American Society of Interventional Pain Physicians | February 1, 2017
American Society of Interventional Pain Physicians | August 2, 2017
 

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2017 ASIPP Washington Legislative trip

Set for Sept 12-13, 2017 


At no other time in the history of the American Society of Interventional Pain Physicians has it been more important for you, as members, to get involved in our advocacy efforts. Our specialty has been gravely affected by drastic and severe coverage cuts. These cuts so radical, they have hurt more than just our bottom lines; some practices and surgery centers have been forced to close their doors.  

The election of President Trump and his appointment of Representative Tom Price as Health and Human Services Secretary and Seema Verma to head the Centers for Medicare and Medicaid Services have given us some hope and an opportunity to achieve some of our goals, and possibly reverse these cuts retroactively and reinstate the previous reimbursement or even improve reimbursement for 2018. 

Now is our chance! Let your voices be heard! 

We have scheduled a legislative conference September 12 and 13. To participate in this conference, you must to be in Washington on Tuesday, September 12 in order to attend the preparation session. Wednesday, September 13, we will head to Capitol Hill to hear speeches and meet with Senators and Representatives. Some appointments may continue through Thursday. If you would like to leave on Wednesday, please do not plan on leaving before 6 pm.  

Each member is expected to visit two senators and one member of Congress for a total of three visits.  

ASIPP will be booking a block of rooms for those who choose to attend. You will be responsible for travel expenses.  

Please let us know as soon as possible if you will be attending so that we can begin making the appointments. Contact Kasi Stunson kstunson@asipp.org.


  Analysis of U.S. medical groups finds adoption of non-physician providers and support staff among factors driving more profitable and productive groups
Profitability also impacted by payer mix, as well as rising information technology and drug costs

Medical Group Management Association (MGMA) released its 2017 MGMA DataDive Cost and Revenue Survey today which revealed that one of the key factors of medical group profitability and productivity resides in the utilization of non-physician providers and key support staff.
Between 2015 and 2016, practice operating expenses increased at nearly the same rate as revenue. The practices that came out with increased revenues owe it namely to increased non-physician providers and support staff. The practices with a higher non-physician provider (NPP) to physician ratio (0.41 or more NPPs per full-time equivalent [FTE] physician) earn more in revenue after operating cost than practices with fewer NPPs (0.20 or fewer NPPs per FTE physician) regardless of specialty.   

  Survey: How do payer mix, IT expenses impact practice revenue?

Operating expenses increased at nearly the same rate as revenue between 2015 and 2016, according to a survey released by the Medical Group Management Association. For the survey, MGMA gathered data and insights from more than 2,900 organizations and 40 specialties and practice types. Here are four survey insights.
1. Practices with a higher non-physician provider to physician ratio (0.41 or more) earned more in revenue after operating cost, compared to practices with a lower non-physician provider to physician ratio (0.20 or fewer). 
2. In the last year, physician-owned practices spent between $2,000 and $4,000 more per full time equivalent physician than one year prior. The increase was less for hospital-owned practices.
3. Drug supply costs have increased more than 10 percent per FTE physician across practices.
4. Primary care practices with a lower percent of government payer mix reported higher operating costs, and even higher revenues after operating costs.  

Energy Drinks and the Heart: Are They Safe for Consumption?

I recall getting a call from the emergency department (ED) several years ago about a young man in his early 30s presenting with typical angina at rest. A quick glance at his electrocardiogram (ECG) revealed an ST-elevation myocardial infarction (STEMI), and his troponins exceeded 35 ng/mL. 
I took him straight to the catheterization lab, where he was found to have a sticky thrombus occluding the left anterior descending artery, but no other significant coronary artery disease. I remember going back and asking him questions to figure out why a 30-something-year-old was having a myocardial infarction.
He wasn't a smoker, had no family history of coronary artery disease, and had no risk factors. The only thing that stood out at the time was that he was an avid drinker of energy drinks. He had gulped down a couple off-brand energy drinks filled with unrecognizable ingredients and lots of vitamin B6, vitamin B12, and caffeine.   

  What Do Patients Want?
Four things patients look for in a physician  

Though the future of healthcare coverage is uncertain, more Americans have access to care than ever before -- at least for the time being. Along with that access comes the opportunity for patients to pick a physician. So what are these patients looking for when choosing a doctor, and what makes them decide to leave one for another? To find out, we  recently surveyed nearly 500 healthcare consumers. Here are a few of the things we learned about what they want and what physicians can do improve their practice and retain their patients.    

  Are Prescribing Habits to Blame? A Closer Look at the Opioid Epidemic  

Pop quiz: "What's the most common long-term complication after elective surgery?" Whatever you're thinking, it's probably not that. In fact, it's looking more and more like the answer might well be opioid dependence.1 
Surprising? Sure. But also worrisome, because there's no doubt that surgical practices have had a hand in exacerbating the nation's burgeoning opioid epidemic. Prescription opioids are classic gateway drugs: nearly 75% of heroin users report previous abuse of opioids. And there's good reason to believe prescription pain killer prescribing patterns are linked to eventual heroin usage; for instance, regions where physicians are, for whatever reason, less likely to prescribe opioids to black patients for chronic and postsurgical complaints have experienced a persistent increase in the proportion of heroin users that are white.2     

  Can You Name More Than 5 Street Terms for These Drugs?  

In light of the plethora of street names used to refer to a number of drugs of abuse, the Drug Enforcement Administration (DEA) has issued an unclassified intelligence report designed as a “ready reference for law enforcement personnel … to identify a wide variety of controlled substances, designer drugs, and synthetic compounds.”  
The agency compiled this list in consultation with several law enforcement entities, in addition to online resources, and expresses caution regarding the fluid nature of the “drug scene,” which may lead to unavoidable amendments and deletions to this rich and colorful urban nomenclature.    

  Senate Renews FDA User Fee Bill  

WASHINGTON -- With little debate, a legislative package that determines how much drug and device makers must pay the FDA passed the Senate in a vote of 94-1 on Thursday.
"The Senate has sent to the president's desk legislation that will speed cures and treatments into patients' medicine cabinets. The first step was last year's passage of 21st Century Cures to spur medical research, and this is the next step -- ensuring patients see the benefits of those research advancements, said Sen. Lamar Alexander (R- Tenn.), who chairs the Senate Health, Labor, Education and Pensions (HELP) Committee, in a press statement.    

CMS to allow both 2014, 2015 certified EHRs in 2018

CMS has released the final Inpatient Prospective Payment System rule for fiscal year 2018, which addresses important health IT issues. Listening to the pleas of various advocacy groups, CMS will implement the 90-day meaningful use reporting requirement and allow additional flexibility in EHR adoption. Hospitals reporting measures related to clinical quality and meaningful use in the calendar year 2018 will be able to use the 2014 edition of certified EHR technology, the 2015 edition of CEHRT or a combination of the two.
"This final rule will help provide flexibility for acute and long-term care hospitals as they care for Medicare's sickest patients," said CMS Administrator Seema Verma. "Burden reduction and payment rate increases for acute care hospitals and long-term care hospitals will help ensure those suffering from severe injuries and illnesses have access to the care they need."

  Maintenance of Certification and Texas SB 1148 A Threat to Professional Self-Regulation

During the 2017 legislative session Texas lawmakers voted to approve Senate bill (SB) 1148 entitled “Relating to Maintenance of Certification by a Physician or an Applicant for a License to Practice Medicine in This State.” SB 1148 was intended to restrict the use of maintenance of certification (MOC) as a credential for hospital privileging, to wit: “a hospital, institution, or program that is licensed by this state, is operated by this state or a political subdivision of this state, or directly or indirectly receives state financial assistance may not differentiate between physicians based solely on a physician's maintenance of certification.”
The original bill was also written to prevent managed care plans from “differentiating between physicians based solely on a physician's maintenance of certification in regard to: (1) paying the physician; (2) reimbursing the physician; or (3) directly or indirectly contracting with the physician to provide services to enrollees.” SB 1148 was introduced by 2 physician-legislators, received support of the Texas Medical Association (ostensibly reflecting the temperament of its members), was vigorously debated and opposed by some academic and community physicians, and was signed into law by the governor on June 15, 2017. A major impetus for the introduction of SB 1148 came from physician dissatisfaction with the MOC programs developed by the member boards of the American Board of Medical Specialties (ABMS). MOC critics argue the programs are excessively costly, are time consuming, are irrelevant to practicing physicians, and, most importantly, fail to improve patient care.


  How Aetna, Anthem, Cigna, Humana and UnitedHealth performed in Q2

The health insurance industry's five largest payers reported solid earnings for the three months ended June 30 in fiscal year 2017.
1. Hartford, Conn.-based Aetna reported net income of $1.2 billion in the second quarter of this year, compared to $791 million in the same period last year. Although Aetna's profits rose, the payer saw second quarter revenues decrease year-over-year to $15.5 billion from $16 billion last year. Aetna reported operating expenses of $2.6 billion in the second quarter, down from $2.9 billion in the same period last year.   

  Kaiser's operating income jumps 57% to $772M

Oakland, Calif.-based Kaiser Permanente reported higher revenue and operating income for its nonprofit hospital and health plan units in the second quarter of 2017. 
Kaiser saw revenue climb to $18.1 billion in the second quarter of this year. That's up 14.6 percent from revenue of $15.8 billion in the same period of 2016.  
That boost was attributable, in part, to the system's health plan unit. In the first half of 2017 Kaiser added 1.1 million health plan members. This growth was partially attributable to Kaiser's acquisition of Seattle-based Group Health Cooperative in February. As of June 30, Kaiser had about 11.7 million members.

Pain clinic and owner to pay $250k to settle billing fraud case

Atlanta Medical Clinic, which is a pain management clinic, and owner Timothy Dembowski, DC, have agreed to pay the federal government $250,000 to resolve False Claims Act allegations, according to the Department of Justice.
According to the government, AMC and Dr. Dembowski submitted fraudulent claims to Medicare for services performed by a physician who worked at the pain clinic and was suspended from the Medicare program. The pain clinic and Dr. Dembowski allegedly stated in claims submitted to Medicare that services the suspended physician provided were performed by a different physician, according to the DOJ.
AMC and Dr. Demowski also allegedly violated the False Claims Act by submitting claims to Medicare for administering a foreign, non-FDA approved knee treatment drug to Medicare patients.    

JULY ISSUE NOW AVAILABLE!

Interventional Pain Management Reports is an Open Access online journal, a peer-reviews journal dedicated to the publication of case reports, brief commentaries and reviews and letters to the editor. It is a peer-reviewed journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine.  

We would like to invite you to submit research case reports, brief commentaries and reviews to Interventional Pain Management Reports Journal. Your article will be published ‘FREE’ of charge.  

Led by Editor in Chief: Kenneth Candido, MD, Chairman and Professor, Department of Anesthesiology , Advocate Illinois Masonic Medical Center in Chicago, IPM Reports focuses on the promotion of  excellence in the practice of interventional pain management and clinical research.  

Interventional Pain Management Reports is an official publication of the American Society of Interventional Pain Physicians (ASIPP) and is a sister publication of Pain Physician. Interventional Pain Management Reports Interventional Pain Management Reports is an open access journal, available online with free full manuscripts.    

The benefits of publishing in an open access journal that has a corresponding print edition journal are:  
  • Your article will have the potential to obtain more citations.
  • Your article will be peer-reviewed and published faster than other journals.
  • Your article can be read by a potentially much larger audience compared with traditional subscription-only journals.  
  • Open Access journals are FREE to view, download and to print.
So submit today your:
Case Reports
Technical Reports
Editorials
Short Perspectives

  Click HERE to read the Instructions for Authors for article submission    

Click HERE to submit a manuscript

State Society News  
September 15-17, 2017: California  

CASIPP 8th Annual Meeting
September 15-17, 2017 Loews Santa Monica Beach Hotel
Additional 10% discount for ASIPP Members – enter ASIPP17 in the discount box at registration To register: http://www.casipp.com/2017-meeting-registration.htm    

October 7, 2017: New York
 
The 2017 The Art and Science of Pain Management: A Clinical and Research Update will be Oct. 7, 2017 at The Gideon Putnam, 24 Gideon Putnam Road, Saratoga Springs, NY 12866
The meeting is sponsored by Albany Medical College’s Department of Neuroscience and Experimental Therapeutics and the Office of Continuing Medical Education and the Albany Medical Center Provider Unit for Continuing Nursing Education. Registration Deadline is October 2, 2017.
For information regarding the conference, contact the Office of Continuing Medical Education by phone at (518) 262-5828, fax at (518) 262-5679 or e-mail at pricej@mail.amc.edu.


Send in your state society meeting news to Holly Long, hlong@asipp.org
  The NIPM-QCDR, a new offering from ASIPP®, is specifically tailored for interventional pain physicians. Your practice can use the NIPM-QCDR to fulfill the 2017 requirements of the Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS).  
  • Meet CMS MIPS mandates for Quality and Improvement Activities
  • Receive credit toward Advancing Care Information
  • Report on specialty-specific measures developed by ASIPP
  • Understand and adjust your 2017 performance to optimize future CMS reimbursement with real-time reports available on-demand
  • Be better prepared for CMS quality reporting in future years when penalties and incentives get even larger
  • Improve the quality of patient care in the specialty of interventional pain managementLearn more and get started with 2017 reporting by visiting ArborMetrix.com/NIPM-QCDR.
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