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action-alert-on-medicaid-reimbursementAction Alert on Medicaid ReimbursementLatest_NewsShared_Content/News/Membership_Memo/2023/january-27/action-alert-on-medicaid-reimbursement<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/megaphone-evergreen-645x425px.jpeg" class="pull-right" alt="megaphone illustration" /></div> <h5>January 27, 2023</h5> <h2>Action Alert on Medicaid Reimbursement</h2> <p>The WSMA is committed to focusing on the one of the biggest funding challenges faced by physicians and health care practitioners: Medicaid payment rates that do not come close to covering the cost of care and do not support access to care for the most vulnerable. During the 2023 legislative session now underway in Olympia, the WSMA is asking the Washington State Legislature to support an increase in Medicaid reimbursement rates for professional services to the equivalent paid by Medicare, adjusting to inflation moving forward. The estimated fiscal impact for the 2023-25 biennium is $200.4 million in state general funds, leveraging a more than 2-to-1 federal match for an overall investment of $634.8 million.</p> <p>This week, we sent an action alert to WSMA members to encourage grassroots advocacy on this issue. It's imperative that lawmakers hear directly from members of the physician community on how these funds will affect their ability to practice good medicine and provide patient care. If you haven't yet responded to the call to action, please take a moment to contact your legislators. <a href="https://www.votervoice.net/WSMA/Campaigns/99646/Respond">Visit the WSMA's new Action Center to send your message</a>.</p> </div>1/27/2023 12:00:00 AM1/1/0001 12:00:00 AM
hpv-vaccine-now-recommended-at-age-9HPV Vaccine Now Recommended at Age 9Latest_NewsShared_Content/News/Membership_Memo/2023/january-27/hpv-vaccine-now-recommended-at-age-9<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/istock-1296415706-645x425px.jpeg" class="pull-right" alt="Physician talking with masked patients" /></div> <h5>January 27, 2023</h5> <h2>HPV Vaccine Now Recommended at Age 9</h2> <p>The Washington State Immunization Information System updated its guidance, beginning Jan. 20, to reflect the recommendation to administer the human papillomavirus vaccine starting at age 9. This change signals an important step in increasing HPV vaccination coverage across the state of Washington, and follows recommendations by the American Cancer Society, American Academy of Pediatrics, Washington State Vaccine Advisory Committee, and the Washington State Department of Health.</p> <p>In preparation for this change, we encourage you and your office to create a plan and implement the structural changes needed within your organization to start vaccinating at age 9. <a href="https://doh.wa.gov/sites/default/files/2023-01/HPV%20Vaccine%20Forecast.pdf?uid=63cb06e042473">This guide</a> gives a visual representation of how this change is presented in the Washington State Immunization Information System. There are no major differences in the IIS from a user and technical perspective other than the age of the vaccine forecast has changed to 9. HPV vaccines do not need to be entered differently into the IIS than before this forecast update.</p> <p>To assist in efforts to implement changes needed to start routinely vaccinating at age nine, use the provided list of resources:</p> <ul> <li><a href="https://hpvroundtable.org/wp-content/uploads/2022/11/FINAL_NW-Summit-Clinic-Toolkit-Print-On-Demand-Kits.pdf" target="_blank" rel="noreferrer">Start At 9 Toolkit (hpvroundtable.org)</a></li> <li><a href="https://hpvroundtable.org/wp-content/uploads/2022/09/HPV_Roundtable-HPV_Why_Age_9_Sales_Sheet_WEB.pdf" target="_blank" rel="noreferrer">Why Age 9? Fact Sheet - National HPV Roundtable</a></li> <li><a href="https://hpvroundtable.org/action-guides/">Clinician & Health Systems Action Guides - National HPV Roundtable</a></li> <li><a href="https://doh.wa.gov/sites/default/files/2022-07/348-612-ProtectChildAgainstViruses-en-L_0.pdf?uid=62e71bb87bc1a">HPV At 9 (DOH)</a></li> <li><a href="https://doh.wa.gov/sites/default/files/legacy/Documents/Pubs/348-613-HPVVaccinationAlgorithm.pdf" target="_blank" rel="noreferrer">HPV Vaccination Algorithm (DOH)</a></li> <li><a href="https://www.cancer.org/content/dam/cancer-org/online-documents/en/pdf/flyers/hpv-vacs-just-the-facts-for-providers.pdf" target="_blank" rel="noreferrer">HPV Provider Fact Sheet (cancer.org)</a></li> <li><a href="https://publications.aap.org/aapnews/news/14942/Why-AAP-recommends-initiating-HPV-vaccination-as?searchresult=1">Why AAP recommends initiating HPV vaccination as early as age 9 | American Academy of Pediatrics</a></li> </ul> </div>1/27/2023 12:00:00 AM1/1/0001 12:00:00 AM
session-update-public-hearings-on-abortion-access-and-prior-authorization-this-weekSession Update: Public Hearings on Abortion Access and Prior Authorization This WeekLatest_NewsShared_Content/News/Membership_Memo/2023/january-27/session-update-public-hearings-on-abortion-access-and-prior-authorization-this-week<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/2023-legislative-session-updates-645x425px.png" class="pull-right" alt="2023 Legislative Session Updates logo" /></div> <h5>January 27, 2023</h5> <h2>Session Update: Public Hearings on Abortion Access and Prior Authorization This Week </h2> <p>Proposed bills on two key WSMA legislative priorities - establishing abortion and reproductive care protections and standardizing prior authorization practices - received public hearings this week as state lawmakers closed out week three of the 105-day legislative session.</p> <h3>Access to abortion care takes center stage</h3> <p>A number of bills on the subject of access to abortion received hearings on Tuesday, Jan. 24, including:</p> <ul> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=8202&Initiative=false&Year=2023">Senate Joint Resolution 8202</a>, which would enshrine legal access to abortion and contraception in the Washington state constitution, was heard in the Senate Health and Long Term Care Committee.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1469&Year=2023&Initiative=false">House Bill 1469</a>, which would establish liability protections for patients and health care professionals from criminal and civil actions based on the provision of abortion care and gender-affirming care services, was heard in the House Civil Rights and Judiciary Committee.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1340&Initiative=false&Year=2023">House Bill 1340</a>, which would specify that unprofessional conduct under our state's Uniform Discipline Act does not include the provision of abortion care in a state or for a patient who resides in a state where such services are prohibited for the purpose of Washington state licensure and discipline, was heard in the House Health Care and Wellness Committee. These protections would also extend to gender-affirming care services. HB 1340 is sponsored by Committee Chair Rep. Marcus Riccelli, D-Spokane.</li> </ul> <p>WSMA President Katina Rue, DO, attended the hearings testifying on behalf of the WSMA in support of these proposals. Joining Dr. Rue at the HB 1469 hearing was Sarah Prager, MD, who testified in support on behalf of the Washington Section of the American College of Obstetricians and Gynecologists. Also heard on Tuesday were <a href="https://app.leg.wa.gov/billsummary?BillNumber=5242&Chamber=Senate&Year=2023">Senate Bill 5242</a>, which would prohibit copays, deductibles, and other cost-sharing requirements on abortion services, and <a href="https://app.leg.wa.gov/billsummary?BillNumber=5489&Initiative=false&Year=2023">Senate Bill 5489</a>, the companion bill to HB 1469 establishing liability protections.</p> <h3>Prioritizing prior authorization reform</h3> <p>On Wednesday, WSMA priority legislation <a href="https://app.leg.wa.gov/billsummary?BillNumber=1357&Year=2023&Initiative=false">House Bill 1357</a> concerning prior authorization was the subject of a public hearing in the House Health Care and Wellness Committee. Sponsored by Rep. Tarra Simmons, D-Bremerton and brought forward by the WSMA, HB 1357 would limit the utilization of prior authorization where codes are approved at exceedingly high rates and standardize requirements across insurance carriers. The WSMA testified in support.</p> <h3>In previous weeks: Scope of practice and gun violence</h3> <p>Of particular note, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1041&Year=2023&Initiative=false">House Bill 1041</a>, which would grant prescriptive authority to psychologists under certain circumstances, was heard in the House Health Care and Wellness Committee on Jan. 11. The WSMA testified in opposition as <a href="[@]wsma/advocacy/legislative_regulatory/issue-briefs/scope-of-practice-efforts.aspx">per policy opposing scope efforts by nonphysician practitioners without commensurate training to ensure patient safety</a>. The second week of session saw several high-profile hearings on firearm legislation. The WSMA has a variety of relevant policy and supports legislation to reduce firearm violence, including the proposed assault weapons ban, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1240&Year=2023&Initiative=false">House Bill 1240</a>.</p> <h3>For more detailed session updates</h3> <p>For weekly session updates with greater details on bills being debated in Olympia, WSMA members may subscribe to the WSMA Outreach & Advocacy Report by emailing Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a>. </p> <p>And don't forget: If you are passionate about direct advocacy, come to <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">Olympia on Feb. 3 for the 2023 WSMA Legislative Summit</a> and join your like-minded colleagues and peers from across the state as we take our advocacy message directly to legislators.</p> </div>1/27/2023 12:00:00 AM1/1/0001 12:00:00 AM
updated-washington-practitioner-application-supports-physician-well-beingUpdated Washington Practitioner Application Supports Physician Well-BeingLatest_NewsShared_Content/News/Membership_Memo/2023/january-27/updated-washington-practitioner-application-supports-physician-well-being<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/smiling-docs-645x425px.jpeg" class="pull-right" alt="smiling doctors" /></div> <h5>January 27, 2023</h5> <h2>Updated Licensing and Credentialing Applications Support Physician Well-Being</h2> <p>The WSMA is pleased to report that physicians and other licensed practitioners will now benefit from newly updated licensing and credentialing forms in Washington state. These widely used forms have been revised with input from the physician community, and reflect a growing awareness of the barriers to wellness that medical licensing and credentialing insurance applications were creating for physicians and practitioners. </p> <h3>Updated Washington Practitioner Application </h3> <p>This month, a streamlined <a href="https://www.wamss.org/resources/washington-credentialing-standardization-group/">Washington Practitioner Application</a> was introduced. 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 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> </ul> <ul> <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 PHI ends up on the WPA.</li> </ul> <h3>Washington licensing applications newly updated</h3> <p>The Washington Medical Commission has updated its <a href="https://wmc.wa.gov/licensing/applications-and-forms">licensing questions</a> to remove potentially invasive or stigmatizing language around mental health. The commission changed the question to an attestation and provided information about the Washington Physicians Health Program. These new updates follow changes in 2019 removing the requirement for applicants to disclose mental health or substance use disorder information resulting from new "safe haven" provisions. </p> <p>The WSMA gives special thanks to Washington Physicians Health Program Executive Medical Director Chris Bundy, MD, MPH, a strong physician advocate who helped provide guidance to both the Washington Medical Commission and the credentialing standardization committee on the changes to these forms.</p> <p>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>1/27/2023 12:00:00 AM1/1/0001 12:00:00 AM
doctors-making-a-difference-abigail-plawman-mdDoctors Making a Difference: Abigail Plawman, MDLatest_NewsShared_Content/News/Latest_News/2023/doctors-making-a-difference-abigail-plawman-md<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img alt="Doctors Making a Difference: Abigail Plowman, MD logo" src="/images/Newsletters/Reports/2023/january-february/dmd-website-image-plawman-645x425px.png" class="pull-right" /></div> <h5>January 24, 2023</h5> <h2>Doctors Making a Difference: Abigail Plawman, MD</h2> <p> Abigail Plawman, MD, an addiction medicine fellowship director at MultiCare's East Pierce Family Medicine Residency program, is working to bring the many facets of substance use disorder treatment and obstetric care together. Part of the Substance Treatment and Recovery Training program, the inpatient START unit at Good Samaritan Hospital in Puyallup opened this July and is providing much- needed care to a uniquely underserved population. Dr. Plawman talks about the efforts behind opening the new unit. </p> <p> <strong><em>WSMA Reports:</em> Tell our readers about the START program and unit.</strong> </p> <p> <em>Dr. Plawman:</em> The START program has two parts: a hospital unit and an outpatient clinic. The START Clinic is a walk-in multidisciplinary clinic based at the East Pierce Family Medicine Residency, where pregnant people can seek prenatal care, medication management for substance use disorders, social work support, and referral to community programs. The START Unit is an 18-bed voluntary treatment program at Good Samaritan Hospital where pregnant people of any gestational age can obtain medical stabilization of their use disorder or withdrawal, group treatment with trained counselors, education around both obstetrics and substance use disorder recovery, obstetric care including delivery if indicated, and connection to community resources after discharge. </p> <p> <strong>Where did the idea come from for the unit at Good Samaritan?</strong> </p> <p> In 2014, I had a pregnant woman come to my office with a printout of her medical records in her hand. She had been doing exceptionally well in sustained recovery on Suboxone for five years, and after revealing her pregnancy to her physician she had been abruptly cut off from that practice due to the physician's discomfort with treating pregnant women. Around the same time, another pregnant woman I was treating had been turned away from obstetric care when she revealed that she was in treatment at a methadone program. Both women were doing everything in their power to stay healthy and care for their pregnancies, and the medical system was not capable of meeting their needs. </p> <p> I approached the East Pierce Family Medicine Residency with the goal of partnering to serve this unique population, and the program enthusiastically embraced providing these essential services. The walk-in clinic opened thereafter, and the groundwork was started to create the inpatient hospital program at Good Samaritan. </p> <p> <strong>What kind of response have you gotten from patients? </strong> </p> <p> The demand for our services was instantaneous. By far, the most common reason pregnant people seek care from us is difficulty stopping fentanyl use and challenges getting onto appropriate medication in the outpatient setting. More than half of our participants are also seeking help to stop using methamphetamine and have struggled to obtain consistent prenatal care. </p> <p> We have received heartwarming feedback from many patients, including one woman requesting to bring her baby back to visit us because she is doing so well! I am grateful that we have already had more than one client referred to us from another prior participant-I consider this type of referral among the most powerful ways we receive feedback. Treatment is challenging, and it takes a lot of bravery to seek care during pregnancy, so we are all in awe of how hard our clients work to make changes in their lives. </p> <p> <strong>Have any aspects of running the unit surprised you in good or bad ways? </strong> </p> <p> Seeking recovery in pregnancy involves systems of care that historically have operated within their own silos: behavioral health, substance use treatment programs, obstetric care, pediatric and newborn care, and even primary care. It has been both delightful and challenging to balance the needs of these different programs and departments in bringing together the right resources for our clients. We learned quickly, for example, that we needed to be aware of our neonatal intensive care census in the hospital as part of planning for high- risk treatment admissions to be prepared for unexpected needs from other services if an abrupt delivery was to take place. </p> <p> <strong>What has been the biggest challenge in getting the unit up and running?</strong> </p> <p> One, of course, is financial and staff shortages-no surprise to anyone working in health care today. The other challenge has been straddling multiple regulatory and care domains in everything from certification to care delivery to staffing. Continuously balancing the urgency of pregnancy with the need to provide not only medical but also psychiatric and social support makes me profoundly grateful for the compassionate and skilled team we have assembled.</p> <p> <em>This article was featured in the January/February 2023 issue of WSMA Reports, WSMA's print magazine.</em> </p> </div>1/24/2023 12:00:00 AM1/1/0001 12:00:00 AM
2023-legislative-session-update-week-32023 Legislative Session Update: Week 3Latest_NewsShared_Content/News/Latest_News/2023/2023-legislative-session-update-week-3<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/791757558"><img src="/images/Newsletters/latest-news/2023/jan/legislative-update-week-3-2023.png" alt="Legislative Update logo for the week of January 23, 2023" /></a> </div> <h5>January 23, 2023</h5> <h2>2023 Legislative Session Update: Week 3</h2> <p>WSMA Associate Director of Legislative and Political Affairs Alex Wehinger gives an update on bills related to abortion access scheduled for hearings in the Legislature this week. <a href="https://vimeo.com/791757558">Watch the video</a>.</p> <h3>Join us at the WSMA Legislative Summit for a panel discussion on abortion in Washington</h3> <p>Sen. Karen Keiser (D-Des Moines); WSMA President-Elect and OB-GYN Nari Hesmati, MD; and Planned Parenthood State Director Courtney Normand will join us at the Legislative Summit next Friday, Feb. 3 in Olympia for a panel discussion on the state of abortion in Washington. The meeting is free for WSMA members - <a href="https://wsma.org/wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">register today</a>.</p> </div>1/23/2023 12:00:00 AM1/1/0001 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 WellnesLatest_NewsShared_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="https://www.wamss.org/resources/washington-credentialing-standardization-group/">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 12:00:00 AM1/1/0001 12:00:00 AM
oic-releases-new-report-on-the-use-of-prior-authorization-in-washingtonOIC Releases New Report on the Use of Prior Authorization in WashingtonLatest_NewsShared_Content/News/Membership_Memo/2023/oic-releases-new-report-on-the-use-of-prior-authorization-in-washington<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/paperwork-645x425px.png" class="pull-right" alt="illustration of a doctor and patient standing next to a tall stack of paper " /></div> <h5>January 13, 2022</h5> <!-- **************************NEW ARTICLE****************************** --> <h2>OIC Releases New Report on the Use of Prior Authorization in Washington</h2> <p>In 2020, the WSMA successfully advocated for legislation requiring the Washington State Office of the Insurance Commissioner to release an annual report on insurance carriers' prior authorization practices. <a href="https://www.insurance.wa.gov/sites/default/files/documents/2022_health_plan_prior_authorization_report_0.pdf" target="_blank" rel="noreferrer">This year's report</a> shows the prevalence of prior authorization increasing significantly over last year, with carriers approving the overwhelming majority of services. The report further calls into question the utility of prior authorization, which acts as a barrier to care for patients, drives costs for physicians, and diverts health care workforce from care delivery.</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. Takeaways from the 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 authorizations for numerous codes were approved 100% of the time. Of the 486 distinct codes included in carriers' reporting, 416 (86%) were approved 100% of the time. </li> <li>Carriers' reported response times for prior authorization requests varied 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 these services.</li> </ul> <p>The report findings track with the experience of WSMA members, who regularly rate frustration with prior authorization as their top priority for advocacy. Working with Rep. Tarra Simmons (D-Bremerton), the WSMA will be bringing 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> </div>1/13/2023 12:00:00 AM1/1/0001 12:00:00 AM
wsma-highlights-medicaid-and-prior-authorization-priorities-as-legislative-session-gets-undeWSMA Highlights Medicaid and Prior Authorization Priorities as Legislative Session Gets UndeLatest_NewsShared_Content/News/Membership_Memo/2023/wsma-highlights-medicaid-and-prior-authorization-priorities-as-legislative-session-gets-unde<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/wa-state-flag-capitol-645x425px.png" class="pull-right" alt="Washington state flag flying in front of capitol building" /></div> <h5>January 13, 2022</h5> <h2>WSMA Highlights Medicaid and Prior Authorization Priorities as Legislative Session Gets Underway</h2> <p>The 2023 state legislative session began this Monday. The primary responsibility for the Legislature during the 105-day long session will be to negotiate a two-year budget to fund the state's operating expenses, and, as with every session, hundreds of legislative policy proposals will be under consideration by lawmakers.</p> <p>While the WSMA will engage on a variety of issues impacting the house of medicine, our priority fiscal and policy issues as determined by member feedback are as follows:</p> <p>Budget priorities:</p> <ul> <li>Across-the-board Medicaid reimbursement rate increases.</li> <li>Health care workforce, system capacity, and physician residency funding.</li> <li>Foundational Public Health Services.</li> <li>Taxes.</li> </ul> <p>Legislative priorities:</p> <ul> <li>Standardizing the prior authorization process.</li> <li>Ensuring access to abortion and reproductive health care services.</li> <li>Preventing numerous inappropriate scope-of-practice increases.</li> <li>Addressing gun violence.</li> </ul> <p>In anticipation of session, the WSMA turned to the <a href="[@]Shared_Content/News/Press_Release/2022/access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-reveals">media</a> to begin making the case for its top two fiscal and policy priorities. In <a href="https://www.yakimaherald.com/opinion/guest-commentary-washington-legislators-must-prioritize-medicaid-funding/article_e1cb5f20-7a87-11ed-9a88-77d5a78d2c84.html">editorials</a> and <a href="https://komonews.com/news/local/washington-state-hospital-association-wsha-cut-services-financial-losses-bed-revenue-survey-cardiac-cancer-emergency-department">earned</a> <a href="https://app.criticalmention.com/app/#clip/view/d184d7de-e6ba-42f5-a000-61c57500c9aa?token=fb894da5-a101-41e8-b8a5-82a8fe619df6">media</a>, the WSMA has highlighted how low Medicaid reimbursement and health plan prior authorizations result in barriers to care for patients and further strain outpatient practices struggling with workforce shortages, inflation, ongoing disruptions of the pandemic, and now a <a href="[@]Shared_Content/News/Membership_Memo/2022/december-23/omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut">2% reduction in Medicare reimbursement</a>.</p> <p>The WSMA will be engaging a full-court press to advocate for these two priorities throughout session. We will keep members apprised of developments and opportunities for engagement. For weekly session updates delivered to your inbox, members may subscribe to the WSMA Outreach & Advocacy Report, published weekly, by emailing Alex Wehinger at <a href="mailto:alex@wsma.org">alex@wsma.org</a>. If you are passionate about direct advocacy, come to <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">Olympia on Feb. 3 for the 2023 WSMA Legislative Summit</a> and join your like-minded colleagues and peers from across the state as we take our advocacy message directly to legislators.</p> </div>1/13/2023 12:00:00 AM1/1/0001 12:00:00 AM
2022-mips-hardship-exception-application-due-jan-32022 MIPS Hardship Exception Application Due Jan. 3Latest_NewsShared_Content/News/Membership_Memo/2022/december-23/2022-mips-hardship-exception-application-due-jan-3<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/stethoscope-on-table-645x425px.jpeg" class="pull-right" alt="stethoscope laying on a table" /></div> <h5>December 23, 2022</h5> <h2>2022 MIPS Hardship Exception Application Due Jan. 3 </h2> <p>The deadline to submit a 2022 MIPS extreme and uncontrollable circumstances exception application is Jan. 3, 2023. We are concerned that practices that need the relief will miss the opportunity to file a MIPS exception application with the upcoming holidays as well as continued COVID and staffing disruptions. The American Medical Association has requested that the Centers for Medicare and Medicaid Services once again automatically apply the exception for 2022 MIPS reporting, or, at a minimum, extend the deadline until the end of the 2022 data submission period, which is March 2023. If the policy changes to provide additional relief from MIPS, we will keep you apprised.</p> <p>In the interim, physicians who are interested in requesting an extreme and uncontrollable circumstances exception and avoiding a 2024 payment adjustment <a href="https://qpp.cms.gov/mips/exception-applications?py=2022#extremeCircumstancesException-2022:~:text=reasons%20identified%20below.-,Extreme%20and%20Uncontrollable%20Circumstances%20Exception,-MIPS%20eligible%20clinicians">may do so until 5 p.m. PT on Jan. 3, 2023</a>. If you believe you've been affected by an extreme and uncontrollable circumstance (such as the public health emergency triggered by the COVID-19 pandemic), you can apply whether reporting <a href="https://qpp.cms.gov/mips/traditional-mips?utm_source=newsletter&utm_medium=email&utm_id=newsletter_december2022&utm_content=tradmips">traditional MIPS</a> or the <a href="https://qpp.cms.gov/mips/apm-performance-pathway?utm_source=newsletter&utm_medium=email&utm_id=newsletter_december2022&utm_content=app">APM Performance Pathway</a>.</p> </div>12/23/2022 12:00:00 AM1/1/0001 12:00:00 AM
governor-releases-budget-proposal-for-2023-2025-bienniumGovernor Releases Budget Proposal for 2023-2025 BienniumLatest_NewsShared_Content/News/Membership_Memo/2022/december-23/governor-releases-budget-proposal-for-2023-2025-biennium<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/spring-wa-capitol-645x425px.jpeg" class="pull-right" alt="Washington state capitol building in spring" /></div> <h5>December 23, 2022</h5> <h2>Governor Releases Budget Proposal for 2023-2025 Biennium</h2> <p>Last week Gov. Jay Inslee released his budget proposal, kicking off negotiations around the next two-year state spending plan and signaling the approach of the legislative session that begins on Jan. 9. Spanning $70 billion in spending, the governor's proposal would increase state spending by around 12% and does not rely on new tax increases. </p> <p>In announcing his budget, Inslee highlighted proposed investments in housing and homelessness, climate change, and behavioral health, including $50 million to address the opioid epidemic-including funding to support the <a href="https://wsma.org/wsma/resources/opioids/better_prescribing_better_treatment/wsma/resources/opioids/better_prescribing_better_treatment/better_prescribing_better_treatment.aspx?hkey=b6fb0ec0-8bc2-4e53-bf4c-9f148599cbeb">Better Prescribing, Better Treatment</a> program, the joint initiative of the WSMA and the Washington State Hospital Association to inform physicians' prescribing patterns.</p> <p>The budget aligns with other WSMA priorities, including proposed funding and associated policies to ensure access to abortion services and to address gun violence, and proposed investments in our health care workforce, most notably the creation of 400 new nursing slots and a public health degree program at Washington State University.</p> <p>Investments are also proposed to support access to health care coverage for undocumented immigrants ($19 million); fund public health and winding down COVID-19 services ($120 million); and to increase capacity in the health care system by raising Medicaid rates for long-term care facilities and facilitating discharge of patients from hospital settings (more than $300 million across multiple appropriations). </p> <p>State revenues have remained strong in the wake of the COVID-19 pandemic, yielding around $1.5 billion more than was expected through 2025. Collective bargaining agreements the governor recently struck with state employee unions consumed some of that capacity, however, limiting investments in new programs. One of those agreements stipulates that for care delivered in state employee health plans, ARNPs will be reimbursed at the same rate as physicians. The WSMA has opposed this policy in recent years when it's been proposed as legislation and the collective bargaining agreement represents a potential end-run around the Legislature.</p> <p>While Gov. Inslee's budget does not raise taxes, it does propose new spending in the form of bonding capacity to support $4 billion in investments in housing and to address homelessness. This would require a referendum to voters. The budget also relies on revenue from the state capital gains tax that was adopted in the 2021 session and is currently the subject of a legal challenge pending the state Supreme Court.</p> <p>WSMA's top budget priority for the 2023-25 state fiscal cycle is an across-the-board rate increase for professional services delivered in the Medicaid program. Increasing Medicaid rates to Medicare levels would cost the state an estimated $134 million annually, leveraging $290 million in federal funds for a total annual investment of $423 million. While this funding was not included in the governor's budget, we will be advocating for its inclusion in legislative spending plans, which will likely be released in early April and finalized before session is scheduled to adjourn on April 26.</p> <p>If you're interested in staying plugged in to the WSMA's work in Olympia, you <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/legislative_summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">can register for the 2023 Legislative Summit</a> taking place on Feb. 3, and receive our weekly Outreach and Advocacy Report by emailing WSMA's Legislative Coordinator Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a>. </p> </div>12/23/2022 12:00:00 AM1/1/0001 12:00:00 AM
omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cutOmnibus Bill in Congress Includes 2% Medicare Physician Payment CutLatest_NewsShared_Content/News/Membership_Memo/2022/december-23/omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-barcode-645px.jpeg" class="pull-right" alt="Medicare barcode" /></div> <h5>December 23, 2022</h5> <h2>Omnibus Bill in Congress Includes 2% Medicare Physician Payment Cut</h2> <p>Despite calls from the American Medical Association, the WSMA, and the physician community, the must-pass omnibus spending deal struck by congressional leaders this week will apply a 2% cut in 2023 and at least a 1.25% cut in 2024 to physician Medicare reimbursements.</p> <p>As the WSMA recently <a href="https://wsma.org/Shared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship?_zs=Pimae1&_zl=dV3k8">reported to our members</a> and to <a href="https://wsma.org/Shared_Content/News/Press_Release/2022/access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-reveals.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">the media and the public</a>, physician practices across the state are grappling with the economic hardship caused by workforce shortages and inflation. While the physician community was successful in staving off as much as an 8.5% cut in 2023, the WSMA is still deeply concerned about the impact a 2% reduction in Medicare reimbursement will have during a difficult time for practices and on the heels of a highly disruptive pandemic.</p> <p>When adjusted for inflation, Medicare physician payments dropped by 22% from 2001 to 2021. With additional cuts in 2023, physicians simply cannot afford to operate under the current payment system. This latest disappointing news from Congress underscores the need for a comprehensive rethink of the Medicare payment system. The WSMA will be joining the AMA in seeking to reform the Medicare payment system in 2023 based on the principles of simplicity, relevance, alignment, and predictability. <a href="[@]wsma/advocacy/medicare_payment_reform/wsma/advocacy/medicare_payment_reform/medicare_payment_reform.aspx?hkey=d1a48c1c-af7b-4680-bd55-967338f3c977">Learn more about our plan for reforming Medicare</a>.</p> </div>12/23/2022 12:00:00 AM1/1/0001 12:00:00 AM
wsma-economic-impact-survey-of-physician-practicesWSMA Economic Impact Survey of Physician PracticesLatest_NewsShared_Content/News/Latest_News/2022/wsma-economic-impact-survey-of-physician-practices<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/july/doc-patient-exam-room-645x425px.jpg" class="pull-right" alt="physician treating a patient" /></div> <h5>December 19, 2022</h5> <h2>WSMA Economic Impact Survey of Physician Practices</h2> <p>Over the last several years, the WSMA and Washington State Medical Group Management Association have periodically conducted surveys to better understand the economic challenges facing physicians, their practices, and patients resulting from COVID-19. Feedback has been vital to our advocacy at the state and federal levels as we secured regulatory and financial relief for medical practices. </p> <p>With the recission of COVID-19 proclamations and regulatory waivers and the 2023 legislative session on the horizon, the WSMA and the WSMGMA conducted a sixth survey to better understand how these issues have affected physicians and patients to inform our advocacy.</p> <p>Results from this latest round of surveying clearly demonstrate that inflation and workforce shortages, as well as the ongoing COVID-19 pandemic, are still adversely impacting outpatient physician practices, and hindering patient access to care across Washington. Respondents also note that administrative tasks, such as prior authorization remain burdensome to their practices and further strain their limited staffing resources.</p> <p>If actions are not taken to shore up the medical practice community, access to outpatient care in our state will be severely diminished over the next year. Patients will no longer be able to get care, at the right time, at the right place, creating even more pressure on our already overwhelmed hospitals.</p> <p>During the 2023 state legislative session, the WSMA will ask the Legislature to raise Medicaid rates to Medicare levels, as physician groups and practices overwhelmingly believe that doing so will help stabilize finances while maintaining access for current Medicaid panels and even increasing to include more patients. In addition, the WSMA will help introduce legislation to rein in insurance carrier prior authorization practices, which would also relieve staffing challenges currently felt by most of the medical practice community.</p> <p>Download the <a href="javascript://[Uploaded files/News and Publications/Latest News/2022/inflation-survey-final.pdf]">November 2022 practice economic survey results</a>.</p> <h3>About the respondents</h3> <p>Eighty-two physician practices responded, representing more than a thousand physicians and health care professionals that provide care to millions of Washingtonians.</p> <ul> <li>26% of survey respondents were solo practitioners.</li> <li>44% were in practices of 2-10 physicians and</li> <li>7% were in practices of 11-20 physicians.</li> <li>12% of respondents represented practices of 21-50 physicians, and</li> <li>11% represented practices with over 51 physicians.</li> </ul> <p>These represent smaller outpatient practices that are not affiliated with a hospital system and are often the only care provided in some communities, especially rural areas.</p> <h3>Medicaid patients </h3> <p>Most of these practices serve Medicaid patients (75%) in addition to commercial and Medicare patients.</p> <h3>Staffing shortages have led to practice closures and reduction in services</h3> <p>Regarding staffing, 89% of respondents said are having experiencing shortages. Of the respondents experiencing staffing shortages, 77% are experiencing challenges filling administrative staff positions, 75% are experiencing challenges filling medical assistant positions, 40% are having trouble filling nursing positions, and 33% are having trouble hiring physicians.</p> <p>Staffing shortages have meant 46% of practices have had to reduce patience access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients. One respondent noted that <em>"We will most likely close our Walla Walla office by the end of the year. We understand we are the only eye surgeon serving the low income."</em> If current staffing and financial trends continue, 51% of practices aren't confident they'll be able to provide the same level of patient access a year from now.</p> <p>Other strategies to mitigate staffing challenges:</p> <ul> <li><em>Delayed well child care and chronic disease management.</em></li> <li><em>Our waiting room is now where we see patients.</em></li> <li><em>Limited number of new patients.</em></li> <li><em>Closed on Friday, longer wait times for patients.</em></li> <li><em>Delays in care and decreased access to services.</em></li> <li><em>Cut back on clinic based testing and closed satellite office.</em></li> <li><em>Increased workloads for staff which is causing burnout.</em></li> </ul> <h3>Inflation is impacting almost all practices </h3> <p>Inflation is impacting practices: 51% of respondents said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation, 89% noted the rising cost of labor. To mitigate the impact of inflation, over 30% of practices have reduced office hours, patient access, and services and treatments offered to patients.</p> <p>What physician groups said about inflation:</p> <ul> <li><em>Our staff are getting lured away for high cash compensation and forsaking our generous benefits package to keep up with their short-term financial stressors of rising rents/transportation/food.</em></li> <li><em>Supply chain disruptions, we can't get flu test kits, off and on shortages or syringes or medications.</em></li> <li><em>Payroll taxes, office equipment, supplies, malpractice insurance, property upkeep, and business taxes. Just to mention a few. I currently have my business for sale, it's become too much for a private practice to stay in business.</em></li> <li><em>Inflation is going up. Payment from insurers is going down or staying flat. This trajectory in not sustainable to recruit and retain physicians to our specialty in the long term.</em></li> <li><em>We raised our rates where we were able to, but insurance payments have not kept pace with inflation.</em></li> <li><em>Stopped services where reimbursement did not keep up with cost of goods used.</em></li> <li><em>Work harder and longer. Seeing 30+ patients per day per doctor at times.</em></li> <li><em>Limiting Medicaid patients.</em></li> </ul> <h3>Ideally, practices should have 18 weeks' (roughly four months) worth of days "cash on hand"</h3> <p>Defined as the number of days their organization can pay its operating expenses with current cash available, 93% of practices responded with having less than 4 months days cash on hand. Over half of practices report that their days cash on hand is down since November of 2021. Of those who reported that their cash on hand was down, 83% attributed it to staffing shortage or inflation.</p> <h3>Access to care for Medicaid patients is threatened</h3> <p>Of practices that see Medicaid patients, 46% have had to limit the number of Medicaid patients they see due to the practice's current financial statement. Furthermore, several respondents who haven't had to limit the number of Medicaid patients note it is a possibility in the future.</p> <ul> <li><em>We will have to limit should funding continue not to match inflationary increases.</em></li> <li><em>Not yet, but soon going that route.</em></li> <li><em>That could happen. That's what other practices are doing.</em></li> <li><em>We had a much larger number of Medicaid patients, but due to very poor financial return, we had to stop taking any new Medicaid patients, as well as turning away others that once were patients, but we hadn't seen within a year. We were going broke and didn't want to close our clinic.</em></li> <li><em>We have always had open access to all children, but for the first time in our 42-year history we are not taking new patients. We are unable to attract MDs to fill vacancies because we cannot compete with larger institutions that either do not take Medicaid or cap the number of Medicaid patients at a low rate.</em></li> <li><em>We had to discontinue providing eyewear to our Medicaid patients through the state plan. The payment of $20 per pair of eyewear was resulting in a substantial net loss.</em></li> <li><em>This remains the toughest population for us to see, primarily because the reimbursement is so low.</em></li> </ul> <h3>Without support patient access will suffer over the next year</h3> <p>Medical practices were asked if they will be able to provide the same level of patient access a year from now if staffing and financial trends continue. Just over 50% said they are not confident.</p> <h3>Medicaid rate increase a commonly cited solution</h3> <p>When asked if raising Medicaid rates to Medicare levels would be sufficient to maintain current Medicaid patent caseload, 63% said that would be sufficient; 37% said they would be able to increase their Medicaid caseloads.</p> <ul> <li><em>If (Medicare and Medicaid) rates were the same, we would consider increasing our caseload.</em></li> <li><em>Medicaid reimbursement has not increased in 20 yrs. Wages have changed dramatically.</em></li> <li><em>Variance in reimbursement (between Medicaid and other payers) is no longer sustainable.</em></li> <li><em>Increase in reimbursement for patient care would be helpful to keep on track with the other costs due to inflation.</em></li> </ul> <h3>Prior authorization an enormous burden for medical practices</h3> <p>Without prompting by the survey, several respondents noted the toll administrative burden and prior authorization requirements contribute to economic and staffing challenges:</p> <ul> <li><em>Work to increase reimbursement and cut red tape. Prior authorizations are a killer for staff.</em></li> <li><em>Help to improve prior authorization used as tactic to delay and deny care. Payer abuse in paying for approved services. Improve Medicaid rates to Medicare rates.</em></li> <li><em>Decrease administrative burdens and barriers which add to cost of overhead and do not add value to practice, i.e., prior authorization, poor EHR interoperability, regular insurance audits, increasing reimbursement for primary care, reimbursement for nutritional counseling, improving access to MHP.</em></li> <li><em>Commercial payers need to jump in and help by ending the onerous prior authorization processes. This alone would free up hours of precious staff time.</em></li> </ul> </div>12/19/2022 12:00:00 AM1/1/0001 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 PaymentLatest_NewsShared_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="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=/campaigns/96014/respond" 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="https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Other%20Services%22,%22sort%22:%22desc%22%7D">near the bottom</a> (47th), and is in the <a href="https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/?currentTimeframe=0&sortModel=%7B%22colId%22:%22FMAP%20Percentage%22,%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="https://www.healthaffairs.org/do/10.1377/forefront.20190401.678690/full/">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>12/16/2022 12:00:00 AM1/1/0001 12:00:00 AM
access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-revealsAccess to Care Will Continue to Diminish In Washington Without Intervention, New Survey RevealsLatest_NewsShared_Content/News/Press_Release/2022/access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-reveals<div class="col-md-12"> <div class="col-sm-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>December 14, 2022</h5> <h2>Access to Care Will Continue to Diminish In Washington Without Intervention, New Survey Reveals</h2> <p> SEATTLE, WA - Results from a <a href="[@]Shared_Content/News/Latest_News/2022/wsma-economic-impact-survey-of-physician-practices.aspx">new survey</a> indicate inflation and staffing shortages continue to severely strain Washington's medical practice community and hinder patients' ability to access care during a crucial period of recovery our state. If actions are not taken to shore up the outpatient practice community, access to care in our state will continue to diminish over the next year, creating even more pressure on our already overwhelmed hospitals. </p> <p> The survey* focused on practices that are not affiliated with a hospital system and are often the only care provided in some communities, including underserved and rural areas. Eighty-two physician practices responded, representing more than a thousand physicians and health care professionals that provide care to millions of Washingtonians. </p> <p> Survey toplines: </p> <ul> <li>Nearly 50% of respondents noted their practice has had to reduce patient access, including reducing office hours, services, and treatments, in response to staffing shortages.</li> <li>More than 30% have had to reduce patient access, including reducing office hours, services, and treatments, in response to inflation.</li> <li>Nearly 50% have had to limit the number of Medicaid patients they see due to the practice's current financial statement.</li> <li>Fewer than 10% have the minimum available cash required for operating expenses ("days cash on hand," defined as 18 weeks' worth), with nearly half of practices having less than four weeks' worth of available cash.</li> <li>Just over 50% expect further reductions in patient access a year from now if staffing and financial trends continue</li> <li>Increasing Medicaid reimbursements and reducing staffing strain from prior authorization requirements were the most commonly cited solutions to easing the pressures experienced by practices.</li> </ul> <p> Survey respondent TRA Medical Imaging, which provides imaging services for over a million South Puget Sound patients in multiple outpatient clinic locations, has been forced reduce office hours as well as access to treatments, and is experiencing severe patient backlogs. TRA President and practicing radiologist Douglas Seiler, MD, said, "This is a very difficult time for our clinics. The last thing we ever want to do is reduce the care we provide to our patients, but in this economy, stagnant reimbursements and insurer requirements that add significantly to our practice and staffing costs leave us little choice." </p> <p> "The WSMA is concerned that there may be patients facing problems accessing basic care in their communities, and if we don't prioritize our community practices and clinics now, the problem will only get worse" said Jennifer Hanscom, chief executive officer of the WSMA, representing nearly 12,500 physicians and physician assistants statewide. "These community practices are critically needed to prevent increasing volume and strain on our already stressed hospital emergency departments, and in the long-term, to support the ability of patients to access care in their communities." </p> <p> The WSMA is urging Washington lawmakers and patients to support two initiatives in the upcoming state legislative session that could help keep practices open and patient care widely available: </p> <ul> <li>The WSMA is asking the Legislature to raise Medicaid rates for all physician specialties to adequately cover expenses, as physician groups overwhelmingly report that doing so will help stabilize finances and maintain access for current Medicaid patients or help increase their Medicaid caseloads. Today, Medicaid covers 30% of the state's patient population, and while businesses in other industries may increase prices to address inflation, medical practices seeing Medicaid patients are constrained from doing so as the state legislature sets Medicaid rates.</li> <li>The WSMA will support legislation that would reduce administrative burden by reining in insurance carrier prior authorization practices, which limit access to care for patients and would also relieve staffing challenges currently felt by most of the physician community.</li> </ul> <p> "Physician practices and ambulatory surgery centers are the first line of defense for patient health, and it's essential that they are supported to ensure patients can get basic care and have their health needs managed and addressed at the right time and at the right place," Hanscom said. "Raising Medicaid rates and reducing staffing pressures from burdensome prior authorization insurer requirements would be a shot in the arm for our practices-and for some, a lifeline-by helping to keep doors open and care available to all Washingtonians when and where they need it." </p> <p> Interview opportunities with some physicians who participated in this survey are available. </p> <p> *The survey was shared in October and November with 5,000 physicians working in independent (non-networked) physician clinics. 26% of survey respondents were solo practitioners. 44% were in practices of 2-10 physicians and 7% were in practices of 11-20 physicians. 12% of respondents represented practices of 21-50 physicians, and 11% represented practices with over 51 physicians. </p> <p><strong> For more information, contact:</strong> </p> <p> Cindy Sharpe<br /> Communications, Washington State Medical Association<br /> <a href="mailto:cindy@wsma.org">cindy@wsma.org</a> / 813.244.2883 </p> <p> <strong>About the Washington State Medical Association</strong><br /> The WSMA represents nearly 12,500 physicians, physician assistants, resident physicians, and medical students across all specialties and practice types in Washington state. The WSMA has advocated on behalf of the house of medicine for more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care. </p> </div>12/14/2022 12:00:00 AM1/1/0001 12:00:00 AM
action-alert-how-you-can-help-cancel-medicare-payment-cutsAction Alert! How You Can Help Cancel Medicare Payment CutsLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/action-alert-how-you-can-help-cancel-medicare-payment-cuts<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-cta-1-645x425px.png" class="pull-right" alt="Protect patient access to care illustrated graphic" /></div> <h5>December 9, 2022</h5> <h2>Action Alert! How You Can Help Cancel Medicare Payment Cuts </h2> <p>If Congress fails to act soon, physician Medicare payments will be cut by 4.5% on Jan. 1, 2023, due to regulatory changes enacted by the Centers for Medicare and Medicaid Services. Cuts of this magnitude would severely impede patient access to care and place further strain on an already stressed practice community. When adjusted for inflation, Medicare physician payments have dropped by 22% from 2001 to 2021. Physicians simply cannot afford to operate under the current payment system.</p> <p>We have been raising the red flag over these cuts for months-and lawmakers are beginning to listen. But we need to keep the pressure on. The "lame duck" session of Congress is always a chaotic time with numerous priorities and interests vying to be included in the final must-pass package. It's urgent that the physician community push back on these cuts and ensure that physicians and patients don't get lost in the end-of-year shuffle.</p> <p><strong>What can you do to help cancel the cuts:</strong></p> <ol> <li>Contact your lawmakers through this link and share it with your colleagues: <a href="http://www.bit.ly/PhysicianMedicare">www.bit.ly/PhysicianMedicare</a></li> <li>Share this link with your patients: <a href="http://www.bit.ly/PatientMedicare">www.bit.ly/PatientMedicare</a></li> <li>Reach out to your member of Congress to schedule a meeting/phone call. <ul> <li>Download the AMA'sCancel the Cuts Action Kit: <a href="http://www.bit.ly/MedicareActionKit">bit.ly/MedicareActionKit</a></li> <li>Contact <a href="mailto:PoliticalAffairs@ama-assn.org">PoliticalAffairs@ama-assn.org</a> if you need help connecting with your member of Congress or need tips on how to effectively communicate your message and prepare for your meeting.</li> </ul> </li> </ol> <p>Time is running out. <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=/campaigns/96014/respond">Contact Congress now</a> and demand that they protect patients and practices by canceling these devastating Medicare cuts in their entirety before the clock strikes zero.</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
cms-announces-rulemaking-to-improve-prior-authorizationCMS Announces Rulemaking to Improve Prior AuthorizationLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/cms-announces-rulemaking-to-improve-prior-authorization<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/administrative-burden-645x425px.jpeg" class="pull-right" alt="administrative burden illustration" /></div> <h5>December 9, 2022</h5> <h2>CMS Announces Rulemaking to Improve Prior Authorization </h2> <p>In a breaking development this week, the Centers for Medicare and Medicaid Services announced the commencement of rulemaking to streamline prior authorization.</p> <p>The proposed rule shares many elements of the Improving Seniors' Timely Access to Care Act (S. 3018/S.R. 3173)<em>, </em>national legislation for improving prior authorization supported by the American Medical Association and the WSMA. Rule provisions include concepts such as tightening turnaround times and use of an electronic portal among others and would apply to Medicaid and Medicare Advantage plans. <a href="https://www.cms.gov/newsroom/press-releases/cms-proposes-rule-expand-access-health-information-and-improve-prior-authorization-process">Read the CMS press release for details</a>.</p> <p>Prior authorization is a top advocacy priority for the WSMA and we continue to push at all levels for improvements to the process in the interest of expediting access to care for patients and relieving administrative burden for physicians. We're pleased to see CMS take action on the issue with rulemaking.</p> <p>At the state level, the WSMA has been formulating legislation for the 2023 legislative session that would effect similar improvements to prior authorization among state-regulated health plans. WSMA staff is assessing how our legislative proposal intersects with the draft CMS rule. We will continue highlighting this issue in Olympia and the "other" Washington and will keep members apprised of developments.</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
local-health-officers-and-health-care-leaders-recommend-wearing-masks-indoorsLocal Health Officers and Health Care Leaders Recommend Wearing Masks IndoorsLatest_NewsShared_Content/News/Press_Release/2022/local-health-officers-and-health-care-leaders-recommend-wearing-masks-indoors<div class="col-md-12"> <div class="col-sm-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>Dec. 9, 2022</h5> <h2>Local Health Officers and Health Care Leaders Recommend Wearing Masks Indoors</h2> <p> Communities across our state and around the U.S. are experiencing an unprecedented surge in viral respiratory illnesses, including respiratory syncytial virus (RSV), influenza, and COVID-19. As health officers and health care leaders working to improve the health of Washington residents, we recommend that everyone wear a high-quality, well-fitting mask when around others in indoor spaces to protect against both acquiring and spreading these infections to others. </p> <p> We also urge everyone who is eligible to stay up to date on your vaccinations. Vaccinations are the most important way to protect against severe influenza and COVID-19 infections, including hospitalization and death. Everyone 6 months and older should be vaccinated against these diseases and those who are eligible for an updated COVID-19 booster should get it now. </p> <p> Other necessary strategies include: </p> <ul> <li>Staying home from work and school and testing for COVID-19 if you develop symptoms.</li> <li>Having a plan for rapid treatment for COVID-19 and influenza for people who are at increased risk for severe infections.</li> <li>Improving indoor air quality through ventilation, filtration, and UV technology where appropriate.</li> </ul> <p> We expect the flu to circulate for months, so now is the time to get your flu shot! </p> <p> The flu is most dangerous for: </p> <ul> <li>Children under 5 years (especially under 2).</li> <li>Adults 65 years or older.</li> <li>Those who are pregnant.</li> <li>Anyone living with a health condition like asthma, diabetes, or heart disease.</li> </ul> <p> Consult with your physician or health care provider about the need for testing or treatment if you are at increased risk for severe influenza or are unsure. </p> <p> In addition to RSV and influenza, new COVID-19 variants are taking hold and immunity from past vaccination is waning for many people who have not yet received an updated booster shot. The surge in these viruses is resulting in many illnesses, contributing to rising absenteeism in schools this fall. This impact extends to businesses, workers, and families. </p> <p> For people who develop symptoms, and for parents of young children, it’s important to <a href="https://www.marybridge.org/for-patients-families/where-to-seek-care/">know when to contact your physician or health care provider for advice or an evaluation</a>. </p> <p> Working together and using multiple, layered strategies to limit the spread and impact of these viruses will provide benefits to all of us during this fall and winter respiratory virus season and help relieve serious stress on our health care system. </p> <p> Thank you to everyone for doing what you can to help. </p> <h3>Local health officers</h3> <p> Dimyana Abdelmalek, MD, MPH, Health Officer, Thurston County Public Health<br /> Allison Berry, MD, MPH, Health Officer, Clallam and Jefferson Counties<br /> Anthony L-T Chen, MD, MPH, Director of Health, Tacoma-Pierce County Health Department<br /> Jeff Duchin, MD, Health Officer, Public Health - Seattle and King County<br /> Amy Harley, MD, MPH, Co-Health Officer, Whatcom County Health Department<br /> Frank James, MD, Health Officer, San Juan County Health & Community Services<br /> Steven Krager, MD, MPH, Deputy Health Officer, Clark, Pacific and Skamania Counties<br /> Mark Larson, MD, Health Officer, Kittitas County Public Health Department<br /> James Lewis, MD, MPH, Health Officer, Snohomish Health District<br /> Alan Melnick, MD, MPH, Health Officer, Clark, Pacific and Skamania Counties<br /> Gib Morrow, MD, MPH, Health Officer, Kitsap Public Health District<br /> Greg Thompson, MD, MPH, Co-Health Officer, Whatcom County Health Department</p> <h3>Health care leaders</h3> <p> June M. Altaras, MN, NEA-BC, Executive Vice President, Chief Quality, Safety and Nursing Officer, MultiCare Health System<br /> Michael H. Anderson, MD, Chief Medical Officer, Virginia Mason Franciscan Health<br /> Mike Barsotti, MD, FAAP, President, Washington Chapter of the American Academy of Pediatrics <br /> Tori Bernier, Chief Nursing Officer, Summit Pacific Medical Center<br /> Timothy Dellit, MD, interim Chief Executive Officer, UW Medicine, interim Executive Vice President for Medical Affairs and interim Dean of the UW School of Medicine<br /> Mike Glenn, MHA, Chief Executive Officer, Jefferson Healthcare<br /> Jennifer A. Graves, RN, MS, Vice President, Quality and Safety, Kaiser Permanente Northwest and Kaiser Permanente Washington, Regional Chief Nursing Executive, Kaiser Permanente Washington<br /> Sean Gregory, Chief Executive, PeaceHealth Southwest Medical Center<br /> Carlton Heine, MD, PhD, FACEP, FAWM, Chapter President, Washington American College of Emergency Physicians<br /> Mark Johnson, MD, President, Washington Academy of Family Physicians<br /> Scott Kennedy, MD, Chief Medical Officer, Olympic Medical Center<br /> Robb Kimmes, Chief Executive Officer, Skyline Health<br /> David Knoepfler, MD, MBA, Chief Medical Officer, FACP, FHM, Overlake Medical Center<br /> Onora Lien, Executive Director, Northwest Healthcare Response Network<br /> Carma Matti-Jackson, President & Chief Executive Officer, Washington Health Care Association<br /> Ruth McDonald, MD, Chief Medical Officer, Seattle Children’s<br /> Deb Murphy, MPA, J.D., President & Chief Executive Officer, LeadingAge Washington<br /> Ettore Palazzo, MD, FACP, Chief Medical & Quality Officer, EvergreenHealth<br /> Charles Prosper, Chief Executive Officer, PeaceHealth St Joseph Medical Center<br /> Katina Rue, DO, President, Washington State Medical Association<br /> Cassie Sauer, President & Chief Executive Officer, Washington State Hospital Association<br /> Arooj Simmonds, MD, Regional Chief Medical Officer, Puget Sound Region, Providence Swedish<br /> Dori Unterseher MN, RN, Chief Nursing Officer, Harbor Regional Health<br /> Lynnette Vehrs, RN, MN, President, Washington State Nurses Association<br /> Darryl Wolfe, Chief Executive Officer, Olympic Medical Center</p> <p> For more information, contact: </p> <p> Graham Short<br /> WSMA Director of Communications<br /> 206.329.6851 (cell/text)<br /> <a href="mailto:gfs@wsma.org">gfs@wsma.org</a> </p> <h3>About the WSMA</h3> <p> The Washington State Medical Association represents more than 12,000 physicians, physician assistants, resident physicians, and medical students in Washington state. The WSMA has advocated on behalf of the house of medicine more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care. </p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-prioritiesPrior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative PrioritiesLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-priorities<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/ls-2018-01-245-straightened-645x425px.jpeg" class="pull-right" alt="Capitol building" /></div> <h5>December 9, 2022</h5> <h2>Prior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative Priorities</h2> <p>WSMA's government affairs team will highlight these and other WSMA legislative priorities during a webinar on <a href="https://us06web.zoom.us/meeting/register/tZApc-ugqz4pE9IXUUHeiTCjN4q1HKfMfLvo">Tuesday, Dec. 13, at noon</a>. The hour-long session will serve as an opportunity for WSMA members to preview the 2023 state legislative session that begins in January and learn more about WSMA's legislative priorities and the health care policy landscape. Members are encouraged to participate-there will be time during the session for you to provide feedback on any concerns or issues you or your practice are facing. Register for the webinar <a href="https://us06web.zoom.us/meeting/register/tZApc-ugqz4pE9IXUUHeiTCjN4q1HKfMfLvo">online</a>.</p> <p>Medicaid reimbursement, prior authorization, and ensuring access to abortion and reproductive health care services will also be among the priority fiscal and policy issues that will be the focus of the 2023 WSMA Legislative Summit, scheduled for Feb. 3, in person at the Capitol. We hope you will don your white coats and join us in Olympia to help advocate for these WSMA legislative priorities-<a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">registration for the Feb. 3 event is free</a> (lunch will be provided).</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
single-dose-vials-of-bivalent-covid-19-vaccine-now-availableSingle-Dose Vials of Bivalent COVID-19 Vaccine Now AvailableLatest_NewsShared_Content/News/Membership_Memo/2022/december-9/single-dose-vials-of-bivalent-covid-19-vaccine-now-available<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/istock-1372360890-645x425px.jpeg" class="pull-right" alt="physician administering vaccine" /></div> <h5>December 9, 2022</h5> <h2>Single-Dose Vials of Bivalent COVID-19 Vaccine Now Available</h2> <p>Updated single-dose vials of bivalent Pfizer COVID-19 vaccine for people 12 years of age or older are now available in limited quantities to jurisdictional and federal entity administration partners, per an announcement from the U.S. Department of Health and Human Services. This limited introduction of single-dose vials is designed to allow for the administration of updated COVID-19 vaccines in more places, such as physicians' offices or mobile clinics that may not have the capacity or demand to keep multi-dose vials of COVID-19 vaccine on hand.</p> <p>Single-dose vials will be available at a minimum order quantity of 50 doses. Awardees will be limited to not more than 150 single-dose vials per order. HHS is encouraging eligible partners to direct their orders of single-dose vials to sites such as doctors' offices or community health centers that have consistently low or irregular patient traffic or might not otherwise offer the COVID-19 vaccine. Partners are strongly encouraged to consider equity and consult resources, such as <a href="https://www.cdc.gov/coronavirus/2019-ncov/vaccines/reporting-vaccinations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fdistributing%2Fabout-vaccine-data.html">national data published by CDC</a> on updated vaccine uptake by race and ethnicity.</p> <p>HHS offers a <a href="javascript://[Uploaded files/For Members/aspr-one-dose-vial-1pg.pdf]">quick fact sheet</a> with specifications and ordering information for the single-dose vial Pfizer bivalent booster.</p> </div>12/9/2022 12:00:00 AM1/1/0001 12:00:00 AM
 
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