Future of Family Medicine - AAFP wants your input

Following are several of the key questions the Core Team is considering as CFAR develops the current state analysis. We welcome input on these questions or general comments via FutureFM@AAFP.org.  

• Is the patient-centered medical home (PCMH) the model of the future? 
• How will the PCMH model need to evolve to meet the demands of the Triple Aim?
• Is population health a key part of family medicine? How should family medicine integrate with public health? 
• How will disruptive technology alter the practice of family medicine? 
• What changes are needed in the current payment structure to support the future of family medicine? 
• What data is available/needed to support changes in payment structure? 
• How does a narrowing scope in maternity and children's care impact the practice of family medicine?

The Core Team and Steering Committee will meet on Dec. 8. We will continue to provide monthly updates throughout this process.

The Public Health community is gearing up to keep influenza rates down!  They've dedicated Dec. 8-14 as Vaccinate Illinois Week and IAFP is supporting the efforts. We encourage all our members, and their colleagues and staff members to get the flu vaccine and also help ensure their patients are vaccinated. 

If you do not offer flu shots at your practice Chicago Dept. of Public Health has a flu shot locator: http://chicagoflushots.org/

IDPH web site with links to local health departments http://www.idph.state.il.us/flu/vaccine.htm

Free influenza vaccines are available at a CDPH Fast-Track Immunization clinics.

To find a CDPH influenza vaccine clinic or a nearby retail pharmacy in Chicago.

To find a retail pharmacy or private clinic outside of Chicago.

Here are some tools you can use!

Thanks to a grant from the Illinois Dept. of Public Health (IDPH), IAFP has produced primary care CME and complementary patient education materials to use for the 2013 flu vaccine season.  The high-quality CME is free and online anytime at www.iafp.com/education. 

Get the tools for your practice:  Link to the order form her for brochures, posters and an educational DVD video for your practice. You can access the video on the IAFP YouTube channel here, to post on your web site, download, or link from your social media patient education strategies.

Vaccinate Illinois Week Webinar

The Illinois Chapter, American Academy of Pediatrics and Vaccinate Illinois Week partners are hosting a webinar on Tuesday, December 10, 2013 from 12:00-1:00pm Get an update on current influenza activity for the 2013-2014 influenza season and cover the importance of yearly influenza vaccination. Click here for more information and to register for the webinar.

You can Link to a PSA that was created a mother/daughter team who will be participating on the Flu Vaccine webinar on Tuesday, December 10. 

Member Briefing #3: Serving patients who gain coverage Jan. 2014

IAFP has developed our third Member Briefing addressing aspects of the Affordable Care Act. Briefing #3 features a handy chart to help you and your practice staff effectively incorporate the newly insured into your practice operation, whether they are enrolled in Medicaid or purchased a plan on the Marketplace.

Medicaid Payment Parity

Can you share your story about how Medicaid Payment Parity has helped your practice?  All it takes is a few sentences that AAFP can share in making their case to Congress to ensure these boosted Medicaid payment rates become permanent.  Send your input to Vince Keenan and vkeenan@iafp.com.

Some background and updates for you:

Medicare rates, in part, are calculated using the Geographic Practice Cost Index (GPCI).  In Illinois, there are 3 Medicare localities with different GPCI rates: one for Chicago, one for East St. Louis, and one for the rest of Illinois.  For the purposes of the Medicaid payment increase, states were permitted to decide if they were going to make geographic adjustments or not. According to the state plan amendments (SPA) submitted to CMS, Illinois chose to use the mean GPCI over all counties. This explains why the increased rates may be different than what Medicare providers at your institution are receiving.  For more information on the Medicare Physician Fee Schedule, refer to this CMS fact sheet. 

Medicaid providers are still receiving very large increases for primary care and vaccine administration services over 2013-2014.  A Kaiser report indicates that on average, physicians will receive a 73% increase in fees for primary care services in 2013.  Physicians in Illinois will receive over a 50% increase in fees for primary care services.

The fee schedule for ACA enhanced payments can be found on the HFS website as "ACA EM Fee Schedule."  ICAAP has created a spreadsheet that compares the ACA enhanced payments to the current HFS fee schedule so providers may review their potential enhanced payment. (Note: this is for informational use only and was not developed by HFS.) 

Federal Update - An end to the SGR?

Once again, U.S. physicians stand on the cliff of a massive Medicare payment cut, estimated at 24.4 percent, to welcome the New Year on Jan. 1.  The Senate Finance and House Ways and Means committees are considering a bipartisan, bicameral proposal that would repeal the SGR and implement several measures to transform Medicare payment from a fee-for-service system to a value-based system.  The proposal is a start - that needs improvement.  AAFP has given the committees its qualified support for the proposal, and has submitted a list of recommendations (www.aafp.org).

AAFP argues that a 10-year pay freeze will not help solo and small family medicine practices keep their doors open to Medicare patients.  The proposal would freeze physician payment levels through 2023, but it creates a set of performance-based incentives for practice and quality improvements. It also includes bonus payments for physicians participating in alternate payment models, like patient-centered medical homes, and it provides some, but not enough money to help small practices in rural areas participate in alternative payment models. Some changes have been made to the original proposal, but the 10-year freeze remains intact.   

An "open discussion session" on Capitol Hill is scheduled for Dec. 12. Current analysis predicts a 3-month patch, as it's not expected that Congress can pass a repeal and replacement before they adjourn for the year on Dec. 13. 

CHICAGO MEMBERS - City budget includes a 50-cent cigarette tax increase

The Chicago City Council passed a budget on Nov. 26 that included a compromised 50-cent increase in the cigarette tax.  To continue the comprehensive approach to fighting tobacco use in Chicago, Mayor Rahm Emanuel is taking on e-cigarettes and flavored tobacco products. One ordinance would make Chicago the first to prohibit the sales of e-cigarettes to anyone under 18 years old and also include e-cigarettes in the city's clean indoor air act.  The other would prohibit the sale of flavored tobacco, including menthol flavor, within 500 yards of a school.   IAFP supports both proposals and expects to provide testimony at a joint hearing of the Health and Finance committees next week. 

Private Family Practice full time position available in Evergreen Park. Offers busy practice with in house laboratory, DEXA scan, PFT, etc. Established EHR system. In professional building next to Hospital for convenient rounding. Attractive compensation and benefits. Start date January 2014. Contact Dr. Scott Hanlon: 708 423 2662, scotthanlon@sbcglobal.net

Know a good nurse?  ELMHURST CLINIC

The Triage Nurse is a Registered Nurse (RN) responsible for patient care needs through the use of inbound and outbound telephone practice.  The Triage Nurse continuously demonstrates positive customer relationship skills by assessing caller needs through active listening, clinical assessment, education and advanced problem-solving abilities.  The Triage Nurse will actively manage patient's immediate and ongoing needs with attention to acute and preventative intervention.

REQUIRED: Operational knowledge of physician practice, Knowledge of health insurance and managed care, Exceptional interpersonal skills with ability to communicate clearly in English, both oral and written. Must possess basic computer and internet skills; 35 WPM proficiency. Adult and Pediatric experience.

PREFERRED: BSN degree, Prior work in a Family Medicine setting, highly preferred. Minimum 3 - 5 years of clinical experience in an acute care/ambulatory setting, Knowledge of outpatient triage, prescription refills and Medical Home practices preferred, Knowledge of community resources, Telehealth experience. Bilingual Spanish.

Contact:  Kathy Hester,Recruiter

Elmhurst Memorial Hospital Human Resources Department

PHONE - 331-221-0179 E-MAIL Khester@emhc.org

MEDICAL DIRECTOR- Family and Adult Medicine at Erie Family Health Center

Site Medical Director for new Erie Waukegan site opening July 2014 - Apply at www.eriefamilyhealth.org
The Site Medical Director for Waukegan will collaborate with: the Site Health Center Operations Director regarding all aspects of site management; the Medical Directors for Family and Adult Medicine, Child and Adolescent Medicine, and Women's Health to recruit, retain, and develop clinical providers; improves the quality of care of patients at the site by working with site providers, QI and Erie provider leadership to establish evidence-based best practices for the site; leads the clinical team to insure cohesive care throughout the site; maintains referral relationships with the site's hospital partners; gets to YES with Erie's patients and employees to help provide service excellence.
Requirements: MD or D.O from accredited institution, licensed physician in Illinois. Additional master's level degree in public health, management and administration or equivalent experience, preferred. Board Certified in primary care discipline. Federal DEA license, CPR certification. Two or more years of clinical primary care experience. Previous leadership experience preferred. Bilingual (English/Spanish) preferred, proficiency in medical Spanish required.

HIPPA and HITECH for Small Practices

Many small practice physicians may assume responsibility to ensure that the practice fulfills the regulatory requirements outlined by the HIPAA Privacy and Security Rules. There are two dimensions to meeting the rules. The first is to make sure that applicable policies, procedures, and documentation are in place. The second is ensuring that all staff is aware of and abides by the requirements. Internist Stasia Kahn, MD has a blog on EMR issues and has a new post detailing strategies she found useful over the years in meeting this responsibility. This year was especially challenging from a privacy and security viewpoint because of modifications to these rules brought about by legislation under HITECH and Omnibus.

http://www.emrsurvival.com/main/  

Need Help with Meaningful Use?

Training on the Marketplace for you or your staff

EverThrive  (formerly the Illinois Maternal and Child Health Coalition) is doing four-hour presentations to build awareness about the Illinois Marketplace.  This does not qualify persons who attend to be marketplace-Certified Application Counselors but would be a "Marketplace 101" course.  Attendees will be equipped with information on how to connect communities to coverage.  Here is list of presentations.  Plans are underway for more presentations statewide in first quarter 2014.  

If you have a news item to share, email it to Ginnie Flynn at gflynn@iafp.com.