NCMS Morning Rounds 8-9-19

Enjoy your weekend! But first, here’s your

 NCMS Morning Rounds.

Aug. 9, 2019

Treasurer Finally Sees the Light on Clear Pricing Project

Late yesterday afternoon State Treasurer Dale Folwell announced that physicians now will have the choice of joining the Blue Cross Blue Shield of North Carolina’s Blue Options Network or the new State Health Plan Network, part of what Folwell has been calling the Clear Pricing Project, to care for State Health Plan members.

After the second deadline to join the new Clear Pricing Project Network passed on Monday with none of the state’s major health systems signing on, health care options for the more than 700,000 state employees who receive care as part of the State Health Plan narrowed considerably. The majority of physicians in the state would have been considered out-of-network for State Health Plan patients.

This latest move comes after more than 18 months of negotiations between Folwell, the NCMS and other health care stakeholders over the best way to maintain the State Health Plan’s solvency. The NCMS encouraged the Treasurer to pursue his goal of improved solvency for the Plan through broader use of innovative models of care grounded in the Triple Aim.

Yesterday those who had signed onto the new State Health Plan Network received an email from the treasurer’s office explaining that you now will have the choice of either staying in the new network or enrolling in Blue Options Network, whichever you determine would best suit your practice. Together the two networks will consist of more than 68,000 providers across the state. This helps ensure State Health Plan employees will have access to the physicians and physician assistants they currently see.

This move signals the treasurer’s willingness to incentivize the value of primary care while aggressively pursuing value-based contracting, for which the NCMS strongly advocates.

‘Prescribe’ a YMCA Medical Membership

As part of the NCMS Foundation’s Our Community Health Initiative (OCHI) partnership with the YMCA of the Triangle, area physicians and physician assistants can now refer patients for a YMCA Medical Membership.

Medical memberships are for those with a health issue such as pre-diabetes, weight management, cancer, high blood pressure or risk of falling due to age or illness. Being a YMCA Medical Member means the patient has full YMCA access and benefits, care coordination with a health coach and enrollment in one of the Y’s evidence-based programs to address the particular health issue. The membership cost to the patient is reduced thanks to a 3-year grant from Blue Cross Blue Shield of North Carolina.

The NCMS’ OCHI allows you to refer patients electronically and receive real time information back from the YMCA on the patient’s progress. For the moment, the YMCA of the Triangle is the only group receiving referrals, but the plan is to expand the program to YMCAs and YWCAs statewide in the coming months.

To date, the Triangle YMCA reports there have been 53 referrals for a YMCA Medical Membership with 21 patients registering for fall classes, which start in September.

Learn more about OCHI and YMCA Medical Membership.

Last Chance: Apply Now for 2020 Leadership College

Don’t miss this chance to enhance your leadership potential by becoming part of the NCMS Foundation’s Leadership College, a program of the Kanof Institute for Physician Leadership. Several spots still are open in the coming year’s class of scholars.

As a Leadership College scholar you will:

*Gain better insight into your unique leadership style;
*Hone your skills to be a more valuable leader on the health care team;
*Meet colleagues from throughout the state to share ideas and perspectives on today’s health care environment.

This award-winning program boasts over 300 alumni who now hold prominent leadership positions in their practice, health system and beyond.

Learn more and apply today. You’ll be glad you took this opportunity for career and personal development!

In the News

How to Use Twitter According to a Health System’s Chief Medical Social Media Officer, The Advisory Board Forum, 8-7-19

Learning Opportunity

MAT Waiver Trainings are available Sept. 27 in Asheville. One session “Providers’ Clinical Support System: Buprenorphine Office-Based Treatment for Opioid Use Disorders: The ‘Half and Half’ Course” is meant for prescribers and will be held from 1:30 to 6 p.m. Learn more and register.

The second session that day is geared for other members of the health care team and is called “Recovery Within Reach: Building Team Expertise in Office-Based Opioid Treatment (OBOT)”, and will be held from 1:45 to 6 p.m. Learn more and register.

For comprehensive listings of MAT Waiver Trainings throughout the state, visit the NCMS Foundation’s Project OBOT site.


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