Saturday, December 16, 2017

OCMA Blog

IMQ's Stepping Up to Leadership earlybird pricing ends January 31

Earlybird pricing for the Institute for Medical Quality (IMQ) Stepping Up to Leadership conference ends January 31. Sponsored by IMQ and the PACE Program at UC San Diego, Stepping Up to Leadership is an interactive training course that helps physicians learn best practices and creative approaches for resolving common problems encountered as a medical staff officer or department or committee chair. Through small-group interactive teaching modalities, the course gives both experienced and new physician leaders the opportunity to gain practical knowledge and skills, and to learn the tools and techniques that are essential to effectively lead a medical staff. This is an event for the entire leadership team.The program addresses:

  • What it takes to be a successful leader;
  • Aligning medical staff & hospital interests;
  • Effective communication;
  • Challenges to on‐call panels, credentialing;
  • Disruptive professionals, impaired individuals;
  • Physician well being committees;
  • Using quality measures to enhance outcomes;
  • Legal considerations

The 2014 Stepping Up to Leadership program will take place March 6-8 at the Loews Coronado Bay Hotel in San Diego. A generous grant from the Physicians Foundation allows IMQ and PACE to offer Stepping Up to Leadership at prices as low as $595. Take part in an interactive learning environment led by expert faculty who engage participants through self‐assessments, Q&A, role playing & case studies.

Register now at http://physician-leadership.org/.


Local charity reports on recent volunteer medical mission to Vietnam

The second volunteer medical mission of the year undertaken by Arpan Global and its large cadre of supporters was October 5-12, 2013, to the Thai Hoa Hospital in Cao Lanh Vietnam (the Dong Thap province). This hospital lies to the south of Ho Chi Minh City by about a 3-hour bus drive in a very rural area.  It is a tropical area, lush with green vegetation and abundant rice fields.  The people are warm, friendly, eager to practice any English they know, curious about the rest of the world, and willing to help in any way possible for whatever reason.  Their hospitality was heartfelt and their kind and gentle words and actions clearly came from the heart.

The Thai Hoa Hospital is a relatively new, private hospital built specifically to serve a large catchment area in the Don Thap province and is located in fairly close proximity to the older public hospital.  The first floor contains the outpatient clinic areas, radiology, pharmacy, emergency treatment and waiting areas.  Upstairs is the labor and delivery units, postpartum, the nursery (which includes three isolettes and a ventilator for premature babies), and the pediatrics ward.  The third floor holds the operating rooms (including one dedicated for cesarean sections), recovery room, and the general wards.  The facility is clean, modern, and there is a real sense of pride of ownership among those who work there.

This was one of the largest mission teams that Arpan Global has assembled, with 52 dedicated individuals making their way to the other side of the planet in order to participate.  The range of medical and healthcare services represented was quite wide:  

  • Anesthesiology
  • Pediatrics, including neonatology
  • Internal Medicine, including cardiology
  • Radiology, including ultrasonography
  • Surgery, including plastics, GI, urology, orthopedics, ENT
  • Obstetrics and Gynecology
  • Dentistry
  • Nursing
  • Occupational therapy
  • Pharmacology
  • Social worker

Even nonmedical experts were present, willing and able to do whatever they could to help with patient flow and even patient care when possible.  

While the hospital isimpressive for its modernity, it attracts a patient population that can be limited in size.  The outpatient sites serviced by the team were another story.  Patients in local towns and villages lined up for the chance to get a lottery ticket to be seen by the visiting medical team and they were there early in the morning, ready and willing to wait all day if necessary.  Triage desks were set up at each site with local volunteers from Cao Lanh serving as translators.  Vital signs were taken and after the concerns of the patient were ascertained, they were directed to an available medical team for evaluation, diagnosis and treatment.  (If specific specialty needs were identified, they were sent to the experts on site).   A space for occupational and physical therapy was created at each site, as was an impromptu pharmacy and dispensary.  The dental area was extremely popular and often the last to finish each day.  After several of these day-long outpatient visits, it became clear that hypertension (often severe and completely uncontrolled), osteoarthritis, chronic low back pain, and lack of oral hygiene were among the preeminent and common complaints in the general population. 

Trips to orphanages along with visits to government sponsored homes for disabled children and the elderly homeless were also part of the itinerary.  Arpan Global was able to donate a water filter, washer and dryer, and a computer to some of these facilities.  A day-long trip to a shelter for women and girls who had been victims of human trafficking highlighted the impact that desperate levels of poverty and lack of vocational skill sets play in enabling trafficking to occur. 

By the end of the week, the team had seen over 800 patients, performed 125 dental procedures, several complex medical procedures, and many diagnostic procedures, allowing for appropriate treatment and intervention to begin for those patients.  More importantly, the team members felt like they had made a difference in the lives of people and the only issue of concern was the feeling that they wanted to do more.   Vietnam has been called Asia’s ‘comeback kid’ economically and while many are feeling the success, there still remains a great need for modernization and improvement in the health care system.  Arpan Global is proud to have had the opportunity to make its own contribution towards meeting that need in its own way.

For more information please contact Sudeep Kukreja, MD at (714) 585-1920

Vietnam mission team, Arpan Global Charities

Competition Opens for Young Physicians Patient Safety Award

Medical Students and Residents Encouraged to Submit Essays for $5,000 Awards


Napa, California—November 18, 2013
—Entries are now being accepted for the 2014 Young Physicians Patient Safety Award, The Doctors Company Foundation announced today. Medical students and residents are eligible to compete for six $5,000 awards. Winners will also receive travel to the Association of American Medical College’s Integrating Quality meeting in Chicago June 12–13, 2014, where the awards will be presented.

Entrants must be third- or fourth-year medical students or first-year residents who were in a hospital setting as of June 2013. Entrants must submit a 500- to 1,000-word essay describing an instructional patient safety event they experienced during a clinical rotation that resulted in a personal transformation. Essays are due by 5:00 PM (ET) on Monday, February 3, 2014. Online entry forms are available at http://bit.ly/PtSafetyAward.

The contest is sponsored by The Doctors Company Foundation in partnership with the Lucian Leape Institute at the National Patient Safety Foundation (NPSF). Entries will be judged by a panel selected by the NPSF.

“One of the missions of our Foundation is to support patient safety education for healthcare professionals,” said Leona Egeland Siadek, the Foundation’s executive director. “The Young Physicians Patient Safety Award is a key to this mission. These essays bring to the forefront the importance of making the culture of safety an integral part of the culture of medicine.” 

Past winning essays can be read at http://npsfcongress.org/young-physicians-essays/2013-winners-one/.

About The Doctors Company Foundation
The Doctors Company Foundation was created in 2008 by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer. The purpose of the Foundation is to support patient safety education for healthcare professionals, patient safety research with clinically useful applications, and medical professional liability research. In this context, patient safety is defined as a healthcare discipline that minimizes the incidence and impact of adverse events by redesigning systems and processes using human factors principles to reduce errors.

### 
Contact: Alina Gomez, agomez@the doctors.com

Prescription Drug Abuse – What to Look For

By Ann Whitehead, JD, RN
Vice President of Risk Management & Patient Safety Cooperative of American Physicians, Inc.

The Centers for Disease Control and Prevention (CDC) has classified prescription drug abuse as an epidemic. A staggering statistic from the National Drug Abuse Institute reveals prescription drugs are the second most abused drug, behind marijuana, by seniors in high school. The CDC finds overdoses from prescription painkillers resulted in more deaths in 2010 than heroin and cocaine combined.1

Prescription drug abuse affects all age, race, gender, and socioeconomic classes. Here are two examples: the patient on an antidepressant prescribed by his psychiatrist was also taking a narcotic prescribed by an orthopedist. In a drug-induced haze, the man threw himself down a flight of stairs, breaking his neck; or the 83-year-old patient who recently came to the office for morphine who later tested positive for cocaine. Both patients create liability and treatment issues for their physicians. 

Although many types of prescription drugs are abused, there is currently a growing, deadly epidemic of prescription painkiller abuse. Nearly three out of four prescription drug overdoses are caused by prescription opioid painkillers. The U.S. Drug Enforcement Administration (DEA) and the California Department of Justice are aggressively prosecuting individuals who prescribe opioids illegally and those who operate “pill mills.” Physicians face challenges when trying to spot the patient who may be abusing prescription drugs or possibly improperly sharing them with others. The following are some suspicious behaviors that may raise the red flag. 

The patient may:

• Refuse to grant permission to obtain old records or communicate with previous physicians.
• Demonstrate reluctance to undergo comprehensive histories, physical examinations, or diagnostic testing, especially urine drug screenings.
• Request specific drugs (often because of the higher resale value of brand names).
• Profess multiple allergies to recommended medications.
• Resist certain treatment options.
• Threaten doctors or display anger during visits.
• Consistently target appointments at the end of the day or during off hours.
• Repeatedly lose prescriptions.
• Request escalation in dosages.
• Demonstrate noncompliance with prescription instructions.

A helpful tool for physicians is the “Opioid Overdose Toolkit: Information for Prescribers” recently released by the Substance Abuse and Mental Health Services Administration (SAMHSA).2 This guide offers tips on safe prescribing and preventing opioid overdose including: assessment, state drug monitoring programs, medication selection, prescription writing tips, use of naloxone, and deciding when to stop opioid.

Lastly, if you get a call from the DEA or local law enforcement, contact the CAP Hotline for assistance.

For more information about CAP, or to request additional information or risk management publications, please contact us at: MD@CAPphysicians.com, or call 800-356-5672. You can also visit our website at: www.CAPphysicians.com.


1 Centers for Disease Control and Prevention (CDC). CDC grand rounds: Prescription drug overdoses – A U.S. epidemic. MMWR Morb Mortal Wkly Rep.2012; 61(1):10-13.
2 Substance Abuse and Mental Health Services Administration. SAMHSA Opioid Overdose Toolkit” Information for Prescribers. HHS Publication No. (SMA) 13-4742. Rockville, MD: Substance Abuse and Mental Health Administration, 2013.


CMA launches Covered California Provider Education Program

The California Medical Association (CMA) and the CMA Foundation have been awarded a $1.5 million grant from Covered California, the state's new health benefit exchange. The grant application was submitted in partnership with the Latino Physicians of California, the American Academy of Pediatrics and a number of CMA's component medical societies.
 
The grant is being used to establish the CMA's "California Health Benefit Exchange Outreach and Education Program." The goal is to help medical professionals across the state and their health care teams to educate their patients about the new coverage options available through Covered California and the financial assistance available to help pay for them. The program will focus more intensive outreach to physicians working in communities with a large number of consumers eligible for Covered California.
 
Physicians are powerful and effective messengers to deliver information to patients. We will be working to educate not only physicians, but also the office and health care teams that support physician practices. We will work with registered nurses, medical assistants, nurse practitioners, physician assistants, office managers and other physician practice staff in the targeted geographic areas that have the highest number of newly eligible exchange enrollees. All staff working in a practice or clinic will have an opportunity to learn more about Covered California insurance plans to fully utilize their skills and potential in educating patients about exchange eligibility and enrollment.

Regional Outreach

The California Health Benefit Exchange Outreach and Education Program will have four regional Provider Educators, with one assigned to each of the following regions: 1) Fresno, Kern, Tulare and Kings Counties; 2) San Diego, Riverside and San Bernardino Counties; 3) Los Angeles and Orange Counties; and 4) San Joaquin, Santa Clara, Alameda and Contra Costa Counties. For those practices in regions not listed, CMA Foundation staff will provide outreach and education. 

Educational Strategy

The educational strategy will be a multifaceted approach that factors in the different physician practice environments and incorporates multiple strategies to communicate with the physicians and their health care teams. The approach will incorporate group learning sessions, focus groups, educational print medium and one-on-one "touches" supported by newsletters, webinars and e-communication.
 
We will develop learning communities of grantees, sub-grantees and other interested partners to share challenges and best practices and to help us use resources as effectively as possible.
 
Our strategy will also include the following: 

  • Identify the gaps in physician knowledge about the exchange and design educational messaging to address those gaps.
  • Create a master list of existing regularly held meetings of the association members and partners so that we can utilize the already built network and standing meeting schedule
  • Establish lesson plans to ensure consistency in presentations.
  • Identify physician champions to be trained to educate their peers and other health care professionals and staff.
  • Establish a Physician/Health Care Worker Subcommittee to provide message testing, guidance and input on presentations and one-on-one education.
  • Make resources available through the physician practice to patients, helping them understand Covered California.
  • Develop a physician toolkit comprised of essential outreach materials for physician champions and their health care teams to give to patients.
  • Work with hospitals and health plans to book training and education sessions in hospital grand rounds, regularly scheduled patient-support focused meetings and medical staff meetings.

Resources

For the full Covered California Grant Newsletter, click here.

For a list of Health Benefit Exchange resources available to physicians, click here.

All resources are available on the CMA website at  http://www.cmanet.org/issues-and-advocacy/cmas-top-issues/aca/.

OCMA members may contact Physician Advocate Mitzi Young with questions about Covered California and the Health Benefits Exchange at (888) 236-0267 or myoung@cmanet.org

OCMA Internist and Addiction Specialist Receives Gary Nye, MD Award

Max A. Schneider, M.D., an Orange County internist and addiction specialist, was given the Dr. Gary Nye Award at the 2013 at the California Medical Association (CMA) House of Delegates held this weekend in Anaheim. The award is given annually to a CMA member physician who has made significant contributions toward improving physician health and wellness.

Dr. Schneider for over 40 years has helped educate medical students, residents and physicians on addiction as a disease and the specific risks it poses for physicians. 

He was instrumental in establishing addiction medicine as part of the medical school curriculum at University of California, Irvine School of Medicine.

Dr. Schneider helped establish the concept of physician well-being committees and has served on the well-being committees for the Orange County Medical Association, St. Joseph’s Hospital, Children’s Hospital of Orange County and Chapman Hospital.

A fellow and past president of the American Society of Addiction Medicine, he also is past chairman of the Board of Directors of the National Council on Alcoholism and Drug Dependence and has served as a consultant to the Drug and Alcohol Advisory Committee of the U.S. Food and Drug Administration.

Dr. Schneider graduated from the University of Buffalo, School of Medicine in 1949. He practiced internal medicine in his native Buffalo for 11 years until 1964 and since 1964 has practiced in Orange County.

Your Participation is Requested - 2013 Employee Salary Survey

The California Medical Group Management Association (CAMGMA) is coordinating their 2013 salary survey. They are using a dynamic new instrument which provides real-time results back to the participants, along with customized reports.
 
Data entry and support is being coordinated for OCMA members by Jay Wikum, CPA (Business Partner - HMWC CPAs and Business Advisors).
 
The link to the online instrument can be found at: http://www.camgma.com/.  The data entry period is scheduled to run through September 30, 2013
 
If you have any questions on the survey or the instrument, feel free to contact Jay Wikum at (714) 505-9000.
 
Click here to access the form directly.

Upcoming CalOptima Provider Forum on Duals Demonstration

On July 10, the OCMA, CalOptima and the Health Networks in the CalOptima health care delivery system co-hosted a forum for physicians to learn about the contracting options for the upcoming "duals demonstration."  The demonstration will entail enrolling the dual-eligible (Medicare/Medi-Cal) beneficiaries in Orange County into CalOptima. OCMA has been advocating that physicians and their dual-eligible patients have multiple options for participating in the demonstration, including an option that allows physicians to contract directly with CalOptima. 

 

On Wednesday, August 14, CalOptima will host another forum which will include the Health Networks to once again reach out to physicians and educate them on the various contracting options the CalOptima board of directors will consider at their next board meeting.  If you missed the July 10th forum, OCMA strongly encourages you to attend the forum on August 14.  It is imperative that CalOptima and the Health Networks hear from the physicians that are caring for the dual-eligible patients in Orange County. The invitation to the August 14 forum is attached.

 

Note: this forum will be held at CalOptima. See invitation for full details.

 

Thank you for your attention to this matter.


Resources to Assist Physicians with the Medicare Contractor Transition

Goal:   Provide members with information and resources to prepare their practices for the transition of Medicare contractors from Palmetto to Noridian on September 16 (Part B).

 

Current CMA Resources

 

1. CMA’s Medicare Transition webpage – CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access updates and important information regarding the transition in one easy-to-access to location. All resources related to the Medicare transition will be accessible through this site.

2. CMA’s Medicare Transition Guide: What physicians need to knowThis guide, which members can download free from the CMA website, includes an FAQ that includes information on the transition dates, what will remain the same with the transition and what will change, Noridian’s online provider portal, what practices can do to prepare for the transition, and links to additional resources and way to stay apprised of new information on the transition.

3. CMA Practice Resources (CPR)CMA Practice Resources is a free monthly newsletter from CMA’s practice management experts that focuses on critical payor and health care industry issues, including the Medicare transition, and how these issues directly impact the business of a physician practice. To sign up, visit the CMA website or contact CMA Member Services at (800) 786-4262.

4. CMA webinarAt the request of CMA, Noridian has agreed to conduct a webinar for CMA members on August 7 from 12:15-1:30pm.  The other webinars Noridian is offering is open to all provider types in California, Nevada, Hawaii, and the U.S. territories of American Samoa, Guam and the Northern Mariana Islands. However, the August 7 webinar will be limited to CMA members and will give attendees an opportunity to ask their specific questions. This webinar will be held at the OCMA Conference Center during a "Lunch & Learn." 
During the gathering, we will participate in the "live" CMA Medicare Transition webinar and then discuss any questions. To register for the Lunch & Learn, click here.


For those who miss the live webinar, it will be available on-demand via the CMA website.

 

5. Content alert updates - The CMA website allows registered users to create custom content alerts on the top­ics that are of interest to you. Once signed up, you will be notified any time there is new content posted in one of your interested areas, including Medicare issues. To sign up, users should visit their account dashboard on the CMA website and click on “my alerts,” then select “Insurance Reimbursement -> Medicare.”

 

CMA Resource in Development

 

  • Practice preparation checklist indicating all of the steps practices should take to prepare for the transition to Noridian. This document will be added to the Medicare Transition Guide.

 

MEC Engagement

 

The Priority Assistance Committee recommends that MEC proactively educate members about the resource available from CMA to help navigate contracting with the exchange.


  • Promote CMA Medicare transition website
  • Promote CMA’s Medicare transition guide
  • Promote Aug 7 Medicare transition webinar (promo from CMSS coming)
  • Include articles and announcements in CMS publications and communications
  • Alert CMA’s Michele Kelly 213/226-0338 mkelly@cmanet.org of any issues related to the transition. 

Additional Resources


  • Noridian’s transition website: The Noridian transition website includes information on what’s new/changing and what will remain the same during and after the transition.
  • Paul O’Donnell, Noridian (701) 277-2401.  NOTE: MEC are welcome to contact Mr. O’Donnell directly; however, it is important to keep CMA/Michele Kelly in the loop so that she is aware of issues as they arise.

 

Additional Medicare-related Resources

 

1.      Medicare Enrollment Guide for Physicians - This document guides  physicians through the enrollment process and assists enrolled physicians who are making changes or who must revalidate their enrollment.

2.      Getting Started with the Medicare Physician Quality Reporting System (PQRS) – this guide assists physicians with understanding and complying with PQRS.

3.      Medicare Electronic Prescribing Overview: Payment Incentives and Payment Reductions – Overview of electronic prescribing (eRX) program, including incentive payments for physicians who e-prescribe and payment penalties for physicians who do not.

4.      Medicare Part B Important Changes: What they mean to your practice

5.     Medicare Audit Guide for Physicians – Guide for preparing and responding to a Medicare audit.

6.      Various Medicare webinars available on demand at www.cmanet.org/events

7.      Numerous Medicare-related CMA On-Call documents can be downloaded at www.cmanet.org


Announcement: Medicare SGR and GPCI Bill Clears Committee

On Wednesday, July 31, the House Energy & Commerce Committee voted UNANIMOUSLY to approve H.R. 2810, the bill to repeal and replace the Medicare SGR. Included in that bill is a California Medicare locality reform (known as the "California GPCI Fix") which will update payments for the urban physicians in Locality 99 and Locality 3 while holding the rural physicians in these localities harmless from payment cuts. 

 

OCMA and CMA are pleased with this herculean effort to move Medicare SGR legislation on a bipartisan basis as well as update the outdated Medicare physician payment localities.  CMA physicians have cleared the first hurdle in a long legislative process. The Medicare SGR and GPCI Locality  issues will now be taken up by the House Ways & Means Committee as well as the Senate Finance Committee.   

 

While there are several aspects of the bill that concern CMA, including the downside penalties and lack of adequate updates, the bill meets many of the goals that CMA advocated to Congress to eliminate the annual threat of nearly 30% SGR payment cuts, 5 years of stable updates, a continuation of the Fee-for-Service (FFS) program with opportunities for updates, and incentives to help physicians transition to new payment and delivery models. There is still much work to be done on the entire bill and Congress recognizes that.  

 

If you would like further details on this matter, please contact OCMA.

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