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weekly-rounds-march-1-2024-in-the-fight-for-a-stronger-medicaid-patients-are-our-bottom-lineWeekly Rounds: March 1, 2024 - In the Fight for a Stronger Medicaid, Patients Are Our Bottom LineLatest_NewsShared_Content/News/Weekly_Rounds/2024/weekly-rounds-march-1-2024-in-the-fight-for-a-stronger-medicaid-patients-are-our-bottom-line<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-heshmati-2023-645x425px.png" class="pull-right" alt="Weekly Rounds logo with Nariman Heshmati, MD" /></div> <h5>March 1, 2024</h5> <h2>In the Fight for a Stronger Medicaid, Patients Are Our Bottom Line</h2> <p>Nariman Heshmati, MD, MBA, FACOG, WSMA President</p> <p> This year is the 10th anniversary of Washington state's expansion of the Medicaid program. The WSMA was proud to support the expansion, which immediately provided health insurance to hundreds of thousands of Washington residents-giving them access to needed health services and protection from health-related economic hardship. </p> <p> The number of Medicaid enrollees has grown to 2 million people in our state, demonstrating a significant scale of need. But as physicians and physician assistants, we know that coverage doesn't equal access. While Washington has made coverage available to more people, reimbursement rates are so abysmal that many, if not most, practices simply cannot afford to see the number of Medicaid patients who need care. </p> <p> The WSMA has long advocated for improved reimbursement rates, and we have had some targeted success. The Legislature has improved rates for primary care, for example, and the rate increase made it easier for thousands of patients to access care. </p> <p> <strong>This year, we asked the Legislature to raise Medicaid reimbursement rates across the board for the physician community.</strong> Working in partnership with legislative leaders, we developed a covered lives assessment, which is a financial mechanism for leveraging federal funds without the appropriation of state general fund dollars (Read more about how the assessment works on our <a href="">dedicated webpage</a>). </p> <p> The assessment was introduced in both the House and Senate and received a hearing in the House Appropriations Committee. The WSMA's financial modeling indicated that the benefit to the state would be nearly $500 million, which would have been sufficient to get Medicaid rates up to Medicare levels and would provide an ongoing source of revenue. </p> <p> With a short 60-day legislative session, we knew passage would require an unprecedented effort. With experts in finance, state budgeting, and advocacy, the WSMA helped legislators see how low rates hurt access to care across specialties and regions. Hundreds of WSMA members from across the state sent in letters of support, provided stories, <a href="">briefed reporters</a>, and much more. </p> <p> <strong>It's clear that tenacity will also be required. </strong>The covered lives assessment faced opposition from some in the insurance carrier community and skepticism on the part of state agencies. Lawmakers from both parties reviewed the bills and raised their own questions, and ultimately key legislators signaled that the assessment is unlikely to be included in this year's budget update. We're going to spend the next few months working with these stakeholders and legislators to address their concerns, build their allyship, and implement a lasting fix for Medicaid rates. </p> <p> Next year, the Legislature will develop a new biennial state budget, but make no mistake, our work is already underway. WSMA staff, leadership, and membership all have crucial roles to play in educating lawmakers about the necessity of improving Medicaid reimbursement rates for all specialties and all regions. We will have more information in the weeks ahead on concrete actions you can take during this interim period to advocate and educate. All Medicaid patients deserve the same access to whole-body care that Medicare and privately insured patients receive. It's time for the state to stop denying essential care to 2 million Washington residents. </p> <p> We are profoundly grateful for everyone who took the time to advocate on this issue and are committed to continuing the fight. If you want to know more, please join us on March 8 at noon for the full legislative debrief. Our government affairs director, Sean Graham, and his team will break down the politics, lessons, and successes of the session, detail the concerns from insurers and state agencies with the covered lives assessment, and talk about the direction for next year. <a href="">Register online</a> for this free session. </p> </div>3/1/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024-legislative-session-update-state-budget-proposals-the-good-and-the-bad2024 Legislative Session Update: State Budget Proposals: The Good and the BadLatest_NewsShared_Content/News/Latest_News/2024/2024-legislative-session-update-state-budget-proposals-the-good-and-the-bad<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href=""><img src="/images/Newsletters/latest-news/2024/february/leg-update-video-2-26-24.png" alt="WSMA Legislative Update: Week of Feb. 26, 2024" /></a> </div> <h5>February 26, 2024</h5> <h2>2024 Legislative Session Update: State Budget Proposals: The Good and the Bad</h2> <p> With a week and a half left in the 2024 state legislative session, WSMA Director of Government Affairs Sean Graham gives an update on some positive investments included in the House and Senate budget proposals, and where our proposal to raise Medicaid rates stands. <a href="">Watch the video</a>. </p> <h3>Join us for a post-session webinar Friday, March 8</h3> <p> The 2024 state legislative session is scheduled to adjourn on Thursday, March 7, and all WSMA members are invited to attend a free post-session Advocacy Council meeting on Friday, March 8, at noon via Zoom. WSMA's government affairs team will review the outcomes of WSMA's priority bills, the final state supplemental budget, and give an insider's perspective on the broader health care policy landscape. </p> <p> And as always, we want to hear your feedback on everything that's happening in Olympia and any concerns or issues you or your practice are facing, so we will hold time during the meeting for questions. </p> <p> <a href="">Register here</a>. You will receive a confirmation email with the connection information after registering. The meeting will also be recorded and posted to the WSMA website. </p> </div>2/26/2024 12:00:00 AM1/1/0001 12:00:00 AM
budget-proposals-released-as-2024-session-hits-homestretchBudget Proposals Released as 2024 Session Hits HomestretchLatest_NewsShared_Content/News/Membership_Memo/2024/february-23/budget-proposals-released-as-2024-session-hits-homestretch<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/spring-wa-capitol-645x425px.jpg" class="pull-right" alt="flower on trees at Washington state capitol" /></div> <h5>February 23, 2024</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Budget Proposals Released as 2024 Session Hits Homestretch </h2> <p>With just over two weeks remaining in the 2024 session, majority party Democrats in the Senate and House of Representatives have released their operating budget proposals. Both supplemental spending plans adjust the two-year state budget enacted last year and would increase spending by around 2.5%, funding investments in government around health care, education, and more.</p> <p>In crafting the proposals, budget writers accounted for slower but positive projected state revenue collections as well as November's ballot initiatives that could significantly impact state budgets by repealing the capital gains tax and the <a href="">Climate Commitment Act</a>, which funds state investments in climate projects. </p> <h3>The missing Medicaid investments </h3> <p>Building off of WSMA's recent success in increasing Medicaid reimbursement for some primary care, pediatric, and behavioral health services, we went full throttle into this session with the goal of increasing Medicaid rates across the board for all physicians in all settings to at least the equivalents paid by Medicare. Responding to direction from key legislators who indicated a dedicated revenue source would be needed to support the investments, we proposed <a href="">House Bill 2476</a> to establish a covered lives assessment to fund rate increases. </p> <p>In spite of the extensive engagement of the physician community, which included physicians from across specialties and geographies testifying in support of HB 2476, meeting with legislators, sending hundreds of messages in support of the bill, writing letters to their local papers, and speaking directly with reporters about the importance of improving rates, we are disappointed that our proposal to increase Medicaid rates is not included in legislative budget drafts.</p> <p>Regardless, the WSMA remains steadfast in using the final days of session to continue to push for HB 2476 to be advanced and incorporated into budget negotiations in the final weeks of session. If you haven't yet done so, take just a moment to <a href="">urge your legislators in the House and Senate to add the covered lives assessment to the 2024 state operating budget</a>.</p> <h3>Workforce and public health </h3> <p>Promoting physician and health care workforce is another budget priority for the WSMA and here we're pleased that legislative budgets propose to substantially increase funding for graduate medical education. The Family Medicine Residency Network, the state's primary residency funding stream, would see an infusion of $12.8 million in new federal funds. The graduate medical education program at UW Medicine would also see increased support from federal funds. Taken together, these investments will support the next generation of our state's physician workforce, as we know that physicians tend to practice where they train.</p> <p>Speaking of physicians and workforce, there are appropriations in the budget proposals to support the implementation of two WSMA-backed bills proposed by physician specialties that are pending this year. <a href="">Senate Bill 5184</a> is being proposed by anesthesiologists to establish licensure for anesthesiologist assistants, and <a href="">House Bill 2355</a> from the radiologists establishes a radiologic technologist certification. Additionally, the House budget includes funding requested by the pediatricians to support youth mental health screenings and services.</p> <p>More broadly, legislators continued their recent work of responding to the fentanyl epidemic and expanding access to behavioral health care. Key proposed investments include funding for the operation of Olympic Heritage Behavioral Health, which was recently acquired by the state, and increased capacity at Western and Eastern State Hospitals. There's also support for naloxone distribution, opioid use disorder medications, and fentanyl awareness campaigns.</p> <p>During the final weeks of session, legislators will work to reconcile differences between the House and Senate budget, in addition to finalizing details on the hundreds of bills that are still eligible for consideration. The 2024 session is scheduled to adjourn on Thursday, March 7. </p> </div>2/23/2024 12:00:00 AM1/1/0001 12:00:00 AM
register-for-feb-29-webinar-on-polst-and-advance-care-planningRegister for Feb. 29 Webinar on POLST and Advance Care PlanningLatest_NewsShared_Content/News/Membership_Memo/2024/february-23/register-for-feb-29-webinar-on-polst-and-advance-care-planning<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/polst-webinar-2-29-24.png" class="pull-right" alt="POLST webinar graphic" /></div> <h5>February 23, 2024</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Register for Feb. 29 Webinar on POLST and Advance Care Planning </h2> <p><em>CME is available for this lunchtime session.</em></p> <p><a href="[@]eventdetail?eventkey=POLST0224">Registration is now available</a> for "POLST and Advance Care Planning in Washington State: Where We Are Now," the latest in WSMA's Continuing Professional Development webinar series, offered free to WSMA members as a benefit of their membership.</p> <p>During the noontime session on Thursday, Feb. 29, you'll hear from Washington POLST clinician experts who will review statewide initiatives, updates, and resources available to physicians, advanced practitioners, and other members of the health care team to promote advance care planning and goals-of-care conversations. Featured presenters include Sharmon Figenshaw, ARNP, palliative care nurse practitioner and co-chair of the Washington POLST Task Force, and Hilary Walker, OTL, chair of the Washington Serious Illness Care Coalition and program coordinator for advance care planning with PeaceHealth Medical System. Sharmon and Hilary will offer insights into "the right document, at the right time, for the right person" and invite participation in open discussion about how advance care planning documents and POLST are currently being used in your medical systems.</p> <p>Bring your questions on how we can all better ensure people with serious illness receive care that is consistent with their values and goals. Be part of the conversation and learn how you can get involved. <a href="[@]eventdetail?eventkey=POLST0224">Register today for this free session for WSMA members</a>. This activity is approved for <em>AMA PRA Category 1 Credit</em>â„¢.</p> </div>2/23/2024 12:00:00 AM1/1/0001 12:00:00 AM
wsma-continues-advocacy-on-medicare-payment-rate-cutsWSMA Continues Advocacy on Medicare Payment Rate CutsLatest_NewsShared_Content/News/Membership_Memo/2024/february-23/wsma-continues-advocacy-on-medicare-payment-rate-cuts<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/medicare-graphic-645x425px.png" class="pull-right" alt="Support Medicare Sustainability graphic" /></div> <h5>February 23, 2024</h5> <h2>WSMA Continues Advocacy on Medicare Payment Rate Cuts </h2> <p>The physician community continues to urge Congress to reverse the 3.4% Medicare payment rate cut that went into effect Jan. 1, 2024. <a href="">H.R. 6683</a>, which would eliminate the rate cut, remains at the center of WSMA's advocacy on this issue.</p> <p>The WSMA is advocating that Congress pass H.R. 6683 or include a fix in the next congressional appropriations package, expected to be voted on in March. Last week, WSMA's policy team <a href="">sent letters</a> to Washington's congressional delegation expressing disappointment in Congress for not addressing the cut during the most recent continuing resolution discussions and urging them to take action that is long overdue. Earlier this week, following the lead of the American Medical Association, WSMA's policy team requested that Washington's senators <a href="javascript://[Uploaded files/News and Publications/newsletters/2024/boozman-welch-doc-cut-fix-letter.pdf]">sign onto a letter</a> drafted by Sen. John Boozman (R-AR) and Sen. Peter Welch (D-VT) requesting Senate leadership to urgently take action to reverse the rate cut.</p> <h3>Contact your congressional delegation today</h3> <p>Please take a moment to contact your members of Congress and share the importance of reversing the cuts. Contact your members by using the AMA's <a href="">call to action</a> or by contacting offices <a href="">directly</a>. With any questions, contact <a href=""></a>.</p> </div>2/23/2024 12:00:00 AM1/1/0001 12:00:00 AM
wsma-shares-concerns-with-board-of-optometrys-sb-5389-rulemakingWSMA Shares Concerns with Board of Optometry's SB 5389 RulemakingLatest_NewsShared_Content/News/Membership_Memo/2024/february-23/wsma-shares-concerns-with-board-of-optometrys-sb-5389-rulemaking<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/eye-exam-645x425px.jpg" class="pull-right" alt="patient receiving an eye exam" /></div> <h5>February 23, 2024</h5> <h2>WSMA Shares Concerns with Board of Optometry's SB 5389 Rulemaking</h2> <p>The Washington Legislature approved <a href="">SB 5389</a> concerning optometry scope of practice during the 2023 legislative session. Among other things, the bill, which was opposed by the Washington Academy of Eye Physicians and Surgeons and the WSMA, expands an optometrist's prescriptive authority, ability to administer injections, and perform certain advanced procedures. The bill leaves the finer details of implementation up to the Board of Optometry via rulemaking. Last month, the Board of Optometry released draft WAC language specific to prescriptive authority and advanced procedures. That language is available <a href="">here</a> and <a href="" target="_blank" rel="noreferrer">here</a>.</p> <p>During a stakeholder meeting in late January, the WAEPS and the WSMA shared our concerns with the draft WAC. Those concerns include a lack of clarity in the language, a need for additional guardrails, and a requirement that an optometrist performing advanced procedures partner with a board-certified ophthalmologist to manage adverse events. In a <a href="javascript://[Uploaded files/News and Publications/newsletters/2024/WSMA comment BOO rulemaking SB 5389.pdf]">letter submitted this week</a>, the WSMA elaborated on our concerns.</p> <p>Should you have any questions on this rulemaking, please contact <a href="">WSMA Associate Policy Director Billie Dickinson</a>.</p> </div>2/23/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024-legislative-session-update-conversations-in-olympia-shift-to-budget-proposals2024 Legislative Session Update: Conversations in Olympia Shift to Budget ProposalsLatest_NewsShared_Content/News/Latest_News/2024/2024-legislative-session-update-conversations-in-olympia-shift-to-budget-proposals<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href=""><img src="/images/Newsletters/latest-news/2024/february/leg-update-video-2-19-24.png" alt="WSMA Legislative Update: Week of Feb. 19, 2024" /></a></div> <h5>February 19, 2024</h5> <h2>2024 Legislative Session Update: Conversations in Olympia Shift to Budget Proposals</h2> <p>WSMA Associate Director of Legislative Advocacy Alex Wehinger gives an update on next steps for state budget proposals. Watch the video. <a href="">Watch the video</a>.</p> </div>2/19/2024 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-feb-16-2024-5-things-to-know-this-weekWeekly Rounds: Feb. 16, 2024 - 5 Things to Know This WeekLatest_NewsShared_Content/News/Weekly_Rounds/2024/weekly-rounds-feb-16-2024-5-things-to-know-this-week<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>February 16, 2024</h5> <h2>5 Things to Know This Week</h2> <p>Jennifer Hanscom, CEO</p> <p> As is typical during each year's legislative session, we are laser focused on bills that impact the practice of medicine and patients' access to care. However, there are several other issues we are working on at the WSMA. Here are some quick highlights from Olympia and DC and for the profession. </p> <h3>Stalled bills for this year</h3> <p> We've entered the final half of this year's legislative session, as Feb. 13 marked the date policy bills needed to pass from their originating chamber. Already, several bills have stalled, at least for this session, including the following WSMA-opposed bills related to scope of practice and the business of medicine. These bills didn't meet key deadlines and are not expected to receive further consideration this year: </p> <ul> <li><a href="">SB 5411</a>: Would have granted naturopaths prescriptive authority for all Schedule II-V drugs, including opioids, fentanyl, and ketamine, without detailing specific education and training requirements.</li> <li>H<a href="">B 2116</a>: Would have granted the Pharmacy Quality Assurance Commission authority to establish rules identifying drugs, drug classes, and devices that a pharmacist may prescribe and the types of patients and circumstances in which a pharmacist can prescribe.</li> <li><a href="">SB 6144</a>: Would have allowed, under certain conditions, psychologists to be granted prescriptive authority for psychotropic medications used in the diagnosis and treatment of individuals with certain mental and behavioral disorders.</li> <li><a href="">SB 5373</a>: Would have required that ARNPs and physician assistants be reimbursed by commercial insurers at the same rate as physicians, counter to <a href="[@]wsma/about/policies/whats_our_policy/insurance/equal-pay-for-equal-work.aspx?_zs=B3aFd1&_zl=U56S9">WSMA policy</a>.</li> <li><a href="">HB 2119</a>: Would have limited the ability to collect medical debt.</li> <li><a href="">HB 2066</a>: Would have prohibited health care facilities and providers from engaging in certain contracting tactics to shift more power in contract negotiations toward insurance carriers.</li> </ul> <p> For an update on other bills the WSMA is actively working on, be sure to review our weekly Outreach and Advocacy Report, emailed weekly to members via our Olympia team (to subscribe, email <a href="">Chelsea Thumberg</a>). Bills considered necessary to implement the budget, such as WSMA-priority <a href="">HB 2476</a>/<a href="">SB 6309</a> that would increase Medicaid reimbursement rates via a covered lives assessment, are exempted from the policy deadlines. </p> <h3>Medicaid reimbursement rates</h3> <p> Speaking of the covered lives assessment, HB 2476 had a public hearing yesterday, Thursday, Feb 15. I'm happy to report that over 600 individuals and groups signed on in support of HB 2476 prior to the hearing-a fantastic show of support for the bill and the need to address low reimbursement rates this legislative session. Thank you to Sung-Won Kim, MD, an Olympia ENT, and Douglas Seiler, MD, a Tacoma radiologist, for testifying in support at the hearing and sharing the physician perspective of how Medicaid underpayments translate to care barriers for their patients. </p> <p> The WSMA is sparing no effort to support HB 2476/SB 6309 this session. Following the hearing on Thursday, we held a media briefing on Friday to make our case to the media and the public. Our briefing explained how years of underfunding in the Medicaid program has hampered access to outpatient care in communities throughout Washington. Thank you to Douglas Seiler, MD, from TRA Imaging, Katina Rue, DO, WSMA past president, and Andrea Kalus, MD, University of Washington associate professor of dermatology, who were able to shed light on what their patients are enduring to the reporters present. </p> <p> Be sure to <a href="[@]Shared_Content/News/Press_Release/2024/hb-2476-will-improve-reimbursements-strengthen-medicaid-improve-access-to-care-in-washington-state?_zs=B3aFd1&_zl=a56S9">read our press release</a> for more details. And if you or your clinic is active on social media, help us spread the need to pass HB 2476/SB6309 this legislative session. </p> <h3>Medicare cuts</h3> <p> In the other Washington, organized medicine continues the battle to reverse cuts to Medicare. H.R. 6683 would eliminate the 3.6% payment cut that went into effect on Jan. 1, 2024. The WSMA is advocating that Congress pass H.R. 6683 or include a fix in the next congressional appropriations package, expected to be voted on in March. Earlier this week, we sent letters to Washington's congressional delegation expressing our disappointment in Congress for not addressing the cut during the most recent continuing resolution and urging them to take action that is long overdue. Please contact your members of Congress and share the importance of reversing the cuts. You may contact your members through the <a href="">AMA's Call to Action</a> or by contacting offices directly. </p> <h3>Health equity CME requirement</h3> <p> We know that continuing professional development is an obligation and prerequisite for enhancing the quality of health care. The WSMA offers exclusive learning opportunities for members either free of charge or at a discounted rate. While Washington state has very few required CME courses, beginning this year, the state will require that health care professionals complete a minimum of two hours of health equity continuing education training at least once every four years. </p> <p> As a benefit of membership, the WSMA will soon launch a podcast series that meets this new requirement free of charge. The material will be presented in a four-part miniseries podcast for convenient access for busy professionals. The series will showcase how some of your colleagues have tackled health equity, diversity, racism, and inclusion both structurally and individually. The podcast series is scheduled to launch in March and has been approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>. Learn more on the <a href="[@]Shared_Content/News/Membership_Memo/2024/february-9/new-wsma-program-will-meet-state-requirement-for-health-equity-cme?_zs=B3aFd1&_zl=c56S9">WSMA website</a>. </p> <h3>Membership matters</h3> <p> I am so grateful for your investment in the WSMA. If you haven't yet paid your membership dues for 2024 or are unsure of your membership status, call our membership team at 206.441.9762 or <a href="">send them an email</a>. Many medical groups cover WSMA dues on your behalf; others ask that you submit receipts to your medical staff office or HR department for reimbursement. If you have questions, our membership team can help. </p> <p> And as always, thanks for all you do! </p> </div>2/16/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024-legislative-session-update-status-update-on-wsma-supported-bills2024 Legislative Session Update: Status Update on WSMA-Supported BillsLatest_NewsShared_Content/News/Latest_News/2024/2024-legislative-session-update-status-update-on-wsma-supported-bills<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href=""><img src="/images/Newsletters/latest-news/2024/february/Leg-Update-Video-2-12-24.png" alt="WSMA Legislative Update: Week of Feb. 12, 2024" /></a> </div> <h5>February 12, 2024</h5> <h2>2024 Legislative Session Update: Status Update on WSMA-Supported Bills</h2> <p>WSMA Director of Government Affairs Sean Graham gives an update on some good bills the WSMA is supporting this session, including two bills intended to bolster the health care workforce. <a href="">Watch the video</a>.</p> </div>2/12/2024 12:00:00 AM1/1/0001 12:00:00 AM
new-wsma-program-will-meet-state-requirement-for-health-equity-cmeNew WSMA Program Will Meet State Requirement for Health Equity CMELatest_NewsShared_Content/News/Membership_Memo/2024/february-9/new-wsma-program-will-meet-state-requirement-for-health-equity-cme<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/multicolor-word-bubbles-645x425px.png" class="pull-right" alt="multi-color word bubble illustration" /></div> <h5>February 9, 2024</h5> <h2>New WSMA Program Will Meet State Requirement for Health Equity CME </h2> <p><a href="">A new state requirement</a> now in effect requires health care professionals to complete a minimum of two hours in health equity continuing education training at least once every four years. WSMA members take note: As a member benefit, the WSMA is collaborating with Edwin Lindo, JD, to produce engaging education to fulfill this requirement as set forth by the <a href="">Washington</a> State Department of Health. In this 4-part audio miniseries, Lindo will cover the history of racism in medicine and the impacts of the medical profession on health equity. He will also share how some of your colleagues have tackled these thorny issues, structurally and individually, and give you ideas on how to incorporate equity principles into practice.</p> <p>This podcast miniseries will be free for members and will be available in early March. Stay tuned. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢.</p> </div>2/9/2024 12:00:00 AM1/1/0001 12:00:00 AM
osteopath-board-updates-credentialing-application-to-support-physician-wellnessOsteopath Board Updates Credentialing Application to Support Physician WellnessLatest_NewsShared_Content/News/Membership_Memo/2024/february-9/osteopath-board-updates-credentialing-application-to-support-physician-wellness<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/steth-warm-background-645x425.jpg" class="pull-right" alt="stethoscope resting on a folded cloth" /></div> <h5>February 9, 2024</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>Osteopath Board Updates Credentialing Application to Support Physician Wellness</h2> <p>At the request of the WSMA and Washington Physicians Health Program, the Board of Osteopathic Medicine and Surgery voted to change its application language to mirror the current Washington Medical Commission <a href="">practitioner application</a>, which was updated in 2023 with physician input, in order to decrease barriers to seeking help, a decision widely praised by <a href="[@]Shared_Content/News/Weekly_Rounds/2023/Weekly_rounds_january_20_2023_new_washington_practitioner_application_supports_physician_wellness">the WSMA and other physician community advocates</a>. Like the commission application, the osteopath application will now include a disclaimer before applicants are asked to disclose sensitive demographic information. The updated language is more respectful to applicants, helps them avoid feeling the need to over-disclose on their applications, and represents further progress in decreasing barriers to seeking help for physicians and physician assistants in our state.</p> <p>The Board of Osteopathic Medicine and Surgery spokesperson told the WSMA to expect the updated application this spring. The WSMA will keep its osteopath members apprised when the updated application is available.</p> </div>2/9/2024 12:00:00 AM1/1/0001 12:00:00 AM
tell-the-legislature-to-make-medicaid-a-priority-this-sessionTell the Legislature to Make Medicaid a Priority This SessionLatest_NewsShared_Content/News/Membership_Memo/2024/february-9/tell-the-legislature-to-make-medicaid-a-priority-this-session<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/february/medicaid-initiative-billnumbers-graphic-green-645x425px.png" class="pull-right" alt="Support Equitable Access graphic" /></div> <h5>February 9, 2024</h5> <h2>Tell the Legislature to Make Medicaid a Priority This Session</h2> <p>WSMA-supported bills to increase Medicaid reimbursement rates to Medicare levels have been introduced in both chambers: <a href="">House Bill 2476</a> (Rep. Nicole Macri, D-43, and Rep. Marcus Riccelli, D-3) and <a href="">Senate Bill 6309</a> (Sen. Emily Randall, D-26, and Sen. June Robinson, D-38). These bills establish a covered lives assessment and allow the state to draw down federal funds and increase rates across the board for all specialties.</p> <p>The WSMA is a powerful advocate in the Legislature, but we are stronger when physicians and physician assistants, their staff, and their teams join us in active advocacy. Here are concrete steps you can take right now to help support HB 2476 and SB 6309 and higher Medicaid reimbursements.</p> <h3>Urge your lawmakers to support HB 2476 and SB 6309</h3> <p>If you haven't yet done so, please take a moment right now and contact your lawmakers and urge support for HB 2476 and SB 6309. Our grassroots action platform makes it easy to look up your legislators and send a message - <a href="">thank you for taking action</a>.</p> <h3>Use our campaign resources to spread the word to your colleagues</h3> <p>To help our efforts in the Legislature and physician community scale, here are resources you may freely use to support HB 2476 and SB 6309:</p> <ul> <li><a href="" target="_blank" rel="noreferrer">Fact sheet on HB 2476 and SB 6309</a>.</li> <li><a href="">Take Action website</a> explaining the reimbursement issue and the impact on patients and highlighting stories from physicians who are concerned about access to care.</li> <li>Letters submitted to the <a href="" target="_blank" rel="noreferrer">House</a> and to the <a href="" target="_blank" rel="noreferrer">Senate</a> supporting the covered lives assessment proposed in HB 2476 and SB 6309 and signed by nearly 60 health and physician groups.</li> <li><a href="javascript://[Uploaded files/News and Publications/newsletters/2024/medicaid-initiative-billnumbers-graphic-green-645x425px.png]">Social media graphic (YES to HB 2476/SB 6309)</a>. If you or your organization uses social media, please help us amplify our message. Follow the WSMA on <a href="">X</a> (formerly Twitter), <a href="">Facebook</a>, and <a href="">LinkedIn</a>. We will in turn follow you back and amplify your campaign posts. Make sure to tag us in your posts (@WSMA_update on X and @Washington State Medical Association on Facebook and LinkedIn).</li> <li><a href="">Medicaid patient survey</a> gives insight into the patient experience. When they can't get the care they need, they're managing more pain, delayed diagnoses, and additional ED visits.</li> </ul> <p>We're always happy to talk with you and hear your questions and concerns-reach out to WSMA CEO Jennifer Hanscom at <a href=""></a>, WSMA Director of Government Affairs Sean Graham at <a href=""></a><span style="text-decoration: underline;">,</span> or WSMA Director of Communications Graham Short at <a href=""></a> with any questions or requests.</p> </div>2/9/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024-legislative-session-update-upcoming-session-deadlines-and-scope-of-practice-bills2024 Legislative Session Update: Upcoming Session Deadlines, and Scope of Practice BillsLatest_NewsShared_Content/News/Latest_News/2024/2024-legislative-session-update-upcoming-session-deadlines-and-scope-of-practice-bills<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href=""><img src="/images/Newsletters/latest-news/2024/february/leg-update-video-2-5-24.png" style="width: 645px;" alt="WSMA Legislative Update: Week of Feb. 5, 2024" /></a> </div> <h5>February 5, 2024</h5> <h2>2024 Legislative Session Update: Upcoming Session Deadlines, and Scope of Practice Bills That Won't Advance</h2> <p>WSMA Director of Government Affairs Sean Graham gives an update on some important upcoming session deadlines and cutoffs, and on bills that will not advance this session, including several scope of practice expansion bills the WSMA opposed. <a href="">Watch the video</a>.</p> </div>2/5/2024 12:00:00 AM1/1/0001 12:00:00 AM
weekly-rounds-feb-2-2024-we-need-your-advocacy-to-help-medicaid-bills-advanceWeekly Rounds: Feb. 2, 2024 - We Need Your Advocacy to Help Medicaid Bills AdvanceLatest_NewsShared_Content/News/Weekly_Rounds/2024/weekly-rounds-feb-2-2024-we-need-your-advocacy-to-help-medicaid-bills-advance<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>February 2, 2024</h5> <h2>We Need Your Advocacy to Help Medicaid Bills Advance</h2> <p>Jennifer Hanscom, CEO</p> <p> Last week I hit the road for points south to connect with our members at WSMA's Legislative Summit in Olympia, as well as at a physician engagement event at TRA Imaging in Tacoma. Ever since the pandemic, I am so deeply appreciative of these opportunities to connect in person! It's a great way for me to hear from you and to share how the WSMA is representing you and your patients in our advocacy work. Thanks to all of you who took the time to join these discussions. </p> <p> As you've heard quite a bit lately, the WSMA's number one priority this year is to address Medicaid reimbursement. Our greatest challenge is it being an off-budget session where significant new investments aren't often considered. Regardless, at the direction of legislative leadership we have brought forth a proposal that provides an alternate source of funding to draw down federal funds to support bringing Medicaid rates in line with 2023 Medicare rates, with inflationary adjustments. Bills have been introduced in both the Senate (SB 6309) and the House (HB 2476). </p> <p> As soon as a public hearing on the bill is scheduled, we will let you know. In the meantime, help us ensure that the Legislature understands the urgency of addressing this issue now. <a href="">Please email your local legislators today using our grassroots advocacy platform</a>. </p> <p> We ask that you also email budget chairs <a href="">Rep. Timm Ormsby</a> (D-Spokane) and <a href="">Sen. June Robinson</a> (D-Everett), and caucus leaders <a href="">Speaker Laurie Jinkins</a> (D-Tacoma) and <a href="">Sen. Andy Billig</a> (D-Spokane) and ask that they give HB 2476 and SB 6309 a hearing as soon as possible. You can use this message as a template: </p> <p> <em>I'm writing to urge your support for the covered lives assessment in HB 2476 and SB 6309, which would increase Medicaid reimbursement rates for professional services delivered by physicians, physician assistants, and ARNPs, and ask that you give these bills a hearing as soon as possible.</em> </p> <p> <em>Prioritizing a broad-based Medicaid reimbursement rate increase through the proposed covered lives assessment will improve access to care for Washingtonians at a time when it is desperately needed and long overdue. This is a short session and the issue is urgent-our patients can't wait.</em> </p> <p> <em>Please support HB 2476 and SB 6309 and bring these bills forward for a public hearing.</em> </p> <p> We heard from several key legislators at the Summit-they all noted the importance of hearing from physicians on these issues. With few health care practitioners in the Legislature-and no physicians-your voice matters. Speak up today. </p> <p> Speaking up is a key aspect of leadership, and the WSMA is here to support you on your leadership journey. Registration is now open for the popular <a href="[@]WSMA/Events/Leadership_Development_Conference/WSMA/Events/LDC/leadership_development_conference.aspx?hkey=c7532c38-057a-4568-8a3c-078182469222">WSMA Leadership Development Conference</a>, scheduled for May 17-18 at Campbell's Resort in Chelan. </p> <p> Heading a strong speaker lineup for the Thomas J. Curry Leadership Keynote address is social scientist and futurist Jeff Goldsmith, who believes that physicians have been badly mistreated by the changes in health care. He argues that the impact of disruption in health care has often been destructive, as the focus on technological potential and large corporate enterprises disrupt traditional care enterprises. He explores the questions: Have they neglected the disruptive potential of economic and political forces on how health care is paid for? And how can disrupters be partners in the strategic development of the health enterprise? </p> <p> Other conference speaker highlights include Alex Ding, MD, who will explore what physicians should know about artificial intelligence, and Joel Bervell, a WSU medical student and popular social media "Medical Mythbuster," who will speak about health equity for health care leaders. A host of other speakers will be on hand to discuss topics ranging from financial wellness to building strong teams to supporting better patient care. The conference is approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>. </p> <p> Be sure to register today and make plans to bring your whole family. The resort is family friendly, and this is the perfect conference to recharge your battery, both professionally and personally. </p> <p> I hope to see you there! </p> </div>2/2/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024_legislative_session_update2024 Legislative Session Update: Bringing Our Plan to Increase Medicaid Rates to the LegislatureLatest_NewsShared_Content/News/Latest_News/2024/2024_legislative_session_update<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href=""><img src="/images/Newsletters/latest-news/2024/january/Leg-Update-Video-2-1-22-24.png" alt="WSMA Legislative Update: Week of Jan. 15, 2024" /></a> </div> <h5>January 22, 2024</h5> <h2>2024 Legislative Session Update: Bringing Our Plan to Increase Medicaid Rates to the Legislature</h2> <p>WSMA's Director of Government Affairs Sean Graham talks about one of our top legislative priorities that we'll address at this Wednesday's 2024 <a href="[@]wsma/events/wsma_legislative_summit/legislative_summit.aspx">WSMA Legislative Summit</a>: Increasing Medicaid reimbursement rates. <a href="">Watch the video</a>.</p> <p>Online registration for the WSMA Legislative Summit is now closed, but walk-in registration is welcome.</p> <p> </p> </div>1/23/2024 11:27:33 AM1/1/0001 12:00:00 AM
Weekly_rounds_jan_19_2024_fighting_for_the_sustainability_of_medicare_and_medicaidWeekly Rounds: Jan. 19, 2024 - Fighting for the Sustainability of Medicare and MedicaidLatest_NewsShared_Content/News/Weekly_Rounds/2024/Weekly_rounds_jan_19_2024_fighting_for_the_sustainability_of_medicare_and_medicaid<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>Jan. 19, 2024</h5> <h2>Fighting for the Sustainability of Medicare and Medicaid</h2> <p>Jennifer Hanscom, CEO</p> <p> Welcome to 2024. While it's a new year, the work at the WSMA remains the same: Advocating for the sustainability of our two major government health insurance programs and payers, Medicare and Medicaid. As we shared in the fall, the WSMA is focused on addressing these two programs that are crippling the financial viability of many practices and impeding access to care in communities around our state, as so eloquently shared by Judy Kimelman, MD, (OB-GYN); Sung-Won Kim, MD, (ENT); Jeffrey Frankel, MD, (urologist); Anna McKeone, MD, (emergency physician); and Douglas Seiler, MD, (radiologist) in the <a href="[@]Shared_Content/News/Latest_News/2024/when_practicing_medicine_is_a_losing_proposition.aspx">January/February issue</a> of WSMA Reports. </p> <p> </p> <h3>Congress fails to provide "fix" to Medicare payment cut in new continuing resolution to fund federal government</h3> <p>Today, Congress passed a continuing resolution to temporarily fund the federal government, just barely meeting the deadline to act and avoid a government shutdown. Unfortunately, as part of the continuing resolution, Congress did not include a "fix" to reverse the 3.37% Medicare physician payment cut that went into effect Jan. 1, 2024.</p> <p> As many of you know, the only way to reverse this cut was by an act of Congress. The WSMA engaged extensively on this issue, meeting with our congressional delegates to secure their support, issuing calls to action urging physicians in Washington state to contact their members of Congress, submitting comment letters to Washington's delegation beginning in April of 2023, and signing onto American Medical Association letters to key members of Congress.</p> <p> The need for Congress to act to reverse this cut is imperative. The fiscal stability of physician practices is now in greater jeopardy with the new cut in effect, as is the ability for patients to access care in their communities. We will keep members apprised of developments at the federal level and of opportunities for you to advocate for a fix.</p> <p> Congress’ failure demonstrates the need for broader, long-term Medicare payment reform that includes annual inflationary updates. To that end, the WSMA supports the Strengthening Medicare for Patients and Providers Act (<a href="">H.R. 2474</a>) and will be urging Washington's congressional delegation to sign on in support. </p> <h3>Urging state action on Medicaid reimbursements</h3> <p> Speaking of timing, the WSMA is preparing to formally introduce our Medicaid reimbursement proposal, which puts into motion a covered lives assessment in order to bring reimbursement for physician and other professional services at a minimum in line with Medicare payments. The assessment would be applied to insurance carriers (mainly Medicaid managed care organizations) to generate revenue, mostly from the federal government, which would then be used to fund an across-the-board rate increase up to at least Medicare equivalents indexed to inflation in future years.</p> <p>As we await the final bill, here are four things you can do right now to support this effort:</p> <ol> <li>Sign on to our <a href="javascript://[Uploaded files/News and Publications/newsletters/2024/Sign-on letter Medicaid Jan2024.pdf]">letter to Washington lawmakers</a> expressing the need to expand access to care through improved reimbursement rates and a covered lives assessment. Staff is aiming to finalize the signatories by the end of this week. Email WSMA Director of Communications <a href="">Graham Short</a> if your organization would like to sign on. If you miss the deadline, there may me other opportunities, so don’t hesitate to act.</li> <li>Visit our campaign website at <a href=""></a>.</li> <li><a href="">Share your story</a>. Tell legislators how low Medicaid reimbursements are impacting your patients and community.</li> <li>Learn more about our solution and tell others. <a href="javascript://[Uploaded files/News and Publications/newsletters/2024/WSMA_2024_IssueBrief_Medicaid.pdf]">Download and share a one-page summary of our covered lives assessment solution</a>.</li> </ol> <p> If you are able to take time away from your practice to testify on the bill when introduced, or if you are interested in sharing your story with the media, either via an interview or by submitting an op-ed to your local paper, please fill out our <a href="">Get Engaged</a> form. Our team will be in touch with more information on how you can help.</p> <h3>Stay informed on the action</h3> <p> This legislative session is a short one, expected to adjourn March 7. The WSMA will keep you up to date on issues that impact you and your patients. Here are several ways you can stay informed:</p> <ul> <li> Follow the WSMA on <a href="">Facebook</a>, <a href="">LinkedIn</a>, and <a href="">X</a>. </li> <li> Watch for our legislative update emails every Monday during session. </li> <li> Sign up for the Outreach & Advocacy Report, our Olympia team’s weekly comprehensive update, by emailing <a href="">Chelsea Thumberg</a>. </li> <li> Also, please ensure that WSMA emails are getting through to you by making sure your email preferences are up to date in your member profile on the <a>WSMA website</a>.</li> </ul> <p> As you know too well, policy changes can take years of advocacy. This year our message to Congress and local legislators is: Time’s up. Please join us in communicating the urgency behind these fixes. Thanks for standing together and for supporting your WSMA.</p> </div>1/23/2024 11:27:29 AM1/1/0001 12:00:00 AM
when_practicing_medicine_is_a_losing_propositionWhen Practicing Medicine is a Losing PropositionLatest_NewsShared_Content/News/Latest_News/2024/when_practicing_medicine_is_a_losing_proposition<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2024/january-february/Jan-Feb-Reports-Cover-645x425px.jpg" class="pull-right" alt="cover of November/December 2023 issue of WSMA Reports" /></div> <h5>January 17, 2024</h5> <h2>When Practicing Medicine is a Losing Proposition</h2> <p> By John Gallagher </p> <p>When Sung-Won Kim, MD, became a partner in his ENT practice in Thurston County, he pushed hard for the practice to see Medicaid patients.</p> <p>"We have a great policy in our practice where we accept all insurance," he says. "We don't pick who goes where. We don't prioritize whether it's Medicaid or commercial payers."</p> <p>Now Dr. Kim finds himself in an ethical quandary. Because of the low reimbursement rates for Medicaid, it's not economically feasible to be so open to all patients.</p> <p>"We lose money on our Medicaid patients," he says. "We just can’t sustain it anymore." In 2023, the practice dropped accepting one Medicaid plan. In 2024, the practice is taking even more drastic steps.</p> <p>“We are unfortunately going to limit the remaining Medicaid patients over age 18 to just one a day,” Dr. Kim says. “That means the first appointments are nine months out right now. We’ll see all the cancers and urgent things, but everyone else will have to wait or go to Seattle or Tacoma. It puts three highly productive surgeons out of the pool, and there aren’t that many ENTs in the state to begin with.”</p> <p>The toll the decision is taking on Dr. Kim is noticeable. “I feel terrible about this,” he says. “I’m losing sleep over it.”</p> <p>Dr. Kim is hardly alone in dealing with the pressures from low Medicaid reimbursement rates. Specialists in Washington are reeling from a reimbursement system that has remained unchanged for decades, even though the number of Medicaid patients in the state has nearly doubled. The low rates effectively penalize them financially for treating Medicaid patients.</p> <h3>Penalizing physicians for providing care</h3> <p>The result is that access to care for Medicaid patients is increasingly hard to come by. Moreover, the low rates are exacerbating other disturbing trends affecting the profession in Washington state, including problems in recruiting and the financial stability of practices.</p> <p>“It’s a systemic problem in terms of access and delivery,” says WSMA CEO Jennifer Hanscom. “We’ve seen devastating stories about the time it takes patients to get care and the unfortunate impacts on their health because people can’t get in for a timely visit. Additionally, the few independent practices we have left in our communities are shutting down or consolidating with larger systems, which in turn puts more pressure on the overall system by limiting competition and choice.”</p> <blockquote><span style="font-size: 18px;"> <strong><em>"Lots of specialists have closed their doors to patients due to rising costs and inflation in general. It costs them more to see the patients than they are reimbursed, so as a business model, it's not sustainable." —Anna McKeone, MD</em></strong></span> </blockquote> <p>To address this urgent need, the WSMA is making raising Medicaid reimbursement rates for all specialties a top legislative priority for the new year. The organization is proposing simply bringing the reimbursement rate for all professional services provided by physicians and physician assistants up to parity with Medicare, with an automatic inflationary increase to keep reimbursement at a more sustainable level.</p> <p>Washington state ranks among the worst in the nation for Medicaid reimbursement for specialists. On average, the state pays 57% of the Medicare rate. Only two other states— Rhode Island and New Jersey—pay lower rates.</p> <p>“Other states have made investments to make reimbursements competitive,” notes Chris Coates, CEO of TRA Medical Imaging in Tacoma. “If we were practicing medicine in the state of Idaho, right next door to us, you would see a remarkably different level of reimbursement.”</p> <p>“In my career at the WSMA, I’ve never known Medicaid reimbursement to increase on the specialty side, and I’ve been here over 25 years,” says Hanscom. The Washington State Legislature raised the reimbursement rate to the Medicare level for most primary care and pediatric professional services in 2021. But for specialists, the situation is dire.</p> <p>To take just one example, the Medicaid reimbursement rate for a kidney ultrasound read in 2012 was $21.78. By 2022, that figure had dropped to $20.39, a 6% drop.</p> <p>However, the actual decrease was much greater. Simply to keep up with the cost of inflation, the 2012 figure in today’s dollars would be $27.76 because costs rose by more than 27% over the 10-year period. In terms of constant dollars, the actual drop in reimbursement is more than 25%.</p> <p>“It’s a challenge,” says Jeffrey Frankel, MD, government affairs chair of the Washington State Urology Society. “They [lawmakers] don’t ask physicians how much it costs to see patients. They set the reimbursement based on their budget and not on the cost to physicians.”</p> <p>In some ways, Medicaid has been a success story for Washington. With the passage of the Affordable Care Act, the state was an early adopter of Medicaid expansion. The result was an explosion of coverage for people who previously didn’t have or couldn’t afford it. The number of people on Medicaid in Washington state ballooned from 1.2 million in 2012 to 2.1 million in 2023, an increase of more than 90%.</p> <h3>Worsening the financial squeeze on practices</h3> <p>The boom in Medicaid patients, coupled with the low reimbursement rate, puts a huge financial squeeze on specialists’ practices. “Medicaid is taking up a much more significant portion of the population,” says Dr. Kim. “Initially it was about 10% of patients. Now it’s about 25%. That’s wild to me.”</p> <p>For physicians, the financial pain caused by the low reimbursement rate conflicts with their vocation to help people.</p> <p>“We’re really in this business to take care of patients, but eventually the economic reality hits,” says Dr. Frankel. “Physicians don’t want to talk about money. We want to be altruistic.”</p> <p>Low Medicaid reimbursement has collided with other financial pressures on practices, accelerating troubling trends that were already in place. “When the state passed minimum wage increases and the [reimbursement] rates were frozen, you couldn’t continue to stay open,” says Dr. Frankel. “That’s why practices were being taken over by hospitals. It’s not like you can pass along your costs.”</p> <p>The result was that some physicians actually saw their compensation decline as they cut their own pay to handle higher overhead and low reimbursement. “We’re on average earning less,” says Dr. Kim.</p> <p>Anna McKeone, MD, an emergency physician with Olympia Emergency Services, says that she doesn’t blame the specialists for having to make the tough choice to limit Medicaid patients.</p> <p>“I know multiple specialists who provide excellent care to our community,” she notes. “To expect them to work at a negative to take care of patients is absolutely unreasonable. It was an ethical struggle for them to close their practices to patients, but it was financially unfeasible. I feel bad for them because they want to help people, but they can’t sustain a business model with that level of reimbursement.”</p> <h3>Driving up costs by limiting access</h3> <p>Dr. McKeone sees firsthand the impact that reducing access has on Medicaid patients. In a confounding twist to the supposed savings from low reimbursement, patients seeking access often turn to the most expensive venue for care: the emergency department. For many patients suffering from symptoms and unable to get an appointment with a specialist or with no specialists near them accepting Medicaid, the ED is the only option they feel they have.</p> <p>However, the ED is hardly a solution to the problem, notes Dr. McKeone. Cost is simply one issue. The other is continuity of care.</p> <p>“The biggest thing when we see patients with Medicaid that need follow-up with specialists is that we have very limited resources for them due to reimbursement,” she says. “Lots of specialists have closed their doors to patients due to rising costs and inflation in general. It costs them more to see the patients than they are reimbursed, so as a business model, it’s not sustainable.”</p> <p>The upshot, says Dr. McKeone, is that patients in Olympia must travel 60 miles for care. “People need to be transferred to Seattle, and it overburdens an already overburdened system just because there’s a local clinic that can’t see them,” she says. “It makes the entire system that much more dysfunctional and drives up costs.”</p> <p>Unfortunately, that burden is often too great for Medicaid patients. “Maybe they don’t have the luxury to take time off from work or they don’t have the means to get to these appointments,” says Hanscom. “Then when they figure out all those obstacles, they are told it’s a six-month wait to be seen. That’s not effective coverage.”</p> <blockquote><span style="font-size: 18px;"> <strong><em>"We definitely need a sense of urgency around this situation. I don’t think the public has an appreciation of how tenuous some of the situation is in health care." —Douglas Seiler, MD</em></strong></span> </blockquote> <p>Indeed, Medicaid patients often have greater needs than patients covered by commercial insurance, which makes the low reimbursement rate even more challenging. “They are medically complex and socially complex patients,” says Dr. McKeone. “They often need mental health resources. There’s so little to provide, it’s disheartening.”</p> <h3>Exacerbating physician and staff shortages</h3> <p>One ripple effect of the low reimbursement rate is that it makes physician recruitment that much harder. “When we’re trying to hire a new emergency physician, our reimbursements are lower, so our compensation is lower, which makes it harder to recruit,” says Dr. McKeone.</p> <p>“The state of Washington is becoming less attractive for independent physicians, and a big part of that is Medicaid reimbursement,” says Douglas Seiler, MD, a radiologist who is president of TRA. “The economics are stacked against us. It’s not really different for any other physician specialists.”</p> <p>For radiologists in Washington, there is ample incentive to keep working—for another state. “We can do a lot of our work remotely,” says Dr. Seiler. “I can take a job with another group in another part of the country with vastly different reimbursement and not leave my house.”</p> <p>It’s not just physician recruitment that is affected because of low reimbursement. Coates says that at the Carol Milgard Breast Center in Tacoma, which TRA manages, technologists as well as physicians are in short supply because systems that rely upon commercial payers can offer better wages.</p> <p>“We’ve lost a lot of staff to Kaiser,” he says. “Now we’re booking the next available exams out into July. There are women who are going to have to wait a little longer [for screenings] who potentially have cancer.”</p> <h3>The urgent need for a fix</h3> <p>Given all the problems caused by the Medicaid reimbursement rate, asking legislators to fix the problem is critical. “We definitely need a sense of urgency around this situation,” says Dr. Seiler. “I don’t think the public has an appreciation of how tenuous some of the situation is in health care.”</p> <p>The legislative proposal that the WSMA is making a priority would provide much-needed relief for specialists. “It’s not as if we’re asking for anything exceptional,” says Hanscom. “We are simply trying to cover some of the costs of providing care to those who have Medicaid coverage.”</p> <p>“Our proposal is a more comprehensive approach,” says Hanscom. “We’ve clearly articulated the business case and now we’re gathering the patient stories to amplify the need to do something now. I believe we have people who are sympathetic with what we have to say. The legislators who voted to expand Medicaid want to honor their commitment.”</p> <p>Still, even if legislators understand the need to fix the problem, doing so won’t be easy. For one thing, to address legislators’ financial concerns, WSMA’s proposal doesn’t rely upon the state’s general fund, the way past changes to Medicaid reimbursement have. Instead, the proposal introduces a new tax on covered lives in the state that will be levied on insurance carriers, primarily Medicaid managed care organizations but also commercial payers, that will likely meet resistance from the carrier community.</p> <p>Hanscom acknowledges that the covered lives tax will draw opposition from health plans. However, she also notes that the plans are in many ways already bearing the cost of low Medicaid reimbursement.</p> <p>“They are already in a way being taxed when you think about how practices and physicians are having to make up the difference through their commercial payer contracts,” she points out.</p> <p>The change in reimbursement rates would make a big difference. “I can almost promise you that if Medicaid rates go to Medicare rates, we will open up our panel again to Medicaid and get Medicaid patients in,” says Dr. Kim.</p> <p>In the meantime, Dr. Kim hopes that legislators understand that specialists have reached a breaking point.</p> <p>“I want to make it clear to legislators that they are really hurting their constituents by paying well below sustainable rates for services,” he says. “They’re counting on community doctors to absorb the hit. We have this strong desire to help people, even if it hurts us financially, until we absolutely cannot do it anymore. That’s why I feel so terrible. I want to serve the community.”</p> <p><em>John Gallagher </em><em>is a freelancer specializing in health care.</em></p> <p> <em>This article was featured in the January/February 2024 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>1/18/2024 1:45:07 AM1/1/0001 12:00:00 AM
2024-legislative-session-update-the-2024-legislative-session-has-begun2024 Legislative Session Update: The 2024 Legislative Session Has BegunLatest_NewsShared_Content/News/Latest_News/2024/2024-legislative-session-update-the-2024-legislative-session-has-begun<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href=""><img src="/images/Newsletters/latest-news/2024/january/Leg-Update-Video-2-1-22-24.png" alt="WSMA Legislative Update: Week of Jan. 15, 2024" /></a> </div> <h5>January 22, 2024</h5> <h2>2024 Legislative Session Update: Bringing Our Plan to Increase Medicaid Rates to the Legislature</h2> <p>WSMA's Director of Government Affairs Sean Graham talks about one of our top legislative priorities that we'll address at this Wednesday's 2024 <a href="[@]wsma/events/wsma_legislative_summit/legislative_summit.aspx">WSMA Legislative Summit</a>: Increasing Medicaid reimbursement rates. <a href="">Watch the video</a>. </p> <p>Online registration for the Legislative Summit is now closed, but walk-in registration is also welcome. The event begins at 8:15 a.m. in the Columbia Room at the Washington state Capitol building.</p> <p> </p> </div>1/15/2024 12:00:00 AM1/1/0001 12:00:00 AM
2024-washington-state-legislative-session-in-brief-week-12024 Washington State Legislative Session in Brief: Week 1Latest_NewsShared_Content/News/Membership_Memo/2024/january-12/2024-washington-state-legislative-session-in-brief-week-1<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/january/ls-2018-01-245-straightened-645x425px.jpg" class="pull-right" alt="Washington capitol building" /></div> <h5>January 12, 2024</h5> <h2>2024 Washington State Legislative Session in Brief: Week 1</h2> <p>The 2024 legislative session began on Monday, Jan. 8. Our state's Legislature runs on a two-year cycle, with 2024 being a "short" 60-day session. That means work will move at a fast pace as there will be around 3,000 bills in play and eligible for consideration by the time the gavel drops adjourning session on March 7.</p> <p>The first few weeks of session will focus on public hearings of bills in policy committees. One notable bill that was heard during this first week of session is House Bill 2041, regarding physician assistant collaborative practice. The bill is the product of extensive negotiation between the WSMA and the Washington Academy of Physician Assistants, working at the direction of Rep. Marcus Riccelli (D-Spokane), the chair of the House Health Care and Wellness Committee. The bill preserves physician supervision of PAs who are entering practice and switching specialties. In other circumstances, PAs may work in collaboration with physicians. The WSMA testified as neutral on the bill, citing our negotiations on the bill and an interest in balancing patient safety with promoting the employability of PAs.</p> <h3>Staying engaged and up to date during session</h3> <p>We know you're busy, so the WSMA will provide only brief updates on our priority bills in the Membership Memo during session and will notify you via email with action alerts on urgent matters that need your engagement. For members wanting more frequent and detailed updates on our session advocacy, subscribe to the weekly WSMA Outreach & Advocacy Report by emailing Chelsea Thumberg at <a href=""></a>.</p> <h3>Important session dates</h3> <ul> <li>Monday, Jan. 8: First day of session</li> <li>Wednesday, Jan. 24: <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/legislative_summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">WSMA Legislative Summit</a> - Free registration is available!</li> <li>Wednesday, Jan. 31: Policy committee cutoff</li> <li>Monday, Feb. 5: Fiscal committee cutoff</li> <li>Tuesday, Feb. 13: House of origin cutoff</li> <li>Wednesday, Feb. 21: Policy committee cutoff - opposite house</li> <li>Monday, Feb. 26: Fiscal committee cutoff - opposite house</li> <li>Friday, March 1: Opposite house cutoff</li> <li>Thursday, March 7: Last day of session</li> </ul> </div>1/12/2024 12:00:00 AM1/1/0001 12:00:00 AM
new-prior-authorization-time-frames-in-effect-in-washington-stateNew Prior Authorization Time Frames in Effect in Washington StateLatest_NewsShared_Content/News/Membership_Memo/2024/january-12/new-prior-authorization-time-frames-in-effect-in-washington-state<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/january/administrative-burden-645x425px.jpg" class="pull-right" alt="administrative burden graphic" /></div> <h5>January 12, 2024</h5> <h2>New Prior Authorization Time Frames in Effect in Washington State</h2> <p>New insurance carrier requirements for prior authorization time frames went into effect Jan. 1, 2024 as a result of WSMA-championed <a href="">House Bill 1357</a> from the 2023 legislative session. With new requirements in effect, the WSMA has updated its <a href="">Prior Authorization Navigator</a> to ensure our members reap the full benefit of our advocacy work and that they understand the new reforms contained in HB 1357 and recent related rulemaking.</p> <h3>Shorter turnaround times </h3> <p>Effective Jan. 1, time frames for both electronic and nonelectronic requests and standard and expedited requests have been shortened to ensure timely patient access to care. Visit the Prior Authorization Navigator for a rundown of the shortened turnaround times for prior authorizations for both health care services (look under <a href="">Administrative Requirements</a>) and <a href="">prescription drugs</a>.</p> <h3>To come in 2026-27: EHR integration</h3> <p>New interoperability standards, which take effect in 2026 for health care services and 2027 for prescription drugs, will require insurers and third-party administrators to create application programming interfaces or interoperable electronic processes that will connect to a physician's electronic health record system to enable a streamlined process for submitting requests and reduce administrative burden. Thanks to WSMA's leadership, Washington is the first state in the nation to require carriers to receive prior authorization requests via physician practice EHR.</p> <h3>About the Prior Authorization Navigator</h3> <p>The WSMA originally introduced its Prior Authorization Navigator in 2018 as a mobile-friendly "one-stop shop" for guidance on existing and new state prior authorization requirements. Newly updated and reformatted, the WSMA urges all health care professionals who find themselves engaged in prior authorization processes to use the Prior Authorization Navigator at <a href=""></a> to review the new and existing state prior authorization requirements.</p> <p>With any questions on prior authorization or the Prior Authorization Navigator, do not hesitate to contact WSMA's policy team at <a href=""></a>.</p> </div>1/12/2024 12:00:00 AM1/1/0001 12:00:00 AM
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