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A Letter to Doctors from CMS Administrator Seema Verma

Dear Doctor,

Thank you for the difference you make in your patients’ lives. Many of our nation’s best and brightest students go into medicine – the competition is intense for every spot. To become a practicing physician, you had to put in years of training, hours of studying, and long days and nights on the wards.

Your dedication and commitment have enabled you to join the profession that makes up the core of our healthcare system. But after years of education, training, and hard work, our system is not fully leveraging your expertise. Instead, doctors today spend far too much of their time on burdensome and often mindless administrative tasks.

From reporting on measures that demand that you follow complicated and redundant processes, to documenting lines of text that add no value to a patient’s medical record, to hunting down records and faxes from other physicians and sifting through them, wasteful tasks are draining energy and taking time away from patients. Our system has taken our most brilliant students and put them to work clicking through screens and copying and pasting. We have arrived at the point where today’s physicians are burning out, retiring early, or even second-guessing their decision to go into medicine. In a recent Medscape survey of over 15,000 physicians, 42 percent reported burnout.

Enough is enough. CMS’s focus is on putting patients first, and that means protecting the doctor-patient relationship. We believe that you should be able to focus on delivering care to patients, not sitting in front of at a computer screen.

Washington is to blame for many of the frustrations with the current system, as policies that have been put forth as solutions either have not worked or have moved us in the opposite direction. Electronic Health Records were supposed to make it easier for you to record notes, and the government spent $30 billion to encourage their uptake. But the inability to exchange records between systems – and the increasing requirements for information that must be documented – has turned this tool into a serious distraction from patient care.

CMS is committed to turning the tide. President Trump has made it clear that he wants all agencies to cut the red tape, and CMS is no exception. Last year, we launched our “Patients Over Paperwork” initiative Link goes to third-party website., under which we have been working to reduce the burden of unnecessary rules and requirements. As part of this effort, we have proposed an overhaul of the Evaluation & Management (E&M) documentation and coding system to dramatically reduce the amount of time you have to spend inputting unnecessary information into your patients’ records.

E&M visits make up 40 percent of all charges for Medicare physician payment, so changes to the documentation requirements for these codes would have wide-reaching impact. The current system of codes includes 5 levels for office visits – level 1 is primarily used by non-physician practitioners, while physicians and other practitioners use levels 2-5. The differences between levels 2-5 can be difficult to discern, as each level has unique documentation requirements that are time-consuming and confusing.

We’ve proposed to move from a system with separate documentation requirements for each of the 4 levels that physicians use to a system with just one set of requirements, and one payment level each for new and established patients. Most specialties would see changes in their overall Medicare payments in the range of 1-2 percent up or down from this policy, but we believe that any small negative payment adjustments would be outweighed by the significant reduction in documentation burden. If you add up the amount of time saved for clinicians across America in one year from our proposal, it would come to more than 500 years of additional time available for patient care.

In addition to streamlining documentation, under the leadership of the White House’s Office of American Innovation, we are advancing the MyHealthEData Initiative which promotes the interoperability of electronic medical records. Patients must have control of their medical information; and physicians need visibility into a patient’s complete medical record. Having all of a patient’s information available to inform clinical decision-making saves time, improves quality, and reduces unnecessary and duplicative tests and procedures. CMS is taking action to make this vision a reality, including recently proposing a redesign of the incentives in the Merit-Based Incentive Payment System or “MIPS” to focus on rewarding the sharing of healthcare data securely with patients and their providers.

We welcome your thoughts on our proposals, and we look forward to partnering with you to make them successful. Patients and their families put their trust in your hands, and you should be able to focus on keeping them healthy. And to secure the future strength of our system, we must make sure that the nation’s best students continue to choose to go into medicine.

We need your input to improve the healthcare system. Once again, thank you for your service to your patients.

Sincerely,
Seema Verma

Needing MIPS Help? Utilize Our MIPS Calculator and Service Center

MIPS reporting deadlines are quickly approaching! We have staff and tools available to assist you during the reporting period.

Great Plains Quality Innovation Network offers FREE assistance to all Merit-Based Incentive Payment System (MIPS) eligible clinicians. In addition, we created the MIPS Calculator to assist providers in maximizing their revenue reimbursements. The MIPS Calculator is a robust excel-based, scoring and financial projection estimator based on the CMS 2017 final rule for the MIPS 2019 adjustment year.

The tool is intended to facilitate discussion and create opportunities for strategic planning within a practice or facility as clinicians transition from previous CMS Medicare reimbursement and bonus programs to the currently established Quality Payment Program (QPP). Clinicians are able to use our tool independently, or in conjunction with any of our Great Plains QIN staff, as they begin to navigate the many details of this value-based payment model. Tutorials of how to use the MIPS calculator are found here.

Note: New versions of the MIPS Calculator (based upon the 2018 final rule) are being developed and will be available on our website.

If you are still confused, have questions or would benefit from one-on-one reporting assistance, we can help. The Great Plains QIN has also established a Quality Payment Program (QPP) Service Center. Our subject matter experts are available to assist in answering your questions, provide technical assistance and support for reporting your measures and activities. As an added bonus, by partnering with Great Plains Quality Innovation Network, you can earn points on your Improvement Activities Category. Don’t hesitate to call us to set up an appointment. Learn more and access our team member information on our Web site.

Deadline Reminders

To submit data for the 2017 Merit-based Incentive Payment System (MIPS) performance period, please remember,

See the original article on the Great Plains QIN Blog.

 

 

KFMC Announces Two New Board Members

Dr. Eric Voth and Julie Roth appointed as new Board of Trustees members

February 7, 2018

The Kansas Foundation for Medical Care, Inc. (KFMC) is pleased to announce the appointment of Dr. Eric Voth and Julie Roth as newest members to the Board of Trustees effective January 5, 2018.

Dr. Voth is a specialist in internal medicine, pain management, and addiction medicine as well as Vice-President of Primary Care at Stormont-Vail HealthCare in Topeka, Kansas. He is the chairman of the Institute on Global Drug Policy, is recognized as an international authority on drug use, and lectures on drug policy-related issues, pain management, and appropriate prescribing practices. Dr. Voth also serves as an advisor on alcohol and drug abuse issues to the Kansas State Board of Healing Arts, is a former member of the National Advisory Committee for the Center for Substance Abuse Treatment of HHS, and is a Clinical Professor of Internal Medicine at the University of Kansas School of Medicine.

Dr. Voth has advised several U.S. presidential administrations and testified for numerous Congressional offices on drug related issues for over thirty years. Dr. Voth provides expert testimony on general medical issues, pain management, and addiction issues for both defense and plaintiff cases.

Julie Roth, JD, partner at Spencer Fane in Overland Park, KS, represents large health systems, hospitals and physician practices, and counsels clients on the sale, acquisition, and development of complex joint ventures. With more than 15 years of experience, Julie regularly helps her clients by negotiating and drafting hospital-physician affiliation documents, such as employment agreements, professional services agreements, physician recruitment agreements and clinical co-management agreements.

Additionally, Julie counsels clients on regulatory compliance matters including HIPAA privacy and security rules, Medicare & Medicaid payment rules, Conditions of Participation, and EMTALA. She has substantial experience with electronic health records and the health information technology exchange, and assisted in the development of the Kansas Health Information Technology and Exchange Act, which aligns Kansas law with the HIPAA Privacy Rules. She earned her Masters’ degree in Health Services Administration and is a credentialed Registered Health Information Administrator.

The slate of board members for 2018 is listed below.

  • Spaulding, Ryan, PhD (Chair)
  • Bell, Donna (Vice Chair)
  • Hintz, Thomas (Secretary/Treasurer)
  • Cox, Robert, MD
  • Jacobson, John
  • Praeger, Sandy
  • Roth, Julie
  • Good, Sarah, MHA (KFMC President and CEO)
  • VanHouden, Charles, MD
  • Voth, Eric, MD
  • Wolfe, Brian, MD
  • Yost, Carla, RN.

Brewster Place Staff Participate in Alzheimer's Disease and Dementia Care Seminar

February 9, 2018

Nine staff members from Brewster Place, a faith-based, mission-driven not-for-profit continuing care retirement community based in Topeka, Kansas, completed an Alzheimer’s Disease and Dementia Care Seminar hosted by Great Plains Quality Innovation Network-Kansas.

Upon completion of the seminar, participants have the option to apply to become a Certified Dementia Practitioner (CDP) from the National Council of Certified Dementia Practitioners (NCCDP). All nine students who attended the seminar plan to submit their applications. The Certified Dementia Practitioner is an earned credential that recognizes the highest standard in Alzheimer’s and Dementia education. The CDP certification demonstrates the achievement of specialized training in the areas of Alzheimer’s and Dementia care. Health care professionals and front-line staff who have taken the steps to complete comprehensive training in Alzheimer’s and Dementia Care and have completed certification have the necessary educational tools, new methods and theories to provide care to Alzheimer’s and Dementia patients.

The CDP certification is essential for today’s health care professional and front-line staff as the dementia elderly population continues to rise. “While Alzheimer’s Disease and Related Dementia (ADRD) are considered to be one of the major health issues of the century, many of our direct care workers have not been provided sufficient education on ADRD. To improve quality of care and quality of life for our elders with ADRD, we need a skilled workforce that is equipped with a high level of dementia knowledge and the skills needed to provide person directed, holistic care. I believe knowledge is power and the NCCDP’s CDP program provides caregivers with the insight, tools and resources needed to provide this level of care to our most vulnerable elders,” stated Brenda Groves, LPN, Regional Nursing Home Lead for the Great Plains Quality Innovation Network and facilitator of the Alzheimer’s Disease and Dementia Care Seminar.

“My experience was great. It helped me gain a better understanding of dementia care. I can now take all the information I’ve learned and teach others. I’m truly grateful for the opportunity and the education my instructor provided me on how to give the best care possible in the memory care neighborhoods,” stated Shay Mason, Memory Care Kaizen (Certified Nursing Assistant) at Brewster Place.

For more information about Brewster Place and their efforts, visit http://www.brewsterliving.org.

Franklin County Health Department Sponsors Diabetes Workshop

January 9, 2018

By The [Ottawa] Herald Staff

The Franklin County Health Department will offer a free workshop series for area residents with diabetes and their caregivers, according to a press release.

The six-week workshop series is designed to complement medical treatments and education provided by healthcare providers, the release said. Workshop participants will receive a free copy of the book, Living a Healthy Life With Chronic Conditions.

“The self-management workshops are a great opportunity for individuals with diabetes and their caregivers to learn skills that can change lives,” Erin Laurie, health department health educator and WIC nutritionist, said. “The workshop series was developed by Stanford University and is being utilized around the world to improve self-management skills for those with diabetes. We are very excited to partner with the Kansas Department of Health and Environment and Kansas Foundation for Medical Care to bring these workshops to our community.”

An informational meeting is scheduled for 6 p.m. to 7 p.m. Feb. 6 at the Franklin County Board of Commissioners chambers, 1418 S. Main St., Ottawa, the release said. The meeting allows participants to learn about the program and register for the workshop series, which begins Feb. 13 and ends March 20. The workshop runs 6 p.m. to 8:30 p.m. each Tuesday in the commission chambers.

Space is limited because of the interactive nature of the workshop series. Individuals and caregivers can pre-register by contacting Laurie at (785) 229-3536.

The workshop series is made possible through partnership with Kansas Self-Management Education, the release said. For more information, visit selfmanageks.org.

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