Monday Rx | April 23rd, 2018 | The Fight Continues April 24, 2018 Tag 956 Another week and the fight against anti-physician legislation wages on. Assembly Bill 3087, introduced by Assemblymember Ash Kalra, would establish an undemocratic, government-run commission with nine political appointees who would unilaterally set the price for all medical services that are not already controlled by the government, essentially eliminating commercial healthcare markets in California. The ill-conceived bill is scheduled to be heard in committee as CMA president, Dr. Ted Mazer, will testify on behalf of physicians. The speaker of the Assembly, Anthony Rendon, wants the bill to continue through the process as a battle for common sense looms. For more information, click here. To take action and contact your legislator, click here. CMS Updates The Centers for Medicare and Medicaid Services (CMS) recently finalized a rule increasing baseline Medicare Advantage payment rates for 2019 by an average of 3.4 percent. That is nearly double the 1.84 percent increase the agency initially proposed earlier this year. According to CMS, the proposed pay increase is based on better use of encounter data and changes to the risk adjustment model used to pay for aged and disabled beneficiaries. Under the final rule, 75 percent of Medicare Advantage risk scores will be based on traditional fee-for-service data, and 25 percent based on encounter data (up from 15 percent in 2018). The California Medical Association believes this will reduce the Medicare Advantage plan data requests of individual physicians, which could reduce administrative burdens. Medicare Advantage participation is at an all-time high, with approximately one-third of all Medicare beneficiaries enrolled in a Medicare managed care plan. Enrollment has more than doubled over the past decade and is projected to grow by 9 percent to 20.4 million in 2018. CMS also finalized a policy to prevent Medicare beneficiaries at risk for opioid misuse or abuse from getting prescription drugs from multiple doctors or pharmacies. Beginning in 2019, CMS will allow Medicare Part D plans to restrict at-risk beneficiaries to a single prescriber or pharmacy for access to frequently abused drugs. CMA Endorses Gavin Newsom for Governor You may already know that CMA formally endorsed Lieutenant Governor Gavin Newsom's 2018 bid to become California's next governor. "California's physicians are proud to support Gavin Newsom for Governor," said Dr. Mazer. "Gavin is a lifelong champion for healthcare in California, and we know he will continue to fight for pragmatic solutions to our most crucial healthcare challenges, including working to achieve universal access and tackling our state's physician shortage." Some background on Newsom: As Mayor of the City and County of San Francisco, Newsom worked with healthcare providers to bring the nation's first universal access health system to all residents, regardless of income or immigration status. He fought alongside CMA to restore hundreds of millions of dollars in harmful statewide cuts to Medi-Cal services and vowed to protect access to care for all Californians. Newsom was also the first statewide official to support Proposition 56 and its full state budget allocation to healthcare delivery. More recently, he has reaffirmed his support for a comprehensive legislative approach that creates a pathway to universal health access, renewed investment in prevention and wellness, and bold reforms that bend the cost curve without exacerbating the provider gap. Newsom has long advocated that any strong and successful universal access plan must address California's critical physician shortages and expand medical residency programs so patients can access timely and affordable health care, as well as standardize and reduce administrative burdens so physicians can spend more time on patient care than paperwork.He will also continue working to protect Medicare and raise Medi-Cal reimbursement rates – currently among the nation's lowest – to help increase access for the nearly 14 million Californians, including half of the state's children, currently covered by the program. For more information on Gavin Newsom's candidacy, please visit GavinNewsom.com. May 25th Deadline Looming for Enrollment in National ACO Now onto the member benefits front. LACMA has entered into several exciting partnerships to help physicians in private practice, groups, and hospital environments. National ACO, as I mentioned last week, is uniquely positioned to help physicians.There is a May 25th deadline looming for enrollment. Why is it so important? The deadline is a CMS requirement for NACO to send a list for potential providers to participate in the upcoming Performance Year (PY) 2019. During this time, CMS will check provider eligibility on PECOS and CMS integrity lists. Additionally, CMS will review the providers' billing and coding data to determine a preliminary attribution patient list for PY 2019. Since NACO is a performance-based ACO, it selects physicians who participate through IPAs, medical groups, and associations. LACMA/CMA provides organizational oversight and value-added services that enhance quality performance through the Next Gen ACO Model of care. Interested? Join the NACO Informative Webinar Thursday, May 3, 2018, at 12:00 pm (30mins) REGISTER FOR THE WEBINAR Or, you may contact me if you have questions and would like to get started!We are also in strategic discussions with Bottom Line Concepts to improve discharge patient management, primary care physician referral management and chronic care management from hospital to primary care environments. Meet athenahealth Thursday, April 26th Burbank, CA This Thursday, our preferred partner, athenahealth, is hosting a small dinner in Burbank so LACMA members can learn more about how their EMR platform can help you thrive as an independent physician. Space is limited. This is a small private dinner and we would love to have a few members join us! You will be able to learn more about: 1) How athena helped a fellow LACMA member achieve 99.5% on MACRA/MIPS reporting for the initial year 2017. 2) How a fellow LACMA member cut the no-show rate down to 2% and raised his first-pass billing rate up to 98% using athena 3) How athena is making huge strides to offload administrative work from the practice and help you focus more on patients. Dinner will be held at Morton's Steakhouse from 6:30 PM to 8:30 PM in Burbank. Details here. Email us if you would like to attend. EVENTS You are Invited! Los Angeles County Medical Association's Annual Installation of Officers June 21, 2018 Hotel Casa del Mar 1910 Ocean Way Santa Monica, CA 90405 R.S.V.P lisa@lacmanet.org Join us! Los Angeles County Medical Association's Young Physician's Committee Spring Mixer Friday, May 11, 2018 7:00 PM-10:00 PM THE ABBEY 692 N ROBERTSON BLVD. WEST HOLLYWOOD, CA 90069 RSVP HERE Bridging the Chasm from Clinician to C-Suite Executive: The Physician's Journey into Healthcare Administration Thursday, May 31st 5:30 PM - 7:30 PM USC Verdugo Hills Hospital 1812 Verdugo Hills Boulevard, Glendale, CA 91208 Please join a distinguished panel of physicians and healthcare executives as they discuss the journey from clinical practice to the C-suite. The discussion will focus on what does a physician need to know to be effective in an administrative role within a hospital or healthcare system? What are the approaches that have worked well in making a transition from clinical practice to an administrative leader? What are the keys and/or barriers to successful healthcare administration as a physician leader? Contact us if you are interested in attending!