NCMS Morning Rounds 6-25-19

Happy Tuesday!

Enjoy your NCMS Morning Rounds!

June 25, 2019

Congratulations 2019 HCLM Grads!

HCLM class of 2019. Front row l-r: Truett Smith, PA-C; Kimberly Blasius, MD; Kelley Singer, MD; Jennie Byrne, MD, PhD; Jugta Kahai, MD, FAAP; Frederick ‘Fritz’ Stine, DO, MHA. Back row, l-r: Barbara Walker, DO; Michael Utecht, MD, DVAMC; Stephen Keene, MBA, JD; Christopher Grubb, MD; Jeffrey Hatcher, MD, FACP.

Last weekend the Kanof Institute for Physician Leadership’s latest class of Health Care Leadership and Management (HCLM) scholars graduated from the year-long program. HCLM provides insights into health care economics, finance as well as more in-depth leadership development. Graduates have the vocabulary needed for the business realm and are equipped to take on greater leadership positions in their career.

The program culminated at the NCMS’ Center for Leadership in Medicine in Raleigh with the 2019 HCLM participants presenting the results of their projects, which included a website where health care consumers can get an overview of all medical charges for any procedure or office visit; a team billing process that integrates behavioral and physical health and a wearable device that tracks all aspects of a person’s lifestyle and integrates with their electronic health record.

If you are interested in learning more about the business of health care and honing your leadership skills by being part of the 2020 HCLM class, applications will be accepted until June 30. Learn more and apply.

Reminder: State Health Plan Contracting Deadline is July 1

New provider contracts being offered by the State Health Plan need to be returned by Monday, July 1 in order to remain in-network for State Health Plan members beginning Jan. 1, 2020. As of Jan. 1, the Plan will move to a reference-based pricing model and will use Medicare rates as the reference point, paying providers a percentage above that rate. If you do not wish to participate in the network in 2020, you will be considered out-of-network.

Learn more about the network and contracting process. The full fee schedule is available here.

All questions about these changes must be received by tomorrow, Wednesday, June 26. Questions regarding the methodology used for the reimbursement exhibit should be directed to Other questions should be submitted to the Plan via email to

The State Health Plan also recently finalized the reimbursement levels for vaccines to include drug and administrative reimbursement methods. The administrative codes will be set at 2018 CMS Rates at 160 percent in the Reimbursement Exhibit. The vaccines themselves will be paid 125 percent of the CDC Private Sector Price list.

NCMS at Old North State Medical Society Meeting

NCMS President Timothy J. Reeder, MD, MPH, FACEP along with NCMS CEO Robert W. Seligson, MBA, MA and other NCMS staff attended the Old North State Medical Society’s (ONSMS) 132nd Annual Meeting and Scientific Assembly in Greensboro over last weekend. The meeting agenda included education on prescribing controlled substances and updates on the opioid abuse epidemic in the state; addressing the many facets of racial disparities in health care and understanding the escalating value of African American physicians as leaders in medicine.

Dr. Reeder and Seligson, along with ONSMS leader Eleanor Greene, MD, MPH, spoke on ‘The Importance of Physicians as Leaders in Medicine.’ Other sessions included an update on Medicaid transformation by NC Department of Health and Human Services Secretary Mandy Cohen, MD, MPH, and presentations by specialists on racial disparities in maternal and infant health, cardiovascular health, cancer treatment and mental health care.

Charlene Green, MD, an anesthesiologist in Greensboro, was installed as the society’s President. Congratulations, Dr. Green!

In the News

Medical Schools Are Starting to Diversify. But They’re Learning Hard Lessons Along the Way, STAT, 6-17-19

Learning Opportunity

NCQA’s Introduction to PCMH Program: Foundational Concepts of the Medical Home Oct. 22-23 Asheville. This is an in-depth training on all of the 2017 NCQA Patient Centered Medical Home (PCMH) standards and requirements for achieving PCMH recognition. The meeting is designed for any health care professional or administrator interested in understanding more thoroughly foundational aspects of NCQA’s PCMH. Participants will be able to hear directly from NCQA faculty on foundational concepts, best practices and relevant community health center specific examples to achieve PCMH recognition. Learn more and register.


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