Saturday, April 21, 2018

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Survey: How would the AB 3087 price fixing proposal affect your practice?


Assemblymember Ash Kalra (D-San Jose) last week announced a radical physician rate setting proposal (AB 3087) that would increase patient out-of-pocket costs, create state-sanctioned rationing of health care for all Californians and force physicians out of state or into early retirement.
The RCMA/CMA are asking physicians to answer a few questions about how AB 3087 will impact their practices. The survey is anonymous and the results will help in our legislative efforts to fight this dangerous and irresponsible legislation.
Take the survey now at: www.surveymonkey.com/r/ab3087.
And, if you are among California's physicians that will be forced into early retirement or out of state if AB 3087 passes, we want to tell your story. Drop CMA a line at communications@cmanet.org.

To Take Action Now Visit: www.actnow.io/PriceFixing

For more information about AB 3087 click here.

Please Donate to RIVPAC Today!

As the election cycles gear up, your RCMA Legislative Committee has been hard at work interviewing candidates for local, state and federal offices. It is imperative that we be effective at representing physician interests. Our success depends upon an integrated approach, consisting of lobbying, continuing grassroots activity and political action through RCMA’s Riverside Political Action Committee (RIVPAC).

RIVPAC is operated by physicians for physicians. By focusing physician resources, we support candidates for local, state and federal office who share our philosophy and vision of the future of health care and medical practice.

Please take a minute and contribute to RIVPAC. You can do so by donating online or by downloading the donation form and faxing it back to us at (951) 686-1692.

Strategies for Increasing Patient Safety with Opioids


Despite overall prescribing rates of opioids being at a ten-year low in 2016, the deaths from opioid overdose are increasing. Furthermore, due to the increased scrutiny by law enforcement and regulatory agencies and the risk of dependency and overdose there are increased liability risks for physicians related to opioid prescribing. NORCAL and it's risk management experts have created a special report to offer recommendations supporting sound pain management principles for mitigating these risks and increasing patient safety with opioids. Click the image below or click here to view the few article and download the report on NORCAL's website

Concerns
  • While overall prescribing rates declined to a ten-year low in 2016, deaths from opioid overdoses are increasing.
Challenges
  • Careful prescribing and monitoring practices are essential to safely manage patients’ pain and increase defensibility in the event of a claim.
Best Practices
  • Sound pain management and prescribing principles to help increase patient safety.


IEHP Begins Payment on Prop 56 Supplemental Payments for Physician Services


IEHP has announced that it will begin issuing the first payments for the Prop 56 supplemental payments to providers on March 16th, 2018, prior to receiving funding from the State.

These supplemental paymenst are for claims paid/encounters received on (or before) December 31st, 2017, related to service dates from July 1, 2017 – September 30th, 2017. Prop 56, which funds healthcare, research, and prevention of tobacco use, includes supplemental payments for physicians who participate in Medi-Cal FFS and Medi-Cal Managed Care. The supplemental payments are based on the submission of specific CPT codes through claims or encounters to your IPA or IEHP if directly contracted.

California voters approved the California Healthcare, Research and Prevention Tobacco Tax Act (also known as Prop 56), which increased the excise tax rate on cigarettes and tobacco products. As a result, Assembly Bill (AB) 120 was passed to appropriate Prop 56 funds for specified DHCS health care expenditures during the 2017-2018 state fiscal year. Therefore, this supplemental payment for physician services is based on the payment requirements set forth by DHCS.

For more information contact IEHP’s Provider Service Representatives at 909-890-2054 with any questions. Click here for an FAQ on this supplemental payment program, including questions concerning CPT codes.

Visit our Medi-Cal Resource Center for more helpful information.

Anthem and AMA Pursue Collaboration To Help Create Positive Change To The Health Care System

Health care affordability is one of the biggest challenges facing patients and doctors today. With a shared goal to help patients have improved access to quality, timely and affordable health care, the American Medical Association (AMA) and Anthem, Inc. (NYSE: ANTM) today announced they will seek to identify and collaborate on solutions that drive a high‐value experience for patients, physicians, other health care professionals and health plans.

As the first step, the AMA and Anthem will work together in 2018 to pursue opportunities for collaboration in the following areas:
  • Enhance consumer and patient health care literacy
  • Develop/enhance and implement value‐based payment models for primary and specialty care physicians
  • Improve access to timely, actionable data to enhance patient care
  • Streamline and/or eliminate low‐value prior‐authorization requirements

Continue for full statement.


To learn more about how Anthem and the American Medical Association are working together to make changes in the health care system click here.

CMA publishes guide for physicians affected by EHS contract terminations

The California Department of Managed Health Care (DMHC) issued a cease-and-desist order on December 26, 2017, requiring nine health plans to terminate their contracts with Employee Health Systems (EHS) Medical Group Inc. This order comes after SynerMed—a company closely affiliated with EHS—was accused of blocking patient access to specialists to hold down costs.

EHS has 600,000 patients statewide—90 percent of whom are Medi-Cal managed care patients. As required by the DMHC, health plans affected by this order were required to submit a transition plan by January 3, 2018 and have begun the transfer all EHS patients to different health care providers due to be completed by February 5, 2018.

The California Medical Association (CMA) has published a guide intended to help physicians understand the impact these recent changes may have on their practices and where patients are being moved so they can determine whether to explore contract relationships with other entities.

The guide is free to our members along with other helpful resources in the CMA Resource Library.

Significant new California laws of interest to physicians for 2018

The California Legislature had an active year, passing many new laws affecting health care. RCMA/CMA have provided a summary of these changes spanning a number of topics including health care coverage, drug prescribing & dispensing, and public health. Stay up-to-date by downloading the PDF here.


On the Horizon: New Employment and Labor Laws Affecting California Employers in 2018


By Thakur Law Firm, APC.

With the New Year upon us, we brace for the perennial tidal wave of California employment law changes of statutory tweaks, regulatory guidelines, and myriad new judicial decisions that will impact our clients.  We must make sure to advise our employer clients of any changes to daily operations and policies, as well as stay abreast of the ever-changing rights of employees in the workplace. The variety of new laws and rules can easily overwhelm employers and, if they are not in compliance, even the most well-advised employers might be ambushed by penalties for policies and practices that might well have been permissible just last year. Several new pieces of legislation deal specifically with the job applications and employers’ hiring processes and restrict what information employers can consider in making hiring decisions and what questions they may ask job applicants. As a result, employers must stay vigilant of changes in the law and constantly revise their hiring documents and processes, as well as training procedures for new and existing staff. Most employers want clear, cut-and-dry advice, so they may easily maintain their compliance. To that end, below is a summary of key new laws that the California legislature has enacted, which take effect on January 1, 2018, along with the best practices to be ready and ensure compliance.

Download Summary Of New Laws

Thakur Law Firm Thakur Law Firm, APC, is a full service law firm with expertise in Health Care Law, Business & Employment Law, Estate Planning, Real Estate, Tax Law and Litigation and is offering RCMA members complimentary consultations up to 30 minutes, 10% off hourly rates for pre-litigation, litigation and hourly matters along with flat fees for various contracts, agreements and handbooks. Download Flyer To access this benefit, please contact Pamla Thakur, esq. at pamela@thakurlawfirm.com or (714) 853-9919.

IEHIO Seeks Clinical Informatics Director

Job Title:  Clinical Informatics Director, Inland Empire Health Information Organization (IEHIO)
Location:
  Riverside & San Bernardino Counties, CA (Inland Southern California)
Office Location
:
Riverside
Type: 
Fulltime

Download Job Posting

ABOUT IEHIO
IEHIO is a non-profit grass-roots organization providing linkage between healthcare stakeholders in the Inland Empire and Manifest MedEX, a statewide HIE formed through the merger of Inland Empire Health Information Exchange and Cal INDEX. The focus of IEHIO is on driving HIE utilization in ways that address local priorities and use cases for sharing data while continuing to expand HIE participation in the Inland Empire. IEHIO goals are to coordinate data sharing services not only for treatment at the point of care, but also for care management and population health analytics specific to participant needs and programs; while promoting a community-wide data-sharing model that improves healthcare for all residents of the Inland Empire. IEHIO has also established a Data Servicing and System Administration Group in support of Community Projects which include EMR workflow integration, population health, a community resource platform and E-consults.

JOB DESCRIPTION
The Clinical Informatics Director works closely with the IEHIO Project Lead and IEHIO Participating Providers to ensure that developed functionality of the Manifest MedEx HIE platform meets IEHIO participant needs and make recommendations regarding health IT developments for consideration by IEHIO Board which will then be relayed to Manifest MedEx for product development priorities and requirements. Will work with healthcare organizations and providers to enable technology use for quality improvement and enhancement of care outcomes and to identify priority use cases for the HIE at the community level, for specific programs and/or specific participants. Will communicate and deliver presentations describing the value of IEHIO services. Will provide input to IEHIO committees and workgroups.

DUTIES and RESPONSIBILITIES
Primarily responsible for outreach and public relations with C-Suite Executives of IEHIO participants and will work with Project Manager, Manifest MedEx and IT Initiative vendors in developing communication, training and education to support technology initiatives and implementations.

Lead and/or participate in IEHIO Committees focusing on policy, product development and aligning clinical strategies with providers, technologies and health plans for the achievement of triple aim outcomes and that provide value-added benefits to participating providers. Participate in MX committees and workgroups.

Introduce and gain consensus support for HIE and IT strategies by physicians, hospitals, healthcare delivery systems, educational institutions, and related organizations.

Represent IEHIO at key forums/meetings.

QUALIFICATIONS and REQUIREMENTS

  • M.D. or RN Degree
  • 3+ years of experience in project management required; experience in an integrated health system or health environment preferred
  • Excellent organizational and interpersonal skills a must;
  • Position requires interacting with individuals from a variety of environments and IT literacy, including community based health providers and practice staff, hospital administrators and IS staff, partners from statewide HIE network, state office staff, etc
  • Ability to communicate clearly and effectively
  • Strength in strategic thinking, analysis and problem solving, collaboration, and a results oriented focus
  • Understanding of the technical solutions, governance, standards and policies for a Healthcare Information Exchange (HIE) is required
  • Ability to collaborate in a team environment, as well as work independently

    Download Job Posting

    Submit CVs to dgreen@rcmanet.org

Recognizing the Signs of Physician Burnout

Physicians May Be Prone to Burnout: Recognize the Warning Signs

More than half of U.S. physicians report symptoms of burnout — a 25% increase from 2013 to 2017.¹ This is a serious concern, because physician burnout can lead to patients suffering adverse events² or leave physicians unable to express empathy and compassion with their patients.³

In this special report, the Risk Management Specialists at NORCAL help you identify the signs of physician burnout so you can address it before it harms your practice.

Concerns

  • Learn why physician burnout is a serious problem.

Challenges

  • Recognize warning signs of physician burnout.

Best Practices

  • Know the specialties with the highest rates of physician burnout.

 

Diagnosing Physician Burnout - Special Report

 


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