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AMA Talks Opioid Abuse and MACRA – Top Docs Radio

June 30, 2016 by angishields

Top Docs Radio

AMA Talks Opioid Abuse and MACRA - Top Docs Radio

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AMA Talks Opioid Abuse and MACRA

Patrice A. Harris, M.D., M.A., is a psychiatrist from Atlanta. She is the chair of the American Medical Association’s Board of Trustees (BOT), and she is the chair of AMA’s Task Force to Reduce Opioid Abuse. Dr. Harris has been the president of the Georgia Psychiatric Physicians Association, and she has served on the Medical Association of Georgia’s Council on Legislation.

In 2001, Dr. Harris was honored as the Georgia Psychiatric Physicians Association’s

Psychiatrist of the Year. After she earned her medical degree at West Virginia University, she did her residency in psychiatry and fellowships in child psychiatry and forensics at Emory.

She was also a Barton senior policy fellow at the Emory University School of Law. Dr. Harris was the director of Health Services for Fulton County, and she served as the medical director for the Fulton County Department of Behavioral Health and Developmental Disabilities.

Opioid abuse is a crisis in America. More than 40 people in the U.S. die from an opioid overdose every day, while many more are becoming addicted. The American Medical Association (AMA) Task Force to Reduce Opioid Abuse – which is comprised of 27 physician organizations and the American Dental Association – has announced several recommendations to address this epidemic.

It is urging physicians to register for and use state-based prescription drug monitoring programs (PDMPs) as part of the decision-making process when they consider treatment options. When fully-funded and available at the point of care, PDMPs are an effective tool for physicians to identify patients who may be misusing opioids and can be used to implement treatment strategies, including referral for those in need of further care.

AMA will also continue to work with the administration and Congress to develop balanced approaches to end prescription opioid misuse, as well as supporting congressional and state efforts to modernize and fund PDMPs. Finally, AMA has initiated an educational effort and communications campaign to promote safe,

effective and evidence-based prescribing within the medical profession.

Georgia PDMP registration: www.hidesigns.com/gapdmp

MACRA

According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changed how Medicare health care providers will be paid in several important ways. MACRA

1) eliminated the Sustainable Growth Rate (SGR) formula and 2) created a new framework to “reward health care providers for giving better and not just more care” and 3) combined the existing quality reporting programs (EHR, PQRS) into one new system. According to CMS, this new “Quality Payment Program (QPP)” will replace “a patchwork system of Medicare reporting programs with a flexible system that allows you to choose from two paths that link quality to payments: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models.”

Special Guest:

Dr. Patrice Harris, Chairman, Board of Trustees, American Medical Association

Senate Bill 158 – Top Docs Radio

April 20, 2015 by angishields

Top Docs Radio

Senate Bill 158 - Top Docs Radio

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Senate Bill 158

On this week’s show we continued our monthly series with the Medical Association of Georgia. MAG’s CEO/Executive Director, Donald J. Palmisano, Jr. stopped by for a discussion on the state of Senate Bill 158, changes in the insurance contracting arena, and other topics on the MAG agenda. Donald also shared how he and a colleague were able to raise over $40,000 to support the Think About It campaign to raise awareness and fight prescription drug abuse/addiction in Georgia, participating in a 100 mile race and completing it in under 24 hours. In the days since Donald joined us on the show, Senate Bill 158 was passed.

MAG continues to take steps to enhance the relationship between health insurer Blue Cross Blue Shield of Georgia, Inc. (BCBSGa) and physicians in the state.

At the end of 2014, Georgia Insurance Commissioner Ralph Hudgens rescinded physician contract amendments that BCBSGa had put into place in Georgia following “numerous complaints from physicians (and their practices).”

First MAG/BCBSGa “Physician Advisory Group” meeting took place on February 12. It is forum for physicians to express their concerns, it will give Blue Cross the opportunity to disseminate information about new payer initiatives, it will be a venue for improving communications, and it will serve as a mechanism for physicians to weigh in on Blue Cross’ clinical policies, operations and contracting practices.

The advisory group consists of four MAG member physicians as well as MAG Health Policy and Third Party Payer Advocacy Department Director Susan Moore and BCBSGa Senior Clinical Officer Mark Kishel, M.D., and BCBSGa Director of Network Management/Georgia Provider Solutions Hayden Mathieson. They will meet a minimum of three times a year.

Rental Networks

MAG supports legislation that would limit rental networks in Georgia. A rental network involves a health insurer that rents or sells its network of physicians to another health insurer. These second-level insurers then include the physicians in their health insurance plans – and pay the physicians an even deeper discount – even though they don’t have a contract with the physicians.

It’s not uncommon for physicians to offer their services to a health insurer at a discounted rate because the higher patient volume offsets the costs. However, the aforementioned insurers rent or sell their networks without the physician’s knowledge – so the physicians often aren’t aware that they are in a given network or that they are contractually obligated to deliver patient care at a greater discount.

Rental networks result in mass confusion and higher administrative costs (e.g., the additional staff time that is required to verify a patient’s health insurance coverage and/or confirm the proper payment). Rental networks can also reduce the accessibility of care because physicians are forced to accept the lower (i.e., “re-priced” or “re-rented”) payment or refuse to see the patient for any follow-up or future care.

Rental networks are an inappropriate, profit-driven tactic that undermines the practice environment in Georgia that will exacerbate the physician shortage in the state. Sixteen states have now adopted laws that regulate or limit or prohibit rental networks.

Insurers are prohibited from using rental networks in federal employee health benefits plan contracts.

All-Products Clauses

Insurance companies use ‘all-products or all-or-nothing’ clauses as a cost-control tactic to force physicians to participate in every health insurance product that they offer or be blocked from caring for patients in the insurer’s plan altogether.

By forcing physicians and their practices to agree to all-products clauses, health insurers are undermining the economic viability of the medical profession in Georgia – keeping in mind that a report that was prepared by IMS Health for the American Medical Association determined that physicians in Georgia “created a total of $29.7 billion in direct and indirect economic output (i.e., sales revenues) in 2012… [and] each physician supported $1,559,494 in [economic] output.” It is also worth noting that the report found that “…physicians supported 205,869 jobs (including their own)…[and] $1,089.6 million in local and state tax revenues in 2012.”

Because physicians are constantly wrestling with these manipulative contract provisions, they have less time to spend with their patients.

All-products clauses violate several individual rights, including the right to contract and an owner’s right to operate a business in a free and autonomous way.

Physicians and medical practices in Georgia should be free to accept the health insurance products of their choice versus the ones that’s imposed on them by profit-driven insurance companies.

Eleven states have enacted prohibitions on all-products clauses, including Alaska, Arkansas, Florida, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Minnesota, Ohio, and Virginia – as well as Washington, D.C.

Special Guest

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia

JD Law, Loyola School of Law
Board of Directors, Physician Advocacy Institute
Medical Payment Subcommitte Member, State Board of Workers’ Compensation
Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine
Former Director, Government Relations/General Counsel/Director, GAMPAC

“Think About It” – Top Docs Radio

November 12, 2014 by angishields

Top Docs Radio

"Think About It" - Top Docs Radio

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“Think About It” Campaign to End Prescription Drug Abuse

Prescription medication abuse and subsequent addiction is a serious problem that needs our immediate attention as a community and as healthcare providers. According to the National Institute on Drug Abuse, “Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for nonmedical reasons at least once in their lifetimes.” And, National Council for Alcoholism and Drug Abuse states, “Taking prescription drugs not prescribed for you by a doctor or in a way that hasn’t been recommended by a doctor, can be more dangerous than you think. In fact, it can be fatal. Prescription drugs are the third most commonly abused category of drugs, behind alcohol and marijuana and ahead of cocaine, heroin, and methamphetamine. Some prescription drugs can become addictive, especially when used in a manner inconsistent with their labeling by someone other than the patient for whom they were prescribed, or when taken in a manner or dosage other than prescribed. Overall, an estimated 48 million people have abused prescription drugs, representing nearly 20% of the U.S. population.”

This week I sat down with Dallas Gay and Dr. Tennant Slack along with Lori Cassidy Murphy from the Medical Association of Georgia to talk about their recently-launched campaign to fight prescription medication abuse and addiction. Dallas and Dr. Slack co-chair the campaign and they’re working hard to bring community focus to the problem. The campaign is being funded by the Medical Association of Georgia Foundation and is working to raise awareness of this issue among Georgia’s residents as well as healthcare providers who prescribe controlled medications. Their team has developed colorful handout materials that give key recommendations for persons who have prescriptions for controlled pain or anti-anxiety medications with regard to how they take it, how they store it, and how to dispose of it when they no longer need the medication. Additionally, they’re involved with numerous events around the community to get people talking and thinking about how this problem can be prevented.

Think About It is a program conducted by the Medical Association of Georgia Foundation for the purpose of reducing the incidence of prescription drug abuse and resulting deaths. The concept for the program originated at NGMC in 2010 and is presently co-chaired by Dr. Jack Chapman, Dr. Tennent Slack and Dallas Gay. Hall County has served as the incubator of the program since its inception. The “Help Stop Rx Drug Abuse in Georgia” leaflets encourage Georgians to 1) only take their medicine as prescribed and 2) not share their medicine and 3) store their medicine in a safe and secure place and 4) properly dispose of any unused medicine.

The ‘Think About It’ campaign involves a wide array of organizations, including medical societies, the Georgia Composite Medical Board, the Georgia Board of Pharmacy, the Georgia Pharmacy Association, the Council on Alcohol and Drugs, and the Georgia Bureau of Investigation – as well as other law enforcement agencies, schools, and business and religious and other community organizations.

Thank you for listening and PLEASE SHARE! this podcast with your networks. You may just help someone you care about.

Special Guests

Dr. Tennant Slack, MD, of Northeast Georgia Physician’s Group

Doctorate of Medicine, Emory University School of Medicine
Residency, Anesthesia, Emory University School of Medicine
Fellowship, Pain Medicine, Medical College of Georgia
Board Certified, American Board of Anesthesiology: – Anesthesiology – Pain Medicine

Dallas Gay, Co-Chair, “Think About It” Campaign

Board Member, Northeast Georgia Medical Center
MBA, Georgia State University
Member, Drug Free Coalition of Hall County
Former President, Protein Products, Inc
Former President, American Proteins, Inc.

Health Connect South and Medical Association of Georgia – Top Docs Radio

September 3, 2014 by angishields

Top Docs Radio

Health Connect South and Medical Association of Georgia - Top Docs Radio

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Health Connect South and Medical Association of Georgia

This week on TopDocsRADIO I sat down with Russ Lipari, Founder and CEO of Health Connect South and Donald Palmisano, CEO and Executive Director of the Medical Association of Georgia.

The mission of Health Connect South is to improve the health of our community by acting as a nexus for gathering of healthcare resources in the region to enhance and facilitate collaboration. The purpose of bringing these robust resources together is to expand awareness of data, logistics assets, research efforts, initiatives, etc. By bringing experts together from the various sectors that face the healthcare space, the door is opened to expose as-yet unrealized opportunities to make large impacts on a variety of major health concerns affecting our population. Health Connect South is hosting their inaugural event coming up September 15, with a few of the limited attendee slots left available. On the show, Russ talks about the launch of the organization, its upcoming event 9/15, and discusses the many companies, thought leaders, and health entities coming together to help our community become the premier epicenter for healthcare in the country.

The Medical Association of Georgia is the primary medical association for the physician community in Georgia. Their membership has representation from all specialties and all healthcare delivery settings. They serve as a collecting and distribution hub of academic data that can help clinicians advance their practices to reflect current research. And the association is very active in one of their core functions, serving as the voice of the medical community at the state capital and beyond to help insure legislation that is passed does not hinder the ability of our community’s physicians in their ability to provide the quality of care our citizens deserve. On this episode, Donald Palmisano, CEO/Exec. Dir. of MAG talks about efforts underway to address ACA issues, Medicare reform, and the association’s efforts to raise awareness about prescription drug abuse through their “Think About It” program. Be sure to register for MAG’s upcoming Annual Meeting at Callaway Gardens 10/18.

Special Guests

Russ Lipari, Founder/CEO of Health Connect South