, email Monica Salgaonkar at <a href="mailto:monica@wsma.org">monica@wsma.org</a>. Hospitals or health systems should contact Melina Ovchiyan at <a href="mailto:melinao@wsha.org">melinao@wsha.org</a>. For questions, contact Monica Salgaonkar at 206.441.9762 or <a href="mailto:monica@wsma.org">monica@wsma.org</a>.
</p>
<h3>Education on health equity via "M&amp;M" webinars</h3>
<p>
How do we give autonomy to patients in light of our own predispositions of how we view the world and society? How do we leave stereotypes at the door to ensure patient autonomy?
</p>
<p>
These questions and more will be discussed at the next session of our Health Equity M&amp;M Webinar Series on Friday, April 14 at noon. Think "morbidity and mortality" but with a focus on health equity.
</p>
<p>
These health equity M&amp;M discussions provide a framework for recognizing and examining our own biases and identifying the ways systemic racism exists in our organizations. You'll acquire new tools with which to think critically and identify when to advocate for your patients from historically marginalized communities, ensuring they receive the highest quality clinical care. The health equity M&amp;M discussions serve as one of many mechanisms to address forms of systemic marginalization of patients.
</p>
<p>
During each webinar, Edwin Lindo, JD, facilitates case-based discussions. Lindo is the assistant dean of social and health justice in the Office of Healthcare Equity, an associate teaching professor in the department of family medicine, and an adjunct associate teaching professor in the department of bioethics and humanities at the University of Washington School of Medicine.
</p>
<p>
WSMA members are encouraged to submit patient cases to discuss at an M&amp;M session. Verbal submission of cases is the safest approach to preserving the confidentiality of the information. If you would like to speak with Lindo directly, email Kendra Peterson at <a href="mailto:kendra@wsma.org">kendra@wsma.org</a>. As an alternative, the WSMA has created an <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=CgN5_wMfNU66xEvN3PBcAIl040VJfZtFmgd6Gl6BR-NUOVhWSlJaWVAyODJTUE9UVFVUTjc0ODZFUS4u">online case submission form</a> by which you can share patient cases. Rest assured that case submissions are CQIP and HIPAA compliant.
</p>
<p>
This series fosters a space conducive to building a community of professionals focused on achieving health equity, allowing for discussions of charged but necessary topics. Each webinar is protected under WSMA's CQIP as recognized by the Washington State Department of Health and pursuant to RCW 70.225.040. By registering, you agree to maintain the confidentiality of the cases discussed pursuant to RCW 43.70.510, RCW 70.41.200, and RCW 4.24.250. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢.
</p>
<h3>Networking and developing leadership skills in a lakeside resort setting</h3>
<p>
Many WSMA members are quick to cite the WSMA Leadership Development Conference as one of their favorite WSMA conferences, and not just because of the springtime Lake Chelan resort setting. Most frequently cited is the conference curriculum, which offers top experts in their fields speaking to the latest developments in care delivery, leadership, and quality improvement. <a href="[@]wsma/events/leadership_development_conference/wsma/events/ldc/leadership_development_conference.aspx?hkey=c7532c38-057a-4568-8a3c-078182469222&amp;_zs=B3aFd1&amp;_zl=IRRs8">Registration is now available</a> for the 2023 WSMA Leadership Development Conference, May 19-20 at Campbell's Resort on Lake Chelan. The theme this year is leading transformational change, an appropriate focus for a profession still rebounding from the disruptions of the pandemic.
</p>
<p>
For more on these presentations and speakers, a full conference agenda, registration, and hotel information, visit <a href="[@]wsma/events/leadership_development_conference/wsma/events/ldc/leadership_development_conference.aspx?hkey=c7532c38-057a-4568-8a3c-078182469222&amp;_zs=B3aFd1&amp;_zl=IRRs8">the meeting webpage</a>.
</p>
<p>
The WSMA Leadership Development Conference, designed for professionals at all leadership levels, will help you build leadership skills by exploring new trends in care delivery, leadership, and quality improvement while providing engagement opportunities with other physician leaders during interactive small-group discussions. Health care teams are encouraged to attend, as are families, all of whom will be able to take advantage of the many amenities offered by the resort and the Chelan community.
</p>
<p>
Much of our work on your behalf may be happening behind the scenes, but it's happening nonetheless. If you're ever curious about what we're doing to support you, feel free to reach out to me directly at <a href="mailto:jen@wsma.org">jen@wsma.org</a>.
</p>
<p>
Happy Friday and happy St. Patrick's Day!
</p>
</div> | 3/17/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| doctors-making-a-difference-naomi-busch-md | Doctors Making a Difference: Naomi Busch, MD | Latest_News | Shared_Content/News/Latest_News/2023/doctors-making-a-difference-naomi-busch-md | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2023/march-april/dmd-website-image-nbusch-645x425px.png" class="pull-right" alt="Doctors Making a Difference: Naomi Busch, MD graphic" /></div>
<h5>March 16, 2023</h5>
<h2>Doctors Making a Difference: Naomi Busch, MD</h2>
<p>
After 20 years of practicing primary care, including as the owner of Greenlake Primary Care, a private practice in Seattle, Naomi Busch, MD, drew on her interest caring for patients with eating disorders and began a new role as Washington state's director of medical services for The Emily Program, a network of eating disorder treatment centers in four states. Dr. Busch talks about her new role and what she hopes for the future of the program in Washington.
</p>
<p>
<strong><em>WSMA Reports:</em> What led you to leave your longtime primary care practice to work with The Emily Program?</strong>
</p>
<p>
<em>Dr. Busch:</em> I was excited to work in an integrative model with behavioral health, nutrition, and medical. It also offered me the opportunity to lead a team of physicians, PA-Cs, and ARNPs throughout the state and educate future clinicians. The number of people with eating disorders has increased substantially during and after COVID-19, and The Emily Program has grown to meet this need. I saw it as the next step for me in caring for patients and teaching others.
</p>
<p>
<strong>Were eating disorders an area of focus for you in your primary care practice? </strong>
</p>
<p>
No, The Emily Program first approached me in 2012 to consult with their partial- hospitalization program because of my reputation for providing weight- inclusive primary care. I was drawn to working in this field due to the lack of medical resources available and the possibility of providing specialized medical management. At the time, there was not even a chapter in UpToDate to reference. I spent the next several years attending conferences across the country learning everything I could. As The Emily Program grew to include a residential site, several partial-hospitalization programs in Washington, and locations in Lacey and Spokane, my knowledge grew and was needed in my new role.
</p>
<p>
<strong>What does that role entail?</strong>
</p>
<p>
I provide the medical leadership support for The Emily Program's eight partial- hospitalization programs with over 100 patients and one 16-bed adult residential program, as well as numerous intensive outpatient programs. I lead 10 clinicians (physicians, PA-Cs, and ARNPs), as well as provide consultation for outside primary care physicians. I work directly with Washington state site directors, dietitians, and psychiatric teams. I am part of the national leadership team and serve as a member of our state-based quality committee.
</p>
<p>
<strong>What are the biggest challenges you've faced in your new role, and what is the most fulfilling part?</strong>
</p>
<p>
Going from owning my own clinic to leading the medical for an organization was challenging because I am no longer the ultimate decision-maker. This is also the most fulfilling part of the job! I enjoy working on an interdisciplinary team and collaborating on best practice, policy, and how to meet the needs of our eating disorder patients. It was this community of clinicians, therapists, psychologists, and dietitians that drew me away from primary care and into the field of integrative behavioral health.
</p>
<p>
<strong>Are there any goals you're striving for with The Emily Program in Washington? </strong>
</p>
<p>
I would like to see an expansion of adolescent residential care in the state of Washington. Currently, there are only 26 residential beds for adolescents provided by other companies. I would also like to see an inpatient unit that specializes in eating disorders be developed in our state. Right now, any patient over the age of 18 requiring hospital-level care for eating disorders must leave the state to seek specialized treatment.
</p>
<p>
I am also passionate about educating our future physicians about eating disorders. 30 million people in the country will have an eating disorder in their lifetime. Until the opioid epidemic, anorexia and bulimia had the highest mortality of any other mental illness. I had to fight to learn about the medical impact of these diseases because of how they have been stigmatized. Recognition and management of these conditions should be part of routine curriculum for medical students and residents as they impact every specialty in medicine.
</p>
<p>
<em>This article was featured in the March/April 2023 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/16/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| ian-morrisons-crystal-ball | Ian Morrison's Crystal Ball | Latest_News | Shared_Content/News/Latest_News/2023/ian-morrisons-crystal-ball | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2023/march-april/cover-wsma-marapr-2023-645x425px.jpeg" class="pull-right" alt="cover of March/April 2023 issue of WSMA Reports" /></div>
<h5>March 15, 2023</h5>
<h2>Ian Morrison's Crystal Ball</h2>
<p>
By Rita Colorito
</p>
<h5>
<em>Members only; sign-in required.</em>
</h5>
<br />
<p>
Ian Morrison, PhD, author of "Leading Change in Health Care: Building a Viable System for Today and Tomorrow," likes to joke that he's in the "sweeping generalization business." Joking aside, the Scottish-born futurist bases his predictions on observations and data gleaned from nearly 40 years of working with physicians, health care organizations, and related nonprofits.
</p>
<p>
Morrison's training in health policy and health economics began in Canadian teaching hospitals, where he spent seven years as a researcher on economic studies. His work as a futurist began in 1985, when he joined the Institute for the Future in Palo Alto, California, serving as its president from 1990-1996.
</p>
<p>
During that time, Morrison worked on a project called Looking Ahead at American Healthcare for the Robert Wood Johnson Foundation and the Commonwealth Fund. It was then that he began a 30-year partnership with the Harris Poll and the Harvard School of Public Health focusing on public health, conducting annual surveys of doctors, employers, the public, and sometimes hospitals and state legislatures.
</p>
<p>
In his work today, Morrison helps public and private organizations plan for the longer-term future. "Much of what I talk about as a futurist is based on understanding derived from mining public and professional opinion on health care over a long period of time," he says.
</p>
<p>
Morrison is a featured speaker at the 2023 WSMA Leadership Development Conference in May (see insert in this issue). WSMA Reports asked him what major trends in health care and health care economics he thinks may affect physicians in 2023 and beyond. The conversation was edited for length and clarity.
</p>
<p>
<strong><em>WSMA Reports:</em> The overriding perception in the public is that health care is broken. What's the physician's role in fixing the system and fixing that perception?</strong>
</p>
<p>
<em>Dr. Morrison:</em> We know from surveys that people think the health care system in the U.S. is broken. But if you ask them detailed questions about their doctors, their insurance, they're relatively satisfied. They have a perception that the system is broken, but not necessarily that the care they receive is broken. They do have complaints, particularly for people with chronic conditions, about fragmentation and lack of coordination and difficulty accessing certain things.
</p>
<p>
There is this tension between the system and the experience of care that individuals receive, between the health of the population, where we clearly underperform for the money we're spending. It's crazy. We're five years behind in life expectancy now, behind the Spanish. We're going in the wrong direction in terms of life expectancy and have been for three years now. Yet, we spend literally twice to three times as much as the average European country.
</p>
<p>
There are a number of reasons we underperform. One is we've got the wrong priorities. We are way more invested in high-tech specialty care, and under-invested in primary care, relative to other countries. We lack universal coverage. Obamacare has put a dent in it, but we still have 20 million to 30 million people without coverage, particularly in the 11 states that didn't expand Medicaid.
</p>
<p>
And we're enamored with technology. I'm a beneficiary, having just had quadruple bypass surgery, so I'm not knocking technology. But we're neglecting some of the basic preventive and primary care universality that exists in other systems.
</p>
<p>
<strong>How does that system tension filter down to physicians? What will this year and near future look like in trying to resolve that tension?</strong>
</p>
<p>
The cumulative effect of critiques of the health system is dispiriting to physicians. That's one of the reasons why the burnout numbers among physicians are at an all-time high. We've tracked physicians' satisfaction for decades, and it's never really been that a majority of doctors were dissatisfied. But there have been waves of dissatisfaction. And the COVID-19 pandemic has been a further punch to the gut for front-line physicians.
</p>
<p>
<strong>Are you seeing any indication as COVID-19 starts to wane, hopefully, that those burnout numbers are going to get better? Or that the pressure on physicians will ease?</strong>
</p>
<p>
From the best numbers I've seen, about 2% of doctors have left medicine for other careers. On the margin it may not sound like a big deal, but we were already in a physician shortage situation. The good news is that CEOs and leaders of health systems that I've talked to are extremely mindful that they've got situations of burnout with their physicians. The enlightened ones recognize they have to work with physicians to redesign care processes to bring back some of the joy and meaning of the work and get rid of some of the administrative hassles.
</p>
<p>
<strong>Washington state is often synonymous with technology. You've joked that over- reliance on technology in health care has created a "quantitative patient" and "cyberchondria." How is emerging patient- centered technology affecting physicians?</strong>
</p>
<p>
For years we've tracked through surveys the impact of electronic health records. What we've found is, if you hate your electronic health record, you hate your life. That's a big burden on physicians. I'm hopeful that we get more technological fixes to that problem, where people are not spending their entire time interacting with and entering data in Epic and other medical record systems.
</p>
<p>
The consumerism movement in health care has made patients more demanding of a job that's already hard to do. COVID-19 made the conditions for front-line health workers even more difficult. There are some technological improvements that can be made to enable consumers to interact with doctors. But now we've got to get it right.
</p>
<p>
I'll give you a classic example. My friend, Bob Watcher, MD, chair of the department of medicine at the University of California, San Francisco, shared data a couple of years ago that showed during the height of the pandemic there was a five-fold increase in interactions through Epic on MyChart between patients and physicians. All of that is unpaid, right? Basically, now, in the name of consumerism, we have digital front doors to manage. Another example: After I had surgery at Stanford last year, I emailed my wonderful surgeon through MyChart. She got back to me at 10:50 p.m. on a Saturday night. That's ridiculous.
</p>
<p>
We're overwhelming doctors with digital inquiries in the guise of responsiveness to consumers. But it's a burden on physicians. We have to engineer that particular problem using technology and AI, so that consumers get what they want-which is instantaneous reassurance-but you're not burdening caregivers 24/7. They can have a work-life balance.
</p>
<p>
<strong>What trends are you seeing in health care economics that will impact physicians and physician practices?</strong>
</p>
<p>
Let's start with the basics of how American health care is financed. Right now, it's an elaborate cross-subsidy game, where self-insured employers are charged three times what it costs to deliver the service to make up for the perceived underfunding of Medicare and Medicaid. I say "perceived underfunding " because, in my opinion, when people say Medicare doesn't cover the cost of care, I always rephrase that as Medicare doesn't meet the income expectations of those delivering the care.
</p>
<p>
This raises an important question: Are employers going to continue writing that check? I've been working closely with the Purchaser Business Group on Health. It represents Apple, Disney, Boeing, Walmart, and other large entities that purchase tens of billions of dollars, if not hundreds of billions, in health care [the Washington State Health Care Authority and the Washington State Health Benefit Exchange are also members]. And they are more activated now [to lower costs] than they've been in a long time.
</p>
<p>
They're now flexing their muscle demanding what they call an "advanced primary care" model as the standard. This model uses a lot more selective contracting and narrow high-performance networks.
</p>
<p>
Many of them had been getting 7% rate increases-that's the number I'm hearing employers are being asked to pay in their latest round of negotiations with hospital health systems and physician groups. Up until the recent layoffs, many of these companies were in a war for talent, so they didn't push back. Now that we're seeing Microsoft lay off 10,000 employees, Salesforce lay off 7,000, and Amazon lay off 18,000, I think you're going to see the pushback from employers getting more severe in 2023-24.
</p>
<p>
The other driving force is that is doctors in America are increasingly employed by large health systems or by private- equity-controlled entities. That means they're in somebody else's EBIT-earnings before interest in taxes. One of the key investments that has been made by health systems is to subsidize those physicians to the tune of $200,000 to $300,000 per doctor. They are subsidizing most employed physicians over and above what they're billing. And that's a burden on the system. 2022 ended up being the worst year financially of the COVID-19 cycle for hospitals and health systems because of the tremendous costs in staffing, supply chain issues, and CARES Act money running out.
</p>
<p>
Everybody I've talked to has said they are losing money and it's going to continue through 2023. And the labor shortage is still a big issue. How we resolve that depends on how we organize care.
</p>
<p>
The future is about reengineering care processes so it's team-based. We need people practicing at the absolute top of their license. We need to have surgeons and specialists spend their time doing what they were trained to do. That's actually the story from other countries.
</p>
<p>
When I first came down here from Canada, I teased friends at Stanford that most American specialists are amateurs because they don't practice their subspecialty all of the time. Whereas in Canada, there's so few of these subspecialists that they do nothing but that subspecialty.
</p>
<p>
In terms of where we're headed, enlightened systems are going to lead the charge of clinical redesign of care. And doctors need to be actively engaged and involved in that, particularly the ones employed in these larger systems.
</p>
<p>
As for the future of independent solo practice, they need support to survive independently. They have to be engaged with value-based care systems one way or another.
</p>
<p>
The numbers I've seen that the Physician Foundation put together show a significant uptick in doctors being swept into health systems and private equity- controlled systems during COVID-19. I don't think that's going back in the bottle. I don't think solo, independent fee-for- service practice makes a late-breaking comeback in the fourth quarter. I think it's a relentless grinding of physicians to become part of larger entities.
</p>
<p>
<strong>What should physicians know about advanced primary care and what it means to physicians and health care?</strong>
</p>
<p>
Advanced primary care includes focusing on capitation, or some form of incentive to coordinate care and integrate social determinants of health, like food security, into care. The intent, going back to international comparisons, is to do a better job on the front end so that you negate demand on the back end.
</p>
<p>
The problem is, the facts on the ground are that very few dollars are capitated, particularly in the commercial market where the money is. And that's why Purchaser Business Group on Health initiatives are important to try. If they make meaningful progress with their members toward promulgating value- based care, then that's a huge pivot point.
</p>
<p>
Where we're seeing the managed care movement is in Medicare and Medicaid. Medicare is now a majority Medicare Advantage. And that is the default policy of Congress to essentially delegate the rationing decision to private entities and not be on the hook for the micromanagement to the same extent of Medicare coverage and costs.
</p>
<p>
And every state is flipping over, if they haven't done so, from fee-for-service Medicaid to managed Medicaid. I'm on the board of the Martin Luther King Hospital in Los Angeles, which is a safety net hospital, 97% non-commercial. The only way that math works for us is we have special deals from government to make up the funding.
</p>
<p>
The fact that Washington state has a very important set of initiatives to promulgate value-based care across multiple payers, including Medicaid and state employers, I would say it's further ahead than almost any state in the journey to value-based care.
</p>
<p>
<strong>What does all this mean for physicians this year and the years to come?</strong>
</p>
<p>
I'm reminded when I started in health care in the U.S. of a great line a GI specialist once said of being a doctor: It's still going to be better to be a doctor than anyone else, unless you're seven feet tall and have a terrific hook shot.
</p>
<p>
<em>Rita Colorito is a freelance writer specializing in health care.</em>
</p>
<p>
<em>This article was featured in the March/April 2023 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/15/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2023-legislative-session-update-how-wsma-policy-translates-into-action-in-olympia | 2023 Legislative Session Update: How WSMA Policy Translates into Action in Olympia | Latest_News | Shared_Content/News/Latest_News/2023/2023-legislative-session-update-how-wsma-policy-translates-into-action-in-olympia | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/807363874"><img src="/images/Newsletters/latest-news/2023/march/legislative-update-wk-10.png" alt="WSMA Legislative Update for March 13, 2023" /></a></div>
<h5>March 13, 2023</h5>
<h2>2023 Legislative Session Update: How WSMA Policy Translates into Action in Olympia</h2>
<p>WSMA's Director of Government Affairs Sean Graham talks about how WSMA policy, set each year by the House of Delegates, informs our work in Olympia.
<a href="https://vimeo.com/807363874">Watch the video</a>.
</p>
</div> | 3/13/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| peering-into-the-future | Peering Into the Future | Latest_News | Shared_Content/News/Latest_News/2023/peering-into-the-future | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2023/march-april/cover-wsma-marapr-2023-645x425px.jpeg" class="pull-right" alt="cover of March/April 2023 issue of WSMA Reports" /></div>
<h5>March 13, 2023</h5>
<h2>Peering Into the Future</h2>
<p>
By John Gallagher
</p>
<h5>
<em>Members only; sign-in required.</em>
</h5>
<br />
<p>
WSMA Reports spoke with several prominent physician leaders representing a cross- section of medicine to get their thoughts during a transitional, or as some would say, transformative, time in health care.
</p>
<p>
One theme was consistent among the physicians interviewed for this article: Staffing shortages will be a major issue this year. “All of health care is challenged by staffing issues,†says John Pryor, MD, president and board chair of Proliance Surgeons. “It affects every aspect of care.
It’s optimistic to think we’ll climb our way out of that soon.â€
</p>
<p>
The rest of the answers from these physician leaders provide insights into the range of opportunities and concerns facing health care this year and beyond. Together, those responses paint a picture of a changing landscape as it responds to the trends that are reshaping the profession in Washington.
</p>
<h3>Leadership: Supporting and mobilizing the workforce</h3>
<p>
The issue of health care workforce shortages is a consistent problem for practices across the state that will remain an issue now and beyond, says Donna Smith, MD, president of Franciscan Medical Group and senior vice president of Virginia Mason Franciscan Health.
</p>
<p>
The challenge for leaders, she says, is how to support physicians and other health care personnel in the face of ongoing staffing shortfalls. Doing so is critical to avoid burnout and all the attendant problems that follow in its wake.
</p>
<p>
“We’re going to need to support the people we work with and really figure out ways to engage as physicians and leaders on how to give the best care possible by improving the process of care,†she says. “We have teams of highly motivated and skilled people, but we need to help people stay highly motivated and skilled.â€
</p>
<p>
In some ways, that support may seem, in Dr. Smith’s words, “soft and squishy.â€
</p>
<p>
“It’s about appreciating people and the work we do together to care for other human beings,†she says. “We can all tap into that compassion. That will help people sustain their energy, particularly if they are doing that with a smart team.â€
</p>
<p>
But in other ways, the support is an important reminder as to why physicians chose the profession in the first place. “More people go into health care because they really want to have an impact and really want to do meaningful work that helps other human beings,†says Dr. Smith.
</p>
<p>
Practical changes, such as process improvements, will provide more tangible support. For example, Dr. Smith points to advances in technology as offering ways to facilitate smoother interactions between patients and physicians.
</p>
<p>
The other issue that Dr. Smith sees ahead for this year and future years is the role physician leaders will need to play in addressing social determinants of health outside of the health care system.
</p>
<p>
“Physician leadership will have to step in and influence the conversation in other sectors, whether its policy or funding, in areas that are normally outside of health care but that can absolutely impact disparities in health,†she says. “We can impact the disparities influencing our systems, but we need to step into other conversations to influence the other areas of social determinants of health.â€
</p>
<p>
Dr. Smith says that broadening the conversation beyond leaders’ immediate systems is necessary because the problems extend far beyond the clinics’ doors. “It’s about looking for opportunity to connect the dots in the communities and influence the systems that support the health of the community and not take it all on in health care,†she says.
</p>
<h3>Value-based care: Slowly but surely, it’s coming to Washington </h3>
<p>
Value-based health care has been on the horizon for more than a decade. A survey of U.S. physicians in 2014 predicted that half of compensation in 10 years’ time would be value- based. “It’s obvious we’re way short of that forecast,†acknowledges Imelda Dacones, MD, president of the Washington Optum Care market, which includes The Everett Clinic, The Polyclinic, and the Optum Care Network of Washington.
</p>
<p>
Still, looking ahead into the year, says Dr. Dacones, it’s simply a matter of time. “I believe it’s a given that more will move to value,†she notes. “For us in Optum Health, it’s mission critical to move more to value-based care.â€
</p>
<p>
For the most part, the framework is already in place in many places. “Large health systems more or less have the infrastructure set up already,†says Dr. Dacones. “The opportunity for the state of Washington now is how do we as a community of caregivers, as an ecosystem of care and stakeholders— practices, hospitals, purchasers, legislators, and payers—support each other and our patients in our journey from fee-for-service to value, addressing health equity and disparities and the total cost of care moving forward.â€
</p>
<p>
Dr. Dacones believes that the pandemic has only accelerated the movement toward value-based care. “If you think about practices whose business model was purely fee-for- service, they had no volume during the shutdown,†she says. “Practices consolidated or closed shop because they couldn’t survive. I think practices now see the resiliency that the value- based model offers.â€
</p>
<p>
The per member, per month payment model of value-based care provides practices with a sustainable business model. “It gives you the ability to invest in resources and technology to keep access and care open to patients, to keep them well. Resources that you otherwise won’t have if it’s just fee-for- service,†says Dr. Dacones.
</p>
<p>
This year, Dr. Dacones expects to see hospital systems step up their participation in value. “It’s no secret that Providence’s CEO declared that one of his priorities is to get more into value-based care,†she notes. “I think more hospital executives are pointing to that, and for 2023 we will see more and more movement in that direction.â€
</p>
<p>
However, it’s not just large practices. For value-based care to thrive, it will have to take root throughout the entire system. Dr. Dacones says it is incumbent to ensure that independent practices have the support they need to make the transition. “I see that as an evergreen opportunity to really support independent practices, small, medium, and large group practices, to do value-based care. That’s what Optum Care Network is all about: a physician- and practice-enabling partner for value-based care with a suite of services so more can participate and do well in value.â€
</p>
<p>
All in all, this year represents what Dr. Dacones calls “another growth year in Washington’s journey toward value.â€
</p>
<p>
“For physicians, value-based care or not, with the learnings from the pandemic and workforce shortage, it’s really blowing up our own mental models of care and re-imagining and re-engineering what it needs to be and look like in the 21st century,†she says. “We have to lead that change, and not just manage it, if we are to achieve the quadruple aim.â€
</p>
<h3>Telehealth: The future is even more virtual</h3>
<p>
When Michael Vaughan, MD, a nephro- logist with Kaiser Permanente and executive medical director of operations at Washington Permanente Medical Group, looks at the trends for telehealth this year, he sees the sector becoming more sophisticated in how it meets patients’ needs.
</p>
<p>
“When I talk about the direction telehealth is going, I think about taking what we’re doing and advancing it to a much higher level,†he says.
</p>
<p>
The pandemic certainly turbocharged the emerging trend toward telehealth, as practices found virtual visits a necessary alternative to in-person visits. “The time we had in the pandemic helped catalyze our efforts and helped align a lot of state and governmental regulations around the use of telehealth,†says Dr. Vaughan.
</p>
<p>
Now telehealth is poised to move well beyond phone visits and video visits to more complex technology meant to address patient needs. At Kaiser Permanente, that already includes on- demand virtual visits where patients can talk to physicians. “We are able to meet about 60% of our primary care patient needs through virtual services; 20% of those visits are now on-demand virtual care visits, like online chatting with a physician. The demand for that service has doubled in the past year,†says Dr. Vaughan. (Kaiser Permanente is providing close to 250,000 on- demand virtual visits, including phone, video, and online chatting, per year.)
</p>
<p>
The advantage of the advances in telehealth is that, as Dr. Vaughan puts it, “we meet members where they want to be met.†Much as the work- from-home requirements during the pandemic changed the way people view the work office, so too did the pandemic change how people view the need for a visit to a doctor’s office.
</p>
<p>
“The reality is many people don’t want to come in because it isn’t convenient for them,†says Dr. Vaughan.
</p>
<p>
The opportunity is how to move telehealth to the next level. Washington Permanente is looking for ways to integrate telehealth into care for patients with more complex medical conditions. “We can arrange to integrate the primary care physician and the specialist, so it’s not just the front-line physician,†says Dr. Vaughan. “We can interact with specialty teams to get the information the physician really needs to help them address the needs of patients at hand. Whomever is interacting with the patient on the virtual interface can tap into that live to make sure the patient is getting the care they need, so it’s a high-quality visit.â€
</p>
<p>
For all its advances, telehealth is not a replacement for the work that’s being done, but rather a tool to do it in a new way. “We think our digital health services complement all the other things we are able to do,†says Dr. Vaughan. “Our vision of this is that we really see ourselves as having a very different opportunity to provide value to our patients.â€
</p>
<h3>Independent networks: The consolidation continues</h3>
<p>
The past several decades have seen tremendous consolidation among physician practices throughout the country. We continue to see the effects of this consolidation, specifically reshaping the role of physicians in health care, says Rodney Anderson, MD, president and CEO of Family Care Network, one of the largest independent, physician-owned primary care organizations in Washington.
</p>
<p>
“It’s certainly changing our industry, particularly the influence physicians have in shaping the future of health care,†says Dr. Anderson. He sees two primary issues that will play out in the coming year and beyond as the profession grapples with the impact of consolidation.
</p>
<p>
“The first key issue is how each individual health care organization chooses to balance patient care against financial metrics,†Dr. Anderson says. “I continue to worry that health care organizations will prioritize profits over patients.â€
</p>
<p>
The other is how physicians fit into the changed landscape. “What role do physicians play in defining the future of health care if they are being pushed to the sidelines?†asks Dr. Anderson. “When you put physicians in leadership roles, they prioritize patient care.†As more and more physicians are moved out of key leadership and decision- making roles, Dr. Anderson says that he is worried that the mission of health care “is being distorted.†Not surprisingly, Dr. Anderson strongly encourages physicians to “continually push for more influence, authority, and leadership opportunities, particularly in larger health care entities.â€
</p>
<p>
Dr. Anderson acknowledges that the ongoing financial pressures that practices and smaller community hospitals face add to the incentives to join forces with a larger system. “The ripple effects of the pandemic only added to these financial pressures and have left many smaller health care entities looking for a way to keep their doors open,†he says. “Even though we work hard to provide high-quality, cost-effective care while being good stewards of our financial resources, the fact remains that health care is expensive to provide and requires adequate reimbursement from both the government and insurance companies.â€
</p>
<p>
Compounding the problem is the issue that all physicians are facing: staffing.
</p>
<p>
“It’s all levels, from front-desk employees to nursing staff to physicians themselves,†says Dr. Anderson. “How do organizations grapple with it today?â€
</p>
<p>
The concern Dr. Anderson has is that the search for efficiencies will come at the expense of the patient-physician relationship. “Do you lose that individual, personal touch that makes health care special?†he asks. “Do you sacrifice that sacred doctor-patient relationship in the name of efficiency?â€
</p>
<p>
One thing Dr. Anderson is sure of is that the challenges and opportunities will last well beyond 2023. “Health care continues to evolve rapidly, and the question of how organizations and individual physicians are going to adapt will go on for many years ahead,†he says.
</p>
<h3>Specialties: More surgeries in outpatient settings</h3>
<p>
One trend that has been occurring over the past several years is only going to continue in 2023, according to Dr. Pryor, who is an orthopedic surgeon. That trend is the increasing reliance upon outpatient settings for surgeries, both at ambulatory surgical centers and at hospital-based outpatient departments.
</p>
<p>
“I’m pretty confident that 2023 will continue to see the migration of more and more of our surgeries to an outpatient setting,†says Dr. Pryor. “That is certainly a trend we’ve seen, particularly with spine surgery and joint replacement surgeries.â€
</p>
<p>
As an independent group across Western Washington with approximately 220 doctors in all types of surgical subspecialities, Proliance is a bellwether for the shift in how surgeries are being performed. Dr. Pryor says that the ongoing trend is the result of several factors coming together. “There is the evolution of technique to a less invasive technique,†he notes. “Regulatory and payer policies have recognized the safety, quality, and value of those settings, as well.â€
</p>
<p>
Indeed, the cost savings associated with transferring surgeries to an outpatient setting have been an important driver of the change. Last year, the Centers for Medicare and Medicaid Services eliminated 250 musculoskeletal surgeries from a list of surgeries for Medicare beneficiaries that needed to be performed on an inpatient-only basis. At the beginning of this year, the agency added another 1,500 surgeries to that list.
</p>
<p>
Another development that Dr. Pryor hopes to see in the coming year is a return to the kind of patient-physician relationship that was interrupted because of the pandemic, “as we return, just like our social lives, to more in- person interactions.†Time with patients and their families, which was a casualty of pandemic protocols, says Dr. Pryor, is “the softer side of medicine, but it’s very real to patient experience.â€
</p>
<p>
<em>John Gallagher is a freelance writer specializing in health care.</em>
</p>
<p>
<em>This article was featured in the March/April 2023 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/13/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| session-update-abortion-bills-advance-several-scope-bills-defeated | Session Update: Abortion Bills Advance, Several Scope Bills Defeated | Latest_News | Shared_Content/News/Membership_Memo/2023/march-10/session-update-abortion-bills-advance-several-scope-bills-defeated | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/february/2023-legislative-session-updates-645x425px.png" class="pull-right" alt="2023 Legislative Session Updates logo" /></div>
<h5>March 10, 2023</h5>
<h2>Session Update: Abortion Bills Advance, Several Scope Bills Defeated</h2>
<p>For Olympia watchers, these past few weeks have seen attention focused on various legislative deadlines, each determining whether bills will continue on their paths through the legislative process. Recent deadlines include the fiscal committee cutoff of Friday, Feb. 24, for approval of bills that have a fiscal impact on the state budget, and this past Wednesday's cutoff for bills to pass out of their house of origin. Bills not meeting these deadlines are considered dead for the remainder of the legislative session but will be eligible for further consideration in 2024.</p>
<h3>Several WSMA-opposed scope bills dead</h3>
<p>Some noteworthy scope-of-practice expansion bills opposed by the WSMA based on <a href="[@]wsma/advocacy/legislative_regulatory/issue-briefs/scope-of-practice-efforts.aspx">House of Delegates policy</a> were not approved before Feb. 24 cutoff deadline, including:</p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5411&amp;Year=2023&amp;Initiative=false">SB 5411</a>, increasing the scope of practice of naturopaths.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1041&amp;Initiative=false&amp;Year=2023">HB 1041</a>, granting prescriptive authority to psychologists.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1665&amp;Initiative=false&amp;Year=2023">HB 1665</a>, granting pharmacists the ability to independently "test and treat" certain conditions.</li>
</ul>
<h3>Abortion and reproductive health bills continue their advance</h3>
<p>The following abortion and reproductive health bills passed off the House or Senate floor and will now advance to the opposite chamber:</p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5242&amp;Initiative=false&amp;Year=2023">SB 5242</a>, which would prohibit cost-sharing for abortion services, passed the Senate on Feb. 28. </li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1469&amp;Initiative=false&amp;Year=2023">HB 1469</a>, which would establish liability protections for patients and health care professionals from criminal and civil actions based on the provision or receipt of abortion or gender-affirming care services, passed the House on Feb. 28. </li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1340&amp;Initiative=false&amp;Year=2023">HB 1340</a>, which would specify that unprofessional conduct under our state's Uniform Discipline Act does not include the provision of abortion or gender-affirming care, passed the House on Feb. 28. </li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5599&amp;Initiative=false&amp;Year=2023">SB 5599</a>, which would suspend parental notification requirements for unaccompanied youth in shelters when they are seeking protected health services such as gender-affirming care or abortion services, passed the Senate on March 1. </li>
</ul>
<h3>Other WSMA priority bills passed by the House and Senate </h3>
<p>At the time of writing, the following WSMA-supported bills have survived this week's house of origin cutoff by passing out of either the Senate or House.</p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1240&amp;Initiative=false&amp;Year=2023">HB 1240</a>, banning assault weapons.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1143&amp;Initiative=false&amp;Year=2023">HB 1143</a>, requiring background checks and waiting periods for firearm purchases.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5581&amp;Initiative=false&amp;Year=2023">SB 5581</a>, would develop strategies to reduce or eliminate deductibles and other cost-sharing for maternity care services. </li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5396&amp;Initiative=false&amp;Year=2023">SB 5396</a>, would prohibit cost-sharing on supplemental breast exams and diagnostic breast examinations.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5580&amp;Year=2023&amp;Initiative=false">SB 5580</a>, improving maternal health outcomes.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1151&amp;Year=2023">HB 1151</a>, requiring insurance coverage for fertility services.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1784&amp;Initiative=false&amp;Year=2023">HB 1784</a>, makes appropriations through various state agencies to improve food security. </li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1564&amp;Initiative=false&amp;Year=2023">HB 1564</a>, would prohibit the sale of over-the-counter sexual assault kits. </li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1238&amp;Initiative=false&amp;Year=2023">HB 1238</a>, would provide free meals for students in public schools.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1745&amp;Initiative=false&amp;Year=2023">HB 1745</a>/<a href="https://app.leg.wa.gov/billsummary?BillNumber=5388&amp;Initiative=false&amp;Year=2023">SB 5388</a>, promoting diversity in clinical trials</li>
</ul>
<h3>Testimony highlights from weeks 7-8 of session (Feb. 20-March 3)</h3>
<p><a href="https://app.leg.wa.gov/billsummary?BillNumber=5241&amp;Initiative=false&amp;Year=2023">SB 5241</a>, Mergers and affiliations: Would impose numerous new restrictions and requirements on the ability of hospitals and physician organizations to enter into material change transactions such as mergers and affiliations. </p>
<ul>
<li>There was a public hearing in the Senate Ways &amp; Means Committee on Feb. 21. WSMA's Director of Government Affairs Sean Graham testified in opposition to the bill. </li>
</ul>
<p><a href="https://app.leg.wa.gov/billsummary?BillNumber=1508&amp;Initiative=false&amp;Year=2023">HB 1508</a>, Health Care Cost Transparency Board: Would, among other provisions, authorize the HCCTB to place health care professionals, health care facilities, and insurance carriers on "performance improvement plans," issue fees and fines, and hold public hearings identifying payers or health care professionals who exceeded the benchmark. </p>
<ul>
<li>There was a public hearing in the House Appropriations Committee on Feb. 23. WSMA Past-President Mika Sinanan, MD, PhD, and Government Affairs Director Sean Graham testified in opposition to this legislation. </li>
</ul>
</div> | 3/10/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsma-prior-authorization-bill-approved-unanimously-by-house | WSMA Prior Authorization Bill Approved Unanimously by House | Latest_News | Shared_Content/News/Membership_Memo/2023/march-10/wsma-prior-authorization-bill-approved-unanimously-by-house | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/march/paperwork-645x425px.png" class="pull-right" alt="Doctor and patient standing next to giant stack of paper" /></div>
<h5>March 10, 2023</h5>
<h2>WSMA Prior Authorization Bill Approved Unanimously by House</h2>
<p>On Saturday, the state House of Representatives took action on WSMA's priority legislation to modernize and standardize insurance carriers' prior authorization practices. <a href="https://app.leg.wa.gov/billsummary?BillNumber=1357&amp;Initiative=false&amp;Year=2023">House Bill 1357</a> was approved unanimously by the House, with several legislators giving speeches to share their personal experiences with prior authorization, as well as acknowledging the burden it represents for patients and physicians.</p>
<p>In its current form, HB 1357 represents the product of extensive negotiations with the state's insurance carriers. If passed into law, the bill will expedite turnaround times for prior authorization and make our state a leader in facilitating prior authorization processes that integrate into physicians' electronic medical record systems. Importantly, the bill applies not only to health care services but also to prescription drugs and will be effective for all state-regulated health plans.</p>
<h3>Prior authorization determination timelines </h3>
<p>HB 1357 establishes expedited turnaround times for all prior authorizations, including those for prescription drugs. The timelines for carrier determinations of prior authorizations break down into two categories, depending on whether the prior authorization is submitted electronically (e.g., via integrated prior authorization systems or carrier web portals) or non-electronically (e.g., via fax):</p>
<ul>
<li>Electronic prior authorizations
<ul>
<li>Expedited: one calendar day to approve</li>
<li>Standard: three calendar days to approve</li>
</ul>
</li>
<li>Non-electronic prior authorizations
<ul>
<li>Expedited: two calendar days to approve</li>
<li>Standard: five calendar days to approve</li>
</ul>
</li>
</ul>
<h3>Electronic prior authorization systems </h3>
<p>Building on a proposed rulemaking from the Centers for Medicare and Medicaid Services, HB 1357 mandates that carriers have automated electronic prior authorization systems that integrate into physicians' electronic medical records for health care services by Jan. 1, 2025. By Jan. 1, 2027, carriers must have the systems in place for prescription drugs.</p>
<h3>Office of the Insurance Commissioner prior authorization reporting </h3>
<p>Prescription drugs are added as a category of reporting of carriers' prior authorization practices, to be included in future iterations of the <a href="https://www.insurance.wa.gov/sites/default/files/documents/2022-health-plan-prior-authorization-report.pdf" target="_blank" rel="noreferrer">OIC's annual prior authorization report</a>.</p>
<p>The WSMA is appreciative of <a href="https://housedemocrats.wa.gov/simmons/">Rep. Tarra Simmons (D-Bremerton)</a> for introducing HB 1357 and her leadership on this important issue. Rep. Simmons has repeatedly referenced her past work around prior authorization as a registered nurse, including a stint working for an insurance carrier, in informing her interest in expediting the process for patients and physicians.</p>
<p><strong>What's next?</strong> HB 1357 now moves to the Senate for further consideration, where WSMA will urge its approval.</p>
</div> | 3/10/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| weekly-rounds-march-3-2023-five-things-to-know-this-week | Weekly Rounds: March 3, 2023 - Five Things to Know This Week | Latest_News | Shared_Content/News/Weekly_Rounds/2023/weekly-rounds-march-3-2023-five-things-to-know-this-week | <div class="col-md-12">
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<h5>March 3, 2023</h5>
<h2>
Five Things to Know This Week</h2>
<p>Jennifer Hanscom, CEO</p>
<p>
While it's certainly chilly outside these days, we are busy turning up the heat to persuade our state legislators to step up and fund our ask for Medicaid reimbursement increases across all specialties. You've heard from us quite a bit lately about this top priority, and I heard from several key large group physician leaders just this week about how very concerned they are that the state is overdue in making needed investments to ensure that patients have access to not only health coverage, but also health care. We know that increasing Medicaid reimbursement is the most effective way to improve access to care for Medicaid patients-and that's why we are keeping this issue front and center.
</p>
<p>
Like you, we are always juggling many different issues and concerns. Here are a few quick updates on things you need to know as this week draws to a close.
</p>
<h3>Legislative progress, calls to action</h3>
<p>
On Friday, Feb. 24, the Legislature passed its second key legislative cutoff deadline, when fiscal bills pass out of the committee in the chamber of origin. Progress continues on a number of our top priority bills, including House Bill 1357 regarding prior authorization. In its current form, HB 1357 will expedite turnaround times for all prior authorizations, including those for prescription drugs (one day for expedited review; three days for standard review for electronic submissions). Building on the proposed rulemaking from the Centers for Medicare and Medicaid Services at the federal level, the bill will also mandate carriers to have electronic prior authorization processes that integrate with electronic medical records for health care services in 2025 and for prescription drugs in 2027.
</p>
<p>
In another positive development, several bills the WSMA had concerns with are now considered "dead" for this session, with the caveat that none are ever truly dead until the Legislature adjourns. Some noteworthy WSMA-opposed bills that were not approved before recent cutoff deadlines include:
</p>
<ul>
<li>SB 5411, increasing the scope of practice of naturopaths.</li>
<li>HB 1041, granting prescriptive authority to psychologists.</li>
<li>HB 1665, granting pharmacists the ability to independently "test and treat" certain conditions.</li>
</ul>
<p>
There are still several other bills that continue to advance that the WSMA will continue to work on in the weeks ahead. Be sure to sign up to receive the WSMA Outreach and Advocacy Report to stay up to date on the latest developments. Email Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a> to be added to the list.
</p>
<p>
This month, legislators will start to focus on their budget priorities. Now is the time for WSMA members to make your voices heard. We encourage you to contact your legislators-especially those on budget committees-to urge them to include an increase for professional service reimbursement in Medicaid in the final 2023-2025 budget. As reported in the Feb. 24 issue of the Membership Memo, physicians need to tell legislators their stories about how low Medicaid reimbursements impact practices and patients. I urge you to <a href="https://www.votervoice.net/WSMA/Campaigns/101598/Respond">take a moment to share your story</a>. Doing so really does matter.
</p>
<h3>CMS proposed changes to risk adjustment model</h3>
<p>
At the national level, the Centers for Medicare and Medicaid Services has released its <a href="https://www.cms.gov/files/document/2024-advance-notice.pdf" target="_blank" rel="noreferrer">2024 Medicare Advantage and Part D Advance Notice</a> with proposed changes to Medicare Advantage capitation rate and risk adjustment methodologies. Of concern, CMS is proposing to transition the diagnostic coding system from ICD-9 to ICD-10, which would remove nearly 2,300 codes from the Medicare Advantage risk adjustment model, including but not limited to codes related to major depressive disorder and rheumatoid arthritis, which are prevalent conditions among Medicare Advantage beneficiaries.
</p>
<p>
The WSMA submitted a <a href="https://wsma.informz.net/WSMA/data/images/Attachments/WSMA%20comment%20CMS%20rule%20-%20Advanced%20Notice%202024.pdf" target="_blank" rel="noreferrer">comment letter</a> to CMS outlining concerns with the proposed changes to the risk adjustment model, explaining that impacted physicians' practices would experience revenue cuts, impacting the financial viability of their practices and the ability for Medicare Advantage patients to access health care services in their communities. The changes would also present new challenges to physicians' ability to participate in value-based payment arrangements, a major goal of CMS, should the transition to ICD-10 codes take place.
</p>
<h3>Better Prescribing, Better Treatment program expansion</h3>
<p>
In other news, Better Prescribing, Better Treatment-a collaboration started several years ago by the WSMA along with the Washington State Hospital Association, Washington State Department of Health, and Washington State Health Care Authority-continues to help ensure proper utilization of controlled substances and encourage safe prescribing habits with the sharing of prescribing reports.
</p>
<p>
The program generates quarterly reports on acute opioid prescribing. Each quarter, the WSMA sends opioid prescribing feedback reports to over 10,000 prescribers and organization-level reports to medical group CMOs. At the same time, WSHA sends organization-level reports to hospital CMOs. Reports are derived from Washington state's Prescription Monitoring Program data. Currently, reports are only sent to CMOs who actively enroll their hospital, health system, or medical group in the program.
</p>
<p>
This quarter, however, the program is expanding to allow all medical groups and individuals the ability to enroll and receive these quarterly reports. This includes groups who do not have an approved CQIP plan with the state. To enroll your medical group, practice, or individual physicians into the program, email Monica Salgaonkar at <a href="mailto:monica@wsma.org">monica@wsma.org</a>. Hospitals or health systems should contact Melina Ovchiyan at <a href="mailto:melinao@wsha.org">melinao@wsha.org</a>. For questions, contact Monica Salgaonkar at 206.441.9762 or <a href="mailto:monica@wsma.org">monica@wsma.org</a>.
</p>
<h3>Leadership development at Lake Chelan</h3>
<p>
As we turn the corner on the legislative session, I find myself looking forward to May and once again to the shores of Lake Chelan on May 19-20 for the annual WSMA Leadership Development Conference.
</p>
<p>
One of my favorite things about the LDC is seeing you and your families together enjoying your colleagues, the local wine, and all the resort's spectacular lakeside activities. That's not to overshadow all the leadership skills and knowledge you gain from the experience (and CME to boot!). You're guaranteed to leave Chelan with concrete ideas and skills to utilize right away in your professional life.
</p>
<p>
This year's theme is built around leading transformational change. Keynote speaker and health care futurist Ian Morrison, PhD, will kick things off with his presentation on "Turning the Corner: What's Next for Health Care?"
</p>
<p>
Learn more on the <a href="[@]WSMA/Events/LDC/leadership_development_conference?hkey=c7532c38-057a-4568-8a3c-078182469222">WSMA Leadership Development Conference page</a> on our website.
</p>
<h3>Step into leadership at the WSMA</h3>
<p>
Speaking of leadership, we are looking for a few good candidates for the WSMA Executive Committee, board of trustees, and other leadership positions. If you are looking to take a turn at WSMA leadership or have someone you'd like to support, the WSMA is now accepting applications. Visit the <a href="[@]wsma/about_us/who_we_are/board-of-trustees/wsma/about/who_we_are/board-of-trustees.aspx?hkey=57dca355-fca4-4f4e-9c83-6e35aa4baabe&amp;_zs=B3aFd1&amp;_zl=L3qq8">board of trustees webpage</a> for how to apply.
</p>
<p>
In considering yourself or a colleague for nominations, consider whether you or they are:
</p>
<ul>
<li>Well-informed.</li>
<li>Forward thinking.</li>
<li>Committed to the future of the profession.</li>
<li>Committed to service and the profession above oneself.</li>
<li>Experienced, enthusiastic, credible, and open-minded.</li>
<li>Able to put the WSMA above personal desires or agenda.</li>
<li>Capable of serving as a future president of the WSMA.</li>
</ul>
<p>
The WSMA Nominating Committee will meet in late May or early June to prepare a slate of nominees to present to the House of Delegates at this year's WSMA Annual Meeting, scheduled for Sept. 22-23 in Bellevue.
</p>
<p>
We rely on strong physician leadership here at the WSMA to help us realize our mission of making Washington the best place to practice medicine and receive care. I hope you'll consider this opportunity to be part of the future of medicine in our state. The deadline for submission is April 28, 2023.
</p>
<p>
Once again, I urge you to <a href="https://votervoice.net/WSMA/Campaigns/101598/Respond">share your stories</a> regarding Medicaid reimbursement with your legislators. Now is the time to speak up! Meanwhile, we will stay strong in our quest to make your voice heard. Thanks for all you do.
</p>
</div> | 3/3/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2023-legislative-session-update-a-progress-report-at-the-halfway-point-of-session | 2023 Legislative Session Update: A Progress Report at the Halfway Point of Session | Latest_News | Shared_Content/News/Latest_News/2023/2023-legislative-session-update-a-progress-report-at-the-halfway-point-of-session | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/802564692"><img src="/images/Newsletters/latest-news/2023/feb/legislative-update-wk-8.png" alt="Legislative Update logo for February 27, 2023" /></a></div>
<h5>February 27, 2023</h5>
<h2>2023 Legislative Session Update: A Progress Report at the Halfway Point of Session</h2>
<p>
WSMA's Associate Director of Legislative and Political Affairs Alex Wehinger gives an update on WSMA-priority issues, including prior authorization and scope of practice bills, as we near the halfway point of the 2023 legislative session. <a href="https://vimeo.com/802564692">Watch the video</a>. &nbsp;</p>
</div> | 2/27/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| attorney-general-announces-pro-bono-legal-assistance-to-facilitate-abortion-access | Attorney General Announces Pro Bono Legal Assistance to Facilitate Abortion Access | Latest_News | Shared_Content/News/Membership_Memo/2023/february-24/attorney-general-announces-pro-bono-legal-assistance-to-facilitate-abortion-access | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/february/doc-with-young-female-patient-masks-645x425px.jpeg" class="pull-right" alt="doctor with young female patient" /></div>
<h5>February 24, 2023</h5>
<h2>Attorney General Announces Pro Bono Legal Assistance to Facilitate Abortion Access</h2>
<p>Physicians and health professionals providing abortion and reproductive care services and patients seeking such services now have free legal support for questions and protection against legal actions. Washington State Attorney General Bob Ferguson announced Thursday that health care professionals and care providers in Washington have a new avenue to obtain pro bono legal assistance to facilitate abortion access. Help can be found at a new legal services website managed by the Lawyering Project at <a href="https://atg.us10.list-manage.com/track/click?u=28a64d02479d9d79402df2b20&amp;id=fca6a45ba5&amp;e=3130127e75">abortiondefensenetwork.org</a>. Washingtonians seeking help through the website will be connected to attorneys in a nationwide pro bono network, including several Washington law firms recruited by the attorney general's office, to provide free legal guidance and resources. Ferguson also produced a "know your rights" brochure and a specific form for Washingtonians to file complaints about violations to their reproductive rights. The brochure, <a href="https://agportal-s3bucket.s3.amazonaws.com/uploadedfiles/Another/News/Press_Releases/KnowYourRightsFlier%20FINAL.pdf">available on the&nbsp;attorney general's website</a>, is a guide to Washington state law's protections for abortion and contraception access. The two-page document covers Washington's guaranteed right to choose abortion, access for pregnant people from other states, insurance coverage for abortion care, emergency contraception access, and more.</p>
<p>Anyone with complaints or concerns about violations of reproductive rights under state law is <a href="https://atg.us10.list-manage.com/track/click?u=28a64d02479d9d79402df2b20&amp;id=75a578e43c&amp;e=3130127e75">encouraged to file a complaint</a> with the attorney general's office.</p>
</div> | 2/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
| session-update-prior-authorization-and-gun-violence-bills-advance | Session Update: Prior Authorization and Gun Violence Bills Advance | Latest_News | Shared_Content/News/Membership_Memo/2023/february-24/session-update-prior-authorization-and-gun-violence-bills-advance | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/february/2023-legislative-session-updates-645x425px.png" class="pull-right" alt="2023 Legislative Session Updates logo" /></div>
<h5>February 24, 2023</h5>
<h2>Session Update: Prior Authorization and Gun Violence Bills Advance</h2>
<p>Last Friday, Feb. 17, was the policy cutoff deadline for the 2023 legislative session, meaning that only bills approved by their respective policy committees are eligible for further consideration this session (bills that are considered necessary to implement the budget, or "NTIB," are exempted from the deadline). We are pleased to report that all of WSMA's priority bills subject to the Friday deadline survived.</p>
<h3>WSMA prior authorization bill on the move</h3>
<p>WSMA priority legislation <a href="https://app.leg.wa.gov/billsummary?BillNumber=1357&amp;Initiative=false&amp;Year=2023">House Bill 1357</a>, which would modernize and standardize insurance carrier prior authorization processes, was amended and approved by the House Health Care &amp; Wellness Committee on Feb. 15. The bill then moved to the House Appropriations Committee, where legislators considered the fiscal component of the policy in a hearing this Thursday. The WSMA testified in support of this priority legislation in both hearings. As amended, HB 1357 would:</p>
<ul>
<li>Expedite turnaround times for prior authorization determinations.</li>
<li>Require carriers to develop and implement electronic prior authorization processes that integrate into electronic medical records.</li>
<li>These changes would be applied across all state-regulated health care plans for all health care services and prescription drugs.</li>
</ul>
<h3>Gun violence legislation</h3>
<p>Several bills regulating firearms continue to progress. The WSMA supports the following bills per its <a href="[@]wsma/about/policies/whats_our_policy/guns-and-weapons/gun-control.aspx">policy on gun control</a>. </p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1240&amp;Year=2023&amp;Initiative=false">HB 1240</a> would generally prohibit the manufacture, importation, distribution, and sale of assault weapons. The bill was approved by its policy committee and is now in the Rules Committee.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1143&amp;Initiative=false&amp;Year=2023">HB 1143</a> would require that individuals obtain a permit in advance of purchasing firearms and establishes criteria for the permitting process, including a requirement that individuals must have completed a certified firearms safety training program within the five years prior to purchasing a firearm. The bill was heard in the House Appropriations Committee on Feb. 8.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1562&amp;Initiative=false&amp;Year=2023">HB 1562</a> would modify provisions related to restoration of the right to possess firearms for individuals found guilty of certain crimes. The bill was heard in the House Civil Rights &amp; Judiciary Committee on Feb. 7.</li>
</ul>
<h3>Other hearing highlights from weeks five-six of session (Feb. 6-Feb. 17)</h3>
<p><a href="https://app.leg.wa.gov/billsummary?BillNumber=5059&amp;Initiative=false&amp;Year=2023">SB 5059</a>, Prejudgment interest - This legislation would change the date on which interest begins to accrue on adverse judgements, beginning at the date of the cause of action, rather than when the judgement is rendered. Applies only to arbitration awards and judgments entered following trials. WSMA Director of Government Affairs Sean Graham testified in opposition during a public hearing in the Senate Ways &amp; Means Committee on Feb. 7, noting that the bill does not contain an exemption for medical malpractice cases and would have the effect of increasing the cost of health care. </p>
<p><a href="https://app.leg.wa.gov/billsummary?Year=2023&amp;BillNumber=5242">SB 5242</a>, Cost-sharing for abortion - This legislation would prohibit cost-sharing on abortion services. WSMA Associate Director of Legislative and Political Affairs Alex Wehinger testified in support during a public hearing in the Senate Ways &amp; Means Committee on Feb. 13, encouraging the state to consider ways to eliminate barriers to accessing abortion care. </p>
<p><a href="https://app.leg.wa.gov/billsummary?Year=2023&amp;BillNumber=5236">SB 5236</a>, Hospital staffing standards - This legislation would direct the Department of Labor &amp; Industries to establish minimum staffing standards and revise provisions related to meal and rest breaks, among other provisions. WSMA Vice President John Bramhall, MD, PhD, testified in opposition during a public hearing in the Senate Ways &amp; Means Committee on Feb. 16, noting concerns for potential adverse impacts on patient safety, limiting access to care when facilities couldn't schedule enough staff, and putting more pressure on emergency departments.</p>
<h3>What's ahead</h3>
<p>The next major deadline is today's fiscal committee cutoff, by which time bills with a fiscal impact must be approved by the Senate Ways &amp; Means Committee or the House Appropriations Committee. Both the House and Senate will have until Wednesday, March 8 to approve bills that originated in their respective chambers, after which point policy and fiscal committees will reconvene for public hearings on bills approved by the opposite chamber.</p>
<p>For more on WSMA's legislative agenda, visit <a href="https://wsma.org/">our website</a>. For weekly session updates with greater details on bills being debated in Olympia, WSMA members may subscribe to the WSMA Outreach &amp; Advocacy Report by emailing Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a>. </p>
</div> | 2/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |
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<h5>February 24, 2023</h5>
<h2>Share Your Story on the Impact of Low Medicaid Reimbursement</h2>
<p>Through the forward-thinking actions of our state leaders, Washington state's Medicaid program, Apple Health, today provides essential health coverage to one in three Washingtonians-more than double the number of enrollees since 2008. More Washingtonians than ever have a measure of security in knowing that if they get sick or injured they can receive the care they needed...<em>if</em> they can find care. While state policymakers have scored an A+ on increasing health care coverage to Washington residents, when it comes to increasing access to services, they are failing Medicaid patients and physicians. While the Medicaid program has grown dramatically, payment for Medicaid services has gone down. Physicians treating Medicaid patients continue to do so at a financial loss, with reimbursement rates not coming close to covering the cost of care.</p>
<p>We need physicians to tell their stories directly to legislators of how low Medicaid reimbursements impact their practice and patient access to services. Your stories can help the WSMA get across to lawmakers why we <strong>must improve access to care for Medicaid patients in our state by enacting an across-the-board increase in Medicaid reimbursements</strong>. Legislators will soon be creating a new state budget, and it's critical they include these necessary investments and make good on their promise to Medicaid patients by ensuring care is available in their communities. <a href="https://www.votervoice.net/WSMA/Campaigns/101598/Respond">Please take a moment to share your story</a>.</p>
</div> | 2/24/2023 12:00:00 AM | 1/1/0001 12:00:00 AM |