January 16, 2006

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Maine Health Information Technology Project Names Initial Board
Maine is now a step closer to becoming one of the first states in the nation to develop a statewide electronic information-sharing system that experts say has the potential to improve quality, reduce medical errors and moderate the growth of health care costs. The new board will meet later this month to begin the critical steps necessary to buiild a complex system for which planning has been underway for the past 18 months.
For more information, including a list of the full board, go to www.mhint.org/newco.html

Physician members on the board are Larry Hopperstead, M.D. (Lewiston), David Howes, M.D. (Portland), Rod Prior,M.D. (Farmington), Boyd Buser, D.O. (Biddeford) and Dora Mills, M.D., MPH, (Maine Center for Disease Control and Prevention).  The total board consists of 20 members and includes hospital administrators, consumer advocates, insurer representatives, employer representatives and government officials. 

The electronic system is expected to make medical information-information sharing much more efficient than the current paper-based system, which relies primarily on health records being mailed, faxed or hand-delivered from one office to another.  The system under development in Maine also is being designed to connect to the nation's emerging health information infrastructure.  While electronic information-sharing is occurring within health systems and various communities across the U.S., few states are as far along as Maine in developing a statewide network of this kind.

Information will be drawn from a number of sources across the state, such as the patient's electronic medical record, recent laboratory and diagnostic tests and prescriptions.  The Maine system will provide medical providers the information they need to make better informed decisions, particularly in emergent situations.  Additionally, the new network will be integrated with the state government data system that is used to track disease outbreaks and threats to the public's health, including those that might represent bio-terrorism.

Plans call for the MHINT project to move from its current Planning and Development phase to implementation, which is scheduled to begin in 2007 with a goal of a statewide system being in place by 2010.  More than 100 health care leaders, government officials, consumer advocates, technical experts and others have contributed to the plans to build the new system.  Paul Klainer, M.D. represented MMA on the Technology Committee and Gordon Smith, MMA EVP,  attended meetings of the Governance Committee.

The new board will meet later this month to identify a nationally established technology partner which will work with the organization to build and implement the system.  The board will also in its initial meetings develop a plan for funding system implementation and ongoing operations.

The MHINT project has been overseen by a public-private partnership that includes four organizations that provided initial funding.  They include the Maine Health Access Foundation, the Maine Quality Forum, the Maine Center for Disease Control and Prevention and the Maine Health Information Center.  Additional funding has come from hospital systems, a large health insurer, private foundations and the federal government.

MMA Office Open Today, 7:00am to 5:00pm
Despite the federal and state holiday, the MMA offices will be open today from 7:00am (which is the usual starting time) to 5:00pm.  The MMA offices are available to members all weekdays, excluding only the major holidays.  While the majority of the staff leaves at 5:00pm, many nights the office is open until mid evening because of meetings and work schedules. 

Do not ever hesitate to call when MMA staff can assist  you and your practice in any way.  That is what you pay your dues for. [return to top]

MMA Communicates with Congress on Medicare Physician Fee Reduction
The Maine Medical Association, through its current President Jacob Gerritsen, M.D., communicated with Maine's Congressional delegation last week regarding the urgent need for the Congress to address the Medicare physician fee reduction of 4.4% which was imposed on Jan. 1, 2006 because of the failure of the House and Senate to enact identical versions of the Deficit Reduction Act.

While the House is expected to pass the Senate version of the bill shortly after returning to Washington on Jan. 31, Dr. Gerritsen noted in his communication that House passage is not a foregone conclusion and that few things in Washington can be considered certain in an election year.

The one-year freeze of fees at 2005 rates will cost the federal government $7.3 billion over the next five years.  Because the provisions in the legislation effect only the fees for one-year, physicians and physician organizations will have to continue to work on this issue until a permanent fix is made to the so-called sustainable growth rate (SGR) formula which is expected to reduce fees by a total of 26% over the next six years.  Such a reduction would certainly put at risk the care that physicians provide to Medicare recipients.

Officials at CMS (Centers for Medicaid and Medicare Services) have stated that CMS will restore the 4.4% to physicians, retroactive to Jan. 1, 2006, without physicians having to re-bill, once the Congress has acted and the President has signed the legislation.

This information from CMS was further confirmed by CMS officials from the Boston Regional office who spoke in Boston last Friday to the MMA Executive Committee.  Associate Regional Administrator for Finance James Bryant indicated that despite 20 million claims being received each week nationally, that the fiscal intermediaries had been instructed to restore the 4.4% as soon as possible once the law passes and that it was expected that the amounts could be restored in a single check to each physician.  He further noted that if the law was passed in early February, it was expected that the payments could be made by July. [return to top]

Schedule Changes in First Friday CME Programs
Because of scheduling conflicts, the Feb. 3, 2006 program involving use of physician-specific data is being postponed.  It will be added to the June 2, 2006 program entitled, "Improving Quality in Your Office Practice", which will be a combined program and expanded to four hours from 9:00am to 1:00pm.  A flyer will be distributed soon which will include the faculty for the session.  All First Friday offerings are at the Maine Medical Association offices in the Frank O. Stred Building in Manchester.

The next First Friday program on March 3, 2006 is a unique program being presented for women physicians and office managers, entitled, "Achieving Life Balance:  Leveraging Your Personal Leadership Competencies,", presented by Metamorphosis Consulting of Massachusetts.  The program will be presented from 9:00am to noon.  Cost is only $60 per attendee which includes breakfast and all course materials.

Physicians and office staff may reserve a space for any First Friday session by calling 622-3374 or by e-mailing Gail Begin at gbegin@mainemed.com. [return to top]

Dirigo Health Update
Dirigo Health Executive Director Karynlee Harrington provided updates to both the Dirigo Health Agency Board and the Maine Quality Forum Advisory  Committee last week.  Highlights of the report are as follows:

  • As of the end of the year, 7436 persons were enrolled in the DirigoChoice insurance product.
  • Of these enrollees, 48% were from small groups, 30% were sole proprietors and 22% individuals.
  • Medical expense loss ratio in the plan, for the first year, has been better than expected with the state expected to receive back from Anthem about $7.5 million of the $8.2 paid nder the "Experience Modification Payment."  This payment was made by the state as part of the original agreement and represents the actuarial expectation that persons previously uninsured will use medical care at a pace greater than the previoulsly insured groups.  To date, that has not been the experience in the plan, notwithstanding that between 20% and 40% of the enrollees were previously uninsured.
  • Among the top categories of expense for the first year were endocrinology, orthopedics,  behavioral health and cardiology.

On the legislative front, a bill was reported out of the Insurance Committee this past week that would significantly change the funding sources of the various Dirigo initiatives.  The bill, however, received a majority "Ought Not to Pass" report with Democrats supporting the existing law and most Republicans seeking to change it.  While the bill is not expected to pass (and would likely be vetoed by the Governor if it did), it will undoubtedly lead to contentious debate in both the House and Senate. [return to top]

Legislative Session in Full Swing; Weekly E-Mail Updates Available from MMA
On Wednesday, Jan. 4, 2006, the 122nd Maine Legislature convened at the State House in Augusta for its second session.  Last week, a number of bills of interest to physicians were considered, including L.D. 1420, An Act to Establish a Maternal & Infant Death Review Panel.  This bill, submitted by the Bureau of Health (now named the Maine Center for Disease Control and Prevention) and supported by the Maine Chapter of ACOG, the Maine Chapter of the American Academy of Pediatrics and the MMA,  was narrowly defeated in the House but passed the Senate on initial reading.  It is hoped that the bill will pass in the House when it returns there after Senate passage.

More details on L.D. 1420 and all legislative proposals of interest to physicians are available through the MMA's weekly e-mail update, called Political Pulse which is prepared by Andrew MacLean, J.D. and distributed every Friday while the legislature is in session.  To subscribe (no cost) simply e-mail Charyl Smith at csmith@mainemed.com and indicate that you would like to be on the subscription list. [return to top]

MMA Executive Committee Seeking Resident Member and a Physician Member from Hancock County
The 28-member Executive Committee of  the Maine Medical Association is seeking nominations for a resident position on the Committee and for a physician representative from Hancock county.  At the Annual Meeting in September, members voted to amend the bylaws to permit the Executive Committee to appoint a resident and a medical student to the committee.  The Executive Committee is soliciting nominations for a resident member at this time and continues to discuss the best way to achieve student representation.

There is also a current vacancy on the committee relative to Hancock County. 

Nominations for either position should be submitted to Gordon Smith, the MMA Executive Vice President via e-mail to gsmith@mainemed.com. [return to top]

MMA Executive Committee Retreats in Boston; Hears from CMS and MMS
Twenty-five members of the MMA Executive Committee and four staff met in Boston this past weekend at the Annual President's Retreat.  For over a dozen years, the Executive Committee has taken  a weekend in January to spend approximately ten hours re-defining the mission of the organization and discussing the internal and external factors impacting the Association and its members.  Finances and membership were primary areas of discussion along with a re-examination of the strategic plan adopted at the retreat last year.

In additional to the internal discussion, attendees heard a presentation from two Associate Regional Administrators of CMS on Friday and from representatives of the Massachusetts Medical Society on Saturday morning.  The Massachusetts Medical Society presentation focused on the Society's Task Force on Universal Health Care chaired by Jack T. Evjy, M.D. and Kenneth Peelle,M.D.  Dr. Evjy made the presentation assisted by Elaine Kirshenbaum, VP of Policy Planning and Member Services of the MMS.

Watch for President Jacob Gerritsen's article in your Jan.-Feb. issue of Maine Medicine for a more detailed report on the weekend meeting. [return to top]

MMA Committee on Peer Review and Quality Improvement to Meet on Tuesday
The Association's Committee on Peer Review and Quality Improvement will meet on Tuesday, Jan. 17 at 4:00pm at the MMA offices in Manchester.  The Committee, chaired by Krishna Bhatta, M.D. (William Strassberg, M.D. serves as vice-chair) will meet with Dennis Shubert, M.D., PhD, to discuss a proposal by the Maine Quality Forum to partner with MMA and the Maine Osteopathic Association in a project aimed at encouraging medical practices in Maine to conduct practice assessments focusing on quality.  Watch for a report on the meeting and for more details on the proposal in next week's Maine Medicine Weekly Update.

In addition to the project, the Committee will consider another application for the MMA Office-Based QI Program and review current operation of the Peer Review program. [return to top]

Medicare DME Policy Education Program, Tuesday, March 14, 2006, 4:30 - 6:00 pm

Medicare DME Policy Education Program
Tuesday, March 14, 2006, 4:30 - 6:00 pm
at Majors Mobility Home Medical Equipment
49 Topsham Fair Mall Rd., Suite 7
Did you know that Medicare has made sweeping changes to Durable Medical Equipment (DME) policies that will effect every physician who prescribes medical equipment? With an aging patient population, you will be more likely than ever to encounter these comprehensive new policies. The National Registry of Rehabilitation Technology Suppliers (NRRTS) certified staff of Majors Mobility will present a detailed discussion of the new Mobility Assistive Equipment (MAE) evaluations that you will be conducting along with the new Medicare physician documentation requirements. An equipment and accessories functional comparison will be presented to help prepare physicians for these new policies. The In-Service will be held on Tuesday, March 14th from 4:30 to 6:00 pm at Suite 7 of the Topsham Fair Mall, just off exit 31 on Rt. 295.  There is no charge for the program but registration is requested; please call 1-800-570-3393.  Snow date - March 28th.
[return to top]

Favorable Reports Issued Last Week on Tobacco Control and Emergency Medicine
Many MMWU readers may have seen last week two important reports in the Maine media, the first involving Maine's anti-tobacco efforts, led by MMA and other partners, and the second highlighting Maine's emergency medical treatment system, which was rated the 8th best in the nation.

Maine's tobacco-control efforts won a perfect score from the American Lung Association, the first time a state has received such an accolade.  The Association awarded Maine A grades in four categories in its fourth ranking of states.  Governor Baldacci and health advocates held a press conference on Jan. 10 acknowledging the report and noted that youth smoking rates in the state have declined almost 60% since 1997. 

Edward Miller, who heads the lung association's Maine chapter, credited Maine's comprehensive approach to tobacco control, which has been held up as a national model.  Maine spends more of the money it won in the tobacco lawsuit settlements  than any other state, on a per capita basis, on smoking control and treatment.

Gordon Smith, MMA EVP and a former Chair of the Coalition on Smoking OR Health, credited Maine's public health advocates and voluntary health organizations for their relentless quest for a smoke-free society.  "It has truly been a collaborative effort over the past 25 years," noted Smith, "and I am proud that the Maine Medical Association, along with many other health organizations in this state, has been a leader in this effort."

Jo Linder, M.D., immediate past chair of MMA's Committee on Public Health is the current chair of the Coalition.  Dr. Linder is an emergency room physician and also works part time for the Maine Centers for Disease Control and Prevention.

Congratulations is also in order for Maine's emergency physicians who faired well in a national survey of emergency departments by the American College of Emergency Physicians.  According to the report released last Wednesday, emergency care in Maine ranks eighth behind California, Massachusetts, Connecticut, the District of Columbia, South Carolina, Michigan and Pennsylvania.

States were scored in four areas: access to emergency care; quality and patient safety; public health and injury prevention; and medical liability environment.   Maine received an A for access to care; a C plus for quality and patient safety; a C-minus in the area of public health and injury prevention and a D for the poor medical liability environment. The full report is available online at www.acep.org. [return to top]

For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association