Current Bulletin

  • Coastal Carolina Ranks First in the Nation for Medicare ACO Quality Performance

    Coastal Carolina Quality Care in New Bern ranked first in the nation for quality performance as a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) in 2016. Coastal Carolina had an overall quality score of 96.19 percent, while Physicians Healthcare Collaborative, the ACO associated with Wilmington Health, ranked 15th nationally with an overall quality score of 90.82 percent.

    Other North Carolina MSSP ACOs fared well with eight placing in the top 100 in the nation. The others after Coastal Carolina and Wilmington Health are:*

    • Pinehurst Accountable Care Network, ranked 22nd with an overall quality score of 90.26 percent.
    • Tar River Health Alliance in Rocky Mount, ranked 28th with a quality score of 89.73 percent.
    • Mission Health Partners in Asheville, ranked 35th with a quality score of 89.39 percent.
    • Cornerstone Health Enablement Strategic Solutions (CHESS) based in High Point, ranked 49th with a quality score of 88.72 percent.
    • CaroMont ACO based in Gastonia, ranked 73rd with a quality score of 87.77 percent.
    • Physician Quality Partners, associated with New Hanover Regional Medical Center, ranked 81st with a quality score of 87.3.

    In the MSSP, the Centers for Medicare and Medicaid Services (CMS) measure quality using 34 key metrics in four main areas – patient/caregiver experience, care coordination/patient safety, clinical care for at-risk populations and preventive health.

    Coastal Carolina achieved particularly high marks in patient/caregiver experience and in health screenings in areas such as tobacco use and breast cancer.

    Tomorrow (Thursday, Nov. 16), the NC ACO Council, which brings together representatives of the state’s ACOs participating in the MSSP to discuss best practices and challenges they face, will meet at the North Carolina Medical Society’s (NCMS) Center for Leadership in Medicine. The NCMS has been a steadfast supporter of the move to value-based care and has helped nurture the ACO community in the state through this Council, the NC Population Health Collaborative and by providing resources like the extensive series of Toward Accountable Care Toolkits.

    At the Council meeting tomorrow, there will be much to celebrate with Coastal Carolina’s quality ranking and Triad Healthcare Network’s shared savings as a Next Generation ACO as reported in the last NCMS Bulletin. A recent report from the Health Care Transformation Task Force revealed that overall ACOs cut gross Medicare spending by $836 million last year, including $70.6 million in net savings returned to the Medicare Trust Fund.

    Watch for an upcoming NCMS Spotlight video in which Coastal Carolina’s CEO Stephen Nuckolls discusses participation in the MSSP and Coastal Carolina’s success in achieving the quality benchmarks.

    *The quality scores quoted here were calculated based on the data located at https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/SSPACO/ and is based on quality attainment, and therefore, excludes quality improvement points and the full credit that was given to new participants and existing participants for new measures.

     
  • Vaccine Reimbursement Will Come Within the Year

    The NC Division of Medical Assistance (DMA/Medicaid) has decided not to appeal the Superior Court’s decision that they must rectify the underpayment of Medicaid vaccine administration payments made in 2013 and 2014. Superior Court Judge Beecher R. Gray did revise his order allowing DMA until November 2018 to reprocess the claims. The original order gave DMA 120 days to reimburse practices the $6.74 per affected vaccine.

    The North Carolina Pediatric Society and the North Carolina Academy of Family Physicians (NCAFP) along with eight member practices filed suit seeking to correct underpayment of administration fees on approximately half of the vaccines provided to Medicaid patients under the Vaccines For Children (VFC) program. During 2013 and 2014, all vaccines given under the VFC Program should have received the higher administration fee under the Affordable Care Act. The underpayment affected approximately 2.5 million vaccinations in the state performed by health departments, FQHC’s, pediatricians, and family physicians.

    The North Carolina Medical Society (NCMS) once again congratulates the NC Pediatric Society and the NCAFP for this important legal victory on an issue that the NCMS and the other organizations have all long advocated to correct.

     
  • Introducing the NCMS LEAD Health Care Conference – Oct. 18-19, 2018

    The North Carolina Medical Society (NCMS) is excited to announce our new and not-to-be-missed annual event – the LEAD Health Care Conference. Mark your calendar now for Oct. 18-19, 2018 to be part of this innovative conference focused on Leadership, Education, Advocacy and Discovery – LEAD.

    Based on your feedback, we have designed a conference with the perfect balance of educational sessions and social time with your colleagues from around the state.

    Plan to join us in Raleigh for two days of learning, networking and fun on the town, plus our Annual Business meeting and a gala event to celebrate our NCMS community of physicians and physician assistants.

    Watch your email and mailbox for details on the LEAD Health Care Conference’s educational content, speakers and social events.

     
  • Become a Clinical Quality Leader – Attend CQ University

    Sandra Gomez, RN (l) and Quincy Jones, PA-C with their award-winning poster at Duke’s Safety and Quality Conference.

    The North Carolina Medical Society (NCMS) Foundation, through its Kanof Institute for Physician Leadership, offers a course specifically designed to hone leadership skills to help achieve quality improvement goals. The Leadership in Clinical Quality or Clinical Quality University (CQU) is accepting applications now through Dec. 30 for its 2018 class.

    CQU is a team-based course aims to prepare and support physicians and their staff, as they drive quality improvement projects from planning to implementation and then sustaining the project within their organization. CQ’U’ also leverages the physician leaders’ unique knowledge, skills and attitudes to build teams, enhance communication and develop core leadership competencies.

    Quincy Jones, PA-C is a 2015 CQU alumna. Her team focused their project on substance abuse screenings at Lincoln Community Health Center in Durham. In 2016, she reports that Lincoln providers did over 30,000 substance abuse screenings, with the formal protocol for screenings being piloted and established as part of their quality improvement project.

    The team’s work was recognized last year at the Duke Safety and Quality Conference, where their poster won first place. Since then, Jones presented another poster with updated results from the QI project at the national PA conference, AAPA, last April and has submitted an article for publication to JAAPA as well based on our team’s work. Jones also now teaches QI to PA students.

    She lauds the CQU program for giving her valuable experience and the opportunity to learn and apply knowledge that improves patient care.

    “The team quality improvement project resulted in a practice wide change that has been sustained for almost 2 years now,” she says. “We received feedback and mentoring throughout the program on our QI project which was very helpful in moving the project forward.   The learning opportunities related to team communication skills (Team STEPPS) and patient safety were also so valuable and offer team based strategies that can easily be integrated into clinical settings.

    The 2018 CQU program will begin March 2. Get all the details here and apply today. If you have questions, please contact Erin Grover, egrover@ncmedsoc.org.

     
  • NCMS Employee Benefit Plan Update

    The North Carolina Medical Society (NCMS) Employee Benefit Plan (NCMS Plan) Board of Trustees met Friday, Nov. 10 at the NCMS Center for Leadership in Medicine. The NCMS partners with MMIC Agency, LLC to provide NCMS members with a value-added health benefit plan that is straightforward and specifically customized to meet your practice and employee needs. The NCMS Plan is governed by a Board of Trustees comprised of physicians. Robert Gossett, MD, a urologist from Shelby, serves as Chairman.

    There are several current issues affecting the Plan and its members.  Discussion included:

    • The displacement of Plan members in the Western part of NC is a concern, and the Trustees are following discussions between Blue Cross Blue Shield of NC and Mission Health System in Asheville regarding contract negotiations. Mission Hospital is now out of network with BCBSNC.
    • Trustees are following Federal regulations related to Association Health Plans and assessing potential impact to or opportunities for the Plan.
    • The Plan is offering health wellness grants to select member practices, to provide resources to educate and inform practice employees about their personal wellness that will lead to a decrease in necessary medical care.
    • Other recent benefits added to Plan coverage include MDLive telehealth services and AIM Specialty Health in-home sleep studies integrated with BCBSNC administrative services.

    The NCMS is proud of the Plan and its long-standing, reliable service to members.  Member surveys continue to rate the Plan highly. Cindy L. Tilley, Vice President Human Resources, Hospice & Palliative Care Charlotte Region, is one of many practice administrators supporting this valuable program. She says, “The NCMS Plan is like having an extension of our Human Resources Department & wellness team available at our fingertips.”

    For more information on the NCMS Plan (link to www.ncmsplan.com) as an option for your practice’s group health, dental and life benefits, contact the MMIC Agency at (800) 822-6561.

     
  • Get Ready to Join the NCMS Foundation in the #GivingTuesday Movement

    The NCMS Foundation has joined #GivingTuesday, a global day of giving that harnesses the collective power of individuals, communities and organizations to encourage philanthropy and to celebrate generosity worldwide. Occurring this year on Nov. 28, #GivingTuesday is held annually on the Tuesday after Thanksgiving and the widely recognized shopping events Black Friday and Cyber Monday to kick-off the holiday giving season. When the shopping is done, #GivingTuesday is meant to inspire people to collaborate in improving their local communities by giving to the charities and causes they support.

    #GivingTuesday kicks off the Foundation’s holiday season giving campaign. From #GivingTuesday on Nov. 28 to midnight Dec. 31, the Foundation aims to raise $10,000 and we need YOU to give. Ten thousand dollars is about half the cost of one year of educational loan repayment incentive for one primary care physician, PA or NP practicing in a rural or underserved community. Ten thousand dollars is roughly the cost of one Leadership College scholar for a year-long leadership development course. Through one provider, your gift will impact about 2,300 patients in the coming year, some of whom are our state’s sickest and most economically disadvantaged. On #GivingTuesday, please open your heart to these patients and give.

    “We are happy to participate in this celebration of giving that is transforming how people think about, talk about and participate in the giving season. NCMS members have the rare opportunity to literally change a patient’s world every day. #GivingTuesday allows our members to join with other nonprofits, businesses and corporations as well as families and individuals to collectively create a better world,” said Robert W. Seligson, NCMS Foundation CEO.

    Get ready! We’ll notify you when our #GivingTuesday webpage and donation site is open!

     
  • NC HealthConnex Partners with VA To Support Improved Care Coordination for Veterans

    NC HealthConnex is partnering with the U.S. Department of Veterans Affairs Health Information Exchange (VHIE) to make veterans’ health records available through a secure, standardized electronic system to private health care providers, ensuring up-to-date medical records for former service members are available no matter where they are treated.

    This partnership allows a more complete picture of veterans’ health, providing immunization records, lab results, medications and procedure results and will reduce the need for patients and their families to request paper records.

    The two HIEs are currently in test and anticipate the connection going live early in 2018. Read more about this partnership as well as the November Update with the latest news from the state’s Health Information Exchange Authority, NC HealthConnex.

     
  • Is Forming a Virtual Group to Meet Quality Program Requirements Right for Your Practice?

    Solo practitioners and groups can choose to participate in the Merit-based Incentive Payment System (MIPS) as a virtual group for the 2018 performance period. To form a virtual group for 2018, solo practitioners and groups must follow an election process, and submit their election to the Centers for Medicare and Medicaid Services (CMS) by Dec. 31, 2017.

    To be eligible to join a virtual group, you must be a:

    • Solo practitioner who exceeds the low-volume threshold; and who is not a newly Medicare-enrolled eligible clinician, a Qualifying APM Participant (QP), or a Partial QP choosing not to participate in MIPS.
    • Group that exceeds the low-volume threshold at the group level (i.e., the NPIs within the TIN collectively exceed the low-volume threshold) and has 10 or fewer clinicians (including at least one MIPS eligible clinician).

    Not sure what this is all about? CMS is hosting a webinar offering an overview of virtual groups on Tuesday, Nov. 21 from 1 to 2 p.m. Learn more and register.

    For more information about participating in MIPS as part of a virtual group, the election process and formal agreements, please see the Virtual Groups Toolkit or contact CMS through its Quality Payment Program Center at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).  Or, contact your local support organization.

    The North Carolina Medical Society (NCMS) also may be able to help. If you are interested in forming a virtual group, please contact Belinda McKoy at bmckoy@ncmedsoc.org or 919-833-3836 x142.

     
  • Accountable Care Symposium Available Via Livestream

    Caravan Health will bring population health strategies to health care leaders across the nation by offering a livestream of its second annual Accountable Care Symposium.

    This year’s program will feature thought leaders, industry experts, panel discussions and breakout sessions addressing the most pressing concerns of health system leaders today. Attendees will gain practical knowledge that will accelerate their transformation plans for superior quality and financial results. Hear about real improvements in patient and caregiver lives that have come from practice transformation and how you can apply it in your health system.

    The livestream broadcast will feature both days of the general sessions from 9 a.m. – noon MT (that is 7 a.m. to 10 a.m. ET) on Dec. 6 and 7.  The broadcast is free for Caravan Health and National Rural Accountable Care Consortium participants. Participants must contact their Account Managers for the discount code. The non-participant cost is $99. Learn more and register.

     
  • CMS Releases Final 2018 Quality Payment and Physician Fee Schedule Rules

    On Nov. 2, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 Quality Payment Program (QPP) rule and the 2018 Physician Fee Schedule rule.

    In the press release announcing these final regulations, CMS Administrator Seema Verma said the rules “reflect the agency’s efforts to promote innovation in health care delivery aimed at lowering prices, increasing competition and strengthening the relationship between patients and their doctors.”

    The Physician’s Advocacy Institute (PAI), which is led by North Carolina Medical Society (NCMS) CEO Robert W. Seligson, issued a statement calling the QPP rule a ‘mixed bag’ for physicians.

    “The long-awaited Medicare Quality Payment Program final regulation for 2018 is a mixed bag of policies from the physician perspective. We are pleased to see CMS trying to provide continued flexibility for physicians, incentivize small practices to participate and ease the transition to the quality payment program,” Seligson said, adding, “We encourage CMS to further simplify the Quality Payment Program and reduce the burden on physicians as they transition to it.”

    As for the 2018 Physician Payment Rule, Seligson in the PAI statement said that “certain aspects of the new rule may miss the mark.” He pledged that PAI will continue to collaborate with CMS to ensure physicians get clarity and patients are not harmed by the complexity of the regulation.

    PAI offers the QPP Physician Advocacy and Education Initiative, to offer physician practices the resources they need to navigate the new program.

    The AMA also analyzed the new rules and concluded that, while some of their recommendations were left out, CMS did adopt several important policy changes including several to help physicians in small practices. Their analysis projects that 97 percent of eligible clinicians will avoid a penalty in 2020 based on their QPP participation in 2018.

    Read the AMA’s summary and analysis of the 1,600 page QPP final rule.

    Read the AMA’s summary and analysis of the 1,400 page Physician Fee Schedule rule.