WORD TO THE WISE
Newsletter: October 2017 - Volume 17, No. 10
In this issue:
  • Executive Director Message: Join us for the upcoming Opioid Abuse Symposium!
  • Members on the Move: Past president attends legislative forum
  • Hot topics in medicine: Medicaid payment, medical corps volunteer opportunity
  • Upcoming local events
  • Other events
  • News from COPIC: Opioid seminar - Nov. 9
  • News from CMS: Engage with your state medical society through Central Line
  • News from AMA: Physicians not required to take payments by virtual credit card
EXECUTIVE DIRECTOR MESSAGE  
Join us at the 2017 Opioid Abuse Symposium
This Saturday, Oct. 14, the Pueblo County Medical Society presents the 2017 Opioid Abuse Symposium. The Board of Directors and I have been working hard to re-engineer our events and maximize their value and importance to members. This will be an educational and collaborative event to bring together stakeholders to find solutions to this grave epidemic, starting in our area. RSVP here.

Let me know if you have any questions about the event. I hope to see you there!

Yours sincerely,
Cheryl
719-281-6073 (mobile) / cheryl.law@pueblocms.org
2018 membership dues are now due!
Your 2018 dues invoices are being sent out to your office or home. If you have any address changes, etc, please contact us at billing@pueblocms.org  as soon as possible. If you should have questions regarding the billing, please do not hesitate to give me a call at 719-281-6073 or  cheryl.law@pueblocms.org . We thank you for your continued support!
MEMBERS ON THE MOVE
This section of the PCMS newsletter highlights members who are making a difference in our community or medical field.   Share your news with us
Past president Vargas attends community event on legislative issues
On Friday, Oct. 6, PCMS Past President Alfredo Vargas, MD, and PCMS executive director Cheryl Law attended an all-day community event, The Summit. It was a call to action by the Action 22 Board of Directors to join them in strengthening the voice of Southern Colorado for the 2018 Colorado General Assembly.

The Summit began with a panel discussion on the economic opportunities in Colorado’s energy future moderated by former Colorado governor Bill Ritter. Along with other presentations, there were discussions on landfills and expanding broadband in Rural Colorado. U.S. Sen. Cory Gardner discussed health care and U.S. Congressman Scott Tipton spoke about rural banking.

During the Committees Summit portion of the day, Dr. Vargas and Cheryl attended the Healthcare Committee. Barry Shioshita, CFO of Southeast Health Group, facilitated the discussion of strategies for the upcoming legislative session around such issues as opioid abuse, pain management, the establishment of a viable database to prevent doctor shopping, and affordable care. It was an exceptional discussion and networking with other health care professionals throughout the state strengthened collaborations for PCMS.

Photo: Speaking, center, Vargas shares his thoughts on health care reform in our region.
President-elect Greidanus reports on CMS Annual Meeting
PCMS President-elect Tom Greidanus, MD, traveled to Breckenridge last month for the 2017 Colorado Medical Society Annual Meeting. Below is his report.

Len Nichols, PhD, a Washington D.C. economist with a sense of humor, gave the opening talk Friday evening after the exhibitor reception. His talk was titled: “What the Heck Just Happened? Health Policy Beyond 2017 (We will get through This!)”

Here are the highlights:

  • He discussed that the budget reconciliation option that expired Sept. 30. As you all know, Congress didn’t have the votes to pull that off so they pulled the vote on repeal. 
  • ACOs have mostly failed; the early ones had some success.
  • Primary Care Medical Homes: lots of money spent on this but really not much improvement in quality and no savings.
  • Bundled payments don’t save much except in post-acute ortho.
  • MACRA ended the SGR, but intensifies incentives for doctors to bear risk. 4-7% of payments at risk. Small practices will be exempt from MACRA for one more year.
  • MIPS is a zero-sum game; it is predicted that 80% of small practices will lose with this.
  • Readmissions are down by 2% but mostly due to a subset of hospitals. Some academic centers have done very well with this and have proven to be the more efficient.
  • 85% of hospitals lose money on Medicare. Minus 7.1% negative margin on Medicare for hospitals, which is why expanding Medicare for all will bankrupt hospitals. The average hospital has a positive 6.8% margin overall.
  • SCHIP will be authorized.
  • Per capita health care spending is $10,000. The median family health insurance premium is 24% of the median family income.

Rob Valuck, PhD, gave a talk titled: “The Opioid Crisis: Latest Developments in the U.S. and Colorado.” He discussed the massive scope of the problem. The CDC considers it the 4th most important epidemic in the U.S. after heart disease, cancer and obesity (and the resulting diabetes). There has been a 500% increase in misuse in 12 years. There were 504 prescription drug overdose deaths in Colorado last year, which is the tip of the iceberg of the problem. Nationwide the epidemic a $78.5 billion impact with $62 billion in lost productivity. Colorado is near the bottom in the country for numbers of prescriptions for opioids but near top for non-medical use of drugs. 70% of opioid addicts start with the medicine cabinet. Interestingly there was a study on dentists and post-extraction prescriptions. They may give a prescription for 30 pills but the average patient only takes four after a wisdom teeth extraction. 90% of overdoses are preventable if first responders have Naloxone. 

Save the date for next year’s meeting, Sept. 14-16, 2018, at the Vail Marriott Mountain Resort.
HOT TOPICS IN MEDICINE
Medicaid payment updates
The Department of Health Care Policy and Financing (HCPF) recently announced that they are extending the temporary timely filing extension for an additional six months "in an effort to ensure providers are appropriately paid for services." Effective May 12, 2017, the timely filing limit was extended to 240 calendar days. Effective May 1, 2018, the limit will be changed back to 120 calendar days.

Visit the new Regional Provider Support web page to learn more about the DXC regional field representatives. The regional field representatives were recently hired and are currently training to be available to assist providers with training and technical support for the new Colorado interChange system. For your immediate individual claims questions, the Provider Services Call Center (1-844-235-2387) is the best resource.

The joint effort between CMS, PCMS and many other physician organizations to seek immediate payment and interest on claims improperly denied or delayed is ongoing.
Partnering4Health improves community health by reducing risks of costly chronic conditions
From 2014 to 2017, the Centers for Disease Control and Prevention provided five national organizations funding to work with 94 urban, rural and tribal communities for implementing sustainable changes that support healthy communities and lifestyles. The three-year grant funded project known as Partnering4Health focused on fighting chronic diseases such as obesity, tobacco use, diabetes and heart disease, which are among the nation’s most costly health conditions.

A new report published by the five national organizations – American Heart Association (AHA), American Planning Association (APA), National WIC Association (NWA), Directors of Health Promotion and Education (DHPE) and the Society for Public Health Education (SOPHE) – summarizes the innovative changes made by communities to support healthier lifestyles where people live, work, learn and play.

Access the report at www.partnering4health.org.
Pueblo’s Medical Reserve Corps seeking volunteers
The Pueblo City-County Health Department’s Pueblo Medical Reserve Corps is recruiting medical volunteers to support the work of local public health. Involvement as a volunteer will help to ensure people or animals affected by a disaster will receive the assistance and medical care needed.

Volunteers receive free training, education, and have the opportunity to participate in drills and exercises that will prepare them to assist public health in real-life events. Both medical and non-medical volunteers are needed. Volunteers must be 18 years of age or older, and there is no cost to join. For more information, contact Vanessa Brazee vanessa.brazee@pueblocounty.us or call 719-583-4925.
Physician’s murder highlights risk of saying ‘no’ to opioids
The late Todd Graham, MD, of South Bend, Ind., was primarily a physiatrist, and devoted only a small portion of his practice to pain management. According to a source, Graham was trying to phase out of pain management completely because of how the opioid abuse epidemic had changed that field over the years. Graham, a popular 56-year-old physician, was shot to death on July 26 by the husband of a patient whose request for opioid painkillers he denied earlier that day. This murder highlights the risk for physical violence faced by pain-management physicians, particularly as they and others come under increasing pressure to avoid prescribing opioids for chronic pain. Read more in this Medscape article and make plans to join PCMS for our opioid symposium on Saturday, Oct. 14.
UPCOMING EVENTS
Add your event to our calendar by emailing cheryl.law@pueblocms.org .
MAKE PLANS TO ATTEND the PCMS Opiate Symposium , Oct. 14, 2017
Click here or the image below to RSVP or for more information
Notice: Region VIII Opioid / Prescription Drug Abuse State and Regional Partners Quarterly Call
All interested individuals are invited to participate in this quarter’s Region VIII Quarterly Call, which will primarily focus on how Region VIII state partners, stakeholders, and communities can learn about better connections with existing crisis programs to include Poison Control Centers and 211 in regards to opioid and prescription drug abuse.

The call will be held Thursday, Oct. 26, 1-2:30 p.m. MST. Connect to the webinar through this link . Call in to 1-877-267-1577, Meeting Number: 999 304 312, Password: 80294, Access Code: 999 304 312.
Join CIVHC to learn new insights about how and why health care costs and quality vary across Colorado and the nation
When: Wednesday, Oct. 18, 9 - 11 a.m. MDT
Where: COPIC Mile High Room, 7351 E. Lowry Blvd, Denver, CO 80230 or via Webinar

Join CIVHC and their national partners on Oct. 18th as they reveal initial results of a project aimed at understanding and measuring delivery systems best suited to improve outcomes and lower costs. Preliminary results from Colorado will be shared and they will be looking for input from those in the community to help them shape the remainder of the project and inform some of the initial results.

Click here to RSVP to join in person. Click here for webinar registration.
NEWS FROM COPIC
The Opioid Crisis Part I—The Pain that Won't Go Away  
WHEN: Nov. 9; 12–1pm

WHERE: Cancer Center in Penrose Main Hospital (2222 North Nevada Ave., Colorado Springs, CO 80907)

WHAT: This in-person seminar examines the scope of the opioid problem, and uses the guidance of the CDC, FDA, medical boards and other best practices to describe practical approaches to practice more safely with opioids. Attendees receive one COPIC point and one CME credit.
NEWS FROM THE COLORADO MEDICAL SOCIETY
Connect with CMS through Central Line - a revolutionary engagement platform
Did you know that any member of CMS/PCMS can propose policy ideas for the medical society 24/7 and from the convenience of your computer or smart phone? Engagement with your colleagues and the board of directors is easier than ever before through the Colorado Medical Society's Central Line virtual engagement platform. Central Line has been operational for almost a year and has seen great success among the membership creating dialogue on top issues of concern to Colorado physicians. Log on today -- www.cms.org/central-line -- using your CMS.org login credentials to submit your policy proposal, view current proposals under consideration, select "Interest Areas" so you can be the first to weigh in on a topic you're passionate about, and designate your preferred method of communication (email or text).
NEWS FROM THE AMERICAN MEDICAL ASSOCIATION
Advocacy update: Physicians protected from health plan credit card fees

The Centers for Medicare and Medicaid Services has weighed in with definitive guidance saying that health plans cannot require physician practices or other health care organizations to accept payments made using so-called virtual credit cards that are often accompanied by exorbitant service fees.

In this and other respects, persistence has paid off on AMA advocacy to clarify the Health Insurance Portability and Accountability Act (HIPAA) standard payer-to-provider payment method for electronic funds transfer (EFT).

Ever since the Automated Clearing House (ACH) EFT standard went in effect in 2014, the AMA has advocated that the federal CMS issue guidance spelling out physician rights regarding insurance company electronic payments. The effort proved to be successful as the agency recently posted the requested clarification of its EFT operating rules and standards on its HIPAA Administrative Simplification frequently asked questions webpage .
MISSION:   Facilitate meaningful collaboration of medical professionals in Pueblo County.  
VISION:   Create a medical society that serves as a venue for collaboration for the betterment of healthcare in Pueblo County. The Society’s efforts will improve the practice of medicine and life of medical professionals.
Board Officers: President: Henrique Fernandez, MD; President-Elect: Thomas Greidanus, MD; Secretary: Ross Patrick, MD; Treasurer: Lev Asherov, MD; Past-President: Alfredo Vargas, MD; CMS Representative: TBD |  Directors: Teresa Braden, DO; Donald Luebke, MD; Julie Newburg, MD; Robert Tonsing, MD; Atul Vahil, MD |  Executive Director: Cheryl Law, MA, MNM
This newsletter is intended for the members and interested persons of the Pueblo County Medical Society. If you have received this and wish to opt-out call 719-281-6073 or use the “unsubscribe” link below.