Monday Rx: A Message from Dr. Deen, LACPAC, Monkeypox, Medicare Payment and LA Dodger Healthcare Appreciation Night July 18, 2022 151st Installation of President and Officers, ACO, Aledade, American Medical Association, California, California Attorney General, California Medical Association, CDC, COVID-19, Dr. Deen, health care, LA County, LA Dodgers Healthcare Appreciation Night, Lab Testing, LAC DPH, LACPAC, Los Angeles, Los Angeles City Council, Los Angeles County, Medicare, Medicare Physician Fee Schedule, medicine, Membership, minimum wage, Monkeypox, pandemic, physician-patient, physicians, Public Health, Rob Bonta, SEIU-UHW union, Vaccine, Webinar 1131 Dr. Deen Message for Membership Last Thursday, July 14th, Dr. Omer Deen was installed as the 151stpresident of LACMA. Dr. Deen shared his vision with attendees at the annual event held at the Peterson Automotive Museum: As physicians, we constantly face legislative, regulatory and procedural challenges that impact the physician-patient relationship. From over documentation, archaic and cumbersome pre-authorizations and step therapy to the recent Los Angeles City Council minimum wage hike ordinance to $25 per hour for certain workers at private hospitals, hospital-based facilities and dialysis clinics, but completely exclude workers who do the exact same job at public hospitals, clinics, and health care facilities, including all University of California and county hospitals and clinics. The measures also completely excludes workers at health care facilities not affiliated with hospitals, including community health clinics, Planned Parenthood clinics, nursing homes, medical centers, and more. The measures apply to non-clinical workers like janitors, housekeepers and landscapers at hospital-based facilities, but exclude clinical workers like nursing assistants, medical technicians, and other workers in non-covered facilities. The SEIU-UHW union has filed 10 ballot initiatives in 10 cities — Anaheim/Los Angeles/Long Beach/Culver City/Duarte/Downey/Inglewood/Monterey Park/Baldwin Park/Lynwood — aimed for the November 2022 ballot. We’d like to get your thoughts on this. Let us know whether you support the measure proposed for other cities or not. As physicians, we advocate for the health and wellness of our patients. We have focused for decades on obesity, stroke, cardiovascular disease, cancer, tobacco and alcohol use. Today we face new challenges as do our patients. In typical LACMA fashion, as we have before, we must pivot and deploy energy and resources because today’s challenges are monumental: Gun related injuries and death are the leading cause of death in children. No longer is it motor vehicle accidents. LACMA is partnering with the Chicago Medical Society, California Attorney General Office, New York Attorney General Office and several medical associations across the US to launch an innovative program to educate and inform parents, educators and medical providers as to how to prevent gun violence. Reproductive health laws and how that will impact physicians and patients alike. Health equity and access to care. How can we expand fair and equitable coverage? Reimbursement equity for Medi-Cal providers: For too long physicians serving underserved communities haven’t been paid fair rates. LACMA is part of a coalition to change that. Health issues beyond our borders: Local Ukrainian American physicians have asked LACMA to do something to help the physicians of Ukraine, the people of Ukraine. We have been in discussions with both the Ukrainian Medical Association of North America and the Ukrainian Consul General. I hope to share more news on this front soon. They need crash courses in trauma surgery training for their surgeons and they need prosthetics. LACMA is here to coordinate and collaborate with our local teaching institutions and prosthetics companies to provide the support they need. LACMA continues to innovate and deliver value to our members. In fact, we provide help in the form of legal assistance, contract negotiations, grants, marketing and much more. I’m excited to share that in the next few weeks our benefits portfolio will grow to over 100+ partners, making it the most robust member benefits program in the industry as CMA continues to deliver loan forgiveness, GME funding, COVID-19 relief and much more. Our job, as physicians, is to advocate for the health of our patients and it is the job of the LACMA team to advocate for physicians but we can’t do this without growth. We need to grow, sustain value and make a difference in the lives of members and patients every day. I look forward to serving you this year and doing all I can to support the practice of medicine. To see more photos from our 151st installation event click here. If prompted, enter this password: LACMA2022. LACPAC The Los Angeles County Political Action Committee (LACPAC) held a successful fundraiser for California Attorney General Rob Bonta exceeding fundraising goals. Kudos to LACPAC chair Dr. George Fouras for his leadership and for contributors including Allied Pacific IPA led by Dr. Ken Sim and CALPAC that helped make the event a success. “This was a great event in that it brought physicians together and we were able to hear AG Bonta share priorities for the state now and going forward, particularly those impacting physicians and patients,” said Dr. Fouras. Medicare’s Proposed Fee Schedule & ACOs Physician group responses to the proposed 2023 Medicare Physician Fee Schedule ranged from disappointment over the proposed 4.4% overall payment cut to praise for many of the provisions related to accountable care organizations (ACOs). "The scary part for most of us is we're getting these reductions despite the fact that we're still fighting the pandemic and despite the fact we have a relatively large inflation rate," Sterling Ransone Jr., MD, president of the American Academy of Family Physicians, said in a phone interview. "Seeing 9% inflation for the goods and services we have to pay for, while [also having] a 4.4% reduction in what we're being paid, is scary." For instance, in the Medicare Shared Savings program, the fee schedule would "allow eligible ACOs to receive a one-time fixed payment of $250,000 and quarterly payments for the first 2 years of their 5-year agreement period," healthcare attorneys with the law firm Morgan Lewis said in a blog post. "Quarterly payments would be determined using a 100-point scoring methodology, which would pay greater amounts to ACOs serving high numbers of dual eligible beneficiaries or those living in areas of high deprivation ... with the goal that such increased funding would be used to address the beneficiaries' social and other health needs." The agency would recoup these advanced payments once the ACO begins to show shared savings, but if it doesn't accrue savings, CMS wouldn't recoup any funds unless the ACO gets out of the program during the agreement period, according to the blog post. ACOs could start applying for the advance funding next year, with a target start date of Jan. 1, 2024. Given the goals of getting everybody [now] in traditional Medicare into an ACO by 2030, they have to push on a whole bunch of levers in value-based care. So the whole new approach they borrowed from other experiments in the past is very positive. In 2020, primary care practices in Aledade's Medicare Shared Savings Program (MSSP) ACOs earned an average of $198,000 each in shared savings revenue. Increase fee-for-service revenues by up to 13%. Aledade can help practices in the following ways: Overcome staffing shortages now with expert support from local workflow experts Immediate access to actionable patient data from across the care spectrum in a single platform Quickly reduce administrative burdens with timely patient care alerts and efficient workflow tools To learn more as ACO applications are due August 4th, click here. LAC DPH Update: Monkeypox-Commercial Lab Testing, Reporting, & Vaccine Availability Key Messages: Community transmission of monkeypox continues in LA County. Commercial testing is now available through Labcorp. Additional laboratories are expected to have testing available later this month. Providers should submit specimens through commercial labs if possible. Healthcare providers must report all LA County residents with positive and/or presumptive positive orthopoxvirus test results from commercial laboratories. Monkeypox vaccine supplies remain very limited and are prioritized for residents at highest risk of exposure. Vaccine eligibility will be expanded on July 11. See details below. Situation: The Center for Disease Control and Prevention’s (CDC) reports over 700 confirmed monkeypox/orthopoxvirus cases in the U.S. In Los Angeles County, as of July 7, 2022, 54 monkeypox cases have been confirmed in county residents with no hospitalizations or deaths. Among recent cases, close, sustained skin-to-skin contact, including sexual contact, with a symptomatic person with monkeypox appears to be the most significant risk factor associated with transmission. In this outbreak, many of the reported cases have been among gay, bisexual, or other men who have sex with men (MSM). However, it is important to remember that anyone, irrespective of gender identity or sexual orientation, can acquire and spread monkeypox. Commercial testing for monkeypox is now available through Labcorp. Labcorp is using the CDC’s orthopoxvirus test (which detects all non-smallpox related orthopoxviruses, including monkeypox). CDC anticipates additional commercial laboratories will come online this month which will increase access to testing. For LA County current case counts and situation updates, visit the monkeypox webpage for the general public. Providers should reference the Los Angeles County Department of Public Health (LAC DPH) healthcare provider monkeypox webpage. Read the full press release here. Register for Medicare Payment Principles Webinar July 27 The Medicare physician payment system needs an overhaul to remedy financial instabilities impacting physician practices due to the pandemic, statutory payment cuts, lack of inflationary updates and significant administrative burdens. To define the goals of reform, the AMA and 120 state medical and national specialty societies created the “Characteristics of a Rational Medicare Physician Payment System.” Hear what these principles call on Congress to do to improve the Medicare physician payment system in a new AMA Advocacy Insights webinar on Wednesday, July 27 at 10:00 a.m. Central. Hosted by Sandra Fryhofer, MD, chair, AMA Board of Trustees, the webinar will dig deeper into some of the causes of the current systemic issues and chart a path forward. Additional speakers include: Cynthia Brown, vice president, AMA Government Affairs Jason Marino, director, AMA Congressional Affairs Learn more about the Medicare physician payment principles. Date: July 27, 2022 Register Here Join Us for LACMA Family & Friends at LA Dodgers Healthcare Appreciation Night! The Los Angeles County Medical Association is excited to spend an evening together with all members at the Dodger Stadium for Dodger Healthcare Appreciation Night! Tickets: $20 for LACMA members & first guest $34 for each additional guest up to 3 guests per member. Limited tickets available, RSVP by August 24, 2022. This special event ticket package includes your ticket to the game and an exclusive Healthcare Appreciation Night lightweight hoodie.* Be sure to stick around after the game for Friday Night Fireworks! ***Tickets will be distributed by LACMA prior to the game through MLB Ballpark App once payment has been completed. Attendees will need to download MLB Ballpark App*** Date: September 30, 2022 Time: 7:10 pm PST RSVP Here #MondayMotivation "Seeds are always within us; sometimes it takes a great deal to nourish and encourage their growth." Gustavo Friederichsen Chief Executive Officer Los Angeles County Medical Association “If it matters to our LACMA members, it matters to me.”