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Last week, LACMA partnered with Healthcare Executives of Southern California (part of the American College of Healthcare Executives) and held a physician panel discussion hosted by Dr. Don Larsen, chief medical officer, Providence Saint John's Health Center. Topics included how physicians can navigate the complex healthcare industry to seek senior leadership roles. If members need information or assistance with career paths, let me know and I will connect you with the best solution.

Thank you Dr. Larsenfor your leadership!

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California's End of Life Option Act was recently invalidated by a Riverside County Superior Court judgmentin Ahn v. Hestrin, issued on May 24, 2018. The Act was enacted during a special session of the California legislature that had been called by Governor Jerry Brown in October 2015.

The court judgmentdeclared the Act void for violating the California Constitution because, according to the trial court, the Act is not reasonably related to the health careissues that were the subject of Governor Brown's special session proclamation. Consequently, the judgment prohibits the State from recognizing or enforcing the Act. The judgment also prohibits the Riverside District Attorney from recognizing any criminal exceptions that had been created in the Act in the exercise of his criminal enforcement duties.

California's Attorney General has appealed and will be requesting an appellate court to stay the trial court's judgment from taking effect and thereby keep the Act in place while the appeal is decided. The appellate court denied an earlier request for a stay before the trial court's judgment had been entered.

California became the fifth state in the nation to allow physicians to prescribe terminally ill patients medication to end their lives. The Act permits terminally ill adult patients with capacity to make medical decisions to be prescribed an aid-in-dying medication if certain conditions are met. The California Medical Association (CMA) took a neutral position on the Act when it was approved by the legislature.

Unless and until the trial court's judgment is stayed, the End of Life Option Act is currently invalid and unenforceable. Physicians should consult with their attorneys if they have any questions about the impact of this litigation on their practice or on their patients. CMA is closely monitoring the state's appeal and will advise physicians of new developments.

For more information, or if you would like to discuss the potential impact of the trial court's decision on your practice, contact CMA's Legal Information Line at (800) 786-4262 or legalinfo@cmanet.org.

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The Center for Medicare and Medicaid Innovation (CMMI) recently requested comments on a potential alternative payment model that would allow direct payor contracting within the Medicare fee-for-service program, Medicare Advantage program andMedicaid.

Under the proposal, the Centers for Medicare and Medicaid Services would directly contract with participating provider practices and pay a fixed per-beneficiary, per-month payment to cover various services, such as office visits, certain office-based procedures and time spent managing care for a patient. Practices would also be able to earn performance-based bonus payments if they hit cost and quality goals.

The current models approved by CMMI are extremely limited and there are significant barriers to participation. The California Medical Association (CMA) submitted comments on this issue, urging CMMI to expand the types of alternative payment models without the current financial risk and administrative barriers. Models should work for specialists, as well as primary care physicians and small, independent practices.

CMA also urged CMMI not to require physicians to accept downside financial risk or hold them accountable for the total cost of care—since there are many costs that physicians cannot reasonably influence.

Physician-focused alternative payment models have significant potential to enable physicians to improve the quality of their patients' care, and CMA strongly urges CMMI to greatly increase the number of available alternative payment models in order to make them a viable option for most physicians and have a meaningful impact on spending and quality of care for patients.

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This week, as part of our ongoing LACMA roadshow, I will be meeting with Dr. Lori Morgan, CEO, Huntington Hospital, Robert Allen, CEO, CHA Healthcare and Dr. Laura Mosqueda, Dean of USC Keck School of Medicine.  The purpose of these meetings is to reintroduce LACMA to healthcare leaders and explore ways that we can support their priorities.

Contact meif you have questions and would like to get started! Learn more here.