Week of February 3 - In Case You Missed It...TOMF Medical News Roundup
February 9, 2014
Medicare Payment Fixed?
Health Care Business News (see link below) is reporting that a deal to replace the Medicare payment formula (Sustained Growth Rate, or SGR) is done.
Physicians will receive a .5 percent "raise" from Medicare for the next five years. At the end of that time an alternative payment formula will be in place.
Physicians have worked under a broken and flawed Medicare formula since 1997. During the recession Congress had to vote each year (and often several times a year) to not impose pay decreases to physicians working under the SGR. Last January, physicians faced a 31% pay cut from Medicare before Congress acted.
Trouble still looms. There is no Congressional agreement on the new payment scheme or about how to pay for the SGR repeal.
Chopper to be Based in Cochise County
It takes a while to spool up a helicopter and send it from Tucson to Southeastern Arizona -- and hope it gets back within the Golden Hour for trauma or 90 minutes for heart attacks.
Solution: base the chopper in the middle of the population served.
A helicopter will be based south of the monastery near St. David on property owned by Healthcare Innovations, the ground ambulance company serving the area. Arizona Lifeline Air Ambulance will operate the helicopter.
Thanks to the Feb 5 online version of the Benson San Pedro Valley News Sun website for the good news.
Origins of Osteopathic Medicine Probed
During the coming year the Journal of the American Osteopathic Association is running a scholarly look at how osteopathic medicine evolved throughout the last 100+ years and if the series is anything like the first installment, we are in store for surprises and illumination.
Written by Norman Gevitz PhD, senior vice president for academic affairs at A.T. Still University in Kirksville, the first article (last month) exploded several things we all thought we knew about Andrew Taylor Still. Far from hagiography, the article places Still squarely in his times and shows how he struggled and tinkered to give us a vision for the future.
The next installment, "From School of Bones to School of Medicine" is now in the February 2014 Journal that arrived this week.
CVS Tobacco Policy Changes
As pharmacists become a bigger part of the health team, especially when it comes to population management and shared savings, CVS has taken a huge step against one of its profit centers: the pharmacy chain giant will stop tobacco sales in its 7,600 stores by October 1.
A lengthy press release accompanied the announcement, but it really boiled down to this...CVS says it can't sell health and tobacco in the same venue.
Osteopathic Continuous Certification
February 4, 2014
Some Things to Remember
1. Category 1A Credit is granted for live programs provided by Category 1 CME sponsors. Category 1B is granted for programs of a more casual nature (online, teaching, writing) provided by Category 1 CME sponsors. Category 2A is granted for live programs sponsored by non-AOA accredited providers. Category 2B is granted for programs of a more casual nature (online, teaching, writing) sponsored by non-AOA accredited providers.
2. AOA recertifying physicians must fulfill 120 hours of CME credit during each three year CME cycle. 150 hours are required for the American Osteopathic Board of Family Practice, the American Osteopathic Board of Neuromusculoskeletal Medicine, and the American Osteopathic Board of Anesthesiology.
3. The 120/150 hours may include a variety of credit levels (1A, 1B, 2A, 2B) but must include at least 30 1A credits and 50 specialty CME credits in primary specialties.
4. In order to maintain a license to practice osteopathic medicine in the state of Arizona, osteopathic physicians are required to obtain 20 hours of CME per year. Of that, at least 12 hours must be 1A credit provided by a Category 1 CME sponsor. No more than 8 hours may be provided by an accredited AMA or ACCME provider and certified as AMA PRA Category 1 credit.
So What's Different?
1. For physicians holding certifications of added qualifications (CAQs), a minimum of 50 specialty CME credits for each must also be earned with a minimum of 13 of the credits earned at the level of the CAQ. It is anticipated that physicians may begin to consider prioritizing CAQs due to the additional cost and time involved in the OCC process.
2. Practice Performance Assessment and Improvement is the only new component in the osteopathic continuous certification process. Physicians must engage in continuous improvement through comparison of personal practice performance measured against national standards in their medical specialty. The physician submits information to the board based on their current practice. Documents can include patient surveys and quality improvement data. The data will be reviewed against national standards for patient care, and the physician will receive a report with recommendations for improvement. At that time, physicians should make a plan for ongoing improvement, to be submitted during the next recertification period. It is notable that any specialty board may insert another form of review in place of this component. Physicians who do not see patients or advise residents during the cycle may request an affidavit for the removal of this component from the continuous certification process.
3. All Specialty Certifying Boards operating under the jurisdiction of the AOA have been qualified by the Centers for Medicare and Medicaid Services for the 2013 PQRS MOC Program Incentive. This will allow those who qualify to apply for an additional 0.5% incentive payment for 2013 submitted Medicare/Medicaid claims. CMS requires that physicians be registered for the PQRS, meet the PQRS reporting requirements, be AOA board certified, and be participating in OCC in order to qualify for this incentive. The MOC incentive program requires physicians "to perform activities more frequent than is required" for OCC. Please visit your specialty board website listed on the next page for requirements.
Specialty certifying boards may be contacted using the information here. Please contact them for complete details about eligibility for certification, requirements for maintaining certification, and recertification.
Questions regarding certification status and general OCC information may be directed to the AOA Division of Certification at certification@osteopathic.org or (800) 621-1773, ext. 8266.
For verification of certification please visit www.DOProfiles.org.
Impaired Driving is Impaired Driving
When we imagine driving under the influence we immediately think of having one too many drinks, but new analysis of fatal accidents shows drugs are becoming a bigger slice of the problem.
While US traffic fatalities are dramatically down, fatalities from DUI are rising. A study published in the American Journal of Epidemiology by the Columbia University Mailman School of Public Health, shows alcohol plays a role in more than 40 percent of fatal car accidents. Surprisingly, drugs play a role in 28 percent of fatal accidents.
Marijuana is implicated in 12 percent of fatal accidents, up from 4 percent in 1999.
Drivers under the influence of alcohol increase their risk of a fatality in an accident by a factor of 13. Combining drugs and alcohol and that risk of fatality climbs to 24 times that of a sober person involved in a car accident.
Patients to Get Lab Results Under New Rule
Clinical labs in the U.S. must now give patients their clinical lab results within 30 days under a new federal rule aimed at allowing patients more access to their own health data. Before the rule, only seven states allowed patients to get results and thirteen prohibited it, according to a story in the February 4 Wall Street Journal.
Physicians who order the tests have long opposed this rule because patients do not have the information to respond to abnormal tests. Proponents say that physicians will still probably get the results before patients and can inform them of their patients about options.
Free headache Lecture at JCC Feb 12
"Headaches and Migraine : Symptoms, Treatment and Research" will be the topic of a free lecture, 9 a.m. to 11 a.m. at the Jewish Community Center February 12, presented by the UA College of Medicine. Dr. Wendi Kulin, Adina Wingate and Ken Lamm will speak, said today's Arizona Daily Star.
Adios, Native Son
Since the 1870s people have been sent to Tucson for their health. Rest homes and sanatoriums used to dot the cityscape into the 1960s and one such facility near the University of Arizona was home to a young man, Vernor Lovett, who was born, raised and educated here. He eventually became a general surgeon and had a long practice in the Old Pueblo.
Dr. Lovett died January 20. Services will be February 8, 11 a.m. at Northminster Presbyterian Church, 2450 E. Fort Lowell. Remembrances may be sent to the Gospel Rescue Mission.
Affordable Care Information You Can Use
There are two new electronic products for the premium tax credit now available on the irs.gov website. We have published a one-page electronic flyer (Publication 5120) and an electronic trifold brochure (Publication 5121).
Key Messages:
• Individuals who purchase their health care coverage through the Marketplace may be eligible for the premium tax credit.
• Individuals who are eligible for the credit can obtain advance payments of the premium tax credit (we refer to this as the "get it now" option) or they can wait and "get it later" as a credit on the 2014 income tax return that they file in 2015.
• Advance payments are sent directly to the insurer on the taxpayer's behalf to reduce the taxpayer's out-of-pocket monthly premium.
• Advance payments are not sent directly to the taxpayers.
• Individuals who get advance payments should promptly report to the Marketplace any changes in circumstances, such as changes in their income, marital status, or family size, so that they increase the likelihood of getting the proper amount of advance payments.
• Individuals who get advance payments must file a tax return next year to reconcile those payments, which are based on income estimates, with the credit, which is based on actual income.
Get them here:
http://www.irs.gov/pub/irs-pdf/p5120.pdf
http://www.irs.gov/pub/irs-pdf/p5121.pdf
Spray Right
As cold season reaches its apogee many of us are reaching for nasal spray. The American Academy of Family Physicians offers this advice:
Try an over-the-counter saline nasal spray before using a medicated spray.
Make sure you are able to breathe through each nostril before spraying, otherwise the spray may not be effective.
Point the spray toward the back of your nose. A pump spray should not drip down the back of the throat or out the nose.
If prescribed, use the prescribed spray as directed by your doctor, and allow two weeks or more to gain the full benefit.
Store the spray away from direct sunlight, and keep any pressurized container clean.
Stop using the spray for one to two days if you have nosebleeds, pain or stinging inside the nose.
If nosebleeds persist, use only a saline spray, or apply a thin layer of petroleum jelly inside the nose. Speak with your doctor if problems continue.
No More Chimp Research for Merck
Buried in today's Wall Street Journal (section B-3 by Peter Loftus) is a story that pharma giant Merck & Co will no longer use chimpanzees when testing new drugs. Computer simulations and genetically modified mice will replace chimps.
Chimps are mankind's closest cousins and as such were long valued for testing drugs before they were tried on humans. In 2011 the Institute of Medicine said using chimps in tests raised "ethical issues and carried a moral cost."
HVI Officially Opens
A $17 million renovation behind it, the Carondelet Heart and Vascular Institute at St. Mary's Hospital officially opened last week and TOMF was there to take a tour through the facility. The highlight? A walk through the one of a kind hybrid OR with mood lighting the patient can select with special features pointed out by Derek von Haag MD, the medical director of cardiothoracic surgery at HVI.
Power to Surgical Patients
Adherence to surgical checklists designed to prevent complications is vastly improved when patients ask that the checklists be used, according to American Society of Anesthesiologists, news release last Friday.
The release outlined a small study. Researchers gave the checklist to 43 patients who had their surgical team sign it. Another group of 61 patients did not know about or receive the checklist. Surgical teams were more likely to follow all 26 checklist items when operating on patients who had the checklists.
• allergies were confirmed in 95 percent of patients in the checklist group and 69 percent of patients without the checklist
• the surgical site was confirmed before incision in 74 percent of checklist patients and 54 percent of those without a checklist
• formal counts of sponges and surgical instruments were done in 87 percent of checklist patients and 19 percent of those without a checklist
Click on, or paste into your browser, the link below to see the checklists.
You can find tips about how to get the surgical team to comply at:
Flu Moving Toward Peak
Flu is now reported in all 15 Arizona counties, the Pima County health department told TOMF last Friday, and is moving to peak sometime late next month.
Flu is widespread in 40 states. Vaccines are still recommended but take about two weeks to become fully effective.