Michigan Senate Bill 279 was recently introduced to expand the "scope of practice of registered professional nurses who hold specialty certifications as nurse practitioners." This bill would allow autonomous practice authority for nurse practitioners to deliver care without physician supervision.

SB 279 was referred to the Health Policy Committee; a hearing date has yet to be set. Now is the time for physicians to contact their state senator to share concerns about the impact this bill would have on patient safety and the importance of physician-led team-based care for Michigan patients.

How to take action:

Contact your state senator to urge them to vote NO on Senate Bill 279:

• Michigan State Medical Society (MSMS) created a template that allows for easy action. Click here to view the pre-written template to send to your senator (you may edit to add your personal message if desired).
• View the Michigan Senate Health Policy committee members to see if your senator is on the committee.
• Curious who your senator is? Click here to search.

Patient-centered medical home (PCMH) providers and specialists are now able to bill Blue Care Network and Blue Care Network Advantage for Provider-Delivered Care Management (PDCM) services.

Provider-Delivered Care Management supports the PCMH care model by encouraging providers to deliver coordinated team-based care services. This helps ensure that patients with chronic conditions receive more effective, personalized care from physician-led care teams. PDCM has been shown to help:

• Decrease unnecessary emergency department utilization and inpatient admissions
• Increase closure of quality gaps in care – a HEDIS® measure for BCN Advantage
• Provide improved patient experience through care coordination by the support of a larger care team
• Improve chronic disease management and outcomes (hypertension, diabetes, etc.)

Important notes for practices:

• PDCM is available to all BCN/BCNA members as of January 1, 2023, except FCA/Stelanntis members.
• Providers participating in PDCM receive reimbursement for care management services rendered through 12 procedure codes.
• Practices that engage in PDCM must bill at least one BCN and/or BCN MA PDCM code by December 31, 2023.
• At this time, there is no value-based reimbursement for Blue Care Network so there are no performance targets or incentives.

Eligible providers can click here for a FAQ on the PDCM program through BCN/BCN Advantage.

TPA members can contact Sharon Kraydich, MSN, RN at sharon.kraydich@thephysicianalliance.org with questions regarding the PDCM program and PDCM billing. Practices may also submit an inquiry through the BCBSM PGIP Collaboration site or visit the PDCM page under the Initiatives/Projects/Workgroups tab on the PGIP Collaboration site.

The Physician Alliance team is committed to providing support and resources that help ease members' daily tasks and improve practice efficiencies. The Affiliate Partners program was created to provide cost-effective, innovative solutions to help reduce business overhead costs and optimize business performance. With that in mind, TPA's team is seeking ideas from our members on potential new categories and partners that will benefit practice performance, patient care, revenue and more.

Please click here to submit any ideas, needs, possible companies, etc. TPA's team will evaluate all ideas.

In the meantime, please check out our current partners that offer a variety of services, products and solutions at preferred pricing for TPA members.

Governor Whitmer recently announced that insurers representing the fully insured insurance marketplace in Michigan would maintain coverage for preventive services, despite a recent Texas court ruling. The ruling struck down an Affordable Care Act (ACA) requirement that health insurers cover preventive care services without charging copays or deductibles.

Many healthcare experts and physicians have argued that preventive care is important to overall health and the ruling could jeopardize patient access to care. Preventive care services provide critical health coverage for patients, helping to better manage patient populations and improve overall health outcomes. In response to the ruling, Governor Whitmer announced that all health insurers in Michigan who provide fully insured coverage agreed to maintain preventive care coverage until the Texas court decision is resolved.

Practices can promote preventive care to patients by encouraging wellness visits, screenings, vaccinations, healthy lifestyle and more. TPA practices can access patient education materials and gaps in care toolkits to promote a variety of health topics.

Healthcare practices juggle many competing priorities, including credentialing, scheduling, and most importantly, caring for their patients. Protecting patients against vaccine-preventable diseases is an integral part of today’s healthcare and a critical part of keeping patients healthy. To support their immunization programs, medical practices must acquire vaccines from either a manufacturer or distributor.

While time and costs are associated with securing vaccines, there are ways to streamline the administrative process and save money. Becoming a member of a physician buying group (PBG) is an efficient and economical way for practices and providers to obtain vaccines to support their immunization programs.

What is a physician buying group?

A physician buying group gives providers the buying power to order vaccines at more favorable prices. PBGs are not distributors and do not purchase vaccines, but rather work directly with vaccine manufacturers to provide their members with the best vaccine prices and terms. PBGs are an attractive option for various clinical care settings, including primary care medical practices, multi-specialty groups, urgent care and walk-in clinics, worksite healthcare organizations, and federally qualified health centers.  

How do physician buying groups work?

The goal of a physician buying group to engage multiple providers and use a strength-in-numbers approach to achieve favorable pricing on vaccines and adjacent medical supplies. Almost any type of physician practice, clinic, or urgent care center can become a member of a PBG. A buying group establishes a contract with vaccine manufacturers, allowing members to order directly from manufacturers and participating distributors at a reduced cost savings as a benefit to members.

What are the benefits of a physician buying group? 

The benefits of joining a PBG are unique to each medical practice, but overall, the membership provides access to lower pricing, better payment terms, and in exceptional cases, comprehensive support for all immunization-related issues. 

Source: Atlantic Health Partners, an Affiliate Partner, provides competitive pricing on vaccines as a physician buying group. As an additional benefit to TPA practices, all immunizations are rebate eligible through the Atlantic Health Partners' vaccine purchasing program. Contact Kimberly Thompson at (800) 741-2044 or kthompson@atlantichealthpartners.com for more information on Atlantic Health Partners' vaccine purchasing program.

Medicaid redetermination process has begun: What does this mean for your practice?, MSMS

Here’s a new data point for cancer patients to consider: ‘time toxicity’, STAT

Does discrimination accelerate aging in Black cancer survivors?, ASCO Post

How Hawaii plans to advance pediatric emergency care, Becker's Hospital Review

New study suggests Black women should be screened earlier for breast cancer, CNN

After fall of Roe, future doctors show less interest in training in states with abortion bans or as ob/gyn, NPR

Why millions of kids aren't getting their routine vaccinations, NPR