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In this Issue...
- New Report Finds Infant, Mother Death Rate is Rising
- Grant Program Seeks to Retain Physicians in Rural Idaho
- Congratulations District Two Trustee, Dr. David Leach!
- Introducing the Physician Vitality Program!
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Don't Miss Out on Being an IMA Member!
- Compliance Update: 2023 Year in Review - Health Law Webinar
- IMA Education Webinar - Explore Medicare's Final Rule 2024
- Boise VA Holiday Sponsor Program
- Order Your 2024 AMA Coding BooksToday!
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New Report Finds Idaho's Infant, Mother Death Rate is Rising
By Idaho Capital Sun
All key health indicators have worsened since last year, when Idaho Kids Covered released its first report on the health of Idaho children and mothers.
The mortality rate for mothers rose 121.5%, while the rate for children rose 18%, the report found. Idaho's maternal mortality rate in 2021 was 40.1 deaths per 100,000 births, compared to 18.1 deaths per 100,000 births in 2019. Seventeen Idaho women died while pregnant or within one year of pregnancy in 2021. Idaho's maternal mortality rate is below the national average, which has grown in recent years.
One hundred seventeen infants died in Idaho in 2021, compared to 97 in 2019, according to state records.
To read the entire article, click the button below.
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Grant Program Seeks to Retain Physicians in Rural Idaho
The Idaho Department of Health and Welfare (DHW) has selected 16 rural physicians who will receive grants to help pay down their student loan debts while they continue to serve the rural Idaho communities where they’re needed.
The grants will be issued in November and December as part of the Rural Physician Incentive Program (RPIP), which provides loan repayment for qualifying physicians serving in Health Professional Shortage Areas (HPSAs).
While specific needs vary from one community to the next, nearly all Idaho counties are designated HPSAs. Grant awardees are spread across the state, from Moscow to Rexburg.
“Loan forgiveness programs are an effective mechanism to recruit and retain providers to serve our rural and underserved communities,” said Amy Hirtle, rural health director for the Rural Health and Primary Care State Office. “Since the program’s inception in 2013 over 75% of RPIP recipients remain practicing in Idaho beyond their service obligation to help meet the healthcare needs of Idahoans.”
An appointed board called the Rural Healthcare Access and Rural Physician Incentive Program Grant Review Board met on September 28 in Boise to review applicants and select awardees. Physicians may receive a maximum of $100,000 over a four-year period toward their academic debt.
RPIP is funded by fees assessed to physicians attending the University of Washington and University of Utah medical schools occupying state-supported seats. Preference is given to physicians who paid into the fund, but funding isn’t limited to those candidates. The State legislature also appropriates funds to support the program.
Comments submitted with grant applications help illustrate the challenges Idaho’s rural healthcare providers face.
“Syringa Hospital District (in Idaho County) is located in a rural, medically underserved area where the recruitment and retention of qualified family medicine physicians is both challenging and expensive,” wrote Syringa Hospital in support of the application for Dr. Kelby Wilson, who’s worked at Syringa as a rural family physician since 2019. “Loan repayment is one of the most important recruitment and retention tools we have to offer candidates interested in our area.”
Another application came from Canyon County where the ratio of primary care physicians to residents is 3,110 to one, putting the county at the 90th percentile nationwide, according to a letter from St. Luke’s supporting Dr. Ali Sup’s application.
The St. Luke’s letter cited 23% population growth, a 37% obesity rate compared with 30% statewide, a 25% higher rate of teen births than statewide, and a population for whom 15% are uninsured compared with 13% statewide.
“These factors demonstrate the need to improve the primary care workforce in our county and is why we started our residency program in Nampa,” St. Luke’s wrote. “Dr. Sup represents a success story for us and for the community that she will continue to serve.”
Follow this link for more information about 2023 Rural Physician Incentive Program Awardees.
Rural Healthcare Access Program Awards Also Made
Another program administered by DHW assists rural and underserved Idaho communities to improve access to primary medical and dental healthcare.
The Rural Healthcare Access Program awards are limited to $35,000 per year for an eight-month project period running from November 1 to June 5.
Projects must address needs in designated Health Professional Shortage Areas or Medically Underserved Areas and qualify in three assistance categories: community development, telehealth, and others (such as recruitment and retention).
Five awards were made out of 18 applicants:
- Challis Area Health Center, Inc., $35,000 for provider medical education loan repayment
- Benewah Community Hospital, $34,345 to increase access to pediatric care and for provider medical education loan repayment
- Pocatello Free Clinic, $32,333 to increase access to primary care and dental services
- United Way of Southeastern Idaho, $29,000 to expand access to care with transportation services
- Bingham Memorial Hospital. $29,822 to improve access to care through appropriate health literacy education for the Hispanic community.
Learn more at https://healthandwelfare.idaho.gov/providers/rural-health-and-underserved-areas/loan-repayment-and-grants.
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Congratulations IMA District Two Trustee, Dr. David Leach!
We are happy to announce that David Leach, MD was elected to serve as Trustee for District Two to the IMA Board of Trustees.
Each IMA Board member is a liaison between component societies and the association, represents the societies, advocates for and advises the societies, visits each society, and submits a report to the House regarding his or her trustee district.
The IMA is looking forward to our continued partnership working with Dr. Leach. Congratulations!
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Using the Visit Complexity Code
By Jana Weis, Gill Compliance Solutions
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As part of the Final Rule 2024, HCPCS add-on code G2211 will be added to the Physician Fee Schedule (PFS) and separately payable effective January 1, 2024. The complexity code addresses the issues with coding and valuation of office E/M services that do not fully distinguish and account for resource costs for primary care and other longitudinal care for complex patients. CMS noted that since the E/M visit codes are intended to be used broadly, the complexity of services required to provide this type of care is not fully incorporated as part of the current work valuation. They estimate this code will be used at least 38 percent with office visits, and warrant the increase for “additional resources associated with primary care or ongoing care related to a patient’s single, serious, or complex chronic condition, regardless of visit level.” The Final Rule emphasized that both the patient's condition and relationship with the provider, are the two key elements to deciding if this code is appropriate.
+G2211 - Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition. Add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established (.33 Work Value)
Example of Appropriate Use:
A patient has a primary care practitioner who is the continuing focal point for all health care services, and the patient sees this practitioner to be evaluated for sinus congestion. The inherent complexity that this code (G2211) captures is not in the clinical condition itself— sinus congestion —but rather the cognitive load of the continued responsibility of being the focal point for all needed services for this patient.
Note - the “ongoing care” describes a longitudinal relationship between the practitioner and the patient.
Example of Appropriate Use:
A patient with HIV has an office visit with their infectious disease physician, who is part of ongoing care. The patient with HIV admits to the infectious disease physician that there have been several missed doses of HIV medication in the last month. The infectious disease physician has to weigh their response during the visit —the intonation in their voice, the choice of words—to not only communicate clearly that it is important to not miss doses of HIV medication, but also to create a sense of safety for the patient in sharing information like this in the future.
Note - this is specifically in reference to a single, serious condition or a complex condition where care is ongoing by the specialist.
Inappropriate Use:
- Complexity add-on code would not be appropriate when the care furnished during the outpatient E/M visit is provided by a professional whose relationship with the patient is of a discrete, routine, or time-limited nature
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Examples include (but limited to) a mole removal or referral to a physician for removal of a mole, treatment of a simple virus, counseling related to seasonal allergies, initial onset gastroesophageal reflux disease, treatment for a fracture, and where comorbidities are either not present or not addressed
- When the billing practitioner has not taken responsibility or does not plan on taking responsibility, of the patient for ongoing medical care with consistency and continuity over time
- Cannot be used or added when modifier -25 is on the claim for a significant separately identifiable procedure or service
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Introducing the Physician Vitality Program! | | |
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In October, the Idaho Medical Association (IMA) announced the expansion of a membership benefit that was previously only available to Ada County Medical Society members. The Physician Vitality Program (PVP) offers confidential, affordable, and easily accessible mental health support tailored for Idaho's physicians. It is now available to all medical licensed professionals (physicians, PAs, NPs) who are members of the IMA wherever they practice. PVP was created by Ada County Medical Society in 2016 to address the growing needs of those facing the epidemic of physician burnout, as well as other occupational and personal stressors | |
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The program provides five confidential appointments at no cost, with a strong emphasis on maintaining the privacy of individuals seeking help. While many clinicians have access to Employee Assistance Programs (EAPs) through their insurance plans, they often hesitate to use them due to genuine or perceived confidentiality concerns. ACMS created its own panel of clinically licensed mental health professionals available throughout Idaho and via telehealth and chose those with a reputation for serving medical clinicians. It is suitable for those seeking help for depression, grief, relationship and work challenges, imposter syndrome, and other issues commonly faced by those who practice medicine.
To determine if you are eligible for services, you may verify your IMA membership at https://www.idmed.org/idaho/Idaho_Public/Physician_Finder/Idaho_Public/Physician_Finder/Search.aspx.
To find out more about this program and access appointments, visit the site by clicking the button below.
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Don't Miss Out on Being an IMA Member!
Join thousands of your Idaho colleagues and take advantage of the countless ways IMA can help enhance your professional life.
Idaho Medical Association (IMA) is the leading organization representing physicians in all specialties, practice settings, and geographic locations in our state, and is recognized as the voice of medicine in Idaho. IMA’s mission is to unify and advocate for all Idaho physicians, promote the art and science of medicine, and remain dedicated to improving the health and well-being of all Idahoans.
Idaho Medical Association has over 4,000 members, all Idaho medical professionals who meet the Association's stringent membership requirements. Predominant membership is comprised of over 2,000 actively practicing physicians, including residents, with the balance of members comprised of retired physicians, physician assistants, nurse practitioners, and medical students.
IMA Benefits and Services:
- Legislative Representation
- Reimbursement Services
- Payor Policy Portal
- Physician Advocacy
- News Publications
- IMA Financial Services
- Webinars and Workshops
- Physician Vitality Program
- Annual House of Delegates
- Preferred Partners
* Don't forget: If you pay your AMA dues through the IMA, the IMA benefits.
You can easily join IMA by visiting www.idmed.org or contacting us at (208) 334-7888.
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Compliance Update: 2023 Year in Review
Health Law Webinar
YOU'RE INVITED
December 14, 2023
12:00 PM - 1:00 PM MST
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Compliance issues faced by healthcare providers continued to be at the forefront throughout 2023. Join Holland and Hart Thursday, December 14, for a recap of the most significant healthcare compliance developments of the year, including:
- End of the Public Health Emergency
- OIG’s New Compliance Guidance
- HIPAA and Data Privacy
- Information Blocking Penalties
- AI Issues
- No Surprise Billing Rules
- Hospital Price Transparency
- Telephone Consumer Protection Act (TCPA)
- Antitrust
- Anti-Discrimination Laws
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Speaker
KIM STANGER
Partner
208.383.3913
View Bio
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Take Advantage of this Educational Opportunity!
We will be hosting our last IMA Educational Opportunity of the year, which will be 2 hours long. Our 2024 topics and registration form will be released soon so keep an eye out.
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