Maine Medicine Weekly Update - March 19, 2018
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President Proposes Cutting Opioid Rx by 1/3, Death Penalty for Sellers, Other Measures

President Donald Trump set out his plan to combat the opioid crisis in a speech March 19th at Manchester Community College in New Hampshire. The plan includes cutting opioid prescriptions, interdiction of illegal drugs, prevention, and medication-assisted treatment.

 

In a speech that lasted roughly 35 minutes, President Trump called several people to the microphone for brief statements, including the family of an overdose victim, an immigration agent, the manufacturer of Narcan®, and HHS Secretary Alex Azar. He spoke of increasing penalties for drug traffickers (including the death penalty), and he cited "sanctuary cities" like Lawrence, Massachusetts and Boston as sources of "fentanol" being sold in southern New Hampshire.

The president also applauded the manufacturers of naloxone for providing the "life-saving" opioid antagonist to high schools, colleges, and first responders at no charge. We need, he said, to work on the problem of relapse. Trump also promised to work on lowering drug prices, including the price of naloxone, and he spoke in support of "right to try" legislation.

President Trump finished with a call for "trust in our citizens, pride in our country, and faith in our god," stating that with those, "We will not fail" in our fight against the opioid crisis.

Congress Confronts Another Must-Pass Spending Bill Deadline: March 23rd

Congress must act on a temporary spending bill again this week as the previous funding bill expires on Friday, March 23. Discussions continue about whether and how to stabilize the ACA insurance markets and it is possible that a new Collins/Alexander proposal will be included, but the proposal faces significant hurdles.

 

It has been reported in the media that Senators Susan Collins and Lamar Alexander have developed a new insurance market stabilization package with the following features:

 
1.  Funding for cost-sharing reduction (CSR) payments for 3 years.
2.  Ten billion dollars in annual re-insurance funding, also to last three years.
3.  Additional 1332 waiver flexibility for Medicaid.
4.  Expanded eligibility for catastrophic plans.
 
The bill may also include an additional requirement that federal funds could not be used for plans that cover abortion services.  
 
A recent study by the Congressional Budget Office (CBO) found that federal reinsurance funds would significantly reduce premiums for 2019 and beyond. It is estimated that the provisions in the new proposal could reduce premiums by 10% in 2019, 20% in 2020 and 2021 for states that receive reinsurance funding. Without some market stabilization, rates in 2019 are expected to increase significantly particularly in those states that are now approving non-ACA plans.
 
The abortion issue as well as the concern of some Republican lawmakers that the reinsurance is a "bailout" to insurance companies threaten to derail the effort to stabilize the markets as the 2019 rates are being worked on.

New AMA Survey: Patient Clinical Outcomes Shortchanged by Prior Authorization

New collaborative opportunities underway to create positive change - see below. MMA is pursuing a bill, L.D. 1032, advocating the AMA standards for prior authorization in the current legislative session. You can help by contacting your own Senator and Representative and encouraging them to support the minority "ought to pass as amended" report of the Insurance & Financial Services Committee on L.D. 1032. You can find your legislators here. Look for more information in this newsletter when L.D. 1032 comes up for debate in the House and Senate.

 

More than nine in 10 physicians (92 percent) say that prior authorizations programs have a negative impact on patient clinical outcomes, according to a new physician survey released today by the American Medical Association (AMA). The survey results further bolster a growing recognition across the entire health sector that prior authorization programs must be reformed.

“Under prior authorization programs, health insurance companies make it harder to prescribe an increasing number of medications or medical services until the treating doctor has submitted documentation justifying the recommended treatment,” said AMA Chair-elect Jack Resneck Jr., M.D. “In practice, insurers eventually authorize most requests, but the process can be a lengthy administrative nightmare of recurring paperwork, multiple phone calls and bureaucratic battles that can delay or disrupt a patient’s access to vital care. In my own practice, insurers are now requiring prior authorization even for generic medications, which has exponentially increased the daily paperwork burden.”

According to the AMA survey, which examined the experiences of 1,000 patient care physicians, nearly two-thirds (64 percent) report waiting at least one business day for prior authorization decisions from insurers—and nearly a third (30 percent) said they wait three business days or longer.

The high wait times for preauthorized medical care have consequences for patients. More than nine in 10 physicians (92 percent) said that the prior authorization process delays patient access to necessary care; and nearly four in five physicians (78 percent) report that prior authorization can sometimes, often or always lead to patients abandoning a recommended course of treatment.

In addition, a significant majority of physicians (84 percent) said the burdens associated with prior authorization were high or extremely high, and a vast majority of physicians (86 percent) believe burdens associated with prior authorization have increased during the past five years.

The survey findings show that every week a medical practice completes an average of 29.1 prior authorization requirements per physician, which takes an average of 14.6 hours to process—the equivalent of nearly two business days. To keep up with the administrative burden, about a third of physicians (34 percent) rely on staff members who work exclusively on the data entry and other manual tasks associated with prior authorization.

“The AMA survey illustrates a critical need to help patients have access to safe, timely, and affordable care, while reducing administrative burdens that take resources away from patient care,” said Dr. Resneck. “In response, the AMA has taken a leading role in convening organizations representing, pharmacists, medical groups, hospitals, and health insurers to take positive collaborative steps aimed at improving prior authorization processes for patients’ medical treatments.”

In January 2017, the AMA with 16 other associations urged an industry-wide reassessment of prior authorization programs to align with a newly created set of 21 principles intended to ensure that patients receive timely and medically necessary care and medications and reduce the administrative burdens. More than 100 other health care organizations have supported those principles.

In January 2018, the AMA joined the American Hospital Association, America’s Health Insurance Plans, American Pharmacists Association, Blue Cross Blue Shield Association and Medical Group Management Association in a Consensus Statement outlining a shared commitment to industry-wide improvements to prior authorization processes and patient-centered care.

Earlier this month, the AMA and Anthem announced a collaboration that would include, among other goals, identifying opportunities to streamline or eliminate low-value prior-authorization requirements and implementing policies to minimize delays or disruptions in the continuity of care.

To further support prior authorization reform, the AMA has recently produced and released the following educational videos.

  • Video #1 highlights the new AMA survey and illustrates that the undue burdens of preauthorizing medical care and drug treatments have reached a critical level.
  • Video #2 highlights the real opportunity to improve patient experiences while significantly reducing administrative burdens for both payers and physicians by reforming prior authorization and utilization management programs with electronic prior authorization (ePA) that integrates within the electronic health record workflow.
  • Video #3 highlights how physicians can start using ePA and what the AMA is doing to help.

The AMA welcomes the opportunity to work collaboratively with health plans and others to create a partnership that lays the foundation for a more efficient prior authorization process. Please visit the AMA website to learn more about the organization’s ongoing collaborative efforts.

 

RWJ Foundation Releases County Health Rankings & Roadmaps Report

The Robert Wood Johnson Foundation has released its report on County Health Rankings for 2018.

 

 

Maine counties showing the best health outcomes were Cumberland, York, Sagadahoc, and Knox, while those with the worst outcomes were Somerset, Piscataquis, Aroostook, and Washington. Outcomes were measured by equally weighting length and quality of life. Seventeen percent of Maine children live in poverty, with a range of 11% in the healthiest county to 30% in the least healthy.

Maine shows an overall uninsured rate of 10%, with a range by county from 8% to 16%.

One area in which Maine performs much better than the national average is teen births. The teen birth rate in Maine is 18 births per 1,000 female population, ages 15-19, compared to the U.S. rate of 27 per 1,000. Teen birth rates among Maine counties range from 10 to 29 per 1,000.

The report lists things we could do in order to improve overall health. They are:

  • Invest in education from early childhood through adulthood to boost employment and career prospects

  • Increase or supplement income and support asset development in low income households

  • Ensure that everyone has adequate, affordable health care coverage and receives culturally competent services and care

  • Foster social connections within communities and cultivate empowered and civically engaged youth

Maine Quality Counts Publishes new "Choosing Wisely" Toolkit for Employers

 Maine Quality Counts has put out a new toolkit to assist employees in navigating the healthcare system and choosing the care that is right, and most affordable, for them.

 

Maine Quality Counts is working to improve the health of all Maine people (and beyond) by transforming the way healthcare is delivered. We know a “job well done” is only possible when your workplace is healthy and happy – your organization’s success depends on the full strength of your team.

With costs for healthcare coverage and services continuing to rise at nearly twice the rate of inflation, we believe that consumers/ employees need to be more strategic and proactive when seeking healthcare services.

As an employer, YOU can help give your employees the tools they need to navigate today’s complex healthcare system.

The digitally accessible Choosing Wisely® Implementation Toolkit for Employers - “Using Choosing Wisely Tools to Empower Employees” provides resources for your employees, as both patients and consumers, to choose health care that’s high-value and right for them. 

Access the no cost Toolkit now to help them and you choose wisely!

The Choosing Wisely initiative is part of a national and growing global movement to create conversations between health care providers and patients to reduce unnecessary use of tests, treatments and procedures.  It is an initiative of the ABIM Foundation and has spread to 19 other countries.

Additional Choosing Wisely information can be found at: www.mainequalitycounts.org/choosingwisely

 

Diabetes Alert Day - March 27: 3 Strategies that Change the Conversation You Have with Patients on Type 2 Diabetes Prevention

In the current medical system, managing and preventing chronic disease requires a strong partnership between patients and doctors. Consider the statistics around prediabetes: 84 million U.S. adults have prediabetes and 9 out of 10 don’t know it.

 

In the current medical system, managing and preventing chronic disease requires a strong partnership between patients and doctors. Consider the statistics around prediabetes: 84 million U.S. adults have prediabetes and 9 out of 10 don’t know it.

Part of this partnership involves having conversations with patients about their lifestyle and risk factors for chronic disease. Patients may be unaware of their risk level, and many patients have never had a physician discuss prediabetes with them.  

An effective and easy tool to help patients determine their risk of prediabetes and type 2 diabetes is theprediabetes online risk test. This one-minute screening tool quickly determines if a patient needs further testing and encourages at-risk patients to join the National Diabetes Prevention Program (DPP).

The DPP addresses lifestyle changes that can significantly empower patients to take control of their own health. In the case of prediabetes, it can be a reversible condition and the DPP helps prevent or delay type 2 diabetes through lifestyle modifications.

Here are three ways to have productive conversations about prediabetes and help encourage patients to take an active role in managing their health.

Let the patients tell you their concerns

By asking what matters to the patient, you and the patient are both engaged, and the conversation shifts so that you can identify the key issues that are important to your patients.

Once you identify those things, then you can best create a care plan to help patients successfully prevent type 2 diabetes.

One tool that may help how you have these conversations is offered on a new podcast from the American Medical Association (AMA) called AMA Doc Talk. Episode 3, “Coping with chronic disease,” dives into how care teams’ relationships with their patients play a role in management of chronic disease such as type 2 diabetes.

In addition to improving conversations with patients, it’s important that you’re armed with tools that help you have these conversations.

Another useful tool to  educate your patients about the importance of diabetes prevention is the Prevent Diabetes STAT toolkit. This toolkit, developed by the AMA with the Centers for Disease Control and Prevention (CDC), provides resources to remind physicians to screen, test and refer patients with prediabetes to an in-person or online DPP.

Involve the entire care team

The care team plays a key role in helping patients prevent and manage type 2 diabetes and other chronic disease. Developing a team-based approach allows everyone to become actively involved and share responsibility for improved patient care, and the entire practice becomes better equipped to address patients’ questions and needs.

Engaging the care team can help identify patients who may need screening for diabetes, or referral to a diabetes prevention program. The AMA has developed a STEPS forward module for preventing type 2 diabetes in practice, which includes resources to help you and your team determine roles and responsibilities regarding diabetes prevention and your practice workflow.

Thepre-visit planning component of the STEPS  forward module can also help improve the efficiency of care given in order to identify all patients at risk for chronic disease who come into your office.

Consider using a health coach

A key part of patients taking an active role in their health is ensuring that they understand their care plans and how to achieve their health goals. It’s important for patients to understand that physicians and care teams are best suited to help them actively self-manage chronic disease, such as type 2 diabetes, or prevent it from developing.

Health coaches can be great support systems that help educate patients and give them the skills and knowledge they need to participate in their own care. Making use of health coaches is also another way to continue to build strong relationships and improve the conversations you have with patients.

As a part of its STEPS forward program, the AMA has developed a module for health coaching that explains how it can be incorporated into a practice that includes case studies of how it’s been done successfully along with downloadable tools and implementation support.

The health coach may be even be part of your practice’s own diabetes prevention program or may help connect patients who have prediabetes to a National DPP in your nearby community or online. However health coaches are integrated into a practice, they can help bridge a gap between you and your patients and help engage them in actively participating in their own health.

Implementing these three strategies can help make the precious time you have with patients to discuss type 2 diabetes and other chronic disease prevention more effective, and the conversations you have more constructive and beneficial.

 

 

MMA Board Approves Climate Change Resolution

In a recent meeting the MMA Board of Directors approved a resolution submitted by the Public Health Committee and championed by Dr. Paul Potvin on the issue of climate change.

 

The resolution was based upon a report of the United Nations Intergovernmental Panel on Climate Change and a report published in the Lancet which called climate change, "The biggest global health threat of the 21st century."

The resolution was voted on favorably at the Annual Session in the fall of 2017 and was recently approved by the MMA Board in accordance with the bylaws.

It reads as follows:

Therefore, Be it Resolved

 1.       That the Maine Medical Association urges the Congress and President of the United States of America to enact, without delay, legislation to reduce carbon emissions in the US, considering, among other options to address that, a revenue-neutral carbon fee and dividend.

2.        That the Maine Medical Association stands ready to work with any level of government, groups interested in health, and the people of Maine initiatives such as, to advance the development and maintenance of alternative energy sources to reduce Maine’s dependence on fossil fuels; to encourage energy conservation initiatives including fuel efficient vehicles and active transport (walking and bike riding); to promote development in the public health workforce to better respond to health threats posed by climate change; to advocate for improvement in the surge capacity of the healthcare system in Maine; to communicate to the public and health care providers the health effects of climate change including risks and ways to reduce them; to support scientific research on the health effects of climate change; to monitor and report on environmental conditions and disease occurrence related to climate change; and to develop methods of response and adaptation to climate change effects.

 

Bipartisan Group of Senators Propose Bill to Ban “Gag Clauses” on Prescription Savings

Senator Susan Collins and others have proposed a new bill to prohibit pharmaceutical benefit managers' "gag clauses" that prevent pharmacists from talking to customers about how to save money on their prescriptions.

 

[from the AMA Morning Rounds]

The Hill (3/15, Hellmann) reports a bipartisan group of senators proposed legislation Thursday to prohibit so-called “gag clauses” that “keep pharmacies from proactively telling customers they could save money on a prescription if they paid out of pocket instead of through insurance.” Sens. Susan Collins (R-ME), Claire McCaskill (D-MO), Debbie Stabenow (D-MI), John Barrasso (R-WY) and Bill Cassidy (R-LA) introduced the bill. Collins said, “Americans have the right to know which payment method – insurance or cash – would provide the most savings when purchasing prescription drugs.” The article mentions that the Trump Administration has said it will target drug prices, noting FDA Commissioner Scott Gottlieb, MD, recently “criticized pharmacy benefit managers last week for not passing along the savings they get from rebates from drug manufacturers on to customers.”

       STAT Plus (3/15, Silverman, Subscription Publication) reports that the “federal legislation comes as a growing number of state lawmakers around the country have eyeballed the issue” and at least five states have enacted laws to prohibit gag clauses. Another 18 states have pending legislation, according to the National Academy for State Health Policy.

 

Do you hold a DEA X-waiver to prescribe buprenorphine?

If the answer is ‘yes’, we’d like to hear from you.  Please take our 8-minute survey.

 

As part of our response to the opioid epidemic that is devastating Maine communities, the Maine Medical Association is part of a collaborative effort to expand the availability of Medication Assisted Treatment (MAT)* for people with opioid use disorder.  

We’ve all heard the frustration in our communities that there is a shortage of treatment that is local, affordable, and immediate.  In order to share accurate information with patients and stakeholders, as well as fill gaps in regional treatment capacity, we are assisting in the development of a community resource map that accurately reflects MAT prescriber and addiction counselor capacity in every Maine county.

The information we collect will be compiled and stored here at the Maine Medical Association, and it will be available in database and mapping formats to inform community planning and response efforts.  

If you hold a DEA X-waiver, please help us put a sharper focus on available resources for MAT. Your input is very important to us and to the thousands of Maine people with opioid use disorder and their families.  This survey will take less than 10 minutes.  It is designed for current MAT prescribers and addiction counselors, as well as for anyone who holds the licensure but has not yet joined a collaborative MAT effort in their community.  

Thank you for helping us collect and confirm this important information. 

Link to the survey https://www.surveymonkey.com/r/MaineMAT

*SAMSHA Definition: Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders. https://www.samhsa.gov/medication-assisted-treatment


Legislative Call This Tuesday, March 20th

The Maine Legislature has returned to Augusta. That means public hearings and work sessions have resumed, and it's time for our weekly Legislative Committee calls to continue. The next call will be Tuesday, March 20th, at 8 p.m.

 

MMA Legislative Committee Chair Stephen Meister, M.D. and Vice Chair Katherine Pope, M.D. welcome you to participate in the weekly conference calls of the MMA Legislative Committee.

The next MMA Legislative Committee weekly conference call for the Second Regular Session of the 128th Maine Legislature will take place tomorrow, Tuesday, March 20th, at 8:00 p.m.

Legislative Committee members and specialty society legislative liaisons are strongly encouraged to participate. Any physician, practice manager, or other staff member who is interested in the MMA's legislative advocacy also is welcome to participate. It is not necessary to RSVP for the calls.

Please use the following conference call number and passcode. These will remain the same for every weekly call during the session.

Conference call number:  207-480-4790

Passcode:  057614#

The purpose of the weekly conference calls is to review and finalize the MMA's position on bills printed the previous week, to hear the views of specialty societies on the new bills or their concerns about any current health policy issues, and to discuss the highlights of legislative action of the week. The calls rarely last longer than an hour. The MMA staff lists a suggested position for each bill and any medical specialty particularly affected by the bill.  

If you have an opinion about any of these bills, but cannot participate in the call, please contact Andrew MacLean, Deputy EVP & General Counsel atamaclean@mainemed.com or 480-4187, or Peter Michaud, Associate General Counsel at pmichaud@mainemed.com or 480-4199.

The following are bills of interest to the physician community printed last week. We will discuss the priority bills marked with an asterisk (*) first. This will be important when the list grows in the next few weeks.

*LD 1866: An Act to Increase Youth Mental Health Awareness in Schools

*LD1867: An Act to Reestablish Certain Positions Within the Department of Health & Human Services

*LD 1868: Resolve, to Increase Funding for Evidence-based Therapies for Treating Emotional and Behavioral Problems in Children

LD 1870: An Act to Reorganize the Provision of Services for Children with Disabilities from Birth to 5 Years of Age

*LD 1871: An Act To Implement the Recommendations of the Task Force To Address the Opioid Crisis in the State Regarding Respectful Language

Legislative Report: Female Genital Cutting, Medical Marijuana, and More

A brief summary of some of the hearings and work sessions that took place during the last week, and a look ahead.

 

  • Appropriations & Financial Affairs: MMA board member and medical student Nicholas Knowland was among many witnesses testifying in favor of a bill that would provide interest relief on student loans for persons who agree to spend 5 years living and working in Maine. (See article above in "Spotlight" section.)
  • Criminal Justice and Public Safety Committee: Two competing bills on female genital cutting, or mutilation, have been rejected by the Committee in favor of a third bill in which the Committee is attempting to achieve consensus. The MMA has consistently argued for a clear exclusion for any legitimate, non-cosmetic medical procedures, and many members of the committee clearly favor such an exclusion.
  • Health & Human Services Committee: The HHS Committee is wrapping up its work, and most of the activities this week were focused on amendment and language review.
  • Insurance & Financial Services Committee:  The IFS Committee continues to work on one last health insurance bill, L.D. 696 that would prohibit so-called "non-medical switching" of prescription drugs.  As previously reported, MMA testified in favor of the bill and has been involved in the drafting process.  As of last Thursday, there seems to be bipartisan support for proceeding with the bill as Rep. Bob Foley (R-Wells) has convened a stakeholder group to participate in the drafting process.  If you have experience with this patient problem and would like to share your experience with the IFS Committee members, you can find the Committee members and contact information here.  It will be most effective if you can contact them before the work session tomorrow at 1 p.m.  See also the article above on the AMA's recent prior authorization survey.  The Committee completed a final language review on MMA's prior authorization bill, L.D. 1032, last Thursday.  We will alert you when this bill will be debated through this newsletter.
  • Labor, Commerce, Research & Economic Development Committee: The LCRED Committee held a public hearing on a bill that would streamline the path for veterans from military service in medical positions to an LPN license in Maine. There were several witnesses testifying in favor of the bill, which is based on a report submitted by House Assistant Majority Leader Jared Golden. The Board of Nursing, testifying neither for nor against, pointed out that many aspects of LPN education, including those focusing on pediatrics and geriatrics, are not covered in military training.

Upcoming public hearings and work sessions this week:

CJPS Work Sessions: 
  • LD 1819 and 1822 Female genital cutting

    IFS Work Session:

    • LD 696 Non-medical switching of medications by insurers

    LCRED Work Session:

    • LD 1857 Streamlined LPN licensure for former military medics

      Med Student/MMA Board Member Knowland Testifies on Student Loan Bill

      Nicholas Knowland, a Tufts-Maine Track medical student and member of the MMA Board of Directors, testified last week on LD 1834, a bill that would provide student loan debt relief to those staying in Maine.

       

      Mr. (soon to be Dr.) Knowland testified to the Committee on Appropriations and Financial Affairs that having decided in his late 20s to apply to medical school, he now faces the beginning of his residency with several hundred thousand dollars of student loan debt. He pointed out that 64% of the Maine Track's practicing graduates are working in Maine, as he plans to do after residency. He said people in his position are faced with a choice between a life and career in Maine and having to take the highest paying offer in order to repay massive student loans.

      LD 1834 would provide some interest relief to graduates who spend at least 5 years living and working in Maine. It would not offer any assistance in the payment of loan principal.

      Governor Approves Meningococcal Vaccine Rule

      Governor Paul LePage has approved the DHHS rule adding the meningococcal vaccine to the list of required vaccines for school attendance.

       

      Both the initial vaccine, given before 7th grade, and the booster, required before 12th grade, have been added to the list. The Governor approved a joint rule of the Department of Health and Human Services and the Department of Education. The MMA was instrumental in promoting the rule and in arguing successfully that the 12th grade booster should be part of it.

      QC2018: Building Communities of Practice through Innovation - Wednesday, April 4, 2018

      Maine Quality Counts (QC) will host their annual conference at the Augusta Civic Center. QC has decided to host a half-day conference this year, focused on a select number of topical innovations that are of strategic importance to QC’s members, partners, and stakeholders.

      Maine Quality Counts (QC) will host their annual conference at the Augusta Civic Center. QC has decided to host a half-day conference this year, focused on a select number of topical innovations that are of strategic importance to QC’s members, partners, and stakeholders.

      The Keynote Speaker will be Sanjeev Arora, MD, FACG, MACP – Distinguished Professor of Medicine in the Department of Internal Medicine at the University of New Mexico Health Sciences Center, as well as Director and Founder of Project ECHO (Extension for Community Healthcare Outcomes): a revolutionary, guided-practice model whereby primary care clinicians retain the responsibility of managing their patients, while also increasing their independence and self-efficacy.

      Other topics include: Real-Life Applications of the ECHO Model; Reaching Diverse/Rural Populations through Telehealth; Best Practices and Workflows around Lung Cancer Screening; Addressing Healthcare Affordability; Building Communities of Practice around Older Adults; and an overview of lessons learned from Maine CDC’s Chronic Disease Improvement Collaborative. Registration opens 2/1 - space will be limited, so register early.

      MMA and Jackson Laboratory Seeking Volunteers to Assist with 2018 Maine Cancer Genomics Initiative Forum - April 6-8

      The Maine Cancer Genomics Initiative will hold its 2018 Forum April 6-8 at the Samoset Resort in Rockport, Maine.  MMA has been asked to help staff the Forum and is seeking 4 or 5 volunteers from the ranks of our retired members to assist with registration and hosting of the attendees. In exchange, the volunteers will receive housing and free registration to the conference.

      The Maine Cancer Genomics Initiative will hold its 2018 Forum April 6-8 at the Samoset Resort in Rockport, Maine.  MMA has been asked to help staff the Forum and is seeking 4 or 5 volunteers from the ranks of our retired members to assist with registration and hosting of the attendees. In exchange, the volunteers will receive housing and free registration to the conference. Any MMA member wishing to take advantage of this opportunity should communicate with MMA EVP Gordon Smith at gsmith@mainemed.com.  

       
      The Maine Cancer Genomics Initiative (MCGI) is a collaboration of leading Maine and New England clinical and research institutions focused on advancing cancer care and research in Maine. The Initiative is supported by the Harold Alfond Foundation in partnership with The Jackson Laboratory. Learn more at www.jax.org/mcgi.  The Program is directed by Andrey Antov, Ph.D., M.B.A. with medical direction from Jens Rueter, M.D.
       
      Cancer is the leading cause of death in the state and new tests and treatments for cancer are increasingly based on the genetic testing of tumors. MCGI is designed to foster this emerging approach to cancer care, also known as Precision Medicine, and to support Maine cancer clinicians and patients.

      FREE 8-Hr. MAT Waiver Training Being Offered in Dover, NH - Friday, April 27th

      Helping connect the dots to more effectively address opioid use disorders.

      The New Hampshire Medical Society, NH Bureau of Drug and Alcohol Services, Anthem Blue Cross Blue Shield and New England Addiction Technology Transfer Center Network are pleased to offer FREE 8-hour buprenorphine waiver training in Dover, NH on Friday, April 27th.

      The New Hampshire Medical Society, NH Bureau of Drug and Alcohol Services, Anthem Blue Cross Blue Shield and New England Addiction Technology Transfer Center Network are pleased to offer this FREE 8-hour buprenorphine waiver training.

      Date:
      Friday, April 27, 2018
      Location:
      Wentworth-Douglas Hospital
      789 Central Avenue
      Dover, NH 03820

      Click Here for More Information and to Register
      • Training is available for physicians interested in seeking their waiver to prescribe buprenorphine in the treatment of opioid use disorders. To obtain the waiver to prescribe, providers are required to take eight hours of training.
      • Following trainings, physicians who have successfully completed the course, may apply to the Substance Abuse and Mental Health Administration (SAMHSA) to obtain the waiver.
      • 8 AMA PRA Category 1 credits and a Buprenorphine Training Completion Certificate will be awarded to those who complete all 8 hours of the course and receive a minimum cumulative score of 75% on the examination.
      • Residents may take the course and apply for their waiver when the receive their DEA license. They will need to maintain their certificate of completion following the training.
      • Nurse practitioners and physician assistants who take this 8-Hour MAT waiver course will receive a certificate of completion and can apply it toward the 24-hour training requirement established by the Comprehensive Addiction and Recovery Act (CARA). For the addtional 16 hours, PCSS-MAT is also providing NPs and PAs with the coursework FREE and together they meet the required training to be eligible to apply for the waiver to prescribe buprenorphine.
      • This course has been approved by the NH Board of Medicine as CME that fulfills the opioid prescribing competency requirement.

      CME Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Academy of Addiction Psychiatry (AAAP) and the New Hampshire Medical Society, Anthem New Hampshire, and NH Department of Health and Human Services. AAAP is accredited by the ACCME to provide continuing medical education for physicians.

      Date: Friday, April 27, 2018
      Location:
      Wentworth-Douglas Hospital
      789 Central Avenue
      Dover, NH 03820

      Click Here for More Information and to Register

      Introduction to Lean in Healthcare Full-Day Workshop on Tuesday, May 8

      Are you frustrated by poor communication and waste in your work processes? Lean has recently transformed the way many hospitals and health systems operate. This full-day workshop on May 8 in Augusta provides those who lead hospitals, health centers, practices, and related service industries with an introduction to Lean thinking and process improvement tools.

       

      The first half of the day will cover the principles of Lean thinking and provide several exercises so participants can compare traditional processes to Lean processes. The second half of the day will share an overview of some of the important Lean tools and challenge the class to identify applications for Lean in their organization.

      Lean Healthcare East has over 30 years combined experience in leading organizational transformation and have many engaging exercises and examples to share from their experiences implementing Lean improvements at hospitals and other healthcare related organizations.Click here to learn more and register for the workshop. If you have questions or want to schedule a workshop at your practice please contact the Lean Healthcare East team.

       

      New Free CME on Alzheimer's Risk, Detection, and Management

      Discussing memory concerns with your patients can be difficult. Alzheimer's and other dementias are complex, and patients often have many questions and concerns.

       

      To help you prepare for these visits, the Alzheimer's Association® presents Challenging Conversations About Dementia. In this free course, you'll receive information to confidently approach the detection, diagnostic and care-planning process for your patients with cognitive impairment and dementia.

      For more information and to complete this course, go to www.alz.org/FreeCME. Other tools on the website include the Cognitive Impairment Toolkit.

      Peer Navigation Program from Facing Our Risk of Cancer Empowered (FORCE)

      Free program for those affected by hereditary breast and ovarian cancers.

      The mission of Facing Our Risk of Cancer Empowered (FORCE) is to improve the lives of individuals and families affected by hereditary breast, ovarian, and related cancers.

      The FORCE Peer Navigation Program helps match people facing hereditary cancer with support and resources.  This free program connects cancer survivors, people at high risk and their caregivers to support and resources personalized for them.

      For more information visit the FORCE website at http://www.facingourrisk.org

      Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network

      Take Advantage of Online Learning Opportunities Offering CME Credits - Available 24/7 now from the Northern New England Practice Transformation Network (NNE-PTN).

       

      Take Advantage of Online Learning Opportunities Offering CME Credits - Available 24/7 now from the Northern New England Practice Transformation Network (NNE-PTN)

      The Northern New England Practice Transformation Network, led by Maine Quality Counts in collaboration with the Citizens Health Initiative at the University of New Hampshire's Institute for Health Policy and Practice, and Vermont Program for Quality in Healthcare, Inc., is funded through the Centers for Medicare and Medicaid Services' Transforming Clinical Practice Initiative to provide technical assistance to support you, your practice, and your consumers in the transition to value-based payment. The QC Learning Lab has been designed to support health care practitioners and professionals, and practice teams with a wide range of continuing education offers including online courses, webinars, and learning sessions.

      Topics include:

      • Improving Patient Outcomes with Cost of Care Conversation in the Clinical Practice
      • How to Transform Practice Finances for Success with Advanced Payment Models
      • Seamless Care
      • Get a Grip on Change
      Click here to register for these no cost online learning opportunities, available 24/7 at your convenience.
       
      This project is supported by FONCMS-1L1-15-003 from the U.S. Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the author and do not necessarily represent the official views of HHS or any of its agencies or the Maine Medical Association.

      Medical Board Physician

      Maine Public Employees Retirement System (MainePERS or Retirement System) seeks to engage an additional Psychiatrist for the Medical Board. 

      Maine Public Employees Retirement System (MainePERS or Retirement System) seeks to engage an additional Psychiatrist for the Medical Board.  Physicians of the Medical Board must hold a Maine Physician’s license in good standing and be Board Certified in their area of practice.  Preferred candidates will have experience with case review and or forensic psychiatry.   Medical Board physicians work under contract in an advisory capacity on an hourly fee basis.  Typical time commitment is 15-25 hours per month with flexibility of scheduling.  Some case file review and discussion can be done via videoconferencing.    This is a contract position and not eligible for benefits.

      MainePERS administers a disability retirement program for eligible members of the Retirement System.   The Board of Trustees engages physicians as independent contractors to serve on a Medical Board.  That Board evaluates medical records and provides written consultations to MainePERS and its hearing officers regarding the existence of diagnosable conditions and the presence and permanency of functional limitations in disability retirement cases.

      To apply, please forward your Curriculum Vitae and introductory letter to HR@MainePERS.org or via mail to:

      Maine Public Employees Retirement System
      Human Resources Department
      P.O. Box 349
      Augusta, Maine  04333-0349

      4/16/18

      Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus

      The Central Maine Medical Group seeks BE/BC Internal Medicine physician to join cohesive, well-established, hospital-employed practice in Lewiston, Maine. 

      The Central Maine Medical Group seeks BE/BC Internal Medicine physician to join cohesive, well-established, hospital-employed practice in Lewiston, Maine.  We offer:
      • Up to $200K in medical student loan repayment
      • $50K sign on bonus
      • Up to $12K moving allowance
      • 4 day work week/generous outpatient call
      • Healthy work/life balance
      Central Maine affords easy access to the coast and mountains where you can enjoy four seasons of outdoor activities.  We have a growing arts and restaurant scene in a very safe affordable area to live and raise a family.  To join our growing team, contact Gina Mallozzi, Central Maine Medical Center, 300 Main Street, Lewiston, ME  04240.  Email:  MallozGi@cmhc.org; Fax: 207/344-0696; Call:  800/445-7431; or visit our website:  http://recruitment.cmmc.org/.
       
      7/2/18
       
       

      Family Practice Physician - Bucksport Regional Health Center

      Bucksport Regional Health Center, a Federally Qualified Health Center (FQHC) has a unique opportunity in our small independent, community-based primary care facility offering great quality indicators, team atmosphere and excellent working conditions. 

      Bucksport Regional Health Center, a Federally Qualified Health Center (FQHC) has a unique opportunity in our small independent, community-based primary care facility offering great quality indicators, team atmosphere and excellent working conditions.  Located along the Penobscot River, we are centrally located along the beautiful coast of Maine, close to Acadia National Park and Bangor.

      This is a full scope of outpatient primary care services commensurate with his/her field of training and State of ME licensure.  Offers care to a diverse age population.  Optional 4/5 days/week schedule. 

      Candidates must have graduated from an accredited medical school & completed Family Practice or Med/Peds residencySheila, have a current State of Maine Medical License and D.E.A. Certificate and at least 5 years of experience in the practice of family or internal medicine.  Submit resume and cover letter to: Danel Adams, Human Resources, 110 Broadway, Bucksport, ME  04416,  email dadams@brhcme.org

      4/9/18

      Hospice Physician – Lewiston, ME

      Androscoggin Home Care & Hospice seeks a part time (20 – 24 hours per week)* physician for its growing hospice programs, including home, long term care and general inpatient facility.

      Androscoggin Home Care & Hospice seeks a part time (20 – 24 hours per week)* physician for its growing hospice programs, including home, long term care and general inpatient facility. AHCH is located in central and western Maine, and is the largest and only independent home care and hospice organization in the state.

      We offer a full range of medical practice opportunities, including direct care at our renowned 14 bed Hospice House; Certifications of Terminal Illness; collaboration with our multi-disciplinary home and long term care clinical teams; and consulting with community providers.  Additionally, AHCH offers a competitive salary, a generous benefit package, continuing medical education, paid licensure and support for various dues.

      Requirements Include:

      • A distinct passion for hospice medicine
      • Board certified or board eligible in a relevant specialty
      • General medical experience required; additional geriatric, hospice or palliative care experience a strong plus
      • Demonstrated interest in end of life care and symptom management

      *If full time employment is a requirement or of interest, opportunities may exist for a shared position with another health care collaborator.

      To apply please visit our website at www.ahch.org

      4/9/18

      Internal Medicine Outpatient Physician

      Maine Medical Partners Internal Medicine Westbrook is seeking a BC/BE Internal Medicine physician for their well-established outpatient practice located in the greater Portland, Maine area. 

      Maine Medical Partners Internal Medicine Westbrook is seeking a BC/BE Internal Medicine physician for their well-established outpatient practice located in the greater Portland, Maine area.  The selected candidate will join 4 internal medicine physicians, 4 family medicine physicians and a geriatrician.

      Maine Medical Center has 637 licensed beds and is the state’s leading tertiary care hospital and Level I Trauma Center, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School.  The position involves teaching and mentoring residents and medical students from the Maine Medical Center-Tufts University School of Medicine Medical School Program.

      Situated on the Maine coast, Portland offers the best of urban sophistication combined with small-town friendliness.  Just two hours north of Boston, this is an exceptionally diverse and vibrant community. 

      For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 661-7383 or nathaa@mainehealth.org.

      5/7/18

      Operations Director

      Health Access Network (HAN), a Federally Qualified Health Center (FQHC) in Lincoln, Maine, is seeking a dynamic leader to provide overall leadership and direction in planning and coordinating clinic operations for six sites.

      Health Access Network (HAN), a Federally Qualified Health Center (FQHC) in Lincoln, Maine, is seeking a dynamic leader to provide overall leadership and direction in planning and coordinating clinic operations for six sites. Responsibilities include, but are not limited to: ensure all health center programs meet patient needs, the mission, and ongoing viability of the organization; develop and implement required operational policies, procedures, and systems; implement process improvements that result in operations working more efficiently and effectively; closely monitors productivity; ensures compliance with grant expectations and requirements; 340B program; meaningful use; marketing; public relations; and participates in budget development, strategic planning, and grant writing activities. Oversees IT, EMR, and facilities.

      The Operations Director is considered a valued member of the senior leadership team reporting directly to the CEO.  Must have exceptional verbal / written communication skills and possess compassion, innovation, integrity, and excellence which are the health center’s values.

      Qualifications: Bachelor’s Degree in health administration / related field or combination of experience and education. 3 to 5 years of demonstrated leadership and management experience in healthcare required. Experience working in a FQHC preferred.

      We are a multi-disciplinary community health center with sites in Lee, Lincoln, Medway, Millinocket, and W. Enfield serving patients in Northern Penobscot County. 

      Interested candidates may forward a resume and cover letter to: Sonia Maxwell, HR Director, P.O. Box 99, Lincoln, ME 04457, smaxwell@hanfqhc.org,www.hanfqhc.org.

      Equal Opportunity Employer & Program

      3/26/18


      Outpatient Internal Medicine Physician – Bangor, Maine

      Eastern Maine Medical Center seeks a primary care physician, board-certified/board-eligible in internal medicine, to join our well-established, quality-driven, outpatient practice. Husson Internal Medicine is one of seven primary care practices operated by Eastern Maine Medical Center.

      Eastern Maine Medical Center seeks a primary care physician, board-certified/board-eligible in internal medicine, to join our well-established, quality-driven, outpatient practice. Husson Internal Medicine is one of seven primary care practices operated by Eastern Maine Medical Center. Our practice was the second in the nation to achieve “Patient-Centered Medical Home” status with NCQA. All physicians are NCQA-certified in diabetes and cardiac care. Our primary care network, largest in our area, has adopted a new practice model to include teams of one physician, one nurse practitioner, two registered nurses, and two medical assistants.

      Eastern Maine Medical Center is a 411-bed, regional, tertiary care and level II trauma center serving the more than 500,000 residents living in central, eastern, and northern Maine We offer a collegial atmosphere, cutting-edge EMR, generous vacation and CME benefit, flexible work schedule, and reasonable call schedule. No hospital call required. We also offer a relocation bonus and sign-on bonus in addition to our generous educational loan repayment program.

      Candidates in need of J-1 visa waivers welcome to apply.

      For confidential consideration, please contact:

      Amanda Klausing, AASPR, Physician Recruiter

      Eastern Maine Medical Center

      Phone: 207-973-5358

      ProviderJobs@emhs.org

       3/26/18


      Relocate to Beautiful Southwestern Maine - Medical Director/Family Practice Physician

      Sacopee Valley Health Center has a position available for a Medical Director/Family Practice Physician for our multi-service, progressive, rural federally qualified community health center located in a medically underserved area.

      Sacopee Valley Health Center has a position available for a Medical Director/Family Practice Physician for our multi-service, progressive, rural federally qualified community health center located in a medically underserved area. This position allows for the medical director to apply leadership skills while partnering with health center staff and colleagues to provide optimal health care for our patients on a daily basis. Services on site include integrated primary care, dental services, family planning, mental health counseling, psychiatry, nutritionist, optometry, podiatry, social services support, sliding fee coverage, care management, radiology and lab services. NextGen EMR. Practice is outpatient only with no OB. On-call rotation is 4-5 times per month. NCQA Level III PCMH. Competitive salary and benefits package; physicians are eligible to apply for NHSC loan repayment. We are located in Porter, ME, between Portland and the White Mountains. Area is known for terrific four season recreational activities. Just two and one-half hours from Boston. Submit CV to: Linda Watson, Director of Operations or, (lwatson@svhc.org), Sacopee Valley Health Center, 70 Main Street, Porter, ME 04068. EOE. www.svhc.org Sacopee Valley Health Center is an equal opportunity provider and employer.

      3/26/18

      Clinical Cardiology Opportunity

      Maine Medical Partners MaineHealth Cardiology is seeking an invasive clinical cardiologist (non-interventional) for their practice located in their Augusta and Waterville, Maine locations

      Maine Medical Partners MaineHealth Cardiology is seeking an invasive clinical cardiologist (non-interventional) for their practice located in their Augusta and Waterville, Maine locations.  Selected candidates will join a growing team of over 50 cardiologists who provide inpatient, outpatient and consultative services. 

      Maine Medical Partners MaineHealth Cardiology is a growing practice, with office locations in Augusta, Waterville, Lewiston, Rockport, and Scarborough, and is affiliated with the nationally recognized cardiac services at Maine Medical Center and its parent organization MaineHealth. 

      This integrated practice includes Maine General Health, Maine’s third largest health care system.  The Alfond Center for Health, MaineGeneral Medical Center’s state-of-the art, 192-bed regional hospital, has a cardiac catheterization lab and full on site imaging, including echocardiography and nuclear testing.  The Augusta/Waterville practice consists of 9 cardiologists and 2 advanced practice providers.

      For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 661-7383 or nathaa@mainehealth.org.

      5/14/18

      Opportunities at the VA for Volunteer Physicians

      Take advantage of this opportunity with the Veterans' Administration to thank our veterans in a concrete way for their service and their sacrifices.

      The Physician Ambassador Program was created by the Department of Veterans Affairs as a best practice recruitment and placement initiative seeking fully licensed physicians and clinicians to enhance health care services for Veterans.

      The Physician Ambassador Program is a without compensation program that provides civilian physicians and clinicians an opportunity to give back to the Veteran community by serving in a volunteer role to deliver health care services to Veterans. 

      If you are interested in participating in this program at VA Maine Healthcare System, please contact Jonathan Barczyk at (207) 621-4886.