June 16, 2008

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Senate Struggles to Bridge Partisan Gap on Medicare Physician Payment Fix

A bill submitted by Senate Finance Chairman Max Baucus (D-MT) fails to reach cloture in 54-39 vote on Thursday, June 12, 2008.  Ranking Finance Committee member Charles Grassley (R-IA) offers alternative proposal that also addresses physician payment issue, but differs in several ways, including its funding mechanism.  Both Senators Snowe (who is a co-sponsor of the Baucus bill) and Collins voted in favor of cloture.  Senate Democrats and Republicans will continue negotiations this week in an effort to avoid a 10.6% Medicare physician payment cut scheduled to take effect on July 1, 2008.  This issue has been a focus of the AMA Annual Meeting taking place in Chicago since late last week. 

Senator Baucus' bill is called the Medicare Improvements for Patients & Providers Act of 2008 (S. 3101) and it is funded largely through cuts in payments to Medicare Advantage managed care plans.  the Grassley alternative, the Preserving Access to Medicare Act of 2008 (S. 3118), relies less on cuts to Medicare Advantage plans.  both bills would avoid the proposed Medicare physician payment cut and would provide a 1.1% payment increase for 2009.

Baucus and Grassley said that the two sides would return to work in search of a compromise this week.  Senator Baucus blamed a threatened veto from President Bush for the failure to attract more Republican votes.  

You can find more information about  these two bills and the AMA's efforts to avoid the Medicare payment cut on the web at:  http://www.ama-assn.org/ama/pub/category/14332.html.

Press Conference Highlights CMS' Medicare EHR Demonstration Grant Award

On Wednesday, June 11, 2008, Governor Baldacci joined Deputy HHS Secretary Tevi Troy, Maine Quality Forum Director Josh Cutler, M.D., and Augusta practitioner Michael Szela, M.D. at a press conference in the Governor's office to recognize Maine as one of 12 sites that will participate in a Medicare demonstration project providing financial incentives to small physician practices for using electronic health records to improve quality of care and patient safety.

The Maine award was made to the Maine Chartered Value Exchange Alliance, composed of the Maine Quality Forum, Quality Counts, the Maine Health Management Coalition, and Maine HealthInfoNet.  The other sites are Alabama, Delaware, Jacksonville, FL, Georgia, Louisiana, the Maryland/DC area, Oklahoma, Pittsburgh, South Dakota, Virginia, and Madison, WI.  The 12 sites selected have demonstrated active collaboration among stakeholders, including physicians and other providers, health plans, employers, government, and consumers.

In year one of the demonstration project, physicians who use EHRs will receive financial incentives.  In year 2, the financial incentives will be tied to the practice's performance in using EHRs to measure progress towards various quality standards.  In years 3 through 5, the incentives will be based upon actual performance on the clinical quality measures, not just upon reporting.

Total payments throughout the course of the demonstration could be up to $58,000 per physician or $290,000 per practice during the 5 years.

You can find more information about the demonstration project on the web at:  http://www.cms.hhs.gov/DemoProjectsEvalRpts/downloads/2008_Electronic_Health_Records_Demonstration.pdf   [return to top]

Payor Liaison Committee Meets Wednesday Night on MaineCare PA Issues and Payment Reform

MMA's Payor Liaison Committee will meet on Wednesday, June 18, 2008 at 6:30 pm at the MMA offices in the Frank O. Stred Building in Manchester.  All MMA members are welcome to attend but please call Diane McMahon at 622-3374, ext. 216 to indicate that you will be attending.  Dinner will be available.

Tony Marple, MaineCare Director, will be present to hear from members regarding the prior authorization process, not just for drug approval but for other procedures as well.  During several meetings with physician groups since assuming his current position, Mr. Marple has expressed genuine concern about the MaineCare prior authorization process and its burden on physicians.

Following the MaineCare discussion, Lisa Letourneau, M.D., MPH will lead a discussion of national and state efforts at payment reform. 

The Committee is chaired by Nancy Cummings, M.D., an orthopedic surgeon practicing in Farmington. [return to top]

AMA Annual Meeting Opens In Chicago

The Annual Meeting of the American Medical Association convened on Saturday in Chicago with Maine delegates David Simmons, M.D. and Richard Evans, M.D. and alternate delegates John Makin, Jr., M.D. and Maroulla Gleaton, M.D. in attendance.  Among the issues to be discussed during the four-day meeting are a controversial report by the Council on Ethics and Judicial Affairs on the influence of pharmaceutical interests on the education of physicians.  Another major issue is the pending 10.6% reduction in physician fees paid by Medicare.

During an emotional speech at Saturday's Opening Session, AMA President Ronald M. Davis, M.D., M.P.H. detailed his battle with pancreatic cancer and called on the nation's physicians to leave a legacy to the next generation.  His message was one of hope, both for organized medicine and the future.

Dr. Davis touched upon the many issues affecting physicians today, including the political process surrounding Medicare physician payment cuts.

Also at the Opening Session, AMA EVP Michael Maves, M.D., M.B.A. shared with the audience new television and print ads that are part of the AMA's "Voice for the Uninsured" campaign and discussed the AMA's commitment to providing strong advocacy and valuable resources for physicians.

The House of Delegates by acclamation elected J. James Rohack, MD, president-elect of the AMA.  Dr. Rohack is a cardiologist from Temple, Texas, who has served as a member of the AMA Board of Trustees for the past seven years.  Delegates also re-elected Denver psychiatrist Jeremy Lazarus, MD, to a second term as speaker and Andrew Gurman, MD, a  surgeon in Altoona, Pennsylvania, to a second year term as vice speaker. [return to top]

Maine Multi-Payer Pilot Patient Centered Medical Home Planning Group

On June 9th, more than 40 people met at the offices of MMA in Manchester for the first meeting of the Planning Group for the state's Multi-Payer Pilot on the Patient Centered Medical Home.  Chaired by Lisa Letourneau, M.D., MPH, the group agreed to continue to meet on a monthly basis to work toward an implementation date of January 1, 2009, although several individuals at the meeting observed that a July 1, 2009 implementation date may be more realistic.

Representatives of all the major health plans in the state and MaineCare were present along with representatives of consumer organizations and various provider organizations including MMA, the Maine Hospital Association, the Maine Chapter of the American College of Physicians, the Maine Chapter of the American Academy of Pediatrics, the Maine Academy of Family Physicians, several PHO's, and the  Maine Osteopathic Association.  Other organizations present included Schaller Anderson, the Northeast Health Care Quality Improvement Foundation, the Maine Quality Forum, the Governor's Office of Health Care Policy & Finance, and several consumer organizations.

The anticipated pilot project would establish a reimbursement model that would recognize the value of primary care services.  This value could be achieved by using one or more models of reimbursement including paying a per member per month fee, in addition to fee for service.


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AMA Annual Golf Tournament to be Held Monday, June 23 in Augusta

MMA's Annual Golf Tournament will be held again this year at the Augusta Country Club in Manchester.  Net proceeds from the tournament will benefit the Medical Professionals' Health Program.  The event begins with lunch served on the deck beginning at 11:00 am followed by a shotgun start at noon.  A traditional scramble format will be followed.

Brian Jumper, M.D. is Tournament Director.  If you would like to play in the tournament, sponsor a hole, or donate an item for the raffle, contact Gail Begin at 622-3374, ext. 210 or at gbegin@mainemed.com.

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Staff Changes at the Coding Center

Jana Purrell, CPC, Director of the Coding Center, will be leaving the Center on July 1 to take on a position as Practice Administrator for the employed physician practices at MidCoast Hospital in Brunswick.  She will continue to provide services to the Coding Center through the end of the year on a limited basis, including teaching a full certification course beginning in late July in Portsmouth.

"We wish Jana all the best as she pursues this opportunity at MidCoast Hospital.  She has done a terrific job as Director of the Center which remains a very valuable service to MMA members.  The Center also provides services to members of the state medical societies in New Hampshire and Vermont.  We are looking to continue the services and will be examining all our options,"  stated Gordon Smith, Executive Vice President of MMA.

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Help Guide Future Public Health Policy by completing confidential on-line Survey

The MMA's Public Health Committee is collaborating with the Harvard School of Public Health for healthier children and families and we request your support in completing an on-line confidential survey that should not take more than a few minutes.  All you have to do is click on the link below.

The Maine Medical Association's, Public Health Committee, is collaborating with the Harvard School of Public Health, the New England Coalition for Health Promotion and Disease Prevention for the Regional Governor’s Conference, and the Maine Center for Public Health to assess the status of the New England States on a number of factors associated with overweight and obesity. A set of indicators have been researched and created that illustrate the condition of populations within each state and the prevalence (or lack) or enabling factors that encourage or discourage people to eat well and stay fit. There are many efforts underway to address this crisis, but more are needed, and it will be difficult to devise successful strategies unless we keep track of current and changing conditions - not only of the health status of our population, but also of the "environmental factors" that facilitate or hinder people’s ability to make healthy choices.

To help guide future policy and action around the overweight/obesity epidemic, the Maine Medical Association and the Maine Center for Public Health, have partnered with the Harvard School of Public Health, the New England Governors' Conference, to collect data on member practices for a "Healthy Weight Trends Report." This regional overview, to be issued bi-annually by the New England Coalition for Health Promotion and Disease Prevention (NECON), will be a powerful tool for local progress as well as a national model.

We are asking for your participation in this important effort through completing an anonymous survey on your practices as a physician around healthy weight prevention and management. The survey should take no more than 10 minutes to complete. Please click here (or copy and paste the address in your brower) and complete the survey before June 27, 2008:   http://www.surveymonkey.com/s.aspx?sm=CFjSMcW7kfFXzvwheUYFOQ_3d_3d

Thank you for your help in this important data collection effort. Please contact Alison El Ayadi at the Harvard School of Public Health with any questions regarding the survey or project:

aelayadi@hsph.harvard.edu or 617.877.7424, or you may contact Kellie Miller, MMA staff at kmiller@mainemed.com or 207.622.3374, ext. 229 for information regarding our Maine overweight/obesity public health policy initiatives.

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