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  Community Pulse- July 2015




In This Issue:
JPS - Sponsor Message (Left)
Medicaid, the Affordable Care Act, and Who Got Left Behind
Cherokee Indian Hospital Improves Patient Care, Wait Times with Integrated Care Approach
Local Medical Charity Project Access® Awarded $500,000 Grant by The Duke Endowment
New Members to WCMS
NCMS' Statement On US Supreme Court's Ruling on King v. Burwell
North Carolina health systems consider starting insurance plans
High Court Upholds Health Law Subsidies
CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10
Are you in the Sunshine?
Advanced Care Planning for Patients: Letter from WCMS Member Dr. David Mouw
WCMS Job Board
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Medicaid, the Affordable Care Act, and Who Got Left Behind

WCMS CEO Miriam Schwarz speaks about Medicaid, the Affordable Care Act, and "who got left behind" on the Four Seasons CFL Healthcare Cafe. 

Listen to the recording of the July 6th radio show here.


Medicaid expansion is an issue that affects all North Carolinians, even those who are on private insurance plans. According to a report from the Cone Foundation,the decision not to expand Medicaid in North Carolina directly resulted in 23,000 fewer jobs created statewide in 2014 and 29,000 fewer in 2015. At a county level, there are 1,500 fewer jobs in Buncombe County in 2015 due to the decision not to expand Medicaid.

A special thanks to Project Access® physician volunteers who continue to ensure that those who fall into the Medicaid gap are able to obtain much needed medical services.  

In a time where the NC legislature has opted not to expand Medicaid for all low-income residents of North Carolina, and subsidies are not available for the poorest people in our state to buy health insurance, the charitable work of Project Access® physicians is nothing short of life-saving. Without the generous services donated by these physicians, many in our community would not have access to quality healthcare. 
Cherokee Indian Hospital Improves Patient Care, Wait Times with Integrated Care Approach 

The Cherokee Indian Hospital is working to improve the overall care of its patients as well as improve appointment access with its integrated health care approach. 

Click here to continue reading. 

Local Medical Charity Project Access® Awarded $500,000 Grant by The Duke Endowment
ASHEVILLE. N.C. (June 24, 2015) - Together with Western Carolina Medical Society Foundation (WCMS Foundation), Mission Foundation today announced it has been awarded a $500,000 grant from The Duke Endowment to cover funding shortfalls in WCMS Foundation's Project Access® charity medical care program. Project Access® offers access to free healthcare for low income, uninsured residents of Buncombe County.
New Members to WCMS   

NCMS' Statement On US Supreme Court's Ruling on King v. Burwell

"Broader health insurance coverage for the citizens of North Carolina has been the stated policy and goal of the North Carolina Medical Society (NCMS) for the last 30 years. In the last five years, we have been pleased that more people have health insurance coverage protecting them in case of injury or illness, and hope this trend will continue unabated with the Supreme Court's decision. As recent opinion polls show, the public agrees no working person should have to sacrifice food on the table for medical care.


"No legislation is perfect, especially one as far-reaching as the Affordable Care Act. We will strive to retain the positive aspects of the law and fix what is broken on behalf of our members and their patients. As the oldest and largest physician association in the state, today representing more than 12,500 physicians and physician assistants, we are committed to continuously improving our health care system's quality, efficiency and patient service for the people of North Carolina."

Click here to continue reading. 

North Carolina health systems consider starting insurance plans

"One large health system in North Carolina is ready to launch a Medicare Advantage plan, and two others are mulling the pros and cons of becoming a payer. 

The reason? Nearly every healthcare executive agrees that a hospital or health system today is more than just a site to treat pneumonia or mend a broken leg." 

Continue reading article from Modern Healthcare.  

High Court Upholds Health Law Subsidies

The Affordable Care Act made it through its second do-or-die Supreme Court test in three years, raising odds for its survival but by no means ending the legal and political assaults on it five years after it became law.


The 6-3 ruling, a major win for the White House, stopped a challenge that would have erased tax-credit subsidies in at least 34 states for individuals and families buying insurance through the federal government's online marketplace. Such a result would have made coverage unaffordable for millions and created price spirals for those who kept their policies, many experts predicted.

Click here to continue reading. 

CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10

With less than three months remaining until the nation switches from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures, The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline. In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 code set.

Click here to read more.
Contact: CMS Media Relations, (202) 690-6145 | CMS Media Inquiries AMA Media Relations, (312) 464-4430 


Dear Physicians,Article by Rendi L. Mann-Stadt with Ward and Smith, PA (WCMS Preferred Vendor)

"A section of the Affordable Care Act, known as the "Sunshine Act," or the National Physician Payment Transparency Program, provides transparency by creating a national resource for consumers to research and learn more about the relationships among physicians, teaching hospitals, and industry.

The Sunshine Act imposes reporting requirements on applicable manufacturers and group purchasing organizations ("GPOs") regarding payments and other transfers of value made to "covered recipients and physician owners or investors." Additionally, manufacturers and GPOs are required to report ownership or investment interests held by physicians or their immediate family members in applicable manufacturers and GPOs."

Continue reading.  

Advanced Care Planning for Patients: Letter from WCMS Member Dr. David Mouw

Dear Physicians,


Here's 2 good reasons to invest a little of your valuable time with your elderly patients in an effort to get them to document their Health Care Power of Attorney and Living Will. 1


1) Beginning on Jan. 1, 2016, for the first time, doctors will be paid by Medicare to counsel patients about their options for end of life care. 

2) If you introduce the issue at an office visit, my colleagues and I can get your patient to complete the legal paperwork if you refer them to us for one afternoon or evening workshop.


At the UNCA College for seniors (now called O.L.L.I.), one of my retirement activities is to coordinate an Advance Care Planning Workshop every 4 months. Click here to learn all about these free 2-hr sessions, open to any adult.


So far we have had 11 workshops, attended by over 600 adults, nearly half of whom completed the NC Short form (used by Mission Hospital, includes Living Will and Health Care Power of Attorney). We notarize the form for them before they leave the workshop.


All you'd have to do after introducing Advance Care Planning to a patient is go to the OLLI website and find out the date for the next workshop, advise the patient how to prepare, and write the patient an Rx slip to be at OLLI on that particular date. We'll take it from there. 


I hope we can help you.  And....thanks for helping us by referring some patients.




David Mouw MD PhD

MAHEC Family Practice Faculty 1997-2007

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Learn more about the Western Carolina Medical Society on this page. We would love to hear from you. Please contact us with any questions, comments or concerns you may have.   



Miriam Schwarz


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Miriam Schwarz, MPA

WCMS CEO/Executive Director 
(828) 274-2267 ext. 312