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February Bulletin
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DENVER MEDICAL BULLETIN
Official Publication of The Denver Medical Society

February 2017
The Top Issues that will Affect Physicians in 2017 
According to the AMA, six key issues will impact physicians in the coming year.
The year ahead in medicine, tumultuous as it promises to be, holds several key issues on which physicians should focus their attention. Health insurance coverage and access, prescription drug pricing, the new Medicare payment system and the opioids epidemic all require a strong physician voice present in the conversation.

Health insurance coverage and access 
A new administration will enter the White House on Jan. 20 and the president-elect has expressed his intention to repeal and replace the Affordable Care Act (ACA), which could reduce insurance coverage that more than 20 million Americans gained under President Obama's signature legislation.

Acknowledging that the health system reform is an ongoing process, the AMA has expressed its willingness to work with the incoming administration and Congressional leaders on addressing the shortcomings of current law while maintaining the insurance enrollment gains of the ACA and expanding health insurance affordability and choice. Read more about the AMA's vision on health care reform.

Implementation of new Medicare pay system 
The Centers for Medicare and Medicaid Services (CMS) released its final rule for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) in October, which repealed the flawed Sustainable Growth Rate (SGR) formula in 2015. Thanks to physician feedback, the new payment system—the Quality Payment Program (QPP)—should transition the health care system toward one that supports physician efforts to provide high-quality care.

The AMA will continue its work to make sure this implementation offers the best possibility for success for physician practices. To help your practice transition smoothly, the AMA has put together a collection of resources, such as the payment model evaluator, that are housed on its understanding Medicare payment reform webpage. Learn more about the numerous terms and acronyms associated with the QPP.

Reversing the opioid epidemic 
The latest data from the Centers for Disease Control and Prevention provide a sobering reminder that more work remains to reverse the nation's opioid epidemic. From 2014 to 2015, opioid-related deaths increased from 28,647 to 33,091—with significant increases in death from heroin and illicit fentanyl. At the same time, physicians have been using prescription drug monitoring programs with greater frequency, prescribing opioids more judiciously, taking more education, and becoming trained to treat substance use disorders. And tens of thousands of lives have been saved through the opioid antidote naloxone—thanks in part to nearly every state now having improved naloxone-access laws. While physicians must continue their efforts, to truly turn the tide, greater access to treatment for substance use disorders and non-opioid and non-pharmacologic pain care must occur.

The AMA's Task Force to Reduce Opioid Abuse, a coalition of numerous state and medical specialty societies, will continue efforts to increase registration and use of PDMPs, enhance physician education, reduce stigma of chronic pain and substance-use disorder, enhance access to treatment, and expand access to naloxone through co-prescribing and standing orders.

Prescription drug pricing 
Recent increases in prescription drug prices are of major concern to patients. These increases have created higher costs and price swings, making it difficult for some patients to afford much needed medications. The AMA's grassroots initiative, TruthinRx.org, was launched late last year with the purpose of collecting patient stories about how rising drug prices are affecting their lives. Achieving greater transparency in prescription drug costs and coverage will be significant issues in the coming year as the nation attempts to address these concerns. The AMA's grassroots network is asking the public to join the initiative to uncover the truth about prescription drug pricing.

EHR interoperability 
Physicians enjoy treating patients. A recent qualitative study found that physicians spend nearly two hours on EHR and other clinical desk work for every hour of direct face-to-face time with patients. One of the major sources of professional dissatisfaction found in the study was poor EHR usability and interoperability. This is a battle physicians have been fighting since the introduction of EHRs and the fight isn't over. One key step was taken late last year when Carequality and CommonWell, representing more than 90 percent of the EHR marketplace in acute care settings and nearly 60 percent of the office-based EHR market, entered an agreement to advance nationwide interoperability.

This is a step in the right direction, but physicians have also taken matters into their own hands. It will be important in the coming year to continue progress toward interoperability and make sure that these tools, which hold so much promise, are not just another roadblock to the patient-physician relationship.

Regulatory relief 
The regulatory burden placed on physicians is a major component of physician burnout. Physicians spend too much of their time on administrative tasks rather than providing care to patients. The evolving health care system needs easier enrollment, more rational program integrity rules and, overall, fewer reporting requirements.
 A recent survey asked over 14,000 physicians to identify their levels of professional happiness. Over 50% of respondents said they were "burned out," a 25% increase from just four years ago. The number one driver of burnout? "Too many bureaucratic tasks."

Why Doctors Burn Out

Attest to Meaningful Use by February 28th
A recent survey asked over 14,000 physicians to identify their levels of professional happiness. Over 50% of respondents said they were "burned out," a 25% increase from just four years ago. The number one driver of burnout? "Too many bureaucratic tasks."




See full article and reports here
Physicians have until Feb. 28 to attest to meaningful use for the 2016 program year. Physicians have been required to attest to meaningful use every year to avoid a payment adjustment in future years. For all returning participants, the reporting period will be a minimum of any continuous 90-day period between Jan. 1 and Dec. 31, 2016. 

To attest, eligible professionals should submit their data through the Centers for Medicare & Medicaid Services' (CMS) Registration and Attestation System. To speed the attestation process, the AMA recommends that physicians attest during off-peak hours, such as evenings and weekends, and that they take time now to ensure that their information is up to date before beginning to enter 2016 data. CMS has provided a "What You Need to Know for 2016" tip sheet for eligible professionals.
Mark your calendar!
Colorado Medical Society Physician Leadership Skills Series Starts February 11th!
The series will feature eight innovative programs over the year aimed at deepening your awareness, developing crucial skills and equipping you with the tools and experience you need to lead tomorrow’s health care in Colorado. Sign up here

Practice Management Breakfast Series
Program 1
Wedenesday March 8th, 2017 
Register here

MIX at SIX
March 9th, 2017

Physician networking event 
To register, click here

DMS’ 2017 Medical Spanish Class
April 21-24, 2017
Details and registration

 
 
 
Practice Management Breakfast Series-Medicare Quality Payment Program (QPP)
 
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians over the last decade with uncertainty over painful Medicare cuts. We now begin a major overhaul of the way physicians receive value-based reimbursement as we take the first steps along the journey toward payment reform.  If you participate in Medicare Part B you need to know this!
 
Program 1 
Wednesday, March 8   7 AM — Registration /Buffet Breakfast             
7:30 AM-9:00 AM — Program  

The Curtis Ballroom, 5345 Landmark Place, Greenwood Village, CO 80111  
(Located upstairs from Comedy Works South)  
 
 
The Quality Payment Program and Your Next Steps
Presenters: Courtnay Ryan, Quality Improvement Facilitator, Telligen
                       Andrew Bienstock, Transformation Services Manager, CORHIO
           
During this presentation, we will:
  • describe the Quality Payment Program, including the Merit-based Incentive Payment System  (MIPS) and Advanced Alternative Payment Model (APM) tracks.  
  • discuss the basic components of each track, share tools and resources for clinical quality reporting and  identify next steps for this transition year based on practice size, specialty, location or patient population.   
 
Register for free here.
 
Programs 2-4 are scheduled for June 7, September 6, and November 29 at the same location and time. More details to follow. 
Application deadline extended to February 15, 2017!
Primary Care Practices can access a no-cost opportunity to benefit in-office practice facilitation and clinical health information technology (HIT) assistance to support your work to enhance primary care competencies. EvidenceNOW Southwest is a national program focused on improving cardiovascular outcomes that can help you work on challenges and priorities unique to your practice in your ongoing efforts to provide comprehensive primary care. These activities also align well with the Medicare Quality Payment Program.   
Practice Support includes:
  • 9 months of support from practice facilitators (PFs), clinical HIT advisors (CHITAs), and regional health connectors (RHCs)
    • PF: practice transformation/ QI coaching to develop a customized practice action plan
    • CHITA: data collection/EHR support
    • RHC: connects practices to PH/community resources
  • Maintenance of Certification
  • $500 stipend
  • Access to e-Learning training modules
  • Practice assessments with feedback
  • Opportunity to attend collaborative learning sessions to meet other ENSW practices and share lessons and best practices
  • 18 months of Free PRIME which will help with pulling information from your EHR
  • Use data to improve Care
  • Empanelment
For questions, contact Allyson Gottsman. The Application Deadline has been extended to February 15th
 
Learn more here and to enroll click here
Denver Medical Bulletin: Usha Varma, MD, DMS President and Publisher / Stephen V. Sherick, MD, Chair of the Board / Elizabeth L. Lowdermilk, MD, President Elect / Blaine M. Olsen, MD, Treasurer / Kathy Lindquist-Kleissler, Executive Director. The Bulletin is the official publication of the Denver Medical Society, established April 11, 1871, as the first medical society in the Rocky Mountain West. Published articles represent the opinions of the authors and do not necessarily represent the official policy of the Denver Medical Society. All correspondence concerning editorial content, news items, advertising and subscriptions should be sent to: The Editor, Denver Medical Bulletin, 1850 Williams Street, Denver, CO 80218.
Phone (303) 377-1850.
Copyright © *2017* *Denver Medical Society*, All rights reserved.

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