Current Bulletin

  • NCMS Foundation Launches Project OBOT

    The North Carolina Medical Society (NCMS) Foundation is pleased to announce the launch of Project OBOT or Office-Based Opioid Treatment. The goal of this new partnership is to establish research-based pilot projects throughout the state to increase patient access to opioid treatment and recovery.

    Centene Corporation, the NCMS’ partner in Carolina Complete Health, a health plan developed to deliver Medicaid managed care services in North Carolina, provided a portion of the start-up funding for OBOT.

    “With opioid addiction and overdose deaths ravaging our state and country, the NCMS Foundation brought together a coalition of organizations to help stem the human toll this epidemic is exacting,” said Franklin Walker, MBA, NCMS Vice President for Rural Health Systems Innovations and Executive Director of the Community Practitioner Program. “The overarching idea is simple — give our physician and physician assistant members the tools to truly help their patients with opioid use disorder.”

    The coalition partners currently include the NC Association of Local Health Directors, LabCorp, The Recovery Platform, the University of North Carolina, School of Public Health, Project Echo and the Mountain Area Health Education Center (MAHEC).  Each organization brings special expertise to expanding the use of Medication Assisted Treatment (MAT) in treating opioid use disorder (OUD).

    The statistics are striking:

    • Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
    • Between 8 and 12 percent develop an opioid use disorder.
    • An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.

    Yet, few physicians or PAs are knowledgeable about or trained to provide MAT – in North Carolina less than 3 percent have obtained the necessary certification. Research shows that MAT is successful in treating OUD in about 60 percent of cases whereas abstinence strategies are successful only about 10 percent of the time.

    In addition to offering the necessary training to become certified to provide MAT, the OBOT pilot projects also will offer the technology necessary to coordinate care, track non-compliance, address other determinants of health outcomes and incorporate telemedicine. The teams of experts will help primary care physicians integrate MAT into their regular workflow in hopes that caring for patients with OUD will become routine and will lead to successful treatment of this chronic condition.

    MAT certification trainings are already underway. Watch the Bulletin and the OBOT website for updates and to learn more about the initiative. For more information about getting involved in OBOT, please contact Walker at fwalker@ncmedsoc.org or 919-833-3836 x141.

     
  • NC Legislative Short Session Starts Today

    Dr. Richard M. Wardrop, III (second from right), and six UNC School of Medicine students attended the first White Coat Wednesday of 2018’s legislative short session. Check out our Facebook, Twitter and Instagram feeds for more photos.

    Legislators officially returned to Raleigh today to begin the General Assembly’s short legislative session amid a massive rally by teachers. While the teachers got much of the media attention, North Carolina Medical Society (NCMS) members, including students from the University of North Carolina School of Medicine, were there for White Coat Wednesday to educate legislators on our priority health care issues.

    The short session is primarily focused on tweaking the biennial budget, but the NCMS will be monitoring any legislation that might impact our legislative priorities:

    • Medicaid reform: We are working hard to ensure a streamlined and physician-friendly approach to the transformation of the state’s Medicaid program to managed care.
    • Improved access to care: We support expanding Medicaid so the working poor and those who can’t afford health insurance have the opportunity to get coverage and thus remove barriers to receiving health care.
    • Scope of practice: We are promoting cooperative health care teams that are crucial to the success of the transformation of our health care system while making sure that everyone on the team has the proper training. Patient safety is, of course, our top priority.
    • Protecting our tort reform victory: We will vehemently oppose any erosion of the reforms we won in 2011 while considering any necessary refinements.
    • Opioid abuse epidemic: We will continue to address this issue by advocating for policies that address all facets of this problem as well as the various education and coalition building initiatives we have underway.

    Throughout this session, we offer you many ways to keep up-to-date.

    • Read the NCMS Legislative Blog for daily updates throughout the session.
    • Follow @ncmedsoc on Twitter and Facebook for real time updates.
    • Watch the weekly ‘Bowtie Briefing’ video during the session, in which our Senior Vice President for Advocacy and Advancement and Associate General Counsel Chip Baggett gives you the inside look at what is happening at the General Assembly. This video is emailed to NCMS members each Friday.
    • Read the NCMS Bulletin every other Wednesday.
    • If you want to be directly engaged with your legislators, sign up for a White Coat Wednesday. Our advocacy team will brief you over breakfast and then escort you to the legislative building for meetings with your legislators to discuss what is important to you and your patients. Sign up now.
     
  • The Physicians Foundation Awards Grant to Kanof Institute for Physician Leadership

    The award-winning leadership development programs that are part of the North Carolina Medical Society (NCMS) Foundation’s Kanof Institute for Physician Leadership (KIPL), have received a $150,000 grant from The Physicians Foundation. The money will support two cohorts of the Leadership College and continue to grow and train Kanof Institute faculty over the next two years.

    The Physicians Foundation, is a national organization that seeks to empower physicians to lead in the delivery of high-quality, cost-efficient health care through grants and research. Over the years, the Foundation has been highly supportive of the NCMS’ leadership development programs as well as its Toward Accountable Care Consortium and Initiative.

    KIPL, through its Leadership College and Health Care Leadership and Management courses provide physicians and PAs in North Carolina with the tools and skills necessary to actively engage in the transformation of health care to value-based care. The programs prepare participants to engage with and influence key decision makers on the issues affecting the practice of medicine. The curriculum is developed with the quadruple aim in mind – that is enhancing patient experience, improving population health, reducing costs and improving work life of health care providers.

    To date, KIPL has trained 335 leaders, many of whom today hold prominent leadership positions in health systems and private practices throughout the state. To learn more about KIPL and to apply to be a participant next year, visit the KIPL webpage.

    The generous grant from The Physicians Foundation will allow KIPL to maintain reasonable tuition costs and to further develop the faculty, which is mainly practicing physicians and PAs.

    Thank you to The Physicians Foundation and congratulations to KIPL for the grant award!

     
  • NC Medicaid Began Coverage of 3D Breast Tomography May 1

    As of May 1, 2018, North Carolina Medicaid began covering digital breast tomosynthesis (3D tomosynthesis) for both screening and diagnostic mammography. Practices must submit claims with Healthcare Common Procedure Coding System (HCPCS) code G0279 (Diagnostic digital breast tomosynthesis, unilateral or bilateral) in addition to screening or diagnostic mammography Common Procedural Terminology (CPT) codes 77065-77067.

    As reported earlier in the NCMS Bulletin, the North Carolina Medical Society (NCMS) and radiologists detailed the benefits of 3D mammography to the North Carolina Division of Medical Assistance. We are pleased the Medicaid program decided to begin covering breast tomosynthesis, or 3D mammography.

    Using these higher quality images cuts down on the need for additional tests; help physicians detect more cancers earlier and especially helps detect tumors in women with dense breast tissue.

    The North Carolina General Assembly passed legislation requiring physicians report when a woman has dense breast tissue to make them aware of the special benefits of 3D mammography in their particular case. Commercial insurers, like Blue Cross Blue Shield of North Carolina, does cover 3D mammography.

     
  • NC Treasurer Directs BCBSNC To Cut Provider Rates for State Health Plan

    On Monday, North Carolina Treasurer Dale Folwell, whose office oversees the State Health Plan, directed Blue Cross and Blue Shield of North Carolina (BCBSNC) to reduce provider rates paid by the Plan by at least 15 percent. According to the Treasurer’s announcement, the reduction will be implemented on “major contracts” that BCBSNC will be negotiating with providers starting this year. Read the announcement.

    This move follows Treasurer Folwell’s previous statements that he would seek to reduce costs for the plan to ensure its solvency. [Read this March 2018 Business NC article.] The prospect of such a large proposed rate cut is nevertheless concerning, and could affect the ability of teachers and state employees to receive care.

    The North Carolina Medical Society (NCMS) is gathering more information on the timing and scope of the Treasurer’s proposed rate cut, and how it may affect physicians and their patients. NCMS is looking for solutions that simultaneously keep costs down and improve health. Please watch for additional updates.

     
  • Results of Latest NCMS Snapshot Survey On Opioid Prescribing

    Thank you to everyone who responded to this month’s North Carolina Medical Society (NCMS) Snapshot survey on opioid prescribing. The results of our Snapshot surveys offer NCMS leadership further insight into your experience on important and timely topics in order to remain responsive to members.

    Initial analysis of the results of the opioid prescribing survey show:

    • Members are well aware of the opioid abuse epidemic and the issues surrounding opioid prescribing, but would welcome more education and clarification on the recently enacted STOP Act and other opioid prescribing guidelines as well as on how to treat chronic pain.
    • Most respondents do check the Controlled Substance Reporting System before prescribing, but many still find it cumbersome and object to the legislative mandate to check it.
    • For those who were familiar with the North Carolina Medical Board’s Safe Opioid Prescribing Initiative, many thought it was a necessary mechanism to identify and address over-prescribing by physicians, but worried about intrusiveness.
    • Generally, those who responded do believe that physicians play a major role in stemming the opioid abuse epidemic.

    The randomly selected winners of the $100 Amazon gift cards for completing recent Snapshot surveys include:

    • Donald Clarke, MD
    • Diane Alligood, MD
    • Dianna Howard, MD
    • Paul Fuchs, MD
    • Keegan Anthony Harkins, MD
    • Roger Austin, MD
    • Jennifer Hoover, MD
    • Marci Lait, MD
    • Matthew Chamberlain, MD

    Congratulations to these survey respondents! Please watch for and participate in the next Snapshot survey to be emailed on June 13.

     
  • Has the Practice of Medicine Improved In the Last Two Years? Let Policymakers Know — Take This Survey

    The Physicians Foundation biennial survey of the nation’s physicians is underway and now is the time to share your insights into the practice of medicine. Do you think the practice of medicine has changed for the better or worse in the last two years? The 2016 survey results showed that:

    • More than half of U.S. physicians rated their morale as somewhat or very negative,
    • Almost half said they often or always feel burnt out.
    • 80 percent said they were overextended or at capacity
    • 72 percent said external factors such as third-party authorizations significantly detract from the quality of care they are able to provide.

    Review all the 2016 results. The 2018 survey is currently under way and is your chance to report back. Take the survey now! The 34-question survey asks for your thoughts on issues such as telemedicine, the opioid crisis, value-based compensation, maintenance of certification, electronic health records and the future of medicine.

    The Physicians Foundation, a nonprofit grant-making organization, conducts the survey every two years to better understand the morale, career plans, and practice realities of today’s physicians.

    The results of the previous five surveys conducted by The Physicians Foundation have been used by policy makers and are often quoted in the media including publications like The Wall Street JournalForbes and USA Today.

    The survey may be taken anonymously, or you may include your email address to enter a drawing for a $5,000 Amazon gift card or one of five $500 Amazon gift cards.

    The greater the response, the greater the impact on policy makers and the public!

    Check your email throughout May for a message directly from The Physicians Foundation about the survey, or take the survey online now.

     
  • NCMS Releases Summary of New Opioid Prescribing Rules for Workers’ Compensation

    The North Carolina Medical Society (NCMS) is pleased to offer an easy-to-read overview of the new opioid prescribing rules for workers’ compensation. The rules, adopted by the North Carolina Industrial Commission, took effect May 1.

    Included in the provisions are limitations on quantity and dosing, mandatory drug testing, and risk assessments. The rules also encourage prescribers to consider alternative treatment modalities for pain management, and to consider co-prescriptions for naloxone in some circumstances. And similar to last year’s STOP Act, the rules require providers to review the NC Controlled Substance Reporting System prior to prescribing opioids.

    Click here to access the Opioid Prescribing Rules for Workers’ Compensation: An Overview by the North Carolina Medical Society (PDF – 5 pages).

    We hope this resource will be helpful to you, and we welcome your feedback.

    For more information, the Industrial Commission has also launched a resource page on the rules.

     
  • NCMS Leadership Convenes This Weekend

    The North Carolina Medical Society (NCMS) Board of Directors and the NCMS Foundation Board of Trustees along with the current class of Leadership College scholars will meet this weekend in Chapel Hill to learn and plan for the future. Local Durham Orange County Medical Society members will also have the opportunity to meet with the NCMS Board of Directors.

    Watch the NCMS social media feeds on Twitter, Facebook and Instagram (@ncmedsoc) Friday afternoon and all day Saturday for live updates from this important gathering.

     
  • Carolina Complete Health Network Announces Private Placement

    Carolina Complete Health Network, Inc. (CCHN), a subsidiary of the North Carolina Medical Society (NCMS) formed to build and support a patient-focused, physician-led Medicaid health network, announced this week that in the first quarter of 2018 it raised approximately $1.1 million in a private placement transaction with the North Carolina Community Health Centers Association (NCCHCA) and certain Community Health Centers (CHCs) throughout North Carolina.

    The NCCHCA has served as an integral collaborator with CCHN, and will continue to inform and guide CCHN’s efforts in creating a health care option for Medicaid beneficiaries in North Carolina.

    Community Health Centers are key providers of primary care services to Medicaid beneficiaries, and with its investment, the Centers can actively support CCHN as it pursues this unique opportunity to help lead the Medicaid reform process in North Carolina.

    Under the private placement, CCHN agreed to issue in aggregate to both NCCHCA and Community Health Centers statewide, 1,505 shares of Class P Common Stock at a price per share of $750. CCHN expects to use 55 percent of the private placement proceeds for general working capital purposes and the remaining 45 percent of the proceeds to help fund its portion of the initial capitalization to the joint venture company with Centene Corporation, a diversified, multi-national health care enterprise, to create Carolina Complete Health, a health plan with a patient-focused approach to Medicaid under the reform plan enacted in North Carolina.

    The Class P Common Stock sold in the private placement has not been registered under the Securities Act of 1933, as amended, and may not be offered or sold in the United States absent registration or an applicable exemption from registration requirements.