Continuing to push for the Medicare Patient Empowerment Act

    The AMA and MSDC continue to educate members of Congress about HR 1700, "The Medicare Patient Empowerment Act."  This bill is based largely on policy supported by MSDC at the AMA House of Delegates meeting in 2010, and allows Medicare patients and their physicians to enter into private contracts without penalty to either party. 

AMA resource helps physicians prepare for success under risk-based

payment systems
     The AMA recently published a comprehensive physician resource entitled, "Evaluating
and negotiating emerging payment options." Developed by the AMA and experts in physician payment issues, this resource helps physicians take the practical steps needed to succeed under the risk-based payment arrangements that will likely become more commonplace over the next several years. It is designed to help physicians: 

1. evaluate the risk-based payment contracts offered to them; 
2. understand the contract negotiation process and maximize the likelihood that they will be able to negotiate acceptable contract terms; and 
3. successfully monitor and manage risk over the course of the
   risk-based payment arrangement. 

     "Evaluating and negotiating emerging payment options" begins with an introduction outlining the differences between fee-for-service and the budget-based methodologies that underlie all risk-based payment arrangements. Subsequent chapters provide practice guidance concerning: 

1. how physicians can determine their baseline practice costs; 
2. ongoing fee-for-service payment issues, including issues that arise when fee schedules are based on the Medicare Resource-based Relative Value System; 
3. pay-for-performance programs; 
4. capitation; 
5. shared savings (currently under development); 
6. bundled payments; 
7. withholds and risk pools; 
8. risk adjustment; 
9. stop-loss insurance; 
10. working with actuaries; 
11. negotiating the deal; 
12. joint contracting/collective bargaining; and 
13. ethical implications of financial incentives in managed care contracts.

     Visit www.ama-assn.org/go/payment to access this important resource.

Tell us: Are you experiencing more claim rejections lately? 

     The AMA has learned of numerous physician practice complaints about claim rejections and is addressing this issue with key stakeholders. Are you experiencing more claim rejections than usual, and are you wondering why? It could be due to the conversion from Health Insurance Portability and Accountability Act (HIPAA) Version 4010 to Version 5010, which happened January 1 of this year.
     If you're having issues with claim submissions or are experiencing more claim rejections in your practice, the AMA Practice Management Center has made it easy for you to register complaints about health insurers and other payers. Please visit www.ama-assn.org/go/clickandcomplainfor instructions and downloadable complaint forms. AMA members may contact the AMA Practice Management Center at (800) 262-3211 for additional assistance.  

• A 7-minute video featuring patients and clinicians who discuss the importance of asking questions and sharing information - this tool is ideal for a patient waiting room area and can be set to run on a continuous loop.
• A new brochure, titled "Be More Involved in Your Health Care: Tips for Patients," that offers helpful suggestions to follow before, during and after a medical visit.
• Notepads to help patients prioritize the top three questions they wish to ask during their medical appointment.

2011-2012 Influenza Season:  Antiviral Medication Recommendations

Date: Tuesday, February 28, 2012

Time:  2:00 - 3:00 pm

Join by Phone:

Dial: 800-779-7163

Passcode: 7319016

Join by Webinar:  https://www.mymeetings.com/nc/join.php?i=PW6062720&p=7319016&t=c

Overview:

  CDC estimates that influenza virus infections in the United States result in an average of more than 200,000 related hospitalizations, and between 3,300 to 49,000 deaths each year, depending upon the severity of the influenza season. Annual influenza vaccination is recommended for all persons aged 6 months and older, and is the best way to prevent influenza. However, available evidence for seasonal influenza and 2009 pandemic H1N1 consistently indicates that antiviral treatment, when initiated as soon as possible, can have clinical and public health benefit in reducing severe outcomes of influenza.  During this COCA conference call, a CDC subject matter expert will review current Advisory Committee on Immunization Practices (ACIP) and CDC guidance on the use of antiviral medications in the prevention and treatment of influenza.

     Atlantic Health Partners offers MSDC members the overall best purchasing terms for Sanofi's Fluzone, Merck's Afluria, and MedImmune's Flumist.  As the leading vaccine buying group in the country, Atlantic can assist your practice with reserving flu doses for the upcoming flu season, including Sanofi's High-Dose and Intradermal Fluzone.

     Furthermore, Atlantic provides our members with the lowest costs for the complete spectrum of Sanofi and Merck vaccines.  Thousands of physicians nationwide have seen how Atlantic can improve the financial and operational practice performance of providing immunizations to your patients.

      In addition Atlantic offers a unique program that enables physicians to provide vaccines like Zostavax to Medicare Part D patients with fair and timely reimbursement.

     We encourage you to contact Atlantic to determine how their program can be of benefit to your practice.  You can reach Jeff or Cindy at 1-800-741-2044 or at info@atlantichealthpartners.com