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

Weekly Rounds

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


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weekly-rounds-may-19-2023-meeting-the-challenge-of-improving-access-to-physician-servicesWeekly Rounds: May 19, 2023 - Meeting the Challenge of Improving Access to Physician ServiceWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-may-19-2023-meeting-the-challenge-of-improving-access-to-physician-services<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>May 19, 2023</h5> <h2>Meeting the Challenge of Improving Access to Physician Services</h2> <p>Jennifer Hanscom, CEO</p> <p> In case you missed it: </p> <ul> <li><a href="">WA hospitals close labor and delivery units, raising fears for new parents</a></li> <li><a href="">Obstetrics canary in coal mine</a></li> <li><a href="">Confluence Health cuts COO role</a></li> <li><a href="">Tacoma hospital's latest issue: 'Anesthesia doctors have been leaving for several months'</a></li> </ul> <p> These headlines are just the latest from recent media reports that demonstrate the growing need for investments in health care. Cutting costs alone will not fix this problem, at least not in the short term. The WSMA has been focused in several areas to improve access to physician services in Washington state: This past legislative session, we were successful in getting additional dollars for Medicaid professional services (although more must be done) and we made <a href="[@]Shared_Content/News/Weekly_Rounds/2023/weekly-rounds-may-5-2023-progress-on-improving-prior-authorizations?_zs=B3aFd1&_zl=HVU19">improvements to the prior authorization process</a>. Additionally, Washington lawmakers appropriated dollars toward residency programs, loan repayment for health care professionals, and public health. However, while all of these investments are appreciated, they aren't enough to stem the tide of continuing workforce shortages, growing expenses, and the unfortunate situation of patients losing access to critical services in their local communities. </p> <p> Over the legislative interim, the WSMA will continue to strategize on solutions we can put into action to both ensure access to affordable care and that our members are paid appropriately for their services and their time spent on patient care, rather than on inefficient processes. </p> <p> While we will be working with our members to shape and drive our success, I thought I would also ask the A.I. community for some ideas. Here's what ChatGPT had to say when I asked, "Got any ideas for improving access to physicians in Washington state?": </p> <p> "Improving access to physicians in Washington state can be a multifaceted challenge, but there are several potential strategies that could help enhance access to health care services. Here are some ideas: </p> <ol> <li>Telemedicine expansion: Promote and expand telemedicine services to allow patients to remotely consult with physicians. This approach can help overcome geographical barriers and improve access for individuals in rural or underserved areas.</li> <li>Incentives for rural practice: Implement programs that offer financial incentives or loan forgiveness for physicians who choose to practice in rural or underserved areas. This approach can help attract health care professionals to regions with limited access to medical services.</li> <li>Increase medical school capacity: Expand the capacity of medical schools in the state to train and graduate more physicians. By increasing the number of medical students and residency positions, Washington can address the physician shortage and improve access to health care services.</li> <li>Enhanced scope of practice for non-physicians: Review and consider expanding the scope of practice for nurse practitioners, physician assistants, and other non-physician practitioners. Allowing these professionals to practice to the full extent of their training and capabilities can help meet the increasing demand for primary care.</li> <li>Collaborative care models: Develop and promote collaborative care models that involve interdisciplinary teams of health care professionals. This approach encourages shared responsibilities, with physicians focusing on complex cases while other health care practitioners handle routine and preventive care. This can help optimize physician resources and improve access to care.</li> <li>Streamline licensing and credentialing: Simplify the licensing and credentialing processes for physicians, especially those trained out of state or internationally. Reducing bureaucratic barriers can expedite the entry of qualified physicians into the workforce and increase access to care.</li> <li>Community health centers: Invest in and expand community health centers, particularly in underserved areas. These centers often provide comprehensive primary care services, including preventive care, chronic disease management, and mental health services, improving access for vulnerable populations.</li> <li>Health information technology: Invest in robust health information technology infrastructure, including electronic health records and health information exchanges. Seamless sharing of patient information across health care settings can improve coordination and continuity of care, making it easier for physicians to provide timely and efficient services.</li> <li>Public health initiatives: Implement public health initiatives focused on preventive care, health education, and disease management. By promoting healthier lifestyles and preventing diseases, the demand for physician services may decrease, enabling physicians to dedicate more time to complex cases.</li> <li>Physician workforce planning: Conduct comprehensive physician workforce planning to identify areas of need and develop targeted recruitment and retention strategies. This approach ensures a balanced distribution of physicians across the state, addressing access disparities."</li> </ol> <p> Well done, ChatGPT. With the exception of No. 4, these strategies align with WSMA's advocacy agenda in recent years and encapsulate many of our successes (see numbers 1, 2, 3, 5, 7, 8, and 9). </p> <p> The WSMA continues to grapple with No. 4 and remains committed to using teams to their fullest potential. Our stated policy, however, is clear that absent commensurate education and training requirements to ensure patient safety and a demonstrable and compelling societal need, the WSMA opposes efforts of non-physician practitioners to expand the scope of their practice to include additional services currently performed by physicians. </p> <p> During this interim, the WSMA will be working on No. 10, with a particular focus on workforce in the outpatient ambulatory community. We'll work with physician leaders, the Washington State Medical Group Management Association, and other experts on workforce issues to put forward solutions to improve access to care and physician services in communities throughout Washington. </p> <p> Speaking of solutions, we continue to be vexed by decreasing <a href="[@]wsma/advocacy/legislative_regulatory/issue-briefs/medicaid-professional-services-rate-increase.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&_zs=B3aFd1&_zl=IVU19">Medicaid</a> and <a href="[@]Shared_Content/News/Membership_Memo/2023/may-12/wsma-urges-washingtons-congressional-delegation-to-support-medicare-payment-reform?_zs=B3aFd1&_zl=KVU19">Medicare</a> payments. While not addressed by ChatGPT, we remain committed to improving payment via these public programs. We continue our efforts at both the state and federal levels to draw attention to the need to pay physicians adequately to ensure patients have access to care in their communities. </p> <p> At the closing of my inquiry with ChatGPT, the program noted: </p> <p> "Collaboration between policymakers, health care organizations, and communities is crucial for successful implementation." </p> <p> Agreed! Together, no matter how tired the message may seem, we need to continue to advocate for change if we are to make Washington the best place to practice medicine and receive care. </p> </div>5/19/2023 10:17:38 AM5/19/2023 10:16:58 AM5/19/2023 12:00:00 AM
weekly-rounds-may-5-2023-progress-on-improving-prior-authorizationsWeekly Rounds: May 5, 2023 - Progress on Improving Prior AuthorizationsWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-may-5-2023-progress-on-improving-prior-authorizations<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>May 5, 2023</h5> <h2>Progress on Improving Prior Authorizations</h2> <p>Jennifer Hanscom, CEO</p> <p>When the WSMA surveys our members on the most pressing advocacy issues we face, reforming prior authorization almost invariably is at the top of the list. It's easy to see why-prior authorization can delay care for patients, increase administrative burden and costs for physicians, and divert scarce health care workforce from care delivery.</p> <p>The reforms contained in <a href="">House Bill 1357</a>, which passed the House and Senate unanimously during the 2023 state legislative session, will help establish Washington state as a leader in prior authorization reform. The bill expedites turnaround times for determinations and mandates the implementation of electronic prior authorization processes that integrate into electronic health records, which has been proven to reduce administrative burden. And importantly, the bill applies as broadly as possible on the state level - to all state-regulated health plans and not only to health care services, but also to prescription drugs.</p> <p>I'd like to take a moment to thank the following WSMA members who joined our prior authorization task force last summer to develop legislation for the 2023 session:</p> <ul> <li>Katina Rue, DO</li> <li>Carrie Horwitch, MD</li> <li>Garrett Jeffery, DO</li> <li>Nathan Schlicher, MD, JD</li> <li>Rodney Anderson, MD</li> </ul> <p>Task force members drew from their own firsthand experiences, as well as from insights shared at the WSMA Annual Meetings and policy changes on prior authorization proposed by Teresa Girolami, MD; Hal Quinn, MD; Jeffrey Frankel, MD; and the King County Medical Society via the resolution process. Through this highly member-driven process, HB 1357 was drafted, and Rep. Tarra Simmons (D-Bremerton) signed on as the prime sponsor of the bill.</p> <p>As history often shows, the legislative process demands patience and tempered expectations. This year was no exception with the Centers for Medicare and Medicaid Services releasing a <a href="">draft prior authorization rule</a> on the eve of the state legislative session.</p> <p>Undeterred by the federal announcement, WSMA's government affairs team worked with Rep. Simmons to amend HB 1357 to build on the CMS rulemaking, expediting the implementation of integrated prior authorization requirements for health care services (to take effect in 2025, rather than 2026 as proposed by CMS) and extending the requirements to prescription drugs beginning in 2027.</p> <p>Passing both the House and the Senate unanimously and now awaiting Gov. Jay Inslee's signature, the new law will go into effect Jan. 1, 2024 for all state-regulated health plans across health care services and prescription drugs. The bill applies the following timelines for prior authorization determinations:</p> <ul> <li>For prior authorizations submitted through electronic processes such as web portals: <ul> <li>One calendar day for expedited requests</li> <li>Three calendar days for standard requests (excluding holidays)</li> </ul> </li> <li>For prior authorizations submitted through non-electronic processes such as faxes: <ul> <li>Two calendar days for expedited requests</li> <li>Five calendar days for standard requests</li> </ul> </li> </ul> <p>Throughout the recent legislative session, HB 1357 faced strong opposition from insurance carriers who argued that the bill would prove costly and the timelines proposed were overly aggressive. Legislative leaders such as Rep. Simmons, Rep. Marcus Riccelli (D-Spokane), and Rep. Joe Schmick (R-Colfax) convened negotiations and worked toward compromise. Support from patient groups and the hospital community was integral in maintaining momentum for the bill throughout the process. And to their credit, insurance carriers negotiated in good faith on a difficult issue and ultimately moved to neutral on the final bill.</p> <p>The WSMA will be actively engaged in the implementation of HB 1357, as well as in the associated rulemaking from CMS. There's more work to be done on the issue of prior authorization-this year's successes represent important steps forward, rather than the finish line. But we're proud of this work and deeply appreciative of the physician leaders who helped develop and advocate for House Bill 1357, and for the support of legislators such as Rep. Simmons who helped shepherd the bill through the legislative process.</p> </div>5/18/2023 10:31:55 AM5/5/2023 10:14:27 AM5/5/2023 12:00:00 AM
weekly-rounds-april-21-2023-make-a-difference-by-leading-and-serving-the-professionWeekly Rounds: April 21, 2023 - Make a Difference by Leading and Serving the ProfessionWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-april-21-2023-make-a-difference-by-leading-and-serving-the-profession<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>April 21, 2023</h5> <h2>Make a Difference by Leading and Serving the Profession</h2> <p>Jennifer Hanscom, CEO</p> <p> <em>Nominate yourself or a colleague by next Friday, April 28 </em></p> <p> Leadership is one of WSMA's strategic priorities-perhaps an obvious choice, as we strive to influence and shape the future of the medical profession. We've heard, loud and clear, from our members that leadership development is one aspect of our work that they highly value. That's another reason why we work hard to offer top-ranked educational opportunities to the medical community through our leadership courses and <a href="">Leadership Development Conference</a>. </p> <p> We're so committed to strong physician leadership that it's called out specifically in our motto: "Physician Driven, Patient Focused." With the ever-shifting landscape of health care, the unpredictable direction of regulation and policy, and the need to preserve the sanctity of the physician-patient relationship, we know that physicians must be directly involved in leadership to navigate a healthy way forward for patients and the profession. </p> <p> Another way to grow your leadership skills is to serve in a leadership position with the WSMA. We depend on your engagement so that we are equipped to represent your voice, and those of patients, as we seek to shape the future of health care in Washington state. Your voice, your leadership, and your service with the WSMA do make a difference. </p> <p> I am personally inviting you to consider stepping into WSMA leadership by nominating yourself or a colleague for consideration for a position on the WSMA board of trustees, executive committee, or as a delegate to the American Medical Association. </p> <p> More information about the desired qualifications, a roster of current board members, a nomination form, conflict of interest disclosure statement, and candidate information sheet <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&_zs=B3aFd1&_zl=fM4w8">are available here</a>. </p> <p> Here are a few more things to know about the nomination process: </p> <ul> <li>The WSMA Nominating Committee will meet in late May to prepare a slate of nominees.</li> <li>The slate will be presented to the House of Delegates during the 2023 WSMA Annual Meeting, scheduled for Sept. 23-24 at The Westin Bellevue (all are welcome to attend the meeting-save the dates).</li> <li>The deadline for nominations is next Friday, April 28, although additional nominations may be made from the floor of the House of Delegates.</li> <li>In considering yourself or colleagues for the board of trustees, consider whether you or they are: <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> </li> </ul> <p> It takes bold leadership and a strong sense of service to tackle the challenges facing the profession, your patients, and our communities. If you believe in our mission to provide strong physician leadership and advocacy to shape the future of medicine and advance quality of care for all Washingtonians, I hope you will consider this opportunity. </p> </div>5/18/2023 10:31:54 AM4/21/2023 2:55:51 PM4/21/2023 12:00:00 AM
weekly-rounds-april-7-2023-five-things-to-know-that-may-impact-your-practiceWeekly Rounds: April 7, 2023 - Five Things to Know That May Impact Your PracticeWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-april-7-2023-five-things-to-know-that-may-impact-your-practice<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>April 7, 2023</h5> <h2>Five Things to Know That May Impact Your Practice</h2> <p>Jennifer Hanscom, CEO</p> <p> With spring break in full swing, I'm away for a few days to visit my sons in California. Having this time with them, I'm reminded again of how important it is to take time to recharge, reconnect, and refresh. It's not often that we have the chance to take a break and learn, network, and socialize, while still enjoying our families and the great outdoors. The WSMA Leadership Development Conference, held on the shores of Lake Chelan, offers just that-it's a great opportunity for physicians, physician assistants, and practice staff from all over Washington state to gather, learn about trends in health care, and sharpen leadership skills while also having time to relax with family, friends, and all that a lakeside resort has to offer. </p> <p> I hope to see you at this year's conference on May 19-20. <a href="[@]wsma/events/ldc/leadership_development_conference.aspx?hkey=c7532c38-057a-4568-8a3c-078182469222&WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&_zs=B3aFd1&_zl=MEdu8">Learn more about the conference agenda and be sure to register today</a>. </p> <p> In other news, I wanted to give you a heads up about developments that may impact you and your patients. If we can answer any questions or provide more details, don't hesitate to reach out. </p> <h3>Cigna rereleases burdensome modifier 25 policy</h3> <p> Over the objections of state and federal medical associations, Cigna is rereleasing its policy to require the submission of medical records with all evaluation and management (E/M) claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed. The updated policy goes into effect on May 25. </p> <p> The WSMA is adding its objections to the chorus of opposition from state medical associations, specialty societies, and the American Medical Association. The policy, if it goes into effect, would add significant, unnecessary administrative burden and compliance costs to physician practices, disincentivize physicians from providing unscheduled services, and create duplicate requests. </p> <p> If you have questions or concerns, contact Cigna customer service at 800.882.4462 or contact WSMA Director of Policy Jeb Shepard at <a href=""></a>. </p> <h3>Help Ensure Medicaid patients stay covered with printable flyer for physician offices</h3> <p> If you see Apple Health clients in your practice, <a href="" target="_blank" rel="noreferrer">considering posting this printable flyer</a>, which urges patients to ensure their contact information is up to date so they can be contacted about the Medicaid coverage renewal process, in the following settings: </p> <ul> <li>Office waiting rooms</li> <li>Patient exam rooms</li> <li>Hallways or common walkways</li> <li>Restrooms</li> </ul> <p> The federal public health emergency is set to expire on May 11. The Washington State Health Care Authority and the Department of Social and Health Services resumed normal operations on April 1, meaning they will now begin redetermining all client eligibility for Apple Health coverage. </p> <p> Contact the WSMA's policy department at <a href=""></a> if you have any questions or concerns. </p> <h3>Narcan now easier to access, and what you need to know about MATE training</h3> <p> In late March, the U.S. Food and Drug Administration approved selling naloxone over the counter without a prescription. Narcan, the approved branded nasal spray that is the best-known form of naloxone, can reverse opioid overdoses and is expected to be available over the counter by late summer 2023. </p> <p> Additionally, new requirements for training for medication-assisted treatment as part of the Medication Access and Training Expansion (MATE) Act, passed as part of the Consolidated Appropriations Act of 2023, have been released. The MATE Act's training requirement, which is tied to initial registration or renewal with the Drug Enforcement Administration beginning on June 27, 2023, requires a total of at least eight hours of accredited continuing education on the treatment and management of patients with opioid or other substance use disorders. <a href="">The full guidance is available here</a>. </p> <h3>Physicians Insurance demystifies the litigation process in new webinar</h3> <p> Have you ever wondered what a trial looks like? How you and your care delivery would be represented? How your story would be told? Unfortunately, litigation is something that many physicians will face at some point in their careers. What that means and how that experience may play out are important to understand, as is the support you can expect from Physicians Insurance/MedChoice. </p> <p> As a benefit to the longstanding partnership between the WSMA and Physicians Insurance, WSMA members are exclusively invited to join PI's experts for this upcoming Trial Takeaways webinar on Thursday, April 20 from noon-1:30 p.m. During the 90-minute event, you will hear a formal statement of the facts surrounding a hypothetical, but common, medical negligence claim. Jeffrey Street and Tracy Hooper will present mock opening arguments from both the plaintiff and defense perspectives, followed by discussion and an in-depth look at the strategies, tools, and preparation that can help ensure a successful trial defense. <a href="">Register here</a>. </p> <h3>Urge your representative to oppose the optometrist scope of practice expansion bill</h3> <p> Senate Bill 5389, currently pending a vote in the state House of Representatives, proposes to expand the scope of practice for optometrists, allowing them to perform surgical procedures without sufficient education and training, and broadening their prescribing authority to include oral steroids and injections on and around the eye for the treatment of eye disease. It is essential that legislators hear from physicians and others who are opposed to the bill due to concerns about patient safety. </p> <p> Optometrists are valued members of the health care team and provide important services, such as assessing glasses and contact lens prescriptions, fitting lenses, evaluating and treating less complex and non-surgical eye disease, and adapting prosthetic eyes. However, their education and training does not prepare them for surgical procedures, which require the highest level of surgical precision and technical skills. Optometrists are not surgeons, and it is essential that they work within the scope of their training and experience to ensure patient safety. Please take a moment to <a href="">contact your representative today and urge their opposition to SB 5389</a>. </p> <p> As spring continues to emerge, I hope you'll find time for you and yours. And as always, thank you for your support of the WSMA. </p> </div>5/18/2023 10:31:54 AM4/7/2023 9:22:30 AM4/7/2023 12:00:00 AM
weekly-rounds-march-31-2023-olympia-update-budget-proposalsWeekly Rounds: March 31, 2023 - Olympia Update: What the Legislative Budget Proposals MeanWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-march-31-2023-olympia-update-budget-proposals<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-Sean-Graham-645x425px.jpg" class="pull-right" alt="Weekly Rounds logo" /></div> <h5>March 31, 2023</h5> <h2>Olympia Update: What the Legislative Budget Proposals Mean for Physicians</h2> <p> Sean Graham, WSMA Director of Government Affairs </p> <p> With less than a month remaining in the 2023 legislative session, lawmakers are turning their attention to budget negotiations. Against the backdrop of a <a href="" target="_blank" rel="noreferrer">recently released, relatively foreboding state revenue forecast</a>, majority party Democrats in the Senate and House of Representatives rolled out their 2023-25 operating budget proposals over the last week, each advocating to appropriate around $70 billion over the two-year cycle. </p> <p> In broad strokes, the two spending plans are similar. Both prioritize addressing climate change, behavioral health, education, and housing and homelessness. And neither relies on significant new or increased taxes, including no new taxes on the physician community. But there are hundreds of wrinkles between the two budgets that will need to be ironed out before a final agreement is reached and session adjourns on April 23. </p> <p> WSMA's top budget priority for the 2023 session is across-the-board Medicaid rate increases for "professional services" delivered by physicians, physician assistants, and other health care practitioners. Our ask is to bump up rates to at least the equivalent paid by Medicare and adjust to inflation moving forward. Important for ensuring access to care for patients, it's been years since the state made broad investments in physicians' Medicaid rates. </p> <p> The House budget proposes to increase rates for professional services by a total of $67.8 million (inclusive of federal matching funds), with rate increases going into effect July 1, 2024. This only partially funds our request but would represent a positive first step. The Senate failed to fund this ask in their budget. We are disappointed that neither budget fully funded the ask in the interest of supporting physicians who deliver services in the Medicaid program and the patients they serve. The WSMA will advocate for the inclusion of rate increases at least at the proposed House level in the final state budget. </p> <p> Both budget proposals do fund Medicaid rate increases in other contexts, most notably for hospitals. In the case of hospitals, nursing homes, and ambulances, those increases are funded through "safety net assessments," or taxes, which are levied against the relevant entities to leverage increased federal funds. By comparison, WSMA's ask for a professional services rate increases was from the state's general fund revenue. </p> <p> Another priority funding area for the WSMA in the 2023 session is health care workforce. State funding for physician residencies is maintained in both budgets, with each proposing $2 million in new spending for residencies. There's a distinction in approach between the two budgets, however, with the Senate increasing investments in the state's Family Medicine Residency Network housed at UW Medicine, and the House proposing to run the increased funding through the Elson S. Floyd College of Medicine at Washington State University, designating it for "rural" residencies. </p> <p> Both budgets invest around $20 million in loan repayment programs for health care professionals, though there are some differences in how the funds are appropriated. In addition to existing programs, the Senate proposes to create a new $1.4 million loan repayment program for forensic pathologists. Significant new investments are also proposed for the education and training of nurses and behavioral health professionals, as well as support for apprenticeships. </p> <p> Public health is another bright spot in legislative budget proposals. The House sets a high-water mark of $340 million for Foundational Public Health Services in the 2023-25 biennium, representing a continued prioritization of public health. Both budgets also increase appropriations to the Office of Firearm Safety and Violence Prevention. And both propose new investments to address the opioid epidemic, with the Senate proposing to spend $1.8 million on opioid education, including expanding the Better Prescribing, Better Treatment safe-prescribing initiative jointly run by the WSMA and the Washington State Hospital Association. </p> <p> In other areas of the budget, WSMA staff continue their review and work with legislators and legislative staff to understand the implications of funding proposals. An example is abortion care access, where both proposals make investments short of the level requested by abortion access advocates. Another area where more review is needed is around the differing approaches for funding health care coverage options for undocumented residents of the state. </p> <p> Looking beyond the conclusion of the 2023 session, it's clear that more work will be needed in support of fully funding the state's Medicaid program to ensure access to care for patients and fair reimbursement for physicians. We're disappointed that despite our collective advocacy, with hundreds of WSMA members engaging their legislators from across the state, our ask likely will not be fully funded this year. Legislative advocacy is often a long game, however, and the WSMA is committed to making this our top budget priority until its resolved. </p> </div>5/18/2023 10:31:55 AM3/31/2023 9:50:57 AM3/31/2023 12:00:00 AM
weekly-rounds-march-20-2023-remembering-tom-curryWeekly Rounds: March 20, 2023 - Remembering Tom Curry, Former WSMA CEOWeekly_RoundsShared_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>5/18/2023 10:31:54 AM3/23/2023 3:39:42 PM3/20/2023 12:00:00 AM
weekly-rounds-march-17-2023-five-ways-were-representing-our-membersWeekly Rounds: March 17, 2023 - Five Ways We're Representing Our MembersWeekly_RoundsShared_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&_zs=B3aFd1&_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&_zs=B3aFd1&_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="">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=""></a>. Hospitals or health systems should contact Melina Ovchiyan at <a href=""></a>. For questions, contact Monica Salgaonkar at 206.441.9762 or <a href=""></a>. </p> <h3>Education on health equity via "M&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&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&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&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&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=""></a>. As an alternative, the WSMA has created an <a href="">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&_zs=B3aFd1&_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&_zs=B3aFd1&_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=""></a>. </p> <p> Happy Friday and happy St. Patrick's Day! </p> </div>5/18/2023 10:31:54 AM3/17/2023 11:02:25 AM3/17/2023 12:00:00 AM
weekly-rounds-march-3-2023-five-things-to-know-this-weekWeekly Rounds: March 3, 2023 - Five Things to Know This WeekWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-march-3-2023-five-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>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=""></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="">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="" 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="" 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=""></a>. Hospitals or health systems should contact Melina Ovchiyan at <a href=""></a>. For questions, contact Monica Salgaonkar at 206.441.9762 or <a href=""></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&_zs=B3aFd1&_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="">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>5/18/2023 10:31:55 AM3/9/2023 9:26:31 AM3/3/2023 12:00:00 AM
weekly-rounds-february-17-2023-what-the-end-of-the-federal-public-health-emergency-meansWeekly Rounds: February 17, 2023 - What the End of the Federal Public Health Emergency MeansWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-february-17-2023-what-the-end-of-the-federal-public-health-emergency-means<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 17, 2023</h5> <h2>What the End of the Federal Public Health Emergency Means for Health Care</h2> <p>Jennifer Hanscom, CEO</p> <p> With his public health emergency declaration in January 2020, then-Secretary of the U.S. Department of Health and Human Services Alex Azar responded to a novel coronavirus outbreak that was soon to be identified as SARS-CoV-2. That moment launched the health care community and the nation into uncharted waters, as they sought to navigate the first documented coronavirus pandemic in history-one that tested the fortitude of us all. </p> <p> As the Biden administration announces the end of the federal public health emergency and national emergency declarations related to the COVID-19 pandemic on May 11, the news marks a shift in federal pandemic priorities-and new waters to navigate for those of us in health care. </p> <p> The federal emergency declarations in place since the start of the pandemic provided a broad range of health care flexibilities to mitigate the spread of the novel coronavirus and to ensure care for those sickened while maintaining virtual access to routine health services. Those flexibilities include waived telehealth regulations, expanded Medicaid enrollment, expedited licensing processes, liability protections for physicians and health professionals providing health services, and access to COVID-19 vaccines, tests, and treatment with no cost to individuals, regardless of insurance status. </p> <p> With federal officials having signaled the imminent end of the public health emergency throughout last year, organized medicine and the wider health care community have been preparing, focusing advocacy efforts on unwinding the many flexibilities in a way that minimizes disruptions to patient care while making permanent those flexibilities that have increased access to care or minimized administrative burden. The WSMA provided an <a href="[@]Shared_Content/News/Latest_News/2022/making_the_post_pandemic_transition?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&_zs=B3aFd1&_zl=l8Sp8">overview of what's at stake for physicians and patients and how physicians can prepare</a> in the July/August 2022 issue of <em>WSMA Reports</em>. </p> <p> In recognition of <a href="" target="_blank" rel="noreferrer">organized medicine's advocacy</a>, the <a href="" target="_blank" rel="noreferrer">omnibus spending package</a> passed by Congress in December 2022 extended through the end of 2024 the COVID-19 Medicare telehealth flexibilities made possible under the public health emergency. These flexibilities include many cited by WSMA members as helping their practice expand access to these important services: </p> <ul> <li>Temporary suspension of the geographic site requirement.</li> <li>Allowing the home as an eligible originating site.</li> <li>Allowing entities such as FQHCs and RHCs to continue to be eligible telehealth providers.</li> <li>Removing facility fees for patients receiving telemedicine services in their homes.</li> <li>Delaying the in-person visit requirement before a patient may be eligible for telemental health services.</li> <li>Allowing the continued use of audio-only telehealth services. </li> </ul> <p> Another key flexibility under the public health emergency, enhanced Medicaid coverage, was also addressed in the omnibus spending legislation in a provision ending the enhanced federal funding for the program on April 1, 2023, with exceptions. The Washington Health Care Authority will send patients covered under the program <a href="">a renewal notice prior to the end of their renewal period sometime over the next 12 months</a>, based on a client's renewal date. Physicians, physician assistants, and nonphysician health care professionals can play a vital role in making sure these vulnerable patients continue to receive the services they need by encouraging their patients to keep their <a href="">Apple Health contact information up to date</a> and to read any notices they receive from the HCA or the Centers for Medicare & Medicaid Services. To help spread the word, CMS offers a Medicaid and CHIP Continuous Enrollment Unwinding Toolkit (<a href="" target="_blank" rel="noreferrer">here in English</a> and <a href="" target="_blank" rel="noreferrer">here in Spanish</a>) for partners and stakeholders that may have contact with people with Medicaid insurance. </p> <p> For a broader look at the flexibilities impacted by the ending of the public health emergency, including access to COVID-19 tests, vaccines, and treatments, see <a href="">these</a> <a href="">stories</a> from Kaiser Health News. </p> <p> Throughout the public health emergency, the physician community did not flinch when the spotlight turned their way. Following their oath and their calling, physicians championed the health and safety of their patients, even when it meant putting their own at risk. So, too, did organized medicine respond, by advocating for policies to support the physician and patient communities in a time of crisis. As the spotlight now fades, we are engaged in a new phase of policy support for our profession as it continues to deal with the long tail of the pandemic. Through it all, we continue our work on behalf of the profession and our patients. That does not change, even if circumstances do. Thank you for all you do. </p> </div>5/18/2023 10:31:54 AM2/17/2023 10:53:01 AM2/17/2023 12:00:00 AM
weekly-rounds-february-3-2023-building-community-and-cultivating-leadersWeekly Rounds: February 3, 2023 - Building Community and Cultivating LeadersWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-february-3-2023-building-community-and-cultivating-leaders<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 3, 2023</h5> <h2>Building Community and Cultivating Leaders</h2> <p> Soon after I write this, I'll be headed to Olympia to attend the WSMA's annual Legislative Summit-finally back in person after two years of virtual gatherings. While our virtual sessions were well-received, remote gatherings are a pale substitute for in-person meetings when it comes to building community. And building community is behind all we do at the WSMA-our leadership in advocacy, professional development, and efforts toward inclusiveness and equity all depend upon a strong foundation of community. </p> <p> And speaking of leadership, I want to flag for you the many opportunities the WSMA is offering in 2023 to further your leadership development. If community is the backbone of our work, physician leadership is its eyes and ears-health care advocacy, both in the policy and clinical arenas, depends upon physicians stepping into leadership roles to ensure health care remains patient-focused and physician-driven. </p> <p> Take a moment to review the following opportunities. Registration is open for all of these 2023 dates, so act now to reserve your spot. I hope to see you at one or more of these sessions! </p> <h3>Physician Leadership Course - March 3-May 12, 2023</h3> <p> The WSMA Physician Leadership Course is our basic "boot camp" to familiarize physicians and physician assistants with the four important components of health care leadership: performance improvement, patient safety, and high reliability; leadership and management of individuals, teams, and organizations; planning and finance; and creating and maintaining a personal leadership development plan. </p> <p> The 11-week hybrid-distance course combines face-to-face and online learning to enable participants to begin developing and honing their leadership skills at their convenience. Only three in-person classes are required: March 3-4 and May 12 at the Silver Cloud Broadway Hotel in Seattle. The remainder of the course is conducted online. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. <a href="[@]wsma/education/physician_leadership/physician_leadership_course/wsma/physician_leadership/physician_leadership_course/physician_leadership_course.aspx?hkey=efdc4ad1-ff20-4089-ab51-caafbe73572b&_zs=B3aFd1&_zl=aX2o8">Enroll online</a>. </p> <h3>Leadership Development Conference - May 19-20, 2023</h3> <p> Our annual WSMA Leadership Development Conference will be held in person this May in Chelan. Our theme this year is leading transformational change-an appropriate theme for a profession still reeling from the disruptions of a pandemic and its social upheavals. This conference is for all physicians and physician assistants (teams are welcome, as well), regardless of where you are on your leadership journey, your specialty, or your practice setting. Join us this May on the shores of Lake Chelan and find out for yourself why this conference is one of our most popular events. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. <a href="[@]wsma/events/leadership_development_conference/wsma/events/ldc/leadership_development_conference.aspx?hkey=c7532c38-057a-4568-8a3c-078182469222&_zs=B3aFd1&_zl=bX2o8">Register online</a>. </p> <h3>Physician Leadership Course (fall dates) - Sept. 8-Nov. 17, 2023</h3> <p> The WSMA is pleased to announce a second Physician Leadership Course in 2023 for those physicians and physician assistants unable to enroll in the spring course. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. <a href="[@]wsma/education/physician_leadership/physician_leadership_course/wsma/physician_leadership/physician_leadership_course/physician_leadership_course.aspx?hkey=efdc4ad1-ff20-4089-ab51-caafbe73572b&_zs=B3aFd1&_zl=aX2o8">Enroll for the fall course online</a>. </p> <h3>Dyad Leadership Course - Sept. 29-Oct. 27, 2023</h3> <p> A month-long hybrid-distance course with three live educational workshop days, the WSMA Dyad Leadership Course is intended for physicians and their administrative dyad partners who wish to improve team function and achieve greater operational success within their clinical system. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. <a href="[@]wsma/education/physician_leadership/dyad_leadership_course/wsma/physician_leadership/dyad_leadership_course/dyad_leadership_course.aspx?hkey=f6387317-48e4-44f1-b623-4b00fcba57ab&_zs=B3aFd1&_zl=cX2o8">Enroll online</a>. </p> <h3>Leadership Masterclass - Oct. 5-7, 2023</h3> <p> The WSMA Leadership Masterclass is an intensive three-day adaptive-learning course that examines the complex challenges faced by seasoned physician leaders and provides the tools necessary to solve them. This course will provide additional growth opportunities for physicians who have completed our Physician Leadership Course and have moved on to middle levels of management in their facilities. This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. <a href="[@]wsma/education/physician_leadership/leadership_masterclass/wsma/physician_leadership/leadership_masterclass/leadership_masterclass.aspx?hkey=b3ffc0a4-6cad-4a06-98aa-6e1a5e1e64b2&_zs=B3aFd1&_zl=dX2o8">Enroll online</a>. </p> <p> Thank you for your membership and your strong commitment to medicine in Washington state. Together we are making Washington the best place to practice medicine and receive care. </p> </div>5/18/2023 10:31:54 AM2/6/2023 11:12:49 AM2/3/2023 12:00:00 AM
Weekly_rounds_january_20_2023_new_washington_practitioner_application_supports_physician_wellnessWeekly Rounds: January 20, 2023 - New Washington Practitioner Application Supports Physician WellnesWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/Weekly_rounds_january_20_2023_new_washington_practitioner_application_supports_physician_wellness<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>January 20, 2023</h5> <h2>Updated Washington Practitioner Application Supports Physician Well-Being</h2> <p>Jennifer Hanscom, CEO</p> <p>Last summer, the Physicians Foundation conducted a survey of physicians that focused on physicians' well-being and solutions needed to improve wellness. The survey called out that nearly four in 10 physicians were afraid or knew another physician who was fearful of seeking mental health care given questions asked in medical licensure and credentialing insurance applications.</p> <p>Thankfully, the Washington Medical Commission had the foresight to understand this barrier to wellness that medical licensing applications were creating. As a result, the commission updated language on the initial licensure application and renewal applications so that applicants no longer have to disclose mental health or substance use disorder information due to the new "safe haven" provisions. This happened in 2018 and was hailed as a vast improvement, as well as a meaningful and practical change toward eliminating barriers to wellness.</p> <p>But the work didn't stop there. Earlier this month, a newly streamlined <a href="">Washington Practitioner Application</a> was released, with changes reflecting input from the physician community that will decrease barriers to seeking help.</p> <p>The WPA is a standardized application that is accepted by most physician organizations, hospitals, and health plans and throughout the state. Changes to the application include:</p> <ul> <li>Updated attestation question regarding a practitioner's physical and mental health conditions. After years of discussions and input from numerous organizations, the credentialing standardization committee overseeing the form revisions settled on a more streamlined question that still meets regulatory agency requirements to inquire about a practitioner's mental health status.</li> <li>A new section that asks for contact details for the monitoring program the practitioner is enrolled in but does not ask for any details around the condition or circumstances that led to being admitted into the monitoring program or the practitioner's current status with the monitoring program. This ensures that no practitioner's protected health information ends up on the WPA.</li> </ul> <p>The WSMA gives special thanks to Washington Physicians Health Program Executive Medical Director Chris Bundy, MD, a strong physician advocate who helped provide guidance to both the Washington Medical Commission and the credentialing standardization committee. These combined changes represent significant progress in decreasing barriers to help-seeking for physicians and physician assistants in our state and furthers WSMA's vision to make Washington the best place to practice medicine and receive care.</p> </div>1/20/2023 9:44:19 AM1/20/2023 9:31:31 AM1/20/2023 12:00:00 AM
weekly-rounds-january-6-2023-a-new-year-a-new-chance-to-address-prior-authorizationWeekly Rounds: January 6, 2023 - A New Year, a New Chance to Address Prior AuthorizationWeekly_RoundsShared_Content/News/Weekly_Rounds/2023/weekly-rounds-january-6-2023-a-new-year-a-new-chance-to-address-prior-authorization<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>January 6, 2023</h5> <h2>A New Year, a New Chance to Address Prior Authorization</h2> <p>Jennifer Hanscom, CEO</p> <p> Happy New Year! </p> <p> As I settled back to work after a two-week vacation, I saw the latest issue of WSMA Reports on my desk. The front cover certainly grabs your attention; no doubt the topic of prior authorization had many of you opening the issue to see just what the WSMA can do to address this burdensome barrier to care. </p> <p> "You can't fix what you don't measure," the old adage goes. Along those lines, in 2020 the WSMA successfully advocated for legislation requiring the state Office of the Insurance Commissioner to release an annual report on insurance carriers' prior authorization practices, with the first report due in 2021. In that first report, the OIC found there were numerous codes that were approved 100% of the time. In fact, of the 469 codes reported by carriers, 352 (or 75%) of the codes were approved 100% of the time. Widely used codes for colonoscopies and psychotherapy were approved 99% of the time. </p> <p> The 2021 report also showed that mental health and substance use disorder (MH-SUD) code requests faired poorer against medical surgical code requests (med-surg). Carriers reported a lower number of requests, approval rates, and response times for MH-SUD-related codes. Response times averaged around 174 hours for both inpatient and outpatient MH-SUD, compared to an average of 118 hours for inpatient and outpatient med-surg codes. </p> <p> Fast forward to the <a href="" target="_blank" rel="noreferrer">OIC's year-end 2022 report</a> just submitted to the Legislature on the eve of the 2023 legislative session, which shows the prevalence of prior authorization has continued to increase significantly in several areas. </p> <p> Comprising 2021 claims data from 14 of the state's largest health insurance carriers, the OIC report outlines prior authorization practices across a number of service categories. "Highlights" of the 2022 report include:</p> <ul> <li>For the codes where it's applied most often, carriers' usage of prior authorization increased substantially between 2020 and 2021, in some cases doubling. Among the codes where prior authorization is most frequently required, the average approval rate was 93.45%.</li> <li>Prior authorization for numerous codes was approved 100% of the time. Of the 486 distinct codes included in carriers' reporting, 416 (86%) were approved 100% of the time.</li> <li>As noted in the 2021 report, carriers' reported response times for prior authorization requests varies considerably by the type of service at issue, with determinations for mental and behavioral health services taking much longer than other services. This runs contrary to the state's mental health parity law, which generally requires comparable insurance coverage for mental and behavioral health services.</li> </ul> <p> The report findings track with the experiences of WSMA members, who regularly rate frustration with prior authorization as their top priority for advocacy. </p> <p> Thankfully the WSMA has a champion on this issue in Rep. Tarra Simmons (D-Bremerton). The WSMA will be working with Rep. Simmons to bring forward legislation in the 2023 session to address issues associated with prior authorization, including limiting its utilization where it's approved at exceedingly high rates and standardizing requirements across insurance carriers. </p> <p> The 2023 session is set to convene on Jan. 9 and is expected to run to April 23. </p> <p> In the January/February issue of <em>WSMA Reports</em>, you'll read more about the WSMA's work in Olympia and the issues we will be engaged on. If you'd like more regular updates, be sure to subscribe to WSMA's Outreach and Advocacy Report, which is emailed to subscribers every Friday throughout the session (to subscribe, simply email Alex Wehinger at <a href=""></a>). We will of course keep you updated via our other communications channels. And for those of you who want to engage d irectly in our advocacy work, join us Feb. 3 in Olympia for the WSMA Legislative Summit. You can <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5&_zs=B3aFd1&_zl=scDl8">register here</a>.</p> </div>5/18/2023 10:31:54 AM1/6/2023 9:53:01 AM1/6/2023 12:00:00 AM
weekly-rounds-december-16-2022-all-hands-on-deck-on-physician-paymentWeekly Rounds: December 16, 2022 - All Hands on Deck on Physician PaymentWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-december-16-2022-all-hands-on-deck-on-physician-payment<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>December 16, 2022</h5> <h2>All Hands on Deck on Physician Payment</h2> <p>Jennifer Hanscom, CEO</p> <p> The annual ritual of stopping Medicare cuts is once again upon us. </p> <p> It's frustrating that we find ourselves in that position once again, yet the good news is there appears to be energy at the federal level to reform the program in the coming year. In the meantime, however, it is extremely important that you take time out of your day and urge your local congressional representative to stop the year-end cuts from going into effect. If Congress fails to act, physician Medicare payments are scheduled to be cut by 4.5% on Jan. 1. Cuts of this magnitude would severely impede patient access to care by forcing many physician practices to close and thereby putting further strain on those that remained open during the pandemic. </p> <p> <a href="" class="TextButton">Send your message today</a> </p> <p> The WSMA is also urging all of medicine here in Washington to join us in advocating for the state to increase Medicaid payments for all physicians. </p> <p> What that means is that in addition to you <a href="[@]wsma/advocacy/physician_advocacy/scheduling-a-meeting.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&_zs=B3aFd1&_zl=UV3k8">reaching out to your local legislators</a> to urge their support, we also need specialty societies, county medical societies, and medical groups to join the effort as well. </p> <p> Our ask is for the final 2023-2025 biennium budget to include $134 million of state general fund dollars to increase Medicaid rates for all specialties to approximate the rates paid by Medicare, adjusting to inflation moving forward. This investment will leverage a more than 2:1 federal match equating to an overall investment of $423 million for physician services. </p> <p> What many legislators may not know is that through the course of the pandemic, Medicaid enrollment has increased by around 400,000, bringing total state enrollment to over 2.2 million. This means that almost 30% of our state's residents are now enrolled in Medicaid. </p> <p> At the same time Washington is among the states with the lowest Medicaid rates, particularly for specialty health care services where we rank <a href=",%22sort%22:%22desc%22%7D">near the bottom</a> (47th), and is in the <a href=",%22sort%22:%22desc%22%7D">bottom quartile of states</a> in federal allocation for Medicaid funding. Physicians treating Medicaid patients do so at a financial loss-reimbursement rates for most specialty Medicaid services, for example, are 43% lower than Medicare rates, which are intended to cover the cost of providing care. </p> <p> <a href="">Studies show</a> that raising Medicaid reimbursement rates is the most effective method of increasing physician participation in Medicaid networks. Prioritizing a broad-based Medicaid reimbursement rate increase will improve access to care for Washingtonians by expanding physician participation in Medicaid networks at a time when it is desperately needed and long overdue. </p> <p> This effort will require all hands on deck. As the WSMA <a href="[@]Shared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship?_zs=B3aFd1&_zl=dV3k8">recently reported</a>, physician practices across the state are grappling with the economic hardship caused by workforce shortages and inflation. Your participation to help head off Medicare reimbursement cuts and increase Medicaid rates is critical to our success in ensuring access to care for our state's patients. <a href="[@]wsma/advocacy/take_action/wsma/advocacy/take_action/take_action.aspx?hkey=3598752c-64f4-4866-a95a-7610f4e1dd25&_zs=B3aFd1&_zl=fV3k8">The WSMA has resources available for you to use as you reach out to your local legislators in advance of the 2023 session</a>. </p> </div>12/19/2022 2:18:45 PM12/19/2022 2:18:20 PM12/16/2022 12:00:00 AM
weekly-rounds-12-2-22-help-make-medicine-a-career-option-for-othersWeekly Rounds: December 2, 2022 - Help Make Medicine A Career Option for OthersWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-12-2-22-help-make-medicine-a-career-option-for-others<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>December 2, 2022</h5> <h2>Help Make Medicine A Career Option for Others</h2> <p>Jennifer Hanscom, CEO</p> <p> Please consider the <a href="">WSMA Foundation Scholarship and Diversity Advancement Fund</a> in your 2022 year-end giving. By giving today, you can help change the face of medicine in Washington state. </p> <p> With your support, students like Abigael, Brian, and Timothy can make their dreams a reality. </p> <p> As a Kenyan immigrant, Abigael Mbaluka came to the U.S. as a young girl with her mother and sister. New country, new culture, and a whole new, foreign world. She knew financial resources would be the key to realizing her dream of becoming a physician. </p> <p> Brian Cedeño's career path seemed destined to follow that of his father's-working construction. But a long list of Latino physician mentors showed him-and helped him believe-that becoming a physician was possible. </p> <p> And for Chukwuma "Timothy" Iwuoha, growing up as the youngest of seven children being raised by their single mom, going to college seemed well out of reach. But scholarships made the difference. </p> <p> These three young people are medical students in Washington state today. The scholarships that helped them get there have been life-changing. "There's power in supporting students financially as they strive to be the change they want to see in this world," says Timothy. "You are helping make their dreams of serving the community and improving health care outcomes for all become a reality." </p> <p> Abigael, Brian, and Timothy are taking their places within the medical community. Scholarships helped them achieve that, and you can be part of making that happen for other students as well. Your gift will make medical school a reality for students from underrepresented populations. This is an investment in the future of our profession. Won't you join me in ensuring a diverse future for medicine by donating today? </p> <p> Our goal with the WSMA Foundation Scholarship and Diversity Advancement Fund is to cover full in-state tuition for four years of medical school for the scholarship recipient. We plan to raise $2 million to award the first scholarship, with our ultimate fundraising goal of $5 million to award three scholarships (ideally to each of Washington's medical schools). </p> <p> You can take advantage of year-end giving tax deductions by donating today. <a href="">Click here to donate</a>, or to pay by check, please make it payable to: <strong>WSMA Foundation</strong> and mail the check to: <strong>WSMA Foundation, 2001 Sixth Avenue, Suite 2700, Seattle, WA 98121</strong>. </p> </div>12/16/2022 9:20:05 AM12/16/2022 9:10:48 AM12/2/2022 12:00:00 AM
weekly-rounds-november-18-2022-thankful-for-youWeekly Rounds: November 18, 2022 - Thankful for YOUWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-november-18-2022-thankful-for-you<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>November 18, 2022</h5> <h2>Thankful for YOU</h2> <p>Jennifer Hanscom, CEO</p> <p> With a frosty chill in the air, golden leaves piling up on the sidewalks, and Thanksgiving plans in the works, my thoughts turn to gratitude. </p> <p> You are at the top of my "grateful for" list. Your involvement and engagement with the WSMA make a real difference-for the profession, for your patients, and for your colleagues. We are stronger and better because of you. </p> <p> I hope you feel appreciated, cared for, and supported during this Thanksgiving season. In my book, not all superheroes wear capes. The ones I know wear white coats! </p> <p> Thanks for all you do. Here's wishing you a Happy Thanksgiving. </p> </div>11/18/2022 9:06:04 AM11/18/2022 9:04:20 AM11/18/2022 12:00:00 AM
weekly-rounds-november-4-2022-five-things-to-know-before-year-endWeekly Rounds: November 4, 2022 - Five Things to Know Before Year-EndWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-november-4-2022-five-things-to-know-before-year-end<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>November 4, 2022</h5> <h2>Five Things to Know Before Year-End</h2> <p>Jennifer Hanscom, CEO</p> <p> Halloween, fall colors, chilly temps, shorter days...all point toward the holidays and a new year just around the corner. I'm sure, like mine, your days are getting busier and busier as we close in on 2023. But before we say farewell to 2022, here are five action items that may potentially affect you, so have a quick look below. </p> <h3>Help is available when disaster strikes</h3> <p> We're all breathing a little easier-quite literally-as right now there are no active fires in the state. We know that most of the state suffered from poor air quality throughout the past two months, and some medical practices may have suffered damage because of the earlier fires. </p> <p> I wanted to be sure you know about the AMA Foundation's new Disaster Relief Program that assists practices in FEMA-declared disasters. Washington was recently designated as such due to the recent fires. </p> <p> If your practice or community was impacted the fires or by any other declared disaster, you may benefit from the AMA program, which: </p> <ul> <li>helps individuals impacted by the disaster with medically related aid: medications, emergency first-aid stations, provision of other essential medical supplies, etc.; and/or</li> <li>assists physicians to rebuild practices in the impacted area.</li> </ul> <p> Of course, we hope this is never the case for our practices and communities, but should the need arise, be sure to reach out to the WSMA, who can put in a request on your behalf to the AMA Foundation. </p> <h3>Scholarship to increase physician diversity</h3> <p> We continue to incorporate equity efforts across all of WSMA's work, including the launch of a new <a href="">Scholarship and Diversity Advancement Fund</a> through the WSMA Foundation for Health Care Improvement. Our goal with this fund is to help build a more diverse physician population in Washington state by supporting students who are underrepresented in medicine. We know this is ambitious, but we are committed to changing the face of medicine in Washington state and creating a physician community that mirrors our patient population. </p> <p> Our goal with the fund is to cover full in-state tuition for four years of medical school for the scholarship recipient. We intend to raise $2 million to award the first scholarship, with a further goal to raise $5 million to award three scholarships (ideally, one for each of Washington's medical schools). </p> <p> Won't you join us in this fundraising effort? There are approximately 20,000 licensed physicians in Washington state. If every physician gave $250 to this endowment, we would meet our goal and could start issuing scholarships in the new year. The success of this effort depends upon your generosity and year-end giving is a great way to build a legacy. Donate now and get an additional tax deduction! <a href="">Donate online today</a>. </p> <h3>Take action on two pressing physician priorities</h3> <p> Don't miss these two federal action alerts in play that need your attention: One to <a href="">prevent a nearly 10% cut in Medicare payments in 2023</a> and one that will hold big insurance companies accountable by <a href="">requiring Medicare Advantage plans to adopt transparent prior authorization programs</a>. In both instances, there are promising bipartisan bills on the table-the Supporting Medicare Providers Act (H.R. 8800) and The Improving Seniors' Timely Access to Care Act (S. 3018)-but lawmakers in the Senate and House must hear from more physicians and physician assistant constituents to ensure their passage. Click on the links above to learn more about these action alerts and send your messages today. </p> <h3>Work accomplished and priorities ahead</h3> <p> WSMA's work on your behalf never ceases. We've summarized that work in our 2022 Impact Report, which will be in the mail to you soon. I hope you'll take a moment to look at that snapshot of our efforts and celebrate the major accomplishments in 2022. Our work is powered by you and your membership, so the successes you'll see outlined in the report are a testament to our member physicians and physician assistants who engage through the WSMA to make meaningful change in health care policy and the quality of care in our state. </p> <p> With the 2023 state legislative session beginning in January, we need you with us to maintain our momentum. This session we intend to continue our focus on increasing Medicaid rates for all specialties, standardizing and streamlining prior authorization, supporting legislation that benefits the health of our patients and our communities, and opposing efforts that interfere with the physician-patient relationship. </p> <p> Your membership drives the work we do. Thank you for your ongoing support of the WSMA as a new year of advocacy begins. You can <a href="[@]join-renew?_zs=B3aFd1&_zl=2fCg8">pay your 2023 dues online</a> today. We offer an easy autopay (monthly or yearly) option that you can choose at checkout. Also, remember that many of your medical groups cover WSMA membership. Be sure to check with your medical staff office or practice leadership about getting your WSMA dues reimbursed. Email <a href=""></a> for personal assistance. </p> <h3>Get informed and vote Nov. 8</h3> <p> Ensuring that the physician community's voice is heard in Olympia and Washington, D.C. starts at the ballot box. So, next Tuesday, Nov. 8, we strongly urge you to make your voice heard and vote. All 10 of the state's congressional House seats and more than 120 state legislative seats are up for grabs in key races that will shape the future of health care policy in Washington state. </p> <p> Before you cast your vote, take a moment to download the latest version of the <a href="[@]wsma/advocacy/wampac/wampac_legislator_report_card/wsma/advocacy/wampac/wampac_legislator_report_card.aspx?hkey=11823ee2-e48a-4214-af1a-fcad1da9d502&_zs=B3aFd1&_zl=3fCg8">WAMPAC Legislator Report Card</a> (sign-in required) so you can see how your legislators aligned with WSMA's priorities in the past couple of years. </p> <p> Speaking of WAMPAC, your financial support helps raise up the concerns of the house of medicine in our state. There is still time to join the <a href="[@]WSMA/Advocacy/WAMPAC/Give_to_WAMPAC.aspx?_zs=B3aFd1&_zl=4fCg8">WAMPAC Diamond Club</a> at a special rate of $100 for the duration of the membership cycle, culminating in November's election. Diamond Club members receive access to exclusive insider information about elections. And as a bonus, you'll receive a first-of-its-kind membership pin to recognize your contribution to WAMPAC. </p> <p> We believe physician leadership is paramount to good health care policy and patient care. Your voice and engagement make the difference. Thanks for all you do! </p> </div>11/4/2022 11:44:51 AM11/4/2022 11:29:23 AM11/4/2022 12:00:00 AM
weekly-rounds-october-21-2022-new-physicians-insurance-endorsement-reflects-changing-medicalWeekly Rounds: October 21, 2022 - New Physicians Insurance Endorsement Reflects Changing MedWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-october-21-2022-new-physicians-insurance-endorsement-reflects-changing-medical<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>October 21, 2022</h5> <h2>New Physicians Insurance Endorsement Reflects Changing Medical Liability Landscape</h2> <p>Jennifer Hanscom, CEO</p> <p> Co-authored by Physicians Insurance CEO Bill Cotter </p> <p> The medical community held its collective breath during the trial of RaDonda Vaught, a nurse at Vanderbilt University Medical Center who was found guilty of criminal charges of gross neglect and negligent homicide for administering the wrong medication to a patient-a medical error that led to the patient's death. The case was highly publicized, in part due to the unusual decision to pursue criminal charges in a case where there was no demonstrable malicious intent or impairment. For many in health care the case represents a worrying turn of events for medicine-the criminalization of medical practice. </p> <p> A judge once said "Doctors would not be able to save lives if they were to tremble with the fear of facing criminal prosecution." Indeed, since the Institute of Medicine's landmark 1999 report "To Err is Human" brought a sharp focus on medical errors, the emphasis has been less on punishment and more on learning from mistakes-a paradigm which encourages transparency and quality improvement. </p> <p> Today, physicians and hospitals are operating in an extremely stressful and pressure-filled environment; one that is made even more difficult as they now navigate the legal ramifications of increased criminal medical negligence claims as seen in the Vanderbilt case, the potential for criminal state claims arising out of the U.S. Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, and the subsequent state criminalization of health care practices that have long been the professionally accepted standard of care. </p> <p> Witnessing the change, our homegrown medical liability company, Physicians Insurance A Mutual Company, staying true to its mission of protecting and defending its members, has announced the launch of new <a href="">criminal defense reimbursement coverage</a>. The new coverage allows for support for defense costs incurred when a physician or hospital is responding to a criminal allegation arising from patient care. </p> <p> While medical professional liability policies have historically excluded coverage for criminal actions, Physicians Insurance's new coverage reflects its commitment to protecting and defending health care professionals as they pursue their life's work practicing quality medicine. </p> <p> The new coverage expressly responds to reimburse defense costs up to $250,000 (without eroding limits of main policy) when criminal actions arise from direct patient care. We believe this first-of-its-kind coverage will better support physicians and hospitals amongst today's changing professional liability trends and recent changes in law creating circumstances where physicians and health care professionals may face criminal liability for doing their jobs. </p> <p> This is not about protecting criminals or criminal behavior as defined by law. If an individual is found guilty and has exhausted their appeal rights on the issue of guilt, further reimbursement will not be made, and Physicians Insurance will retain the right to recover funds already paid. </p> <p> The new criminal defense reimbursement coverage supplements any other coverages purchased under the medical professional liability or hospital liability policy. A civil suit and a criminal proceeding are handled separately, following different procedural rules and proceedings, even if both arise out of the same set of facts. The coverage limits available under the underlying policy will remain available for the civil liability suit, and the separate limits under the criminal defense reimbursement will remain available for the criminal proceeding. Health care disciplinary board coverage will also remain available under the underlying policy. </p> <p> It is unfortunate that we find ourselves in a time when such coverage is needed. But this concerning shift in the medical legal community, accusations of criminal actions that come from providing direct patient care, including performing abortions, must not go unnoticed. We fear that this shift to criminalize patient care could have repercussions on the treatment and care physicians provide. </p> <p> *If you are insured by Physicians Insurance, this new coverage will be automatically added to your renewal starting Jan. 1, 2023, unless you opt out. To learn more, go to <a href=""></a>. </p> </div>10/21/2022 11:04:43 AM10/21/2022 11:04:10 AM10/21/2022 12:00:00 AM
weekly-rounds-october-4-2022---caring-community-and-cowsWeekly Rounds: October 4, 2022 - Caring, Community, and CowsWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-october-4-2022---caring-community-and-cows<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-katina-rue-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div> <h5>October 4, 2022</h5> <h2>Caring, Community, and Cows</h2> <p> Katina Rue, DO, FAAFP, FACOFP, WSMA President </p> <p> <em>Dr. Katina Rue shares the lessons she's applying to her presidency in her inaugural address on Sunday, Oct. 2, 2022.</em> </p> <p> It's great to be with you here in Spokane for the opening session of our 2022 meeting of the House of Delegates. Were you all up early this morning reading the reference committee reports? I know I was! </p> <p> As your new president, there are a few things you should know about me. Like you-like each of us-I'm different! </p> <p> Here are a few ways I'm different: Most of you here are MDs. Well, I'm a DO and to the best of our knowledge, I'm likely the first DO to be president of the WSMA! Let's see a raise of hands from any other DOs represented here today! </p> <p> I'm Latina and quite possibly the first Latina to be WSMA president. Who's here who identifies Latinx? Raise your hands! </p> <p> Also, I'm a farm girl. I live in an old stone house on five acres near Yakima with my husband, Aureliano, our daughter, Valeria, a bunch of cows, an occasional sheep, and loads of fruit trees. Let's see it: Anyone else out there live on a farm? </p> <p> Even with these differences, I know we have plenty in common as well: We're all passionate about quality care for our patients, about staying well ourselves so that we can care for others, and about being called to medicine as a profession. And like you, I suffered-and survived-my way through the pandemic and all of its fallout. </p> <p> There were hard moments along the way-some devastating, some inspiring. I'm sure you can identify: Seeing communities of color disproportionately affected by COVID. Seeing physicians, PAs, and staff lead with service above self. Seeing neighbors, friends, and families divided over issues big and small. Seeing colleagues help each other find a healthy path forward, with mind, body, heart, and soul intact. </p> <p> Getting through it all for me meant that I had an opportunity to learn new skills, grow into leadership and face my fears. I've even learned to embrace all that. I mean, I'm standing up here, aren't I? Public speaking has never been on my bucket list! And so, here I am, and I want to share three of lessons that I believe can make a difference in our year together. </p> <p> The first is summed up in a line from a poem by Mary Oliver: "Listen-are you breathing just a little, and calling it a life?" </p> <p> Take a second and hear that line again: "Listen-are you breathing just a little, and calling it a life?" </p> <p> Those words really hit me hard, because in early 2021, it dawned on me that I was only "breathing just a little" and I was calling it a life. I realized I had to take action. I quit my job and took the whole summer off to regroup and refocus my career. The pandemic had worn me down. Stress was taking its toll. I was burned out big time. I knew I needed to reenergize my soul, my life, and my work. I took time to enjoy our farm-the cows, bees, and trees-and my family. Being at the farm with my family feeds my soul-it was just what the doctor ordered. </p> <p> As I reflect on the pandemic years, I know many of you have faced-or are facing-burnout. Maybe you're even feeling like I did-that you're "breathing just a little." Our schedules are packed, time with patients too limited, prior authorizations weigh us down, the hours are too long. More than that, we face external pressures from administration, government, insurance carriers, and regulatory entities-all of which steal time from patient care. </p> <p> And yet, we persevere. We show up to bring health and healing to our patients. We make a difference. </p> <p> Are you "breathing just a little and calling it a life"? You're not alone. I encourage you to reach out and let us know how we can help. I want you to know that everything we do at the WSMA drives toward supporting and advocating for you. We are dedicated to strengthening physician wellness and restoring the joy of practice. Ours is a caring profession-it only makes sense to care for ourselves to ensure we are well enough to care for others. </p> <p> Second, I've learned that TEAM means that "Together Everyone Achieves More." </p> <p> That's a quote from Robert Rohm, who is known for his work on the DISC personality insights training. I've participated in DISC at work and learned a few things about myself. Everyone has a combination of these traits, of course. I'm a "D-I" which means I'm direct and an "influencer." These traits mean that I'm quick to respond, I'm comfortable making decisions in order to move forward, and I can be charming at the same time. As it turns out, I can also be blunt and a control freak-I'm working on all that! </p> <p> Through all this leadership development work, I've been reminded that the leader doesn't have to take everything on themselves. I've learned to better delegate, and to inspire and trust the people around me. A work in progress, for sure! </p> <p> Still, I've learned that together, everyone achieves more. I find that to be true in organized medicine as well. I believe in getting engaged in our profession and in having physicians lead the way in health care. If we don't lead, others will step in to fill the gap. </p> <p> When I was in medical school, I saw my mentors-both faculty and community physicians-modeling involvement in their state osteopathic and allopathic medical associations. I stepped into organized medicine partly because I saw them doing it. And when I came to Washington, it was a natural progression to get involved in the WSMA. I wanted to be part of that passion and commitment to communities, patients, and medicine that I had been part of in Missouri. </p> <p> You're all here today because you care about organized medicine, and you see that it makes a difference. Later this morning, you'll be voting on important policies that will guide the work of the WSMA. But guess what? We don't just do this work here during the Annual Meeting. We are busy doing this work all year long! I'm inviting you to get engaged and help lead the way. Together we are stronger and there is strength in numbers. I encourage you to step up and step into the action. </p> <p> Which brings me to the third thing I've learned: Live like someone left the gate open! </p> <p> I did tell you I'm a farm girl! I'm also obsessed with cows. Who knows why, but I've been crazy about cows ever since middle school in Sequim. No one in my family had cows, but still I was all about cows, cows, cows. Holsteins, Jerseys, Guernseys, Herefords, Highlanders, Dutch Belted, and Charolais…I love them all. Today, we have five cows on our farm. And just so you know, yes, we do name them, and no, we don't eat them! </p> <p> Farm livin' definitely takes a village. We help our neighbors, and they help us. Just over a month ago, Nano and I were out in the pasture helping our heifer, Estrella, birth her calf. Usually cows give birth with ease, but Estrella was having a very hard time getting baby Luna to come out. We had to call for help from our neighbor, who came running. </p> <p> There we all were: mama cow, Nano, the neighbor, and me, literally up to my shoulder inside Estrella. The calf's head was stuck. With some perineal massage, gentle pressure, and two strong men, we were able to pull baby Luna after 60 minutes! Today, mama Estrella is still struggling to gain weight (she's been having postpartum complications) and baby Luna is growing up quite nicely. </p> <p> What does my cow story have to do with anything? Well, it's just that I've learned so much from my cows and my farm and my community. </p> <p> I started this speech talking about the ways in which I'm different. Throughout my life, those differences sometimes felt limiting-as though an electric fence might zap me if I stepped out of my lane. I know others who've felt the same way-women like Astrid Strasik, a fourth year Latina medical student who is not able to be here today, but is making a difference as part of the Medical Student Section! </p> <p> She wrote an article in the latest WSMA Reports-in part, here's what she wrote: "As a Latina walking into a space historically occupied by predominantly white male faces, I am frequently overwrought by feelings of inadequacy. I await the moment I am 'outed' as an imposter, even as I stand in my white coat in the hallways of the hospital." </p> <p> I so identify with her feelings of potentially being "outed as an imposter!" But at the same time, I know this: Diversity is beautiful. Diversity is the art of thinking independently together. </p> <p> I am proud of the work the WSMA is doing right now to ensure that all member voices are heard, as well as our commitment to health equity and eliminating disparities in health care. Already that work is yielding tangible change. Here are just a couple of tangible examples: </p> <ul> <li>This year, WSMA President Mika Sinanan implemented a DEI committee, which has ensured diverse voices are at the table. As you review the resolutions today before the House, you will find we have added a DEI note to every resolution, so that we can consider how the policies we set might affect underrepresented communities.</li> <li>An engaged group of WSMA members joined together to create a Latinx Advisory Council and we hope to add more interest groups soon.</li> <li>The WSMA Foundation added health equity to its strategic plan, and as heard yesterday, has implemented a significant scholarship fund for diverse medical students.</li> </ul> <p> We're excited about all of this, even as we know there is so much more to be done. We're also realistic, recognizing that real change takes time and intention. Even so, the WSMA is committed to working on beautiful diversity for the long haul. </p> <p> Did you notice the song playing when we first came into the room this morning? It's called "<a href="">There's Room at the Table</a>," by a folk singer named Carrie Newcomer. The repeating lyric is "there's room at the table for everyone!" I know this to be true. My cows taught me that we need the village around us. And rather than being fenced in, we need to shake off those limitations and take off running. </p> <p> Let's live like someone left the gate open! </p> <p> Thank you! </p> </div>10/4/2022 10:39:19 AM10/4/2022 10:34:38 AM10/4/2022 12:00:00 AM
weekly-rounds-september-30-2022-words-matter-when-seeking-clarity-in-communicationsWeekly Rounds: September 30, 2022 - Words Matter When Seeking Clarity in CommunicationsWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-september-30-2022-words-matter-when-seeking-clarity-in-communications<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>September 30, 2022</h5> <h2> Words Matter When Seeking Clarity in Communications </h2> <p>Jennifer Hanscom, CEO</p> <p> Accuracy in communication is something we all strive toward but may occasionally fail at achieving. That could be due to how the information is delivered or how it's received. I'm sure, like me, you've had conversations that went along the lines of: "That's not what I meant." And the corresponding reply: "Well, that's what I heard." </p> <p> Words matter. And for physicians, the word "provider" has been vexing for some time, and now seems to be gaining an ever-expanding foothold in health care communications. How many of you have been referred to lately as "Provider Smith" rather than "Dr. Smith"? </p> <p> I realize the growing use of the term is being used as shorthand within health care to encompass various types of medical professionals and facilities with just one simple word. But nothing in health care is simple, including lumping all medical professionals and institutions into a singular term that obscures the qualifications and training levels for the people providing care. In some ways, the simplicity of that term is disrespectful of the long years and effort invested by those who are physicians. </p> <p> At the WSMA, we believe using the term "provider" can lead to misunderstanding and potentially misguided decisions by patients and medical professionals. As per WSMA policy passed and recently reaffirmed by the WSMA House of Delegates-representing most physicians, specialties, and county medical societies in Washington state-the <a href="[@]WSMA/About/Policies/Whats_Our_Policy/Physician_Practice/Providers_Use_Of_The_Term.aspx?_zs=B3aFd1&_zl=lFac8">WSMA does not use the term "provider" to describe a physician</a>. Additionally, as the result of <a href="[@]WSMA/About/Policies/Whats_Our_Policy/Physician_Practice/refer_to_all_medical_professionals_by_their_titles.aspx?_zs=B3aFd1&_zl=nFac8">policy adopted by the WSMA House of Delegates in 2021</a>, the WSMA is highlighting concerns related to inappropriately using one title, such as "provider," to group all medical professionals together. </p> <p> We are not alone in this preference. The American Medical Association has taken <a href="" target="_blank" rel="noreferrer">strong</a> <a href="">positions</a> against this broad usage of "provider," and multiple national medical organizations, including the <a href="">American Academy of Family Physicians</a>, <a href="">American Academy of Emergency Medicine</a>, and <a href="">American College of Physicians</a>, all have position papers stating their opposition to the use of the term "provider." </p> <p> For clarity and to avoid confusion among licensed health care professions, the WSMA will specify individual professions: e.g., physicians, physician assistants, and nurse practitioners. Similarly, when "provider" is used to denote health care organizations, for clarity and to avoid confusion, the WSMA will specify organization types: e.g., hospitals, health care systems, and medical practices. </p> <p> We urge all organizations (including governmental entities) that utilize the term "provider" to instead describe physicians and practitioners by their proper professional titles as per the guidance above. </p> <p> We hope you will join us in this effort and urge your medical group or practice to do the same. <a href="[@]educationmatters?_zs=B3aFd1&_zl=5Gac8">Click here</a> to find more information and detailed guidance to help the public and industry partners better understand the education and training of physicians-the most highly skilled and trained of the health professions-and to explore the problematic issues with the term "provider." </p> <p> This may seem a small or benign concern, but we believe that clarity and transparency in communication can avoid confusion and avert potentially harmful errors. We hope you'll join us in this effort. </p> </div>9/30/2022 10:10:42 AM9/30/2022 10:08:52 AM9/30/2022 12:00:00 AM
weekly-rounds-september-16-2022-wsma-joins-class-action-suit-against-cignaWeekly Rounds: September 16, 2022 - WSMA Joins Class-Action Suit Against CignaWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-september-16-2022-wsma-joins-class-action-suit-against-cigna<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>September 16, 2022</h5> <h2>WSMA Joins Class-Action Suit Against Cigna</h2> <p>Jennifer Hanscom, CEO</p> <p><strong>You are Our Priority...and Our Specialty</strong></p> <p>Physician driven, patient focused. Those four words are the essence of the WSMA-they describe what we do and who we are in a nutshell. I wrote about one aspect of what that phrase means in this space recently. But there are many ways in which that expression guides our work, including calling us to defend and support you by participating in lawsuits and amicus briefs that argue a physician-centric perspective and protect your relationship with your patients.</p> <p>Earlier this year, that meant that we participated in an amicus brief in which we successfully challenged the independent dispute resolution provisions of the federal No Surprises Act, and locally, a brief that reestablished the difference between medical malpractice and informed consent.</p> <p>Very recently, that also meant that your WSMA joined the American Medical Association and the Medical Society of New Jersey as additional plaintiffs in a class-action lawsuit brought forward by three patients against Cigna, one of the country's largest health insurers.</p> <p>The lawsuit documents several instances in which Cigna made misrepresentations to its insureds and to physicians about the money patients owed their physicians for services and Cigna's failure to reimburse physicians at the rates provided in their MultiPlan Network contracts. Among the plaintiffs are a Washington state patient and physician.</p> <p>Given the number of MultiPlan contracts-with some 1.2 million physicians and health care professionals nationwide-it's likely that many of WSMA's members may have a direct and meaningful financial stake in the outcome of this case. Further, this case is broadly important to physicians because it advocates for transparency about medical service payment pricing and pushes back against insurer communications to insureds that interfere with the patient-physician relationship.</p> <p>"Patients and physicians have a right to expect health insurers to uphold their promise to provide fair and accurate payment for medical services," said AMA President Jack Resneck Jr., MD. "But alleged misconduct by Cigna has allowed the insurer's economic self-interest to be prioritized ahead of their promises to physicians in the MultiPlan Network and their patients. The AMA and other physician organizations allege that Cigna's misconduct is riddled with conflicts of interest and manipulations that routinely shortchanged payments to MultiPlan Network physicians and interfered with the patient-physician relationship by ignoring the MultiPlan contracts and making incorrect statements to patients about their liability for the unpaid portion of the billed charges. By joining Stewart v. Cigna as a plaintiff, the AMA hopes to shed light on Cigna's misconduct and create remedies so that patients and physicians can look forward to getting what they are promised."</p> <p>We know that it is not fair for physicians when insurers do not honor their contracts. We joined this lawsuit because the WSMA is committed to fighting for your right to be paid fairly, to have your contracts honored, and to hold insurers accountable.</p> <p>That said, this will be a marathon, not a sprint. We anticipate this case will likely take a few years to be resolved.</p> <p>But, as always, we are in this for the long haul. We don't give up and we will press on when it comes to issues that plague physicians, the profession, and, most especially, your patients. We will continue to defend you so that your rights are protected, your practice or medical group remains financially stable, and you are not encumbered by undue administrative challenges that impact the care of your patients or your personal wellness.</p> <p>Our tagline is our pledge to you: physician driven, patient focused. YOU are our specialty.</p> </div>9/16/2022 10:23:51 AM9/16/2022 10:19:37 AM9/16/2022 12:00:00 AM
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