June 30, 2014

Subscribe to Maine Medicine eNewsletters
Manage Your Subscriptions
Email our Editor...
Maine Medical Association Home Page
. Search back issues
. Plain Text Version
Printer Friendly

Healthcare Cost Work Group to Review Risk Based Contracts with Growth Caps

The Healthcare Cost Work Group, part of the Maine State Innovation Model Initiative (SIM) and led by the Maine Health Management Coalition,k. held its second meeting last Monday and participants voted to focus attention on a strategy involving risk-based contracting with growth caps and price transparency although all the decisions are preliminary as the group continues its work.

The discussion was led by consultant Michael Bailit who is advising the group.  The possible strategies that were not as popular with participants included:

 1.  Reference pricing;

2.  Narrow Networks;

3.  Bundled payments; and

4.  Regulating prices/Rate setting.

There was discussion of reviewing infrastructure (capacity) but many participants noted that lack of previous success utilizing certificate of need laws.  A possible strategy for dealing with physician compensation was also mentioned.  

Risk-based contracting through ACOs and other vehicles appeared to be popular partially because Maine has had some experience with them and because this strategy allowed practices to remain primarily in the fee for service world while moving to a transition platform and learning about their costs.

The goals of the work group are to develop strategies to decrease the rate of price growth, both in fee-for-service and in capitated payment environments.  The group had previously talked about the view that price growth and variation are significant contributors to cost.

MMA representatives will continue to attend the meetings of the work group and report on its work to members through the Weekly Update and Maine Medicine.


MMA Needs Your Imput on MaineCare and ACA Primary Care Fee Increase

The Affordable Care Act made available to all states 100% funding for calender years 2013 and 2014 to increase Medicaid fees to Medicare rates for most primary care codes.  Physicians eligible needed to complete an attestation statement and forward it to the Office of MaineCare Services attesting to the fact that they were practicing in family medicine, internal medicine or pediatrics.  Physicians employed by an entity receiving provider-based reimbursement or salaried by a federally qualified health center were not eligible as their reimbursement methodologies were already enhanced by facility fees.  

Based on information provided by MaineCare, it appears that nearly seven million dollars annually is being received through this increase.  As MaineCare reviews whether to seek state funds to continue the increase, it has asked MMA to inquire of the practices what the impact of the additional reimbursement has been.  Have any practices re-opened to MaineCare patients if they were previously closed?  What was the financial impact of the increase to your practice? Have practices that were still open to MaineCare patients accepted more because of the increase?  Our ability to furnish this type of information will be essential in our advocacy to retain the increase.

While President Obama included an additional year of the increase in his proposed federal budget for FY 2016, this proposed budget is unlikely to be accepted by the Republican controlled House of Representatives.

Any information that you can provide that would be helpful on this issue should be sent to MMA EVP Gordon Smith, Esq., at gsmith@mainemed.com.  Or give Gordon a call at 622-3374 ext. 212. [return to top]

Maine Center for Cancer Medicine is now New England Cancer Specialists

As of June 23rd, the Maine Center for Cancer Medicine is changing its name to New England Cancer Specialists.  With a primary office location in Scarborough and additional offices in southern Maine, New England Cancer Specialists is the largest group of oncologists in private practice in the state.   [return to top]

Ethical Issues in Contemporary Medicine is next First Friday Program on August 1

MMA's popular First Friday educational series continues on Friday morning, August 1st with a program entitled, "Ethical Issues in Contemporary Medicine."   The program will be held from 9:00 am to noon at the offices of the Association in Manchester, Maine although it can also be accessed through webex.  The program will explore many of the ethical issues that arise in a medical practice and hospital today and ethics committee members may find the program particularly valuable.  The faculty will be announced next week along with the specific topics but interested persons may register at any time at www.mainemed.com.  The registration fee is $70 per person. [return to top]

New CMS Rule Allows for Automatic Re-enrollment in Plans Offered on Exchange

Many consumers won't have to re-visit the healthcare.gov website for coverage in 2015 because they will be able to automatically re-enroll if they do not change their existing plan, HHS announced last Thursday in releasing a new rule.  But, if a consumer wishes to shop for lower premiums in a competing plan or their income or family members have changed, the website will be their access for the information they will need.

 The exchanges open for enrollment again on November 15th and will be open until February 15, 2015.

 In making the announcement, new HHS Secretary Sylvia Mathews Burwell said, "we are working to streamline the process for consumers wishing to remain in their current plan."


[return to top]

Maine Quality Counts Launches Patient Provider Partnership (P3) Pilot Initiative

 Maine Quality Counts is launching the Patient Provider Partnership (P3) Pilot Initiative, a program in ten primary care and behavioral health practices with the goal to improve health care quality and reduce avoidable costs by engaging patients more actively in decisions about their health care. 


The P3 Pilot Initiative will address three priority areas of high strategic importance to the state.  The first set of pilots will use the American Board of Internal Medicine (ABIM) Foundation’s “Choosing Wisely®” initiative as the basis for promoting more productive patient-provider conversations and engaging patients in shared decision making about their care.  The second set will focus on shared decision making for low back pain treatment.  The third will focus on medication decisions in behavioral health.


Each of the P3 Pilots will be designed to engage physician practices or provider organizations as a means of testing how such patient-provider partnerships can subsequently be implemented more widely in provider organizations and communities. 


“We need to fully engage patients in their care and patient engagement starts with giving patients the tools they need to work with their health care provider and ask questions.  Patients without the skills to manage their health care incur costs up to 21 percent higher than patients who are highly engaged in their care,” 1 says Dr. Lisa Ryan, P3 Pilot Physician Consultant.


Dr. Neil Korsen, P3 Pilot Shared Decision Making Physician Consultant, says “the time is now to transform the patient-provider experience through the use of shared decision aids that help bring the patient’s views and preferences into the clinical decision making discussion.”


The ten participating practices will attend learning sessions, develop plans to incorporate shared decision making tools and patient aids into their practice workflow and engage and empower patients in the visit.  The pilot program will run through March 2015, culminating with each practice reporting the best practices they discovered for engaging patients in their care.


The P3 Pilot sites are:

Choosing Wisely Pilots:

·         Gardiner Family Medicine

·         Lisbon Family Practice

·         Sebasticook Family Doctors

·         St. Mary’s Regional Medical Center – Poland Family Practice


Low Back Pain Pilots:

·         Intermed

·         New England Sport and Spine

·         University of New England College of Osteopathic Medicine and Southern Maine Healthcare


Medication Decision in Behavioral Health Pilots:

·         EMMC Family Medicine – Husson Avenue

·         Maine Medical Center Psychiatry OP

·         Tri-County Mental Health Services [return to top]

Register Now: MMA's 11th Annual Golf Tournament on Monday, July 21st, Honoring John B. Makin, Jr., M.D.

The MMA's 11th Annual Golf Tournament is scheduled for Monday, July 21st at the beautiful Augusta Country Club in Manchester, Maine.  This year's tournament will honor Past President and avid golfer John B. Makin, Jr., M.D. who died unexpectedly late last year.  The two beneficiaries of the tournament this year are the Maine Medical Education Trust Scholarship Fund and the Memphis Area Golden Retriever Rescue, Dr. Makin's favorite charity.  We welcome players and sponsors both and you will find registration details and online registration on the MMA web site here.  

For more information about the event, you also may contact Lisa Martin at lmartin@mainemed.com or 622-3374, ext. 221. [return to top]

Funds Available for 2014 Patient Experience Surveys

The DHA ‐Maine Quality Forum (MQF) is delighted to announce that it will support the administration of another round of CG‐CAHPS surveys to patients served by primary and specialty practices in Maine. As in 2012, MQF will pay subsidies of up to 90 percent of survey costs to practices that contract with a MQF‐qualified vendor, use an allowable version of CAHPS, and agree to have their survey results publicly reported.

There are two new features to the 2014 initiative that provide greater flexibility to practice sites:

  • Multiple versions of CG‐CAHPS will be supported, including the CG‐CAHPS and the PCMH‐ CAHPS.  
  • Practices may choose to conduct a continuous survey throughout the measurement period or a one‐time survey at the end of the measurement period.

DHA‐MQF is currently accepting applications from survey vendors seeking approval as a Qualified Vendor under this initiative. The list of approved Qualified Vendors will be announced in early July, 2014.  Practices wishing to participate will be required to register in advance. Registrations will be accepted between July 15 ‐ August 15, 2014 at: http://www.mainepatientexperiencematters.org/register.php   [return to top]

MMA Releases Updated Physician's Guide to Maine Law

The Maine Medical Association is pleased to announce that its Physician's Guide to Maine Law has now been updated to reflect additions and changes in statues through the 126th Maine Legislature (2014).  The MMA legal staff continually work to make this resource a useful compendium of state statutes and select federal law impacting the practice of medicine in Maine. This year, the Guide contains several new sections on issues such as record retention and jury duty. Over time, the Guide has changed to include more links to websites, statutes and resources - rather than reprints of full statutes - and so MMA is now making the Guide available largely in electronic forms - on its website or, by request, on CD.  The web version is available at no cost.  A CD is available for $75 and a printed binder with CD for $125.  Contact the MMA at 622-3374 for ordering information.  [return to top]

New Physician's Guide to Closing a Practice Now Available

The Maine Medical Association is pleased to announce the release of a Physician's Guide to Closing a Practice. MMA staff frequently receive questions regarding the steps physicians should take as they consider retiring or closing their practice for other reasons.  While largely geared to the private practitioner, the Guide contains information that should be useful for all physicians, including sections on:  informing patients of the closure, record transfer, record retention and storage, dealing with equipment and supplies, revising your insurance portfolio and informing your staff.   The MMA attorneys would like to thank our Spring legal intern, Kimberly Sampson, a member of the class of 2015 at Maine Law, for preparing much of the document.  

Please share any questions or feedback with Andrew MacLean at amaclean@mainemed.com.   [return to top]

Job Openings

Join the Health Team or Professional Space Available

We are a dynamic Bone Health Team in South Portland Maine, looking for providers to join us to help promote and manage overall health, bone strength, nutrition, fitness and related lifestyle enhancement.  We offer high quality DXA testing and comprehensive osteoporosis management skills.  We created and continue to run the Southern Maine Osteoporosis Support and Education Group - since 1996.  If you really want to help patients to improve their health and their lives - this is the place.   Ann Babbitt MD and Staff

We also offer the opportunity for Office Sharing or Rental:   1) ~ 1500- 4800 sq. ft.  -several offices and exam rooms 9 +, open space for meetings/activities, full kitchen and storage area, 3 bathrooms, lots of parking; all is on ground level. The spaces and possibilities are flexible and options are available.  

Call 207-233-4266 or email ababbitt@maine.rr.com.


Full time Emergency Department Position Available

A full time Emergency Department position is available at Sebasticook Valley Hospital (SVH). Join a hospital employed team of 5 physicians providing 24-hour coverage. ED volume is 13,000 annually. Schedule options include 12 and 24 hr. shifts. SVH is part of the Eastern Maine Healthcare System. Ground transportation and Lifeflight services are available at SVH. The position comes with generous pay rate, vacation, malpractice, relocation expenses, and assistance with medical education debt. Qualifications: Board Certified in Emergency Medicine, or Family Practice with ED/urgent care experience. Contact: Sherry Tardy, 207-487-4085.

Sebasticook Valley Health (SVH) is a progressive 25-bed Critical Access Hospital in Pittsfield, Maine. We are an integral member of the communities it serves. SVH takes a proactive approach in helping people in the Sebasticook Valley region improve the quality of their lives. The hospital works with local businesses, schools, area organizations, and private individuals to make the Valley a healthy place to live. SVH serves an area of approximately 16,500 people and has a wide range of outpatient services, including many specialty services. An expansion and total renovation of the inpatient unit was completed in 2013, offering attractive spacious private patient rooms, state of the art communication’s system.


ED Provider Jobs

Challenging, Lucrative, ED Provider jobs in central Maine - honoring and serving Veterans.  ED Physicians are needed in Augusta. Must-have an unrestricted medical license (from any U.S. state), and current ACLS certification. This is your opportunity to use and develop your skills of diagnosing, treating, and managing patients according to standard, usual, and acceptable methods and techniques.

B/C or B/E specializing in EM, IM, or FP by the appropriate accrediting agencies (EM preferred).

This is the opportunity for you to receive a competitive salary, a generous leave package, excellent health & life insurance benefits, and retirement benefits. You'd be eligible to participate in a pension program as well as a matching Thrift Savings Plan which is similar to a 401K. If you are a veteran, you may be able to combine accrued military retirement credit with VA pension benefits.

Your salary will be determined by local Physician/Dentist Compensation Panel (commensurate with education, experience and qualifications). By law, U.S. Citizens will be given 1st preference but non-citizens will be considered in the absence of qualified citizens. A signing bonus may be available.  Equal Opportunity Employer. Disabled persons and/or veterans are encouraged to apply.

FMI, call John Poulin at (877) 421-8263 x6913, or email him at john.poulin@va.gov

To apply, go to https://www.usajobs.gov/GetJob/ViewDetails/328066200


Department of Psychiatry Faculty Position

The Geisel School of Medicine at Dartmouth, Department of Psychiatry, in a productive collaboration with the State of Maine, is seeking psychiatrists to join our faculty for inpatient responsibilities at the Riverview Psychiatric Center.

Riverview Psychiatric Center is a 92-bed acute psychiatric facility located in Augusta, ME and is the flagship inpatient treatment center for Maine’s public mental health system.  Psychiatrists with expertise in general inpatient psychiatry or forensic psychiatry are encouraged to apply.

Academic duties can include teaching and supervision of medical students and residents. Research opportunities available and encouraged.

Candidates should be board certified or eligible in Psychiatry. This position will include a faculty appointment at The Geisel School of Medicine at Dartmouth at a rank and salary commensurate with experience. Curriculum vitae and three letters of reference, addressed to Dr. William Torrey, Search Chair, should be e-mailed to psychiatry.jobs@dartmouth.edu.  Please reference search number PS0314D.

Dartmouth College/Dartmouth Hitchcock Clinic/Geisel School of Medicine is an equal opportunity/ affirmative action employer with a strong commitment to diversity. In that spirit, we are particularly interested in receiving applications from a broad spectrum of people, including women, persons of color, persons with disabilities, veterans or any other legally protected group.


[return to top]

Upcoming Events

5th Annual Patient Safety Academy

Friday, September 5, 2014

 9 am – 4 pm

University of Southern Maine, Portland campus, Abromson Center

Cost: $50, with a discounted rate of $25 for students

Registration is now open. To register, click here or visit the Patient Safety Academy webpage at usm.maine.edu/muskie/psa

The Maine Public Health Association’s (MPHA) 

30th Annual Fall Conference

October 7, 2014

Augusta Civic Center

Keynote speakers include: Erik N. Steele, D.O., FAAFP, Senior Vice President, Chief Medical Officer, Summa Health System and Paul Kuehnert, DNP, RN Team Director for the Bridging Health and Health Care Portfolio, Robert Wood Johnson Foundation

For more information or to register, click here.


Maine Concussion Management Initiative Training

October 21, 2014 in Portland in conjunction with the Maine Brain Injury Conference

7:30 a.m. - 12:00 p.m. 

Includes An Introduction to Concussions and Concussion Management & Interpreting Neurocognitive Testing (including using ImPACT)

$100 for Health Care Professionals  (CEUs/CME available); $40 for school personnel and all other attendees

For more information or to register, contact Jan Salis, jsalis@aol.com, (207) 577-2018

[return to top]

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