Current Bulletin

  • IMPORTANT Hurricane Information for NCMS Members


    Sept. 12, 2018 – The North Carolina Medical Society (NCMS) is in contact with the North Carolina Department of Health and Human Services Secretary Mandy Cohen, MD, about how our members should best prepare for the approaching storm as well as how you can help in the aftermath of the anticipated hurricane.

    If you are willing and able to help staff shelters if needed, please email your name, cell phone number and your location to NCMS staff Elaine Ellis (eellis@ncmedsoc.org) or Bob Seligson (rseligson@ncmedsoc.org) so we can relay this information to those coordinating the shelter staffing. This information will not be shared beyond the NCMS and the proper authorities. Watch your email and NCMS social media platforms for updated announcements.

    You may also want to consider volunteering your skills to help affected areas by signing up with the American Red Cross. Clinicians may also want to contact their local hospital to inquire about opportunities to support the hurricane response and recovery.

    For doctors and PAs from other states who are interested in volunteering, the NC Medical Board just passed an emergency policy to process temporary licenses during a disaster or State of Emergency. The new policy will allow volunteers to either use the existing hospital credentialing process, or apply for a limited emergency license. These measures will expand the response capabilities in our state. Learn more.

    Here are some other helpful hints for your practice as the storm approaches.

    • Some practices may be concerned about storing vaccines if there is a power outage and the refrigeration system in their office is no longer working. Act now to help ensure safe keeping. Some suggestions include asking the local fire department or community hospital to store them since they have generators to ensure a power source. One practice said they send their vaccines home with staff if the staff still has power and/or backup generators.
    • NCTracks notified those who serve NC Medicaid and Health Choice patients that they may submit claims for early refill of medications during the state of emergency declared by the Governor. The notice reads: “NC Medicaid enrolled pharmacy providers should resubmit these claims with “09” (Emergency Preparedness) in the PA Type Code field and a valid value for an E.R. override in the Reason for Service, Professional Service and Result of Service fields to override a denial for an early refill. Do not place any values in the Submission Clarification Code field.” The notice reiterates that this will only be allowed during the state of emergency.
    • Medicaid will cover a physician/clinician visit for beneficiaries who are evacuated, including those evacuated out-of-state.
    • People who rely on electricity-dependent medical devices should notify their local Department of Social Services as soon as possible. This will help authorities prioritize services during a power outage. Local DSS contact information can be found here: https://bit.ly/2N6zWon.
    • In the aftermath of the storm, medical teams may be mobilized to treat injuries in the hardest hit areas. We will keep you posted on any such initiatives organized by the state or agencies like the Red Cross. As noted above, if you are willing and able to volunteer, please email your name, cell phone number and location to NCMS staff at eellis@ncmedsoc.org or rseligson@ncmedsoc.org and we will relay this information to the proper agencies. We will not share this information beyond the authorities coordinating the relief efforts.

    Be sure to remind your patients of the following:

    • Follow mandatory evacuation orders and evacuation routes. This will be a dangerous storm. Do not ride it out.
    • Never drive through standing water—turn around, don’t drown!
    • Don’t use gas-powered generators/burners inside your house.
    • Stock up and have ready emergency kits, take care of pets, check in with neighbors.
    • Make sure you have your medicines and fill your prescriptions before the storm hits.  Many insurers are allowing early refills to make it easier.
    • Call 211 for non-emergency needs
    • Download the ReadyNC app to a smartphone. This app provides details on how to prepare an emergency kit, where shelters are open, and other essential information. ReadyNC also may be accessed online at https://readync.org/EN/Index.html.
    • Look out for NC Emergency Management’s latest updates at gov/florence.

    For those in the Food and Nutrition Service program:

    • Electronic Benefits Transfer (EBT) cards can be used at any authorized retailer, even if they are in a different state.
    • Current Food and Nutrition Services households (people receiving SNAP benefits) that have a food loss may request replacement benefits through their county DSS.
    • Lost/Damaged EBT cards can be replaced by calling the EBT Call Center at 1-888-622-7328.
     
  • The Move to Value is Showing Savings in NC

    Six North Carolina Accountable Care Organizations (ACO) achieved savings and earned a check back as part of the Medicare Shared Savings Program (MSSP) in 2017, according to recently released data from the Centers for Medicare and Medicaid Services (CMS). The MSSP rewards ACOs for meeting cost savings and quality performance benchmarks by returning a share of those savings to the organization.

    The North Carolina ACOs achieving this shared savings for 2017 are:

    Coastal Carolina Quality Care in New Bern

    • Quality Score of 94 percent
    • Total Savings of $7.29 million
    • Earned Savings of $3.37 million

    Duke Connected Care in Durham

    • Quality Score of 91.5 percent
    • Total Savings of $21.13 million
    • Earned Savings of $9.48 million

    Pinehurst Accountable Care Network (PACN)

    • Quality Score of 89 percent
    • Total Savings of $4.8 million
    • Earned Savings of $2.1 million

    CHESS MSSP based in High Point

    • Quality Score of 95 percent
    • Total Savings of $9.54 million
    • Earned Savings of $4.48 million

    Coastal Plains Network based in Greenville

    • Quality Score of 89 percent
    • Total Savings of $8.95 million
    • Earned Savings of $3.9 million

    Central Virginia Coalition of Health Care Providers (CVCHIP), which serves areas in Virginia and North Carolina

    • Quality = 83 percent
    • Total Savings = $3.56 million
    • Earned Savings = $1.45 million

    Quality scores are based on meeting numerous benchmarks in areas including getting timely appointments, health education, effective communication with patients, screening for a variety of behaviors and conditions and hospital admissions and readmissions among many others.

    Overall, the 2017 data shows that 60 percent of the more than 472 MSSP participants nationwide generated savings and that 34 percent met the benchmarks to earn shared savings.

    The national organization representing ACOs, NAACOs, recently commissioned a study to assess whether the MSSP program is indeed generating savings for Medicare. The results show that MSSP ACOs reduced federal spending by $542 million after accounting for shared savings payments earned by the ACOs. The new study is discussed in the Health Affairs Blog.

    Under the MSSP most ACOs do not bear financial risk for holding down spending and generated gross savings of $1.84 billion for Medicare in 2013–2015, nearly double the $954 million estimated by CMS, according to the study. Read the study results.

    Closer to home, Duke Connected Care was celebrating its achievement.

    “Duke Connected Care’s success is the result of a shared commitment between Duke Health and community providers to cultivate the culture, resources and partnerships necessary to measurably improve health outcomes for our patients,” said Devdutta Sangvai, MD, MBA, associate chief medical officer, DUHS, and executive director for Duke Connected Care.

    Congratulations to all those NC ACOs achieving shared savings! If you would like to learn more about ACOs in North Carolina as well as access resources to help your practice make the move to value, the North Carolina Medical Society has a wealth of information. Please visit our Toward Accountable Care (TAC) Consortium website.

     
  • Welcome Appalachian Regional Healthcare System!

    The North Carolina Medical Society (NCMS) extends a warm welcome to Appalachian Regional Healthcare System (ARHS) physicians. Thanks to the vision of ARHS leadership, we’re pleased that all physicians are now part of the NCMS community.

    “We value all our members. Lately, more and more, health systems throughout the state are recognizing the benefits the NCMS offers — from award-winning leadership development programs to advocacy to being a regulatory watchdog – and are making all their physicians NCMS members,” said NCMS CEO Robert W. Seligson. “For nearly 170 years the NCMS has strived to assist everyone in achieving what is best for the medical community and the patients of North Carolina. We are delighted to welcome Appalachian Regional Healthcare System to our growing membership, and look forward to working with them to accomplish positive and innovative goals for health care in our state. Welcome!”

    ARHS has already availed itself of one of the major benefits of NCMS membership. They are working with the Kanof Institute for Physician Leadership on a customized leadership development program for ARHS.

    The ‘Advanced Leaders Program’ will begin in October, said Kristina Natt och Dag, NCMS vice president for Leadership Development. Over the course of the year-long program, participants will actively engage with facilitators to develop and practice critical leadership skills to meet the challenges of management and leadership, she said.

    “The program is based on the idea of leadership as a journey and throughout the course we will be learning about and discussing leadership styles, change and change immunity and effective communication,” Natt och Dag explained.  This course was designed specifically to meet the needs of ARHS physicians.

    The entire staff of the NCMS looks forward to meeting and working with ARHS members and we hope to see many of you at the upcoming LEAD Health Care Conference, Oct. 18-19 in Raleigh.

     
  • Multi-Payer Expo Rescheduled Due to Hurricane Florence

    The Multi-Payer Expo, originally scheduled to be held tomorrow, Sept. 13, in Durham, has been rescheduled to Thursday, Oct. 4 due to Hurricane Florence. Blue Cross and Blue Shield of North Carolina (Blue Cross NC), together with MEDCOST and UnitedHealthcare are the sponsors of this 2018 Raleigh/Durham Multi-Payer Provider Expo, which will be held at The Solution Center, 1101 Slater Road, Suite 200, in Durham from 8 a.m. to 1 p.m.

    • At 9 a.m. Ryan Camps and Adrianne Overbay of Labcorp will speak on “Helping Providers Succeed in Value-Based Care.
    • At 10 a.m. Lee Katherine Ayer, MHA, CMPE will present on “Design Thinking and the Millennial Patient.”
    • From 1 to 2:30 p.m. there will be a BCBSNC specific session focused on Blue Cross policies, procedures and updates. To register for this session, please click here.

    Follow this link for a printable registration form. To register, please fax your completed registration form to (855) 754-3681 by Friday, Sept. 28, 2018.

     
  • LEAD Conference = Education + Fun!

    Hurricane Florence is looming large, but here’s some good news: The LEAD Conference Early-bird registration discount has been extended by one week. Register by Sept. 17 to save up to $50 in conference fees. And if saving $50 isn’t enough of an incentive, we’ve added a chance to extend your fun with a weekend stay at the Raleigh Marriott Crabtree Valley, plus four tickets to the North Carolina State Fair.

    Register by Sept. 17, save money and be entered to win this weekend package, which includes a one-night weekend stay and breakfast for two at the Raleigh Marriott Crabtree Valley. Choice of weekend is up to you, but will depend on room availability. This weekend package including the Fair tickets will be awarded randomly to an early-bird registrant after the Sept. 17 deadline.

    Register Now!

     
  • PAI Contends Reforming Stark Law Would Improve Outcomes

    The Physicians Advocacy Institute (PAI) recently responded to the Center for Medicare and Medicaid’s (CMS) Request for Information on the Physician Self-Referral Law, known more commonly as the Stark Law. Implemented in 1989 to promote transparency in physicians’ financial relationships and discourage waste, fraud and abuse, many physicians now see the Stark Law as a barrier to participating in initiatives that incentivize better patient care and outcomes through quality-based payment.

    In its letter, PAI formally requested a series of exceptions and clarifications that would promote the adoption and development of value-based care models. Additionally, the letter also highlighted the higher administrative burden for small, medium and solo-practitioners, and called for more support as they update their practice.

    PAI urged CMS to work with providers and state medical societies as it addresses the obstacles created by the Stark Law. PAI believes CMS should offer greater flexibility and guidance to help physicians provide higher quality, coordinated, integrated and holistic care to their patients.

    “We’re encouraged by CMS’s interest in rethinking a law that had the best of intentions but has ultimately become a barrier to quality patient care in today’s marketplace,” said Robert W. Seligson, CEO of the North Carolina Medical Society and PAI President. “Greater flexibility in the application of the law will allow physicians to better coordinate care and more readily transition to value-based care models.”

     
  • Public Supports Truth in Advertising When It Comes to Being Called ‘Doctor’

    The AMA recently released new public opinion survey data to support the AMA Truth in Advertising (TIA) Campaign, which is designed to ensure health care providers clearly and honestly state their level of training, education and licensing. Read the full survey results.

    The new TIA survey results confirm that patients:

    • Remain confused about which providers are trained as an MD or DO;
    • Strongly prefer that a physician perform certain medical procedures;
    • Overwhelmingly support legislation to ensure clarity and transparency in health care advertising; and
    • Agree that only licensed MDs and DOs should be able to use the title “physician.”

    To ensure patients know which “doctor” is providing their care, the AMA model Health Care Professional Transparency Act:

    • Requires all health care professionals to clearly and accurately identify themselves in all writings, advertisements and other communications;
    • Requires all health care professionals to wear, during patient encounters, a name tag that clearly identifies the type of license they hold; and
    • Prohibits advertisements or websites advertising health care services from including deceptive or misleading information.

    Also available for download is an updated TIA Campaign booklet including survey results, model legislation, a template op-ed, talking points and descriptions of the 21 laws adopted since the inception of the AMA TIA Campaign.

    Also available for download is an updated TIA Campaign booklet including survey results, model legislation, a template op-ed, talking points and descriptions of the 21 laws adopted since the inception of the AMA TIA Campaign.

     
  • NC Payers Council Offers 5-Point Plan to Address Opioid Epidemic

    The North Carolina Payers Council, a group of public and private health care payers formed as part of Governor Roy Cooper’s 2017 North Carolina Opioid Action Plan to identify, align and implement policies to combat the opioid crisis, recently released a report with a five-pronged approach to address the epidemic.

    Endorsed by the council’s diverse membership, the approach includes:

    1. Limiting strength and duration of opioid-related medications and promoting opioid-sparing pain treatment
    2. Decreasing barriers to the opioid reversal drug naloxone
    3. Providing access to medication-assisted treatment for opioid use disorder
    4. Using data analysis and surveillance to inform best practices
    5. Supporting health care provider, pharmacist and patient education on safe opioid prescribing, pain management and substance use

    “Too many people are dying. Too many families and loved ones in North Carolina are facing the heartbreak of loss,” said State Health Director and Chief Medical Officer Elizabeth Tilson, M.D., MPH, who chaired the council. “The Payers Council worked to identify tangible things that payers can change as we seek ways to prevent opioid use disorders, move people toward needed treatment and reduce deaths. This work can also be an example for other states seeking ways to fight this epidemic.”

    Council members agreed they would be willing to take the recommendations into consideration for their own health plans.

    Learn more about the Payers Council and its strategies.

     
  • NCMSF’s Project OBOT Is Underway

    Learning how to help those with substance use disorder by working as a team at the Project OBOT training on Sept. 5 at the NCMS Center for Leadership in Medicine in Raleigh.

    The North Carolina Medical Society (NCMS) Foundation’s Project OBOT hosted several Medication Assisted Treatment waiver sessions at the NCMS Center for Leadership in Medicine in Raleigh last week. The morning session focused on building team expertise in the office based opioid treatment model. The evening session was geared toward providers and the clinical support system in using buprenorphine in the office based treatment of opioid disorders. Both sessions were well-attended and more are being planned now. Watch your NCMS Bulletin and the Project OBOT website for details.

    Opioid addiction is a chronic, relapsing brain disease that affects millions of Americans and produces a tremendous burden on the health care system. In 2002, U.S. physicians gained the opportunity to treat opioid-addicted patients with buprenorphine in primary care settings, commonly referred to as office-based opioid treatment (OBOT). OBOT has been shown to be effective in primary care settings and impacts public health through the reduction of opioid use, opioid overdose mortality, and transmission of infectious diseases. However, it remains underutilized.

    One consistently cited barrier preventing OBOT expansion is lack of adequate clinical support given the additional needs for patient monitoring. Successful medication-assisted treatment (MAT) requires a team-based approach just like treatment for other chronic diseases. The NCMS Foundation’s Project OBOT brought together a coalition of health care organizations and community resources to support physicians, PAs and their patients as they undergo Medication Assisted Treatment.

    Listen to the NCMS’ Bedside Manners podcast in which Project OBOT founder the NCMS Foundation’s Franklin Walker talks about ‘Helping Physicians and Patients Tackle Opioid Use Disorder.’

     
  • NC MedAssist – Helping Patients Comply With What You Prescribe

    NC MedAssist, a nonprofit pharmacy program providing access to lifesaving prescription medications, patient support, advocacy and related services to poor, vulnerable and uninsured North Carolina residents, is a crucial component in many patient’s ability to get the medications they need and that you prescribe. Last year, nearly 135,000 prescriptions were filled through NC MedAssist and nearly 22,000 people were served through the mobile free pharmacy.

    NC MedAssist runs on volunteers and is always open to help at their mobile free pharmacy events, which are held throughout the state. Health care professionals are particularly sought after volunteers since you can help answer general health questions. See where there is an upcoming free pharmacy near you.

    Learn more about this worthy organization.