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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-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>2/6/2023 11:13:30 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>1/6/2023 9:53:42 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
weekly-rounds-september-2-2022-playing-hardball-on-your-behalfWeekly Rounds: September 2, 2022 - Playing Hardball on Your BehalfWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly-rounds-september-2-2022-playing-hardball-on-your-behalf<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 2, 2022</h5> <h2>Playing Hardball on Your Behalf</h2> <p>Jennifer Hanscom, CEO</p> <p> As your state medical association, one of our primary roles is to keep you informed of what's happening in the political and policy world. We are engaged in relevant health care discussions across the state and at the national level so that we can keep you up to date on current developments, as well as what's coming up next. We also make certain that your voice is heard and considered in those critical conversations. </p> <p> One policy area where we've engaged extensively in recent years-decades, really-is balance billing, or "surprise billing." After a protracted fight, the Washington State Legislature adopted the <a href=";s,balance%20billing%20under%20certain%20circumstances.&text=Enrollee&%2339;s%20obligation%20to%20pay%20for%20services.&text=Dispute%20resolution%20process%E2%80%94Determination%20of%20commercially%20reasonable%20payment%20amount.">Balance Billing Protection Act</a> in 2019, which prohibits balance billing for emergency services and for certain procedures performed by out-of-network physicians working in in-network facilities. While the law was far from perfect, it reflected a fair compromise and was subsequently used by physician groups in other states as a model to work from. </p> <p> Then in 2020, just as our state law was going into effect, Congress passed its own version of a balance billing prohibition known as the No Surprises Act. Since its passage, the No Surprises Act has been tied up in lawsuits (<a href="[@]Shared_Content/News/Membership_Memo/2022/February_25/federal_judge_rules_for_physicians_in_lawsuit_challenging_no_surprises_act?_zs=B3aFd1&_zl=fmjX8">some of which the WSMA has been successfully supporting</a>) and rulemaking to implement the law. Ultimately, the No Surprises Act will end up superseding most provisions of our state law, due largely to the fact that self-insured health plans can only be regulated by the federal government. </p> <p> Through it all, the WSMA and our Director of Government Affairs Sean Graham have been working at the state level with the Legislature and the Office of the Insurance Commissioner to ensure that physicians in Washington are not unduly disadvantaged by balance billing laws, both in contract negotiations with insurance carriers and during the dispute resolution processes that kick in when out-of-network patients are treated under the laws. </p> <p> Despite our efforts, insurance carriers are wasting no time using balance billing laws to play hardball in contract negotiations. A <a href="">recent article from Modern Healthcare</a> showcases how carriers nationally are using the No Surprises Act to push for rate cuts in contract negotiations with physicians as part of an effort to tip the scales when claims go to dispute resolution. And while a recently issued <a href="" target="_blank" rel="noreferrer">updated rule</a> and <a href="" target="_blank" rel="noreferrer">guidance</a> implementing the No Surprises Act may help deemphasize the importance of carriers' contracted rates, it's likely that theses heavy-handed negotiating practices are here to stay. </p> <p> It's important that we push back against carriers' overly aggressive contracting practices and maintain a level playing field for physicians to contract at reasonable rates. In meetings with medical group leaders, a common refrain is that carriers are demanding significant rate cuts and, in some cases, refusing to negotiate altogether. </p> <p> If your practice is among those that are experiencing challenges in contracting with insurance carriers due to balance billing laws, we'd like to hear from you. Please contact me at <a href=""></a> and Sean Graham at <a href=""></a> so we can discuss further. </p> </div>9/2/2022 9:57:45 AM9/2/2022 9:55:56 AM9/2/2022 12:00:00 AM
weekly_rounds_august_5_2022_tuesdays_primary_elections_the_wave_that_wasntWeekly Rounds: August 5, 2022 - Tuesday's Primary Elections: The Wave that Wasn't?Weekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_august_5_2022_tuesdays_primary_elections_the_wave_that_wasnt<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-alex-645x425px.png" class="pull-right" alt="Weekly Rounds logo with Alex Wehinger" /></div> <h5>August 5, 2022</h5> <h2>Tuesday's Primary Elections: The Wave that Wasn't?</h2> <p> Alex Wehinger, WSMA Associate Director of Legislative and Political Affairs </p> <p> With so many factors at play heading into Tuesday's primary elections, even political insiders were reluctant to make predictions. With no shortage of offices up for election, including 123 state legislative positions, all 10 of the state's congressional House seats, and the U.S. Senate seat held by Sen. Patty Murray, both political parties are expecting primary results to forecast their respective chances in November's general elections. Regardless of the outcome, these elections will have a significant influence over the state's political landscape, impacting the future of health care policy in Washington. </p> <p> The <a href="">secretary of state's elections website</a> is tracking election returns while hundreds of thousands of ballots continue to be counted in the coming days and weeks due to Washington's vote-by-mail system. As such, the takeaways discussed below are preliminary and some results may shift substantially by the time results are finalized and the primary election is certified. </p> <p> At the congressional level, all the state's incumbents appear to be advancing to the November ballot in Washington's "top two" primary system. Issaquah pediatrician Rep. Kim Schrier performed well, garnering just shy of 50% of her district's votes, though the race will remain competitive. It's too soon to tell who Schrier will face in November, with the top Republican challengers separated by less than 1,000 votes. Embattled congressional Republicans who voted for former President Donald Trump's impeachment look to be advancing to the general, with Rep. Jaime Herrera Beutler and Rep. Dan Newhouse surviving conservative challengers. And Sen. Patty Murray bested a crowded field of almost 20 challengers, sailing to a primary victory that portends being repeated in the general. </p> <p> Early results from state legislative races seem to buck conventional wisdom that the president's political party typically loses seats during midterm election years. Going into the primary, Republicans forecasted a "red wave" with campaigns centered on inflation, high gas prices, and public safety. On the other hand, Democrats signaled they were playing defense to retain seats they'd gained since 2018 that looked to once again be competitive. Leaning into the progressive policy wins of recent years, they focused their messaging on abortion access and addressing climate change. </p> <p> Before diving into the details, the open seat race in North Seattle's 46th Legislative District is of particular relevance for the physician community. Lelach Rave, a pediatrician who worked at The Everett Clinic, is leading a crowded primary field, and the other physician in the race, family physician Nancy Connolly, is currently finishing third. There may be shifts in the coming weeks, but at least one physician will be on the ballot for this seat in November, creating an opportunity to see a physician in the state Legislature for the first time in almost a decade. </p> <p> As things stand, Democrats look poised to maintain strong majorities in both the House and Senate, while Republicans are recalibrating expectations and asking themselves what happened. Almost every district that was considered a tossup, or even those targeted as potentially competitive, were handily won by Democrats, including: </p> <ul> <li>10th Legislative District (La Conner): Democrats are performing strongly in both legislative races, with a Democratic challenger on target to potentially knock off a Republican House incumbent.</li> <li>26th Legislative District (Gig Harbor): In what is considered the most competitive Senate race of the year, the Democrat incumbent garnered around 52% of the vote. A Democrat is also ahead in the open seat House race.</li> <li>30th Legislative District (Federal Way): Both Democrat incumbents are winning their races, and a Democrat is also leading the votes for the open seat.</li> <li>44th Legislative District (Mill Creek) and 47th Legislative District (Kent): Between the two districts, all six seats look likely to remain in Democratic control.</li> </ul> <p> Based on preliminary primary returns, the only swing district where Republicans performed particularly well is Whatcom County's 42nd Legislative District. If these numbers hold, there will be lots of speculation in the coming weeks attempting to explain the lack of a Republican wave. There may be several factors, the most obvious being the Supreme Court's decision to overturn Roe v. Wade, which helped galvanize and energize many progressive voters, especially in key Puget Sound swing districts. </p> <p> As you would expect, Democrats are doing victory laps extolling the early returns, while Republicans warn that there are still lots of ballots left to be counted. But barring significant shifts in the primary results as ballots continue to be counted, or political winds shifting between now and November, a Democratic-controlled Legislature looks all but certain to continue in 2023. </p> <p> The general election is on Tuesday, Nov. 8. If you are interested in learning more about campaigns or getting connected with the work of <a href="[@]WSMA/Advocacy/WAMPAC/WSMA/Advocacy/WAMPAC/WAMPAC.aspx">WAMPAC</a>, WSMA's political action committee, please contact Alex Wehinger, WSMA's associate director of legislative and political affairs, at <a href=""></a>. </p> </div>8/5/2022 10:52:14 AM8/5/2022 10:11:57 AM8/5/2022 12:00:00 AM
weekly_rounds_july_29_2022_5_things_you_may_have_missedWeekly Rounds: July 29, 2022 - 5 Things You May Have MissedWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_july_29_2022_5_things_you_may_have_missed<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>July 29, 2022</h5> <h2>5 Things You May Have Missed</h2> <p>Jennifer Hanscom, CEO</p> <p> While for many the news cycle may appear to slow a bit in the summer months, that's rarely the case for physicians and health care. If you've been busy these past weeks, whether in your practice or (hopefully) on a much-needed vacation, here are several quick news updates to keep you abreast of the health care news cycle here in the Evergreen State. </p> <h3>Washington's hospitals and health systems face large financial losses</h3> <p> Last Thursday, the Washington State Hospital Association held a press briefing to announce the results of a statewide financial impact survey of Washington's hospitals. Hospitals representing 97% of all inpatient beds in Washington state responded to survey, which compared hospitals' financial performance of the first quarter of 2022 to the first quarter of 2021. The survey results paint a dire picture, with hospital operating revenues up 5%, operating expenses up 11% (driven by increased workforce, supply, and drug expenses), and total operating losses combined with investment losses resulting in a net loss of $929 million (a 13% net loss). All 52 urban hospitals and health systems reported negative margins, and account for 99% of losses statewide. Of the independent rural hospitals, 18 out of 34 reported negative margins. Reasons cited for these large losses include low Medicaid reimbursement, high inflation and labor shortages, employee compensation increases, temporary labor spending increases, more complex patients with costs of care higher than rates of reimbursement, especially patients on Medicaid and Medicare, and expenses related to the large and increasing number of patients ready for discharge unable to be transferred. </p> <p> In response to this financial shortfall, WSHA is asking the state to act to get difficult-to-discharge patients into appropriate settings to allow hospitals to focus on critical care, and it will seek long-term solutions from the Legislature in 2023, including an increase in Medicaid rates for hospitals, funding for new facilities for patients needing long-term care, and funding to address the behavioral health crisis, including more staffing, facilities, and upstream interventions. </p> <h3>WSMA seeking input for 2023 legislative agenda</h3> <p> Speaking of Medicaid rates, the WSMA will be pursuing raising Medicaid rates to Medicare levels for all physician services in 2023 (to include services performed by PAs and ARNPs). This is just one of the priorities topping our preliminary 2023 legislative agenda. Our team has surveyed WSMA's membership and leadership on the most pressing issues facing their practices and we will be using those results to outline what we plan to pursue in the 2023 session. You can get a preview of what issues are rising to the top of our agenda at our next Advocacy Council meeting on Aug. 16 at noon via Zoom. During the session, our government affairs team will also provide insights on the fall midterm elections and how they may affect our agenda in 2023. <a href="">Register for the WSMA Advocacy Council meeting online</a>. </p> <h3>Registration is now open for the WSMA Annual Meeting</h3> <p> The WSMA is set to have our Annual Meeting Oct. 1 and 2 at the Davenport Hotel in Spokane. In preparing for the policy debate that takes place at the House of Delegates, our staff is collecting resolutions to set our policy or direct our action. If you have an idea you'd like to get before the House of Delegates, a resolution template and other frequently asked questions can be found <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136&_zs=B3aFd1&_zl=mhKU8">on the WSMA website</a>. To have your resolution included in the delegate handbook (a compilation of resolutions and other business to be considered by delegates at the Annual Meeting) you must submit it to <a href=""></a> by Aug. 12. All resolutions must be sponsored by two WSMA delegates. If you need help identifying sponsors or have additional questions on the House of Delegates or resolution drafting, email the WSMA Policy Department at <a href=""></a>. </p> <p> As soon as resolutions are finalized with a fiscal note and health equity note, they will be posted in our password-protected Virtual Reference Committees, where all members can share their thoughts and opinions. <a href="[@]WSMA/Membership/Discussion_Forums/Virtual_Reference_Committees/WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx?hkey=d674a5ae-4fb5-48d6-b969-16aab9b63647&_zs=B3aFd1&_zl=ohKU8">Bookmark the page to join the conversation</a>. </p> <h3>WSMA provides input on apprenticeship rulemaking to L&I</h3> <p> The Department of Labor and Industries has initiated <a href="" target="_blank" rel="noreferrer">rulemaking</a> on apprenticeships as a result of <a href="">Senate Bill 5600</a>, which passed the Legislature in 2022 with the intent of sustaining and expanding the state's registered apprenticeship programs. The WSMA supported this legislation during session and will provide the same support throughout the rulemaking process. The WSMA submitted a <a href="" target="_blank" rel="noreferrer">comment letter</a> on June 24 requesting that L&I consider an apprenticeship platform for medical assistants under the health care and behavioral health platform. Providing medical assistants an apprenticeship pathway will strengthen care teams, improve the quality of care patients receive, and help mitigate workforce issues facing our state. This rulemaking is still in the 101 phase, or Preproposal Statement of Inquiry. The WSMA will be sure to keep you apprised of updates as this rulemaking progresses. </p> <h3>Payers must post negotiated prices</h3> <p> The Centers for Medicare and Medicaid Services' <a href="">Transparency in Coverage final rule</a> took effect on July 1, requiring payers nationwide to publish the cost of nearly every health care service they've negotiated with physicians and health care professionals. The rule requires payers to disclose in-network physician and health care professional rates for covered items and services; out-of-network allowed amounts and billed charges for all covered items and services; and negotiated rates and historical net prices for covered prescription drugs administered by physicians and health care professionals. Payers not in compliance could face fines of up to $100 per day for each violation and for each individual affected by the violation. The rule provides accommodations for health plans using alternative reimbursement arrangements that cannot accurately provide a specific dollar amount until after services are rendered. If you have any questions about CMS' new rule you may contact our policy department at <a href=""></a>. </p> <p> As always, thank you for all you do in caring for Washingtonians, and keeping our state healthy. </p> </div>7/29/2022 10:17:40 AM7/29/2022 10:17:13 AM7/29/2022 12:00:00 AM
weekly_rounds_july_15_2022_impactful_policy_begins_with_a_resolutionWeekly Rounds: July 15, 2022 - Impactful Policy Begins with a ResolutionWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_july_15_2022_impactful_policy_begins_with_a_resolution<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>July 15, 2022</h5> <h2>Impactful Policy Begins with a Resolution</h2> <p>Jennifer Hanscom, CEO </p> <p> Looks like summer has finally arrived in the Pacific Northwest. I hope you have had a chance to take some time for yourself during these summer months. We've all seen so much upheaval over the last several years and even in the most recent weeks. It's a lot to take in. In fact, as I write this, I'm at the WSMA executive committee retreat, where your WSMA leaders are taking a moment to reflect on where we are today and where we, as the voice of the profession and our patients, need to focus in the months and years ahead. </p> <p> The executive committee doesn't do this work in a vacuum. We've met with leaders of county medical societies, specialty societies, medical groups, health systems, and other organizations. During our retreat we are meeting with legislative leaders. All of this is meant to inform our work, including the building of our 2023 strategic plan and next year's legislative agenda. </p> <p> We also anticipate more feedback and direction from our membership at the <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f&_zs=B3aFd1&_zl=IFpS8">2022 Annual Meeting of the WSMA House of Delegates</a>, to be held in person Oct. 1-2 at The Historic Davenport in Spokane. </p> <p> While we have a few months to go before the Annual Meeting, the summer months of July and August are when WSMA delegates prepare and submit resolutions for consideration by the House when it convenes in the fall. Resolutions are one of the main policy drivers at the association. Simply put, they are proposals that ask the WSMA to take a position or act on an issue. </p> <p> While two WSMA delegates are required to sponsor a resolution, any interested WSMA member may initiate a resolution if they have a policy they wish to see passed by the House. (WSMA staff will help you connect with the delegates.) </p> <p> The WSMA offers detailed instructions on <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136&_zs=B3aFd1&_zl=JFpS8">how to write and submit a resolution</a>. There are three stages in a resolution's development: 1. developing your resolution idea, 2. formatting the resolution, and 3. identifying sponsors and submission. </p> <h3>Developing your resolution</h3> <p> To hone your idea, remember that good policy starts with a good resolution. Use the following resources to increase the odds that your resolution leads to a constructive outcome at the House: </p> <ul> <li>Check for existing policy - Take a moment and consult the <a href="[@]WSMA/About/Policies/Whats_Our_Policy/Policy_Index.aspx?_zs=B3aFd1&_zl=KFpS8">WSMA Policy Compendium</a> to make sure the subject isn't already addressed in current WSMA policy. Alternatively, you may seek to modify existing WSMA policy. If you'd like to advance a change in the governance and regulation of the WSMA, download and review the <a href="[@]WSMA/About_Us/Policies/WSMA/About/Policies/Policies.aspx?hkey=672dbce4-f8bc-4f92-9c63-c72558dfa7b6&_zs=B3aFd1&_zl=LFpS8">WSMA bylaws</a> for reference.</li> <li>Check for health equity impact - Before submitting your policy proposal, use this <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?_zs=B3aFd1&_zl=NFpS8#DEI">equity evaluation tool</a> to consistently assess the diversity, equity, and inclusion impacts of potential new WSMA policy.</li> <li>Discuss with other WSMA members - Tapping the expertise of your colleagues can help you hone your proposal and increase its chances for adoption. Post your resolution idea to the WSMA's <a href="[@]WSMA/Membership/Discussion_Forums/General_Discussion_Forum/WSMA/Membership/Discussion_Forums/general_discussion_forum.aspx?hkey=904922a3-1548-46a9-8634-44aa41a0d45d&_zs=B3aFd1&_zl=OFpS8">online general discussion forum</a> for discussion with other members. The forum is password-protected and available year-round.</li> </ul> <h3>Formatting the resolution</h3> <p> Once you've developed and honed your idea, it's time to organize your proposal into the required resolution format. For details on how to format your proposal using the five basic elements of a resolution, review our <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136&_zs=B3aFd1&_zl=QFpS8#howto">detailed instructions</a> on how to format a resolution (a template is provided). </p> <h3>Identifying sponsors and submission deadlines</h3> <p> Remember, resolutions must be sponsored by at least two WSMA delegates, and must be submitted in writing by a delegate, alternate delegate, or member of the board of trustees. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to find a sponsor. Contact us at <a href=""></a> or 206.441.9762 for assistance. </p> <p> To be considered at the 2022 WSMA House of Delegates, be sure to meet these deadlines for resolution submission. </p> <ul> <li>Aug. 12 - Resolutions due for inclusion in delegate handbook.</li> <li>Sept. 1 - Final deadline for resolutions.</li> </ul> <p> Per the WSMA bylaws, resolutions submitted after the final Sept. 1 deadline are considered late and require a two-thirds vote of the House to be considered for debate at the meeting. </p> <h3>What happens after you submit your resolution?</h3> <p> Once you submit your resolution, WSMA staff will review the resolution for any legal or legislative concerns and will work with you to establish a fiscal note (the cost, if any, to implement the resolution if adopted). The WSMA Diversity, Equity, and Inclusion Committee will also evaluate resolutions for equity impacts and will add a health equity note as appropriate. </p> <h3>How to serve as a WSMA delegate at the Annual Meeting</h3> <p> The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county society or specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2022 WSMA Annual Meeting, please contact your local <a href="[@]WSMA/About_Us/Partner_Organizations/County_Medical_Societies/WSMA/About/Partner_Organizations/County_Medical_Societies/County_Medical_Societies.aspx?hkey=718f0a74-10ca-4fe2-8c45-d2434ed861de&_zs=B3aFd1&_zl=TFpS8">county society</a> or <a href="[@]WSMA/About_Us/Partner_Organizations/State_Specialty_Societies/WSMA/About/Partner_Organizations/State_Specialty_Societies/State_Specialty_Societies.aspx?hkey=df249f5e-6385-417e-ba44-426ac03fa84d&_zs=B3aFd1&_zl=VFpS8">state specialty society</a>. </p> <p> This will be our first in-person Annual Meeting in three years, so I hope to see many returning faces for the first time in a long while. And I hope to see even more new faces! For you physicians and physician assistants who are new to the WSMA, the Annual Meeting is an excellent way to get involved and help us achieve our vision to make Washington state the best place to practice medicine and receive care. Please consider joining us, and let's make this meeting one to remember. </p> </div>7/28/2022 4:28:37 PM7/15/2022 10:29:46 AM7/15/2022 12:00:00 AM
weekly_rounds_july_1_2022_services_to_assist_your_practiceWeekly Rounds: July 1, 2022 - Services to Assist Your PracticeWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_july_1_2022_services_to_assist_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>July 1, 2022</h5> <h2>Services to Assist Your Practice</h2> <p>Jennifer Hanscom, CEO</p> <p> We are halfway through 2022 and here at the WSMA we are celebrating a strong membership year. Currently our membership is up nearly 6% over our 2021 numbers, with a record-breaking 12,431 members! </p> <p> There truly is strength in numbers, a strength which enables the WSMA to have a powerful collective voice in speaking up for what matters to physicians. I'm grateful to all the groups and individuals who invest in WSMA membership. By doing so, you're making a direct investment in professional fulfillment, leadership development, and, of course, advocacy. </p> <p> As you know, advocacy is at the heart of our work in Olympia, where we are at the table raising up your voice when discussions regarding health care are taking place. Thanks to those efforts, we had a 100% success rate with our priority bills this year. I hope you've taken a moment to review those successes by reading the 2022 Legislative Report we mailed to you recently. You'll find WSMA's achievements on your behalf outlined there in detail. In case you missed it, WSMA members can access the <a href="[@]WSMA/Advocacy/Legislative___Regulatory/wsma_legislative_report/WSMA/Advocacy/Legislative_Regulatory/wsma_legislative_report/wsma_legislative_report.aspx?hkey=cbef4d49-c104-4c3a-96b4-ac866dcbf5e0&_zs=B3aFd1&_zl=RHgR8">2022 Legislative Report</a> on our website. </p> <p> While we know advocacy is one reason our members engage with and support the WSMA, we continue to deliver on our value proposition to build out resources that help you, particularly in your practice setting. Your membership entitles you to exclusive access to vendor products and services that will help you and your practice or medical group grow and thrive. Even better, these services are directly aligned with solving the practice issues you told us you needed. With your input, we sought vetted partners who would bring you services you need with the additional benefit of a WSMA members-only discount. </p> <p> In addition to our longstanding partnership with Physicians Insurance, our other partners include: </p> <ul> <li><a href="[@]WSMA/Membership/Why_Join_the_WSMA_/Affinity_Program/PatientPop.aspx?_zs=B3aFd1&_zl=SHgR8">PatientPop</a> - A practice growth platform offering digital strategy and services to enhance the patient journey.</li> <li><a href="">iScribeHealth</a> - Efficient mobile solutions to help you save time, with one solution for every workflow.</li> <li><a href="">Gentem</a> - Medical billing solutions that help you get paid more and faster.</li> <li><a href="[@]WSMA/Membership/Why_Join_the_WSMA_/Affinity_Program/sis_nw.aspx?_zs=B3aFd1&_zl=WHgR8">Spectrum Information Services Northwest</a> - Outsource services that automate time intensive processes like mailroom, receivables, payables, and medical records.</li> </ul> <p> Regardless of your practice size or specialty, take a moment to learn more about how your practice can thrive and save at <a href="[@]affinity?_zs=B3aFd1&_zl=aHgR8"></a>. Please share with your practice leadership, as well. </p> <p> As always, thanks for your support of the WSMA. We are here for, and because of, you! </p> </div>7/1/2022 10:22:27 AM7/1/2022 10:20:37 AM7/1/2022 12:00:00 AM
weekly_rounds_june_17_2022_progress_and_priorities_for_the_professionWeekly Rounds: June 17, 2022 - Progress and Priorities for the ProfessionWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_june_17_2022_progress_and_priorities_for_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>June 17, 2022</h5> <h2>Progress and Priorities for the Profession</h2> <p>Jennifer Hanscom, CEO</p> <p> I'm writing this as I fly back to Seattle from the American Medical Association's annual meeting in Chicago. Like many of the participants, this was my first large in-person conference since the pandemic began. It was wonderful to reconnect with WSMA delegates, physicians, and medical association colleagues from across the country, as well as AMA staff. </p> <p> Several physicians from Washington state were in attendance, and two WSMA members were voted into AMA council positions: Sheila Rege, MD, WSMA board member and radiation oncologist from the Tri Cities, was reelected to her position on the Council on Medical Service; and David Cundiff, MD, from Ilwaco, was elected to a position on the Council on Science and Public Health. </p> <p> Along with inaugurating a new president, Jack Resneck, Jr., MD, a practicing dermatologist and health policy expert from the San Francisco Bay Area, the AMA also elected its first openly gay president-elect, Jesse Ehrenfeld, MD, an anesthesiologist from Wisconsin. </p> <p> At the meeting the AMA unveiled its <a href="">Recovery Plan for America's Physicians</a> and highlighted its agenda. If you read our biweekly e-newsletter, Membership Memo, or follow us on social media, you know that the AMA's recovery plan mirrors the WSMA's top priorities: </p> <ul> <li>Fixing prior authorization</li> <li>Reforming Medicare payment</li> <li>Fighting scope creep</li> <li>Supporting telehealth</li> <li>Reducing physician burnout</li> </ul> <p> <strong>As a refresher, here is a quick summary of our work in those areas:</strong> </p> <p> <strong>Fixing prior authorization: </strong>As I referenced in a <a href="[@]Shared_Content/News/Weekly_Rounds/2022/weekly_rounds_april_29_2022_prior_authorization_plagues_us_all?_zs=B3aFd1&_zl=aqJQ8">recent Weekly Rounds</a>, addressing prior authorization is a top priority for the WSMA. You may recall that <a href="">new rules</a> went into effect in 2018 that were intended to ease the administrative burden you face as you strive to meet the requirements of state-regulated insurers or their third-party administrators when seeking prior authorization of medical services. The rules set specific timelines and communication requirements and are <a href="" target="_blank" rel="noreferrer">summarized here</a>. You'll also find guidance on 2015 rules covering prior authorization of prescription drugs. </p> <p> We encourage all of our members who encounter an insurer or third-party administrator out of compliance with Office of the Insurance Commissioner's prior authorization requirements to file a complaint by utilizing the <a href="">WSMA's Prior Authorization Navigator's complaint form</a>. </p> <p> <strong>Reforming Medicare payment:</strong> While the WSMA endorses the <a href="">AMA's principles for reforming Medicare</a>, in the short term we are calling on Congress to stop the permanent 2% cut that is due on July 1, which will raise the physician pay cut from 1.75% to 2.75%, barring congressional intervention. Stay tuned for more information on WSMA and organized medicine's advocacy on this front. And keep your eyes on your inboxes for a potential call to action. </p> <p> <strong>Fighting scope creep:</strong> After two years of virtual legislative sessions in Washington state, we anticipate that many groups will be looking to expand their scope of practice when the Legislature (presumably) returns to in-person work in 2023. This past session, the WSMA was successful in defeating attempts at scope expansion by optometrists, naturopaths, psychologists, and others that would have jeopardized patient safety. You can read more about those efforts in our <a href="[@]WSMA/Advocacy/Legislative___Regulatory/wsma_legislative_report/WSMA/Advocacy/Legislative_Regulatory/wsma_legislative_report/wsma_legislative_report.aspx?hkey=cbef4d49-c104-4c3a-96b4-ac866dcbf5e0&_zs=B3aFd1&_zl=uqJQ8">WSMA Legislative Report</a> (WSMA members only - sign in required). We are confident these groups and others will make another attempt at scope expansion in 2023. </p> <p> <strong>Supporting telehealth:</strong> The WSMA has been advocating for laws to facilitate the proliferation of high-value care delivered via telemedicine for nearly a decade, and Washington state is considered a leader across the country in our telemedicine laws. Based on lessons learned around delivering care over telemedicine early in the pandemic, the WSMA championed legislation that generally requires state-regulated insurers to provide the same coverage and reimbursement for audio-only telemedicine services provided to established patients as they would for care delivered in person or via audio-visual telemedicine. More information about this law and more telehealth flexibilities can be found on the <a href="[@]WSMA/Resources/COVID-19_Response/Telehealth/WSMA/Resources/COVID-19/COVID_19_Telehealth/covid_19_telehealth.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae&_zs=B3aFd1&_zl=1rJQ8">WSMA website</a>. </p> <p> Additionally, as you have read in recent <a href="[@]Shared_Content/News/Membership_Memo/2022/June_10/alaska_updates_telemedicine_licensure_policies_for_established_patients?_zs=B3aFd1&_zl=3rJQ8">Membership Memos</a>, Alaska will join <a href="[@]Shared_Content/News/Membership_Memo/2022/May_13/oregon_updates_telehealth_policy_to_allow_care_by_washington_physicians_and_pas.aspx?_zs=B3aFd1&_zl=4rJQ8">Oregon</a> as the second state in our region to permit follow-up care to established patients without being licensed in those states. </p> <p> We still have work to do to secure continued access to telemedicine services for Medicare patients; a major priority for both the AMA and the WSMA. Stay tuned as those conversations continue with our congressional delegation and in Congress. </p> <p> <strong>Reducing physician burnout:</strong> The WSMA Foundation recently received a $150,000 two-year grant to identify best practices that improve well-being and reduce burnout and have practices and organizations pledge to meet the criteria; and to deliver education on emotional intelligence and peer support. This will be an expansion of our work in transforming practices by introducing efficiencies into care delivery such as <a href="[@]Shared_Content/News/Latest_News/2022/pre_visit_planning_is_increasing_efficiency?_zs=B3aFd1&_zl=7rJQ8">pre-visit planning</a>. </p> <p> As always, we will continue to keep you up to date on the WSMA and the AMA's work in these areas via our Membership Memo and website. </p> </div>6/17/2022 9:55:53 AM6/17/2022 9:54:39 AM6/17/2022 12:00:00 AM
weekly_rounds_june_3_2022_physician_driven_patient_focused_starts_with_youWeekly Rounds: June 3, 2022 - 'Physician Driven, Patient Focused' Starts With YouWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_june_3_2022_physician_driven_patient_focused_starts_with_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>June 3, 2022</h5> <h2>'Physician Driven, Patient Focused' Starts With You</h2> <p>Jennifer Hanscom, CEO</p> <p> You've probably noticed the tagline that is part of WSMA's logo: "Physician Driven, Patient Focused." That phrase is a guiding principle in all of WSMA's work, and nowhere is that more apparent than at the Annual Meeting of the WSMA House of Delegates. </p> <p> Not familiar with WSMA's HOD? Here's what you need to know: The WSMA is governed by a House of Delegates comprising delegates from <a href="[@]WSMA/About_Us/Partner_Organizations/County_Medical_Societies/WSMA/About/Partner_Organizations/County_Medical_Societies/County_Medical_Societies.aspx?hkey=718f0a74-10ca-4fe2-8c45-d2434ed861de&_zs=B3aFd1&_zl=hopO8">county medical societies</a>, <a href="[@]WSMA/About_Us/Partner_Organizations/State_Specialty_Societies/WSMA/About/Partner_Organizations/State_Specialty_Societies/State_Specialty_Societies.aspx?hkey=df249f5e-6385-417e-ba44-426ac03fa84d&_zs=B3aFd1&_zl=iopO8">state specialty societies</a>, special sections, and members of the WSMA <a href="[@]WSMA/About/Leadership/Board_of_Trustees/Board_of_Trustees.aspx?_zs=B3aFd1&_zl=jopO8">board of trustees</a>. </p> <p> All of WSMA's legislative power-including the power to alter, amend, or repeal the bylaws-is vested in the House of Delegates. The speaker of the House serves as parliamentarian. The current speaker of the House is Matthew Grierson, MD, of Seattle, and the vice speaker is Ray Hsiao, MD, of Seattle. </p> <p> Policymaking at the Annual Meeting is primarily driven by resolutions. A resolution is a proposal asking the WSMA to take a position or act on an issue. <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?_zs=B3aFd1&_zl=kopO8">Learn more about resolutions and how they help create and guide WSMA policy</a>. </p> <p> These resolutions are debated in two ways: via WSMA's virtual reference committees (in advance of the in-person meeting) and in person at the Annual Meeting (to be held this year in Spokane Oct. 1-2). </p> <p> Reference committee members consider all testimony-online and in person-as they prepare recommendations for the House of Delegates on how to act on resolutions. These reports are distributed during the final House of Delegates session at the Annual Meeting prior to voting on Sunday, Oct. 2. </p> <p> While only delegates can vote on issues before the House of Delegates, all WSMA members are encouraged to add their voice to the process. If you have an issue you'd like the WSMA to rally behind, a law or regulation you'd like to see opposed or implemented, or a quality issue you'd like the WSMA to advance, a resolution is the perfect way to bring the matter to the attention of the largest physician organization in the state. </p> <p> If you are looking for how to begin putting your idea into motion, check out this webinar presented by your WSMA policy team. The policy team is here to help you draft your resolution and can be reached at <a href=""></a>. </p> <p> Resolutions will be accepted and posted to the virtual reference committees prior to the end of August. We encourage you to engage in the debate online in advance of the meeting. </p> <p> If you'd like to serve as a delegate to the House of Delegates, check with your local county medical society and/or specialty society. </p> <p> If you'd like to serve on a reference committee and join us in Spokane Oct. 1 and 2, contact us at <a href=""></a>. </p> <p> As always, if you have questions, let us know. Contact us at <a href=""></a> or <a href=""></a>. </p> </div>6/6/2022 10:53:08 AM6/3/2022 10:17:24 AM6/3/2022 12:00:00 AM
weekly_rounds_may_6_2022_roe_v_wade_in_the_balanceWeekly Rounds: May 6, 2022 - Roe v. Wade in the BalanceWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_may_6_2022_roe_v_wade_in_the_balance<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/weekly-rounds-article-graphic-heshmati-645x425px.png" class="pull-right" alt="Nariman Heshmati, MD" /></div> <h5>May 6, 2022</h5> <h2>Roe v. Wade in the Balance</h2> <p> Nariman Heshmati, MD, WSMA Vice President </p> <p> On Monday, the national media outlet <a href="">Politico</a> released what appeared to be a leak of an initial draft majority opinion from the U.S. Supreme Court that indicated the justices were prepared to overturn Roe v. Wade. This was a historic breach of the court's protocols for a potentially even more historic change in the law. As expected, this report captured the news cycle and has prompted concern among physicians, health care workers, patients, and beyond. </p> <p> It's important to recognize several things. First, this is a draft opinion. It hasn't changed any laws or the ability of patients to have an abortion. Second, even if the final opinion from the court mirrors this draft opinion, abortion will still be legal in Washington state. In 1970, prior to Roe v. Wade, Washington state was one of the first states to decriminalize abortion, and there have been additional steps taken since then to reaffirm this right. </p> <p> This year, the Legislature passed and Gov. Jay Inslee signed into law the <a href="" target="_blank" rel="noreferrer">Affirm Washington Abortion Act</a>, which notes that "it has also been longstanding public policy of the state to promote access to affordable, high-quality reproductive health care, including abortion care, without unnecessary burdens or restrictions" on patients, physicians, or other clinicians or facilities that provide abortion services. </p> <p> So how does this week's news and its implications impact us in Washington state? </p> <p> We likely will see more patients cross state lines to receive care. Speaking to the <a href="">Spokesman-Review</a>, Paul Dillon, vice president of public affairs for Planned Parenthood of Greater Washington and North Idaho, estimated that their health centers in Washington could see as much as a 385% increase in patients seeking abortion services if Roe v. Wade is overturned. </p> <p> We don't know if we have enough resources to meet this potential patient demand since we don't know yet what that demand is. What we do know is that the house of medicine supports a person's right to an abortion without interference. Last year, in response to the Texas law restricting abortions, the American Medical Association said, "<a href=",physician%20relationship%2C%E2%80%9D%20said%20AMA%20President">the American Medical Association stands firmly against government interference in the clinical exam room</a>." In response to the leaked draft opinion, the American College of Obstetricians and Gynecologists reiterated, "<a href="">We will continue to affirm that the ability of patients to access safe, legal abortion is critical for their health and well-being</a>." </p> <p> The WSMA affirms a <a href="[@]WSMA/About/Policies/Whats_Our_Policy/Abortion/Abortion.aspx?_zs=B3aFd1&_zl=JVVL8">person's right to an abortion as a medical decision to be made under the advice and guidance of a physician</a>, and strongly opposes any attempt to restrict the availability of abortion or other reproductive health care. As <a href="">noted by ACOG</a>, restrictive abortion access laws put physicians and clinicians in the unconscionable position of having to choose between upholding the law and providing appropriate patient care. </p> <p> We do not know what the future will hold. We do know abortion will remain legal in Washington state regardless of how the Supreme Court ultimately rules. We also know that we must continue to advocate at all levels of government, in this Washington and the other Washington, to protect our patients and their access to evidence-based health care services. </p> <p> <em>Nariman Heshmati, MD, is an OB-GYN and vice president of the WSMA. In addition to his role on the WSMA executive committee, Dr. Heshmati is the past chair of the Washington section of the American College of Obstetricians and Gynecologists.</em> </p> </div>5/10/2022 10:31:29 AM5/10/2022 10:31:02 AM5/6/2022 12:00:00 AM
weekly_rounds_april_29_2022_prior_authorization_plagues_us_allWeekly Rounds: April 29, 2022 - Prior Authorization Plagues Us AllWeekly_RoundsShared_Content/News/Weekly_Rounds/2022/weekly_rounds_april_29_2022_prior_authorization_plagues_us_all<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-2021-645x425px.jpg" class="pull-right" alt="Weekly Rounds logo" width="645" height="425" /></div> <h5>April 29, 2022</h5> <h2>Prior Authorization Plagues Us All</h2> <p>Jennifer Hanscom, CEO</p> <p> If there's one issue that unifies all physicians-regardless of specialty, practice size, or employment status-it is their mutual loathing of prior authorizations. According to a 2021 survey from the American Medical Association, physicians complete an average of 41 prior authorizations per week, an administrative burden that consumes nearly two business days of physician and staff time. The burden has become so acute that 40% of physician survey respondents hired staff to work exclusively on prior authorization requirements. </p> <p> Getting authorized to provide services demands time and attention that would be better spent on patients and their care. After-hours navigation of ever-changing, non-reimbursable criteria only adds to the frustration. Physicians and staff are driven to madness by red tape while patients suffer potentially health-threatening delays in receiving approval for necessary treatment, even if-and that's a big "if"-at the end of a long and often arbitrary process the procedure or prescription is approved. </p> <p> Prior authorization undermines physicians' medical expertise and leads to considerable delays in patient care. According to that same AMA survey, 93% of physicians reported care delays associated with prior authorization, and 82% said these requirements can at least sometimes lead to patients abandoning treatment. Failure to administer medically necessary care can lead to poor health care outcomes. Most startlingly, 34% of AMA survey participants reported that prior authorization led to a serious adverse event, such as hospitalization, disability, and permanent bodily damage or death, for a patient in their care. </p> <p> On a macro level, because physician practices need to hire staff to work exclusively on prior authorizations, and with delays caused by the process sometimes leading to serious adverse events requiring higher levels of care, prior authorizations increase the cost of delivering care for everyone. </p> <p> The WSMA has worked hard to address prior authorization challenges in Washington. You may recall that <a href="">new rules</a> went into effect in 2018 that were intended to ease the administrative burden you face as you strive to meet the requirements of state-regulated insurers or their third-party administrators when seeking prior authorization of medical services. </p> <p> The rules set specific timelines and communication requirements and are <a href="" target="_blank" rel="noreferrer">summarized here</a>. You'll also find guidance on 2015 rules covering prior authorization of prescription drugs. </p> <p> <strong>If you encounter an insurer or third-party administrator out of compliance with Office of the Insurance Commissioner's prior authorization requirements, you can easily file a complaint by utilizing the WSMA's Prior Authorization Navigator's <a href="">complaint form</a>. We urge you to take advantage of this tool.</strong> </p> <p> At the federal level, Congress is increasingly concerned about the negative impact of prior authorization on patients and physicians within federal health care programs. In fact, just this week a <a href="" target="_blank" rel="noreferrer">federal report</a> found that some people enrolled in private Medicare Advantage plans were denied necessary care. Helpfully, a bipartisan collection of House and Senate lawmakers have introduced H.R. 3173/S. 3018, the Improving Seniors' Timely Access to Care Act. The bill is sponsored by Washington's CD 1 Rep. Suzan DelBene, with other co-signers from our state including Reps. Schrier (CD 8), Smith (CD 9), Strickland (CD 10), Herrera-Beutler (CD 3), and Larsen (CD 2). </p> <p> The bill reduces unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program. Specifically, the bill would: </p> <ul> <li>Require Medicare Advantage plans to implement electronic prior authorization programs that adhere to newly developed federal standards and are capable of seamlessly integrating into electronic health systems (vs. proprietary health plan portals), as well as establish real-time decision-making processes for items and services that are routinely approved.</li> <li>Mandate that plans report to the Centers for Medicare & Medicaid Services on the extent of their use of prior authorization and the rate of approvals and denials.</li> <li>Require plans to adopt transparent prior authorization programs that are reviewed annually, adhere to evidence-based guidelines, permit gold carding, and include continuity of care for individuals transitioning between coverage policies to minimize any care disruptions.</li> <li>Hold plans accountable for making timely prior authorization determinations and providing rationales for denial.</li> </ul> <p> While the legislation would only apply to Medicare Advantage plans, it represents a major first step at the federal level toward combatting insurer oversteps. The WSMA continues to meet with our members of Congress urging a vote on the bill this calendar year. </p> <p> While we wait to see what action Congress will take, the WSMA continues to work on the issue in our state. Based on the WSMA's recent advocacy, plans in Washington are required to provide data on their prior authorization practices to the Office of the Insurance Commissioner. Data points include those medical/surgical services most frequently requiring authorization, those most frequently approved, and those where authorization is initially denied and then overturned on appeal. Carriers must also report on their average response time for prior authorization requests. This information will help increase transparency and strengthen WSMA's advocacy by improving lawmakers' understanding about the effect prior authorization has on access to care. </p> <p> Even as I write, we are working on our 2023 legislative agenda, and we anticipate our work is far from over on this topic. As we contemplate next steps on this and many other issues in advance of the 2023 legislative session, I hope you'll participate in our upcoming advocacy survey. Your voice-and your membership-matter. </p> </div>4/29/2022 9:58:04 AM4/29/2022 9:56:24 AM4/29/2022 12:00:00 AM
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