November 12, 2007

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Call Your U.S. Senators to Urge Action on Medicare Physician Payment

The U.S. Senate Finance Committee is considering legislation that would replace two years of cuts in Medicare physician payments with two years of positive updates.  But some senators have said they are not hearing directly from physicians about how important it is to stop the looming cuts of 11 to 12% in Maine.  You may use a new phone line established to call the Senators at 1-800-833-6354.

Urge the Senators to include positive Medicare physician payment updates for the next two years in the Medicare bill they are drafting.  Also, urge them to dedicate new funding for this - and not to fund the updates with gimmicks that would result in deeper payments down the road as has been done in the past.

In this type of legislative effort, it is the proverbial squeaky wheel that gets the grease.  If the Congress doesn't hear from physicians, members of Congress will assume that there is no problem.

MMA staff did talk with Senator Olympia Snowe earlier this week.  Senator Snowe is a member of the Senate Finance Committee.  She indicated that the Committee members are committed to fixing the problem this year, in either a one year or two year fix.  But it doesn't hurt to communicate with both Senator Snowe and Sen. Susan Collins, letting them know what an important issue this is to you.

Maine Ranked Seventh Healthiest State in the Nation

In an annual report prepared by the United Health Foundation, the American Public Health Association, and the Partnership for Prevention, Maine moved up two notches from ninth place in 2006 to seventh place this year.  Maine scored high for keeping crime low, for the high percentage of pregnant women receiving prenatal care (85.3%), and for the low percentage of our population without health insurance (9.3%).  Maine lost points for a relatively high rate of death from cancer.

New England, as a region, scored well in the report, which was released for the 18th year.  Among the states, Vermont earned the best ranking, with New Hampshire ranked fourth, Connecticut seventh, Massachusetts ninth and Rhode Island 11th. 

The report is entitled, America's Health Rankings: A Call to Action for People and their Communities.

The least healthy states were generally found in the South, including Tennessee, Oklahoma, Arkansas, Louisiana and Mississippi. 

The report found that overall, the nation's health declined by 0.3% since last year with improvements in reducing cancer and cardiovascular deaths overshadowed by increasing obesity, higher numbers of uninsured people, more children in poverty, and continuing high rates of risky behaviors like tabacco use and violent crime. [return to top]

Caring for the Caregivers: Perspectives on Literature and Medicine

As part of its philanthropic mission, the Maine Medical Association, though the Maine Medical Education Trust, was a financial supporter this past week of the national conference organized by the Maine Humanities Council entitled, Caring for the Caregiver: Perspectives on Literature and Medicine.  The conference was held in Manchester, N.H. and was offered as part of the Council's project, Literature & Medicine:  Humanities at the Heart of Health Care.

The conference attracted nearly two hundred attendees, including many physicians from Maine.  Staff from MMA also attended. 

The conference explored ways in which literature and writing can support the personal and professional development of health care professionals.  The Literature & Humanities program is now a national program for health care professioanals that exists in 19 states.  Maine has been a leader in the effort.

Attendees heard from award winning poet, Rafael Campo, M.D., Rita Caron, M.D. PhD., and Anne Fadiman, author of The Spirit Catches You and You Fall Down.  In addition, there were more than twenty other, smaller sessions to choose from including workshops, discussions, and informal presentations.

For more information see

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MPFS Final Rule Scheduled for Publication November 27

The 2008 Medicare Physician Fee Schedule (MPFS) Final Rule, effective for services on or after January 1, 2008, is on display in the Federal Register and will be published on November 27, 2007.  The rule
identifies 119 measures CMS has selected for eligible professionals to use to report quality-of-care information under the 2008 PQRI.  The rule can be found at:

The Physician Quality Reporting Initiative (PQRI) provisions begin on page 653.  A summary of these provisions is available at:, in the 2008 PQRI Information section of the PQRI web page.  Click on the "PQRI Provisions of the 2008 Physician Fee Schedule Proposed Rule" file in the Downloads section to view the summary. [return to top]

Dr. Robert Ritchie, "Father" of Maine Biotech, Recipient of 2007 Hanley Leadership Award

The physician and scientist known as the "father" of Maine's biotechnology industry has been named the 2007 recipient of the Hanley Leadership Award.  Dr. Robert F. Ritchie will be recognized for his pioneering scientific achievements as well as his collaborative leadership in developing clinical laboratory tests and standards around the globe.

The 5th Annual Hanley Leadership Award was presented to Dr. Ritchie at the statewide Leadership in Action Award Dinner co-sponsored by the Hanley Center and the Institute for Civic Leadership on Monday evening, November 5 at the Marriott in South Portland.  Nationally-known health futurist Jeff Goldsmith presented the keynote address at the dinner.  A statewide audience of more than 400 attended the event.

A resident of Freeport, Dr. Ritchie founded the Foundation for Blood Research in the early 1970's.  FBR became one of Maine's first independent, nonprofit medical research and education institutes.  The Foundation is dedicated to identifying, managing, and preventing human disease through clinical and laboratory investigation.  Under Dr. Ritchie's leadership, FBR has amassed one of the world's largest clinical databases of serum protein results---a critical resource for researchers and health care providers as they seek cures for---and treat---a wide range of diseases.  Nearly four decades ago, Dr. Ritchie developed a laboratory method for measuring serum proteins that revolutionized one aspect of laboratory practice worldwide.  The method allowed the major serum proteins to be measured more rapidly and reliably than with conventional methods and led to the expanded use of such measurements for clinical diagnostic purposes.
Recognizing the need for standardizing the interpretation of the laboratory measurements, Dr. Ritchie became a pioneer in the use of computer-assisted management of laboratory results.  Dr. Ritchie also founded Atlantic Antibodies, a for profit subsidiary of FBR that grew to become a large international manufacturers of high quality laboratory reagents.  Most recently, he has spearheaded the Maine Arthritis Partnership, a unique project aimed at improving care for Maine's aging population.

The Hanley Leadership Award is named for the late Daniel Hanley, M.D., a highly respected physician leader who earned an international reputation for his courage, innovation, and collaboration.  Dr. Hanley headed the Maine Medical Association for 24 years, was the physician at Bowdoin College for more than three decades, and was physician to the U.S. Olympic Committee.  Hanley founded the Maine Medical Assessment Foundation and was a pioneer in the use of data to improve the quality of medical care and outcomes. I n the late 1980s, he worked closely with Senator George Mitchell on legislation that established the federal Agency for Health Research and Quality (AHRQ).  The Hanley Center for Health Leadership was established in 2002 to carry on Dr. Hanley's legacy of leadership.

A native of New York City who began practicing medicine in Maine in the early 1960's, Dr. Ritchie has held numerous roles with the World Health Organization, the Food and Drug Administration, and the International Federation of Clinical Chemists.  He is credited for his leadership in securing agreements from many European nations and other countries throughout the world to use standardized testing and reporting of clinical laboratory results.  This enormously complex, multi-year initiative has led to improvements in the quality of patient care and important cost and time saving.  Closer to home, Dr. Ritchie oversaw the development of a number of innovative medical and environmental education partnerships between the Foundation for Blood Research and Maine schools and universities.  Three of these programs---BioMedWorks, EcoScienceWorks and ScienceWorks---are aimed at encouraging more young Mainers to pursue careers in medicine and science.

Previous winners of the Hanley Leadership Award include Stephen Shannon, D.O., (then) Dean of the University of New England College of Osteopathic Medicine (2003); nationally known medical researcher John Wennberg, M..D. of Dartmouth (2004); Franklin County clinicians Sandra Record, R.N. and Burgess Record, M..D. (2005); and Ann Gahagan, FNP, a Caribou family nurse practitioner and expert in the field of diabetes treatment and prevention (2006). [return to top]

Quality Counts 5- Aligning Partners for Quality, December 7, 2007 at the Augusta Civic Center

So much is changing in the healthcare world and this is a wonderful opportunity to learn about this revolution and how to thrive in it from local and national experts.  There will be opportunities to network one on one with many authorities and well as win one of several prizes that will given away during the day. 

There is even a special discount given to office teams.  We suggest that you send a team of at least two people to cover the many breakout sessions; one being a clinical and one a business person.  If you have someone who works primarily on health improvement in your group, this conference is a must for him or her.  So, do not delay because seating is limited and we have had to turn people away in the past.  You can sign up online at [return to top]

Study Shows "Early Adopters" Expanding P4P Programs

In a study entitled Climbing Up the Pay-for-Performance Learning Curve:  Where Are the Early Adopters Now? published in the November/December issue of Health Affairs on November 1, 2007, Harvard University researchers looked at the P4P programs of 24 early adopters of such programs from their beginning in 2003 to 2006.  The sponsors of the programs ranged in size from 52,000 to 11 million members and were geographically diverse.  The study found that the early adopters of P4P programs were expanding the scope of their programs, particularly to specialists, and are starting to focus on outcome and cost-efficiency measures, rather than simply clinical measures.  While primary care physicians still are the most common practitioners in the programs, specialists such as cardiologists, general surgeons, gastroenterologists, and orthopaedic surgeons have been added since 2003.  Measurement issues have been the biggest obstacle to including specialists.

In 2003, sponsors of programs representing 60% of enrollees measured cost-efficiency, but that figure rose to 92% in 2006 and at least one program in the study made cost-efficiency the principal component of the physician's P4P score.  Sponsors representing 58% of enrollees have increased their overall payments to physicians.  The bonuses ranged from $0.20 to $15 per member per month, but the average was about $1.40 per member per month or 2.3% of overall reimbursement.
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Dr. Bob McAfee Speaks on Dirigo Health Care Reform Initiative at AMA Interim Meeting

The 2007 Interim Meeting of the American Medical Association is now taking place at the Hawaii Convention Center in Honolulu, Hawaii.  The AMA House of Delegates opened the interim session on Saturday afternoon and the meeting runs through mid-day on Tuesday.  On Sunday afternoon, November 11, 2007, AMA and MMA Past President Robert McAfee, M.D. participated in a panel presentation entitled, Health Reformation:  States Take the Lead! sponsored by the AMA Forum for Medical Affairs.  Dr. McAfee, Chairman of the Board of Directors of the Dirigo Health Agency, spoke about the successes and challenges of Maine's health care reform effort.  Richard Frankenstein, M.D., President of the California Medical Association, talked about health care reform proposals by Governor Schwarzenegger and the legislative leadership.  Jon M. Kingsdale, Executive Director of The Commonwealth Health Insurance Connector Authority, spoke about the effort in Massachusetts.  Finally, Linda J. Rasmussen, M.D., an orthopaedic surgeon who is the Immediate Past President of the Hawaii Medical Association, took a different approach in her talk in pointing out that health insurance coverage is of limited value if there is a severe physician shortage as Hawaii is experiencing.  Dr. Rasmussen identified low reimbursement and high professional liability insurance costs as causes for the physician shortage in Hawaii.

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