Posted on
March 10, 2010 at 3:59 pm by Frank Fortin
The U.S. Senate today voted to postpone pending Medicare pay cuts to physicians until September 30.
The vote was part of a bill that provides additional Medicaid assistance to the states, and extends COBRA and unemployment benefits for the long-term unemployed.
The bill now goes to the House, which approved an earlier version of the bill.
If enacted, it would give the Congress more time to work on a permanent reform of the Medicare payment formula, key advocacy goal of the AMA, MMS and other physician groups.
MMS physicians held their first meeting with newly elected Massachusetts Senator Scott Brown on Tuesday afternoon, and the session produced a “good exchange of ideas,” said MMS President Mario Motta, M.D. The meeting was held as part of the American Medical Association’s National Advocacy Conference, held over three days in Washington.
“It was a very cordial meeting,” Dr. Motta said of the 40-minute session with Brown and his staff. “I think we laid the groundwork for a long-term collaborative effort with him to improve health care. We were able to present our viewpoints on key issues, he listened carefully, and he indicated he wanted to work with us. We look forward to an ongoing dialogue with him, just as we have had with every member of our Congressional delegation.”
Physicians were scheduled to meet with every member of the delegation or their staffs. A meeting with Senator John Kerry was on tap for Wednesday afternoon, and sessions with Representatives Markey, Delahunt, Lynch, McGovern, Neal, Tsongas, Tierney, Olver, and Capuano and their staffs occurred over Tuesday and Wednesday. A previous meeting was held with Congressman Barney Frank in his district.
Some 35 physicians, residents, and medical students from Massachusetts attended the event in Washington. The National Advocacy Conference gives physicians the opportunity to share their concerns and perspectives on a range of health care issues affecting physicians, patients, and the health care industry. Among the major issues MMS members discussed were the Medicare payment formula for physicians, defensive medicine, and health care reform.
The March 2010 edition of Physician Focus, the Massachusetts Medical Society’s monthly patient education television program, examines prostate cancer, a disease affecting one in six men and the most common cancer in men other than skin cancer. Each year, more than 192,000 cases of prostate cancer are diagnosed, and 27,000 men die from the disease.
Host John Fromson, M.D. leads two experts in a discussion describing the causes of the disease, risk factors, how the disease is detected and diagnosed, and the pros and cons of various treatment options.
Guests are Thomas Kingston, M.D., President of the Massachusetts Association of Practicing Urologists and a physician with Urology Consultants of the North Shore in Salem, and Richard Babayan, M.D., Chief of Urology at Boston Medical Center and Chairman of Urology at Boston University School of Medicine. Physician Focus is distributed to public access television stations across the state and is available online at www.physicianfocus.org with accompanying text and additional sources of information on the topic.
Posted on
March 2, 2010 at 11:44 pm by Frank Fortin
The Bunning Blockade is over.
The Senate tonight finally passed legislation that temporarily delays a 21 percent Medicare payment cut for physicians, after Sen. Jim Bunning (R-Ky.) ended his controversial one-man fight to block consideration of the bill. The postponement, retroactive to March 1, is set to expire on March 31.
The vote was 78-19. President Obama is expected to sign the bill without delay. It also extends unemployment benefits for the long-term unemployed and provides stopgap funding for highway projects through March 31.
The AMA continues to work for a permanent reform of the flawed Medicare payment formula.
Posted on
February 26, 2010 at 2:18 pm by Frank Fortin
Congress has gone home for the weekend, after repeatedly failing to block the 21 percent cut in Medicare physician payment rates set to take effect on Monday, March 1.
Though the House passed the rate freeze, the Senate failed to do so on three occasions. It was attached to a bill that would also extend benefits and health insurance for the unemployed. But Republican Sen. Jim Bunning blocked it each time, saying it wasn’t paid for by cuts elsewhere in the budget.
“It is unacceptable that Congress has failed to protect the health care needs of our nation’s seniors,” said Mario E. Motta, MD, president of the Massachusetts Medical Society. “Both parties agree the payment formula is broken. All we’re asking for is another 30 days to come up with a new solution. We strongly urge the Senate to get back to work immediately to work on the issue, before seniors’ access to care is compromised.”
Dr. Motta also thanked the Massachusetts congressional delegation for its sustained and committed support for permanent reform of Medicare physician payment system.
The Senate may try again next week. There will be no immediate impact on claims processing. The Centers for Medicare and Medicaid Services has told its contractors to hold Medicare physician claims for 10 business days, effective Monday.
Posted on
February 26, 2010 at 8:52 am by Frank Fortin
For the second time in two nights, a proposal to extend the freeze on the 21 percent Medicare payment cut was derailed in the Senate Thursday night by a bitter dispute over how to pay for it.
Senate leaders are trying to include a 30-day extension for the payment freeze with a bill that would also extend unemployment benefits and health insurance benefits for the unemployed for another 30 days. The Medicare freeze, unemployment benefits and insurance benefits expire at 12 a.m. March 1 unless extended by Congress.
As the newscaster David Brinkley was fond of saying, stay tuned.
Posted on
February 24, 2010 at 4:41 pm by Frank Fortin
The AMA reports that Congress has been unable to resolve the Medicare sustainable growth rate (SGR) crisis during the two-month extension that prevented the 21% cut from taking effect on Jan. 1. Senate Majority Leader Harry Reid is expected to ask for consent on the Senate floor that current SGR payment levels be extended for an additional 30 days to prevent scheduled cuts from going into effect on Monday, March 1.
The extension will be part of a larger package that addresses other expiring provisions that are considered “must pass’ items, such as unemployment insurance and COBRA coverage. The House is expected to consider the package later this week. The AMA has insisted that Congress act this year to permanently repeal the SGR formula and has continued to meet with Congressional and Administration officials to press that point.
At present, no disruptions in processing Medicare physician claims next week are expected.
Posted on
February 23, 2010 at 8:39 am by Frank Fortin
What’s in the President’s reform proposal? A lot – some of it familiar, some of it new.
Once again, Kaiser Family Foundation has produced the best and easiest to use document. It compares President Obama’s proposal with the bills passed by the House and Senate last year.
Posted on
February 11, 2010 at 10:54 am by Rick Gulla
By Barbara Spivak, M.D., President, Mount Auburn Cambridge IPA, and Edward Westrick, M.D., Vice President, Medical Management, UMass Memorial Health Care
With the turmoil surrounding health care issues nationally, it can be easy to forget that, besides taking the lead on expanding access through insurance reform, Massachusetts has been a pioneer in forging consensus around how to measure and report quality data. In fact, this week marks the sixth year that Massachusetts Health Quality Partners (MHQP) has released a report on how medical groups across the state perform on multiple measures of clinical quality.
Once again there’s plenty of good news. Overall, primary care physicians at more than 150 of the state’s medical groups performed better than the national average on 28 of 29 adult and pediatric quality measures reported by MHQP, and above the national 90th percentile on 15 of them.
As Massachusetts turns its attention to addressing the cost and quality of care through delivery system reform, performance measurement promises to play an increasingly important role. Dr. Jack Evjy, MMS Senior Medical Advisor, in a posting on this blog, outlined three essential elements of “patient-centric” system reform: taking an evidence-based approach to care; addressing unnecessary variation, both for under-utilization and over-utilization; and insisting on coordination and collaboration. We couldn’t agree more. Within our own organizations, and as members of MHQP’s Physician Council, we have seen that credible quality data can help drive patient-centered improvements. Here are a few examples of how MHQP’s approach to performance reporting aligns with Dr. Evjy’s criteria for reform.
Focus on evidence-based care MHQP develops their performance reports through a collaborative, evidence-based process based on national standards for clinical quality that are closely related to patients’ health and well-being. Since MHQP compiles HEDIS® data from the state’s five major health plans, their reports generally include enough patients to make the data credible and meaningful at the group level. What’s more, MHQP’s only agenda is quality improvement, and they work closely with all of the major stakeholders, including the Massachusetts Medical Society, to make sure their reports reflect that spirit.
Address unnecessary variation in both under-utilization and over-utilization Even with high levels of performance overall, MHQP still finds that there are significant variations and opportunities for improvement across the state. For instance, one MHQP measure looks at the percent of patients, age 40 and older, who have had a spirometry test to confirm the diagnosis of COPD. The statewide average is 40 percent. While the rate for the best performing group was 64 percent, the lowest rate was only 17 percent, indicating a strong possibility of under-utilization for this simple test.
Similarly, wide variation exists in the over-utilization of imaging studies for adults with low back pain – the best performing group made appropriate use of imaging 97 percent of the time, compared with the lowest-scoring group, at just 52 percent. Improved performance in this measure not only results in safer, better-quality care, but helps reduce unnecessary medical spending.
Encourage coordination and collaboration It is difficult, if not impossible, to make and sustain measurable improvements in clinical quality without enhancing teamwork within physician groups. In its press releaseon their latest clinical quality report, MHQP touches on two examples of how groups have used their performance data to address a major opportunity for improving the treatment of patients with severe depression. In both cases, care coordination and collaboration were key elements of success.
Quality reporting is about to enter a new era as the expanded use of electronic medical records and meaningful use requirements may offer for more refined measures of clinical outcomes than traditional claims data, and MHQP will undoubtedly play an important coordinating role in that transition. In the meantime, however, the collaborative work done thus far by MHQP has built a strong foundation for delivery system reform – one that is unmatched in most other states.
Posted on
February 8, 2010 at 3:05 pm by Rick Gulla
The National Football League’s decision to focus more attention on concussions, or mild traumatic brain injury, is a very good thing, says Alan B. Ashare, M.D., chair of the Medical Society’s Committee on Student Health and Sports Medicine.
But in a newspaper commentary, he argues “While football has brought notoriety to the issue, awareness must spread beyond the gridiron.”
Dr. Ashare, a physician at St. Elizabeth’s Medical Center who is also Chair of the Safety and Protective Equipment Committee for USA Hockey,says “Concussions don’t discriminate by age, gender or activity,” and that “The notions of “toughing it out” or “walking it off” are thankfully giving way to the common sense approach of deciding what’s best for the health of the athlete.”
He urges that parents, coaches, trainers and physicians learn more about concussion and recognize the risk of such injury in other sports and recreational and playground activities as well as football.
Dr. Ashare’s commentary has been published in The Berkshire Eagle in Pittsfield,The Standard-Times of New Bedford, and The MetroWest Daily News in Framingham and has been submitted to other daily papers across the state.
Congress has gone home for the weekend, after repeatedly failing to block the 21 percent cut in Medicare physician payment rates set to take effect on Monday, March 1.
What’s in the President’s reform proposal? A lot – some of it familiar, some of it new.
With the turmoil surrounding health care issues nationally, it can be easy to forget that, besides taking the lead on expanding access through insurance reform, Massachusetts has been a pioneer in forging consensus around how to measure and report quality data. In fact, this week marks the sixth year that Massachusetts Health Quality Partners (MHQP) has released a report on how medical groups across the state perform on multiple measures of clinical quality.
