Current Bulletin

  • Update on State Employee Health Plan Changes

    With the General Assembly temporarily in session to take up issues like voter ID and hurricane relief, there has also been a rich discussion behind the scenes about changes to the State Employee Health Plan (SHP).

    State Treasurer Dale Folwell has said the plan will reimburse providers through reference-based pricing beginning in 2020. Based on feedback from our North Carolina Medical Society (NCMS) members, the move will have different impacts depending on your specialty. Some primary care practitioners will see a significant increase in reimbursement, while surgical specialties likely will see a decrease. The North Carolina Healthcare Association (NCHA), formerly the NC Hospital Association, has vehemently and vocally opposed the Treasurer’s method to get the State Health Plan out of the red since the NCHA maintains that such a change would be uniformly detrimental to hospitals, especially those in rural areas.

    Legislators seem squeamish about getting involved in the debate, having given authority over the SHP to the Treasurer eight years ago, but several have some hesitation about the Treasurer’s plan. Reps. Josh Dobson (R-McDowell), Donny Lambeth (R-Forsyth) and Greg Murphy, MD (R-Pitt) have expressed concerns about a move to reference-based pricing and have suggested studying the impact of such a change before implementing it.

    NCMS government affairs staff urge you to contact your legislator and explain how such a move will affect your practice – for better or worse.

    The NCMS’ position has long been focused on a many faceted approach to transforming our health care system centered on improving health for a community or a defined population like those in the SHP. Rather than simply shifting reimbursement strategy, placing the emphasis on health outcomes will have a long term, lasting effect on health costs.

    Watch our legislative update from Dec. 7 to learn more about these discussions at the General Assembly. Watch now.

    Thank you to those NCMS members who participated in our recent Snapshot Survey on the topic of reference-based pricing and the SHP. Results show the majority of respondents feel that reference pricing is not a valid strategy to contain health care costs. A majority also agreed, however, that reference pricing brings transparency to what is currently an opaque process of reimbursement.

    Watch your Bulletin for future updates on this developing issue.

     
  • Collaborative Care Model Key to Integrating Physical and Behavioral Health

    In response to requests and in preparation for the state’s shift to Medicaid managed care, the NC Department of Health and Human Services (NCDHHS) recently approved collaborative care codes to allow reimbursement for behavioral health integration into primary care settings. North Carolina is one of the first states to adopt these codes, and received some national attention from the American Psychiatric Society (APA) in this article.

    A wealth of resources are available to help practices understand and implement a collaborative care model to integrate physical and behavioral health.

    For a quick overview of what the collaborative care model is, watch this 2-minute video with Jenni Byrne, MD, PhD, Deputy Chief Medical Officer with Community Care of North Carolina. For a little more in-depth explanation, watch this 5-minute video with Dr. Byrne.

    The North Carolina Medical Society (NCMS) along with other organizations like the APA support the collaborative care model and have useful information to offer like the NCMS’ Toward Accountable Care Guide for Psychiatrists and  Toward Accountable Care (TAC) Guide for Child Psychiatry.

    The APA has compiled articles and videos that comprehensively explain what the collaborative care model is and how primary care clinicians might integrate it into their practice. This article from the APA offers a good primer as does this video presentation, which specifically focuses on the collaborative care model and how currently LME/MCOs for mental health Medicaid in North Carolina relate to the model.

    This white paper offers background on the ‘G-codes’ or billing codes that support the collaborative care model. Read this one-pager, which is aimed at psychiatrists, and contains links to in-person and online trainings in implementing this model of care. To clearly understand what this model can do for patients, watch this video, “Daniel’s Story,” profiling a young man who benefited from it.

     
  • Health Costs Decrease Nationwide – a Promising Trend

    A recent report from the Centers for Medicare and Medicaid Services’ (CMS) Office of the Actuary, shows that the United States spent $3.5 trillion on health care in 2017 – or $10,739 per person – but the rate of spending growth fell to 3.9 percent, down from 4.8 percent in 2016. The slower growth in spending was attributed to reduced costs associated with hospital care, physician and clinical services, prescription drugs and Medicaid, resulting in part from decreased utilization of health services.

    Read the AP news story from Dec. 6 when the report was released.

     
  • State Issues Alert on Life-threatening Coagulopathy

    The NC Department of Health and Human Services (NCDHHS), Communicable Disease Branch, has issued an alert to be on the lookout for life-threatening coagulopathy associated with synthetic cannabinoid use. Clinicians caring for patients with suspected vitamin-K dependent coagulopathy associated with synthetic cannabinoids use are encouraged to contact the Carolinas Poison Center at 1-800-222-1212 for questions about treatment and management.

    North Carolina is among the states with the highest number of patients identified with this condition. Read the CDC Health Update.

     
  • Show How You Live the Mission

    NCMS Board member Dr. Rachel Keever shows her Leadership in Medicine un-selfie.

    Now is the time to demonstrate how you live the North Carolina Medical Society’s (NCMS) mission of Leadership in Medicine by giving to the NCMS Foundation by the end of 2018. Your gift, no matter the size, puts Leadership in Medicine in action through programs to improve access to care, encourage innovative payment models, foster leadership development, promote physician wellness and address the opioid crisis. Please give to these crucial initiatives before the end of the year!

    Then show your friends and colleagues by printing out our #LTM “frame”  and taking an #UNselfie (because you’re unself-ish, of course) and post it to Facebook, Twitter, Instagram or your favorite social media platform. Demonstrate your Leadership in Medicine. If you’re not into social media – no worries! Call us ((919) 833-3836 ext. 142), email us, text us ((919) 830-4127) with your photo or your story of how you LIVE Leadership in Medicine every day.

     
  • Help Your Profession – Serve on the PHP Board

    The North Carolina Medical Society (NCMS) appoints five physicians to the Board of Directors of the North Carolina Physicians Health Program (NCPHP). There currently is one vacancy to be filled by an appointee of the NCMS. Learn more about responsibilities of NCPHP Board members.

    The NCPHP offers an experienced team of experts to assist health care providers with substance use disorders, mental health issues, burnout, communication problems and other issues that may affect their ability to deliver optimal care and services to their patients. NCPHP’s expert evaluation, monitoring and treatment referral programs also provide the basis upon which they advocate for participants to their employers, partners, hospitals, insurance panels and licensing boards. To learn more about the important work of this organization, visit the NCPHP website.

    Physicians interested in an NCPHP Board position should complete the application form and return it to Evan Simmons, esimmons@ncmedsoc.org (preferred), or by US Mail to PHP Board Applications, North Carolina Medical Society, Post Office Box 27167, Raleigh, North Carolina, 27611 by Friday, Dec. 21.

     
  • Review the 2019 Medicare Part D Opioid Policies

    The Centers for Medicare and Medicaid Services (CMS) recently shared “A Prescriber’s Guide to the New Medicare Part D Opioid Overutilization Policies for 2019.” Be ready for 2019. Review the article.
     
  • Duke Offers Primary Care Transformation Fellowship

    The Department of Community & Family Medicine at Duke is now accepting applications for its new Primary Care Transformation Fellowship. Physicians (MDs/DOs) and physician assistants board-certified in general pediatrics, general internal medicine and family medicine are encouraged to apply for this two-year opportunity by the Feb. 1 deadline.

    The goal of the fellowship is to train physicians and physician assistants to lead health care transformation and improve health within their communities and community-based practice settings. The fellowship includes coursework from the Duke University Master of Health Sciences in Clinical Leadership program, primary care preceptor training, a mentored transformation project and a fellowship seminar series. Fellows will have 30 percent committed time to complete program requirements. The fellowship begins July 2019.

    Learn more and apply.

     
  • NCMS Plan Moves to Help Prevent Diabetes

    The North Carolina Medical Society (NCMS) Employee Benefit Plan is pleased to announce coverage of the Eat Smart, Move More, Prevent Diabetes program for all NCMS Plan members with prediabetes, beginning in January 2019 ($449 value).

    Eat Smart, Move More, Prevent Diabetes is a year-long, CDC-recognized diabetes prevention program based on proven strategies to achieve and maintain a healthy weight. Key concepts include planning and tracking eating habits and living mindfully to prevent diabetes. The program is delivered in a real-time, online format so participants see and hear their instructor during live sessions, with the ability to interact with the instructor as well as classmates. Participants will be able to work through challenges together as a group and celebrate each other’s successes. Each class is taught by a trained lifestyle coach who provides one-on-one support outside of class.

    If you are interested in learning more about the NCMS Plan please visit http://www.ncmsplan.com/.  If you are a NCMS Plan member and interested in offering this program to your employees, please contact Jason Horay at jason.horay@mmicnc.com.

     
  • Congratulations to Dr. Nance!

    Dr. Nance being sworn in as NCAFP president.
    Photo courtesy of NCAFP.

    Long time North Carolina Medical Society (NCMS) member Alisa C. Nance, RPh, MD, FAAFP, of Mooresville, NC, recently was inaugurated as 2018-2019 President of the NC Academy of Family Physicians. Dr. Nance is owner of Nance Medical Consulting, PLLC and has been an active participant in the NCMS’ NC Population Health Collaborative and NC ACO Council.

    Dr. Nance attended the University of North Carolina at Chapel Hill where she received her undergraduate degree in pharmacy. She went on to receive her medical degree from the Wake Forest University Medical School and completed her residency at Memorial Hermann Southwest in Houston, Texas.

    Congratulations, Dr. Nance!