January 11, 2010

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MMA to Oppose State Budget Cuts Today

MMA President David McDermott, M.D., M.P.H. will testify today before the two legislative committees reviewing Governor Baldacci's proposed reductions in the previously approved biennial state budget.  The cuts, totaling $438 million, hit health care very hard with significant reductions in MaineCare costs impacting hospitals, physicians, and all other MaineCare providers.  Dr. McDermott is a family physician currently serving as Director of the Emergency Room at Mayo Regional Hospital in Dover-Foxcroft.

The hearing on the cuts that impact the MaineCare budget begins today at 10:30 a.m. although it is always difficult to know exactly what time the line items actually will come up.  Provisions regarding mental health are being heard on Wednesday, with the hearing beginning at 9:00 a.m.  These hearings will be conducted jointly with the Legislature's Appropriations and Health & Human Services committees.

The proposed cuts include:

  • Limiting  hospital outpatient visits to 15 per year, with the exception of HIV, cancer, prenatal care, kidney failure and transplant services (does not apply to visits to a physician office)

  • Limiting inpatient services to 5 admissions per year

  • Limiting laboratory and x-rays to 15 per year

  • Limiting mental health outpatient visits to 18 per year

  • Reducing reimbursemet to Critical Access Hospitals from 109 percent to 101 percent

  • Reducing hospital inpatient reimbursement:  $4.1 million in State Fiscal Year 2011

  • Reducing hospital outpatient reimbursement: $3.2 million in State Fiscal Year 2011

  • Cuts to community psychiatric hospitals:  $1.2 million

  • Cuts to mental health and substance abuse outpatient hospital services:  $3.1 million

  • Cuts to community psychiatric hospitals providing involuntary hospitalizatios: $0.6 million

In addition, the supplemental budget includes a tax increase for hospitals of more than $10 million under the Medicaid "Tax and Match" program.  Hospitals receive about 80% of the tax returned in the form of increased MaineCare reimbursement.

The pending increase in the MaineCare physician fee schedule, due to take effect on March 1st, has not been reduced or eliminated in the supplemental budget.  The increase will move the fees from approximately 57% to 70% of Medicare rates.

The budget discussion is expected to last for several weeks prior to the Legislature adjourning in late March or early April.

Dr. McDermott's testimony will be posted on the MMA web site, www.mainemed.com.

HealthInfoNet Reaches Important Milestones

In a comprehensive communication dated January 1, 2010, HealthInfoNet (HIN) Executive Director Devore Culver reported to interested parties on the progress of the project which has begun operating as one of the nation's first statewide electronic health information exchanges.  MMA has been an enthusiastic supporter of HIN since its design phase more than five years ago.  Following are excerpts from Mr. Culver's report:

Today---after less than six months of operations---HealthInfoNet's secure clinical database contains approximately half of Maine's entire 1.3 million population.  This means that clinicians participating in our two-year demonstration phase now have 24/7 access---for the first time---to criticially important patient-specific data.  Hundreds of physicians are now registered with HealthInfoNet.  Each day, more medical care teams are accessing data to help make better-informed decisions.  This has proven particularly useful in the care of more than 70,000 patients who sought care in recent months at two or more provider sites that previously did not electronically share patient data.

Under a new agreement with the state, prescription medication data on some 200,000 Mainers enrolled in MaineCare will soon be brought into our system.  This will allow clinicians to better coordinate the care of MaineCare beneficiaries and reduce the number of unnecessary and duplicative prescriptions.

In the coming months, we will begin expanding HealthInfoNet beyond the 16 provider organizations taking part in our demonstration phase.  Over time, we expect to bring nearly every Mainer into the system.  While some individuals will choose not to participate in HealthInfoNet, the vast majority recognize the exchange's value.  Fewer than 3,000 people have "opted out" so far---less than one-half of one percent of the people who have registered at participating providers in the second half of 2009.

After more than five years of planning, HealthInfoNet passed several important milestones in 2009. 

  • Despite enormous state budget shortfalls, the legislature and Governor approved nearly $2 million from the General Fund to help ensure that HealthInfoNet could complete its demonstration phase.

  • State funding allowed us to "go live" in July, becoming the third state in the nation to begin operations of a statewide electronic exchange.

  • Both of these actions have positioned Maine to receive substantial federal funds through the American Reinvestment and Recovery Act.  This month we expect to receive the first of three annual payments from the federal government totaling nearly $5 million.

  • State legislation and the ARRA formally recognize the key role being played by electronic exchanges and have clarified how we will operate within HIPAA and state privacy statutes.

  • Perhaps more importantly, HealthInfoNet will enable small and large providers across Maine to demonstrate "meaningful use," making them eligible for increased reimbursement from Medicare and MaineCare over the next several years.

On a parallel path, the Governor's office has engaged a wide range of stakeholders to develop a comprehensive health IT strategy for Maine.  It's also established a new office of the Coordinator of Health IT that will be charged with implementing this strategy and aligning various state agencies that have a role in health and health care.

With your support, we've made tremendous progress.  Looking ahead, however, we continue to face many challenges.  Although state and federal funding will allow us to complete our demonstration phase, we still must complete a plan for long term sustainability.  We believe the exchange will require about $5 million a year to operate---costs that will be more than offset by projected savings.

I want to be sure that you and your colleagues are well informed about HealthInfoNet.  I'd be pleased to arrange for a presentation for your organization---or to talk with you one-on-one.

In the meantime, I invite you to visit our website at www.hinfonet.org.





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MeMGMA Offers 2010 Third Party Payer Seminars in Portland & Brewer

The Maine affiliate of the Medical Group Management Association (MeMGMA) has scheduled its 2010 Third Party Payer Seminars for this month, involving the following payers:  CIGNA, Aetna, Anthem, Harvard Pilgrim, Medicare, MaineCare, Martin's Point, MEDNET, & Maine Network for Health.

The seminars are from 8:30 a.m. to 4:00 p.m. on the following dates & in the following locations:

 Wednesday, January 20, 2010:  Keeley's Banquet Center, 178 Warren Avenue, Portland

 Wednesday, January 27, 2010:  Jeff's Catering, 5 Coffin Avenue, Bangor

The seminar cost is $25.00 for MeMGMA members & $45.00 for non-members.

FMI, contact Karen Wheeler at 207-873-6173 or karenkay@roadrunner.com.


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Cracking the Code of Successful EHR Design

Cracking the Code of Successful EHR Design 

Thursday, January 21, 2010 at 12:00 PM ET

With all of the buzz in Washington these days around the HITECH Act and the federal stimulus dollars available to doctors, one could get the impression that electronic health record (EHR) adoption is a no-brainer.  It's not. 

Start your new year off with a little truth in advertising - learn how traditional EHRs consistently fail to help physicians make more money, do less work, or deliver better care. Cost is one factor: traditional EHRs have high up-front fees and revenue-draining maintenance and upgrade costs. 

But the greatest problem with traditional EHRs is that they are designed without an understanding of the fundamental economics of a patient encounter. 

  There Is a Better Way 

  Join athenahealth on January 21st at 12:00 PM ET for a live Webinar to learn more about: 

* The key economic drivers of a typical clinical encounter

* The five critical failures of traditional EHRs

* How a well-designed EHR can reduce costs where they are highest

* How an informed EHR approach leverages all phases of the patient encounter  

 Register for the January 21st Webinar: http://event.on24.com/r.htm?e=184313&s=1&k=7BB95B62D2EC7C6529F006EA8D982EE2&partnerref=MMA

Caitlin Wolf

Senior Marketing Associate

athenahealth, Inc.

Office: 617.402.1205

Cell: 339.221.2552


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Report on Maine Quality Forum Advisory Council Meeting January 8th

The Maine Quality Forum Advisory Council met last Friday morning, January 8th, for its regularly scheduled bi-monthly meeting.  The Council meets at the Dirigo Health Agency offices on Water Street in Augusta.

Following the presentation of routine business by Council Chair Robert Keller, M.D., Council members heard presentations on spine care variations in Lewiston by Ralph Harder, M.D. of St. Mary's Regional Medical Center and on the Phase 2 Paid Claims Analysis by representatives of Health Dialog.  Health Dialog has a contract with the MQF to examine the all payer claims data basis and determine its fitness for research (Phase I).  Part II of its work will involve analyzing variations in cost and quality by provider group.  An important first step is to identify physician groups in Maine and to attribute the  physicians to the right groups.  Following the completion of adequate attribution, the database will be examined to demonstrate variations in cost and quality among practices in Maine, in general and for specific chronic diseases.

The group expects to look particularly at primary care, cardiology, orthopedics, and other specialties as the data emerges. 

For both Parts I and II, Health Dialog will identify the specific cost drivers/services (imaging, lab, specialty visits, hospital admissions) which account for the differences in cost and quality by geographic region and practice.

In Part III, there will be an attempt to analyze systems of care, including identifying systems of care and analyzing cost and quality of potential Accountable Care Organizations along the whole spectrum of care.

The Advisory Council meets next on Friday morning, March 12th, from 9:00 a.m. to noon, again in Augusta. [return to top]

Save Thursday, June 10, 2010 for Third Annual MMA/MHA/MOA Quality Symposium

The Third Annual Quality Symposium presented by the Maine Medical Association, the Maine Hospital Association, and the Maine Osteopathic Association will be held on Thursday, June 10, 2010 at the Samoset Resort in Rockport.  This year's forum will be hosted by the Maine Osteopathic Association as part of its Annual Meeting.  While the final agenda and time are currently being established, the tentative schedule runs from 8:00 a.m. to 2:30 p.m.  Category I CME will be sought and a modest registration fee is anticipated.

For further information, contact Angela Westhoff, Executive Director of the Maine Osteopathic Association at 623-1101.   [return to top]

HHS Designates January 10-16 as National Influenza Vaccination Week

Kathleen Sebelius, HHS Secretary, has announced that HHS and the Centers for Disease Control and Prevention (CDC) are spearheading a nationwide effort to urge more Americans to get vaccinated against H1N1.  The number of people who get vaccinated against influenza typically drops after November.  With more than 118 million does of the H1N1 flu vaccine having been made available, and with flu illness declining in many areas, Americans who have not yet been vaccinated have a window of opportunity to protect themselves and their loved ones.  Encouraging more people to get vaccinated over the next several weeks could prevent serious illness and death.  That's why the Department of Health and Human Services (HHS) has designated January 10-16, 2010 as National Influenza Vaccination Week.

Please share your plans for National Influenza Vaccination Week with them at www.flu.gov/getvaccinated, where they will post events and activities happening all around the country.  This website also has information to help you build your own event, as well as print materials, public service announcements, and website tools to help you spread the message about the importance of getting the H1N1 vaccine.

Below are some useful tips provided by the US Department of Health and Human Services for you to share with your family, friends and colleagues as you begin the New Year:

1.  Add the Vaccine to your New Year's Resolution List -- Getting vaccinated is the best way to protect yourself and your loved ones from the the flu.  To find the H1N1 and seasonal flu vaccine clinics nearest you, visit FLU.gov and type in your zip code.

2.  Be a GERM STOPPER - Cover your nose and mouth when you cough or sneeze, wash your hands often, and avoid touching your eyes, nose and mouth.  Stay home if you are sick and avoid close contact with people who are sick.

3.  Check the facts and stay informed - visit flu.gov regularly for the latest information.  Heard a rumor?  Visit Myths & Facts to fun a fast check at FLU.gov.

The H1N1 flu is a serious disease.  The CDC estimates that between mid-April and November, 2009, 47 million people in the United States were infected and more than 200,000 people were hospitalized and over 9,800 people died. [return to top]

Maine Center for Public Health Conference on "Climate Change and Public Health - April 7, 2010

Michael McGeehin, PhD, MSPH, Director, Divison Environmental Hazards & Health Effects, National Environmental Health, U.S. Centers for Disease Control and Prevention (CDC) and Adjunct Professor, Emory University School of Public Health will provide the Keynote Address at the Maine Center for Public Health's conference, "Climate Change and Public Health:  Understanding the role for public health and health care practitioners" on April 7, 2010 at Maple Hill Farm, Hallowell, Maine.    

Dr. McGeehin has been a scientist with the CDC for more than 28 years and has spent most of that time working on environmental health issues including lead poisoning in children, asthma, drinking water contamination, air pollution, radiation exposures, environmental health tracking, cancer clusters, and morbidity and mortality related to heat waves, hypothermia, and extreme weather events.  Dr. MCGeehin also served as co-chair of the Human Health Sector for the U.S. National Assessment Team, responsible for assessing the possible human health effects on the U.S. population resulting from global climate change.

 The goals for the Conference are:

1.  To create a common understanding in the public health community about the causes of climate change and its impact on health;

2.  To put climate change mitigation and adaption in the context of a public health framework;

3.  To identify co-health benefits and linkages with public health, environmental, health care and community organizations to address climate change from a public health perspective; and

4.  To identify and commit to personal, organizational or policy actions to address the public health impact of climate change.

Agenda and Registration Information available soon.  For more information contact the Maine Center for Public Health at korourke@mcph.org. [return to top]

Downeast Association of Physician Assistants Seeking 2010 Award Nominations

The Downeast Association of Physician Assistants (DEAPA) presents awards each year in recognition of outstanding service to the PA Profession and to DEAPA.  The award categories are:

Physician of the Year - This award is presented to a Maine physician who has demonstrated outstanding support of physician assistants and the PA Profession by precepting, educating, and legislating, or by exemplifying the PA/Physician team approach to medicine.

Rural Physician Assistant of the Year - This award is presented to a Maine physician assistant in recognition of dedicated service to a rural community, both as a health care provider and as a citizen.

Robert J. Lapham Award for Outstanding Service - This award is presented each year to a Maine physician assistant in recognition of outstanding service to the PA profession and to the Downeast Association of Physician Assistants.

Outstanding Health Care Professional - This award is presented to a health care professional who has demonstrated exceptional clinical knowledge and teaching skills, promoting the PA profession, and contributing to the health of Maine.

To make a nomination, send an email to info@deapa.com, along with a brief statement detailing why this individual should be nominated, no later than March 12, 2010.  Or, you can mail or fax to:  DEAPA, 30 Association Drive, Manchester, Maine  04351; Fax:  207-622-3332. [return to top]

Keep ME Well Initiative Ready to Launch on January 19th, 2010

Keep Me Well Initiative online tool is ready to launch on January 19th at 11:45 a.m. at the Hall of Flags in Augusta.  Governor Baldacci will be joined by legislative leaders to showcase this new public health infrastructure work that locally addresses public health needs in ways appropriate to our local communities to make Maine a healthier state . . .

What is Keep ME Well?

Keep ME Well is a tool that will help you find out what you can do to improve your health and assess your individual health risks. Keep ME Well will give you a health report based on your answers to a number of questions and will take you about 10-15 minutes to complete. This tool will help you learn about how your habits affect your health and what you can do about them.

What does Keep ME Well do?

The purpose of Keep ME Well is to promote health and wellness for Maine residents. Keep ME Well will provide you with information on your health, chronic disease and risk factors and it will link you to local resources that can help you take action to lower your risk for disease and improve your health.

Who can use Keep ME Well?

Keep ME Well is for adults age 18 years and older who want to learn more about how to maintain or improve their health. Health guidelines for children and teens are different than those for adults. For this reason, Keep ME Well is not for anyone under 18 years old to use.

Keep ME Well is Free!

Keep ME Well is a public service of the Maine Center for Disease Control and Prevention (Maine CDC), Maine Department of Health and Human Services (Maine DHHS). Maine CDC has organized this effort and by encoouraging people to take a Health Risk Assessment, learn about their risk behaviors and find information to improve their health through the many local resources available, will be able to shine a light on both the importance of prevention and the critical role the new public health infastructure plays.  The states' Healthy Mmaine Partnerships will be engaged in a sweries of very creative strategies to work locally with partners to connect people to services and programs that can help them improve their own health.  For more information, go to:   www.keepmewell.org. [return to top]

Legislative Committee Conference Call Information: NOTE New Number & Access Code!

MMA Legislative Committee Chair Lisa Ryan, D.O. invites any interested physician or physician staff member to participate in the first conference call of the session this Thursday, January 14th at 8 p.m.  The MMA is using a new conference call/webinar service this year.  The toll free call-in number is 1-877-669-3239 and the access code is 23045263.

During the call, participants will discuss the new bills listed below and any highlights of the first two weeks of the Second Regular Session.  [return to top]

New Bills for Review & Consideration This Week

The following are bills of interest to the physician community identified by the MMA staff.  By clicking on the highlighted "LD XXXX," you will go to the summary page for the bill on the legislature's web site.  You can find the text of the bill by following the tabs on the left side of the summary page.  These bills will be on the agenda for the weekly Legislative Committee conference call this week, or you may provide feedback directly to Andrew MacLean, Deputy EVP, by phone at 622-3374, ext. 214 or by email at amaclean@mainemed.com.  You will note that the MMA staff has suggested a position for each bill along with a MMA committee or specialty society that may have a particular interest in the bill. 

LD 1497, An Act to Amend the Law Pertaining to Smoke Detectors and Carbon Monoxide Detectors (monitor; Public Health Committee)

LD 1498, An Act to Adopt a Drug Benefit Equity Law (monitor)

LD 1510, An Act to Maintain Compliance of Maine’s Insurance Laws With National Standards (support)

LD 1520, An Act to Allow the Board of Dental Examiners to Grant Permits to Qualified Individuals to Practice as Dental Residents (monitor)

LD 1542, An Act to Make Maine’s Laws Consistent with the Federal Family Smoking Prevention and Tobacco Control Act (monitor or support; Public Health Committee)

LD 1544, An Act to Amend the Laws Governing the Maine Health Data Processing Center and the Maine Health Data Organization

LD 1568, An Act to Clarify Maine’s Phaseout of Polybrominated Diphenyl Ethers (monitor; Public Health Committee)

LD 1572, An Act to Correct Errors in the Laws Relating to Unlicensed Practice and Other Provisions of the Professional and Occupational Licensing Laws (monitor)

LD 1574, An Act to Amend the Rights and Liabilities of the Supervisory Physician of a Physician Assistant (need more information from DEAPA on rationale for bill)

LD 1591, An Act to Amend the Maine Certificate of Need Act of 2002 Concerning Right of Entry and Investigation (monitor)

LD 1592, An Act to Update the Laws Affecting the Maine Center for Disease Control and Prevention (monitor or support; Public Health Committee)

LD 1599, An Act Regarding the Maternal and Infant Death Review Panel (support; OB/GYNs, pediatricians)

LD 1600, Resolve, to Allow for the Proper Disposal of Medical Supplies (monitor or support; Public Health Committee)

LD 1602, An Act to Clarify the Child Abuse or Neglect Substantiation Process (support; pediatricians)

LD 1608, An Act to Establish an Office of Administrative Law Judges for Licensing Boards (monitor)

LD 1611, An Act to Ensure Humane Treatment for Special Management Prisoners (monitor or support; MCLU has requested MMA support; PSR supports it; MAPP supports it)

LD 1615, An Act to Reimburse Pharmacies Under the MaineCare Program Based on Wholesale Acquisition Costs (monitor)

LD 1616, An Act to Enhance Newborn Blood Spot Screening to Conform to Federal Newborn Screening Standards (support; pediatricians)

LD 1617, An Act Enabling Expedited Partner Therapy (support; OB/GYNs; ACOG supports the concept)

LD 1620, An Act to Protect Health Care Consumers From Catastrophic Debt (support)

LD 1631, An Act to Provide Leadership Regarding the Responsible Recycling of Consumer Products (monitor or support; Public Health Committee)

LD 1640, An Act to Provide for the Safety of Maine Athletes (monitor or support; emergency physicians; Public Health Committee)

LD 1648, Resolve, to Repeal the Fee Increase for Copies of Vital Records (monitor)

LD 1653, An Act to Improve Health Insurance Security (monitor)

LD 1665, An Act to Prevent the Spread of H1N1 (monitor or support: Maine Women's Lobby has asked for MMA support; Maine State Chamber of Commerce, NFIB, Maine Merchants Association & other business groups oppose it)

LD 1671, FY 2010-2011 Supplemental Budget (oppose hospital & other service cuts) [return to top]

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