- Op-Ed: American Health Care Act won’t help patients access doctors or receive affordable, quality care
- Urge Congress to preserve coverage and improve access to physicians!
- "Digital Innovator" and physician Wendy Sue Swanson, M.D., to speak at 2017 Leadership Academy in San Diego
- CMS accepting 2016 meaningful use hardship exceptions
- CMA Council on Legislation meets to discuss 2017 legislative priorities
- CMA releases 2017 annotated Model Medical Staff Bylaws
- Three medical societies receive CDPH awards to promote opioid safety
- Study confirms diabetes prevention programs reduce costs, improve patient outcomes
- Happy Match Day to our future physicians!
Important Dates & Deadlines
- 3/29/17: CMA Legislative Advocacy Day Webinar Training
- 4/12/17: Webinar: Implementing Strategies to Enhance Advance Care Planning
- 4/18/17: CMA's 43rd Annual Legislative Advocacy Day
- 4/26/17: Webinar: Aligning Clinical Practice with Diabetes Prevention: Screen, Test and Refer
- 5/5-7/17: Western Health Care Leadership Academy
- 7/1/17: 2016 Meaningful Use Hardship Exceptions Due
Debra Lupeika, M.D., a family physician at Shasta Community Health Center in Redding, works with the center’s Project HOPE (Health Outreach for People Everywhere) van, which serves over 290 homeless patients every month.
#CMAdocs: Debra Lupeika, M.D.
I was able to treat [the daughter of one of the homeless shelter residents] and expedite a prescription for antibiotics. Transportation and a long ER wait was an issue. The fact that I could easily solve the problem for her lifted a burden. It makes me feel good that I am helping to improve my patient’s lives by providing access to health care. It just feels right.” Read More
Featured member benefit:
Group Health Insurance: No matter what changes occur with federal health reform, the California Medical Association, working with Mercer, can offer you best-in-class group health insurance products and services and make your ride through these turbulent times as smooth as possible. Read More
(Photo courtesy of Rich Pedroncelli/Associated Press)
Quotable: The California Medical Assn. and California Dental Assn. have proposed using tobacco tax money as incentive payments, giving more money to providers who are already serving high numbers of Medi-Cal and Denti-Cal patients. Read More
Physicians in the News
- Dispute over tobacco tax money sparks a budget brawl between the governor and medical groups
Los Angeles Times - 3/16/17
- Governor’s Budget Cuts Force Talented Future Doctors Out of California
Fox & Hounds - 3/15/17
- American Medical Association urges GOP to go 'back to the drawing board'
The Hill - 3/16/17
- Travel Ban Adds Stress To 'Match Week' For Some Doctors
Capital Public Radio - 3/16/17
- Should your doctor talk with you about climate change?
San Diego Union-Tribune - 3/16/17
1. CMA unveils plan to recoup Prop 56 funding to improve access to care
The California Medical Association (CMA), in partnership with the California Dental Association (CDA), unveiled a budget proposal to improve access to medical and dental care for the state’s 14.3 million Medi-Cal and Denti-Cal patients. The proposal focuses on targeted Medi-Cal investments to increase the number of doctors — both physicians and dentists — who participate in these programs and enable them to accept more patients in order to improve Medi-Cal patients’ access to care provided in California.
Gov. Jerry Brown’s 2017-18 current budget proposal takes $1.2 billion in Proposition 56 tobacco tax funds that were intended to improve access to care and instead, uses them for state general fund purposes. The Legislative Analyst’s Office report on Prop 56 points out that this use of tobacco tax funds goes against the “common sense view” of the initiative’s non-supplantation provision and would be subject to legal challenge.
The governor’s proposal also conflicts with the plain language of the tobacco tax initiative that directs funds to be spent to improve access by improving provider payments; the governor’s proposal does nothing to improve access, coverage or care.
“As a physician who has seen firsthand the escalating numbers of patients unable to find a doctor who can viably accept them into their practice, it is clear that tobacco tax must be put to its intended use of increasing patient access,” said CMA President Ruth Haskins, M.D. “This proposal honors the will of voters and the letter of the law for commons sense investments in the Medi-Cal system that will result in vulnerable patients gaining timely access to care.”
The CMA/CDA plan is fiscally prudent – providing supplemental payments based on a sliding scale to correspond with a provider’s level of participation in the Medi-Cal program without exceeding budgeted special funds.
By tethering the supplemental reimbursements directly to the percentage of Medi-Cal or Denti-Cal patients a physician or dentist serves, the plan will produce measurable results for patients; it will be straightforward for the Department of Health Care Services to administer; and it can be implemented regardless of Medicaid funding decisions on the federal level. Most importantly, it will directly increase access to treatment and services for patients who currently face significant barriers to care.
California’s Medi-Cal and Denti-Cal provider networks suffer from chronic underfunding that directly affects patient care. California provider rates are among the lowest in the nation – 48th of 50 states. As a result, only 20 percent of dentists in California are able to accept Denti-Cal patients and 16 California counties either have no Denti-Cal providers, or none accepting new patients. Forty percent of California physicians provide 80 percent of Medi-Cal visits.
Since California’s Medi-Cal and Denti-Cal programs are the nation’s largest, covering more than a third of California’s residents and 60 percent of children, the state needs a robust provider network to meet the medical and dental needs of these 14 million Californians.
The proposal is a common sense solution that targets investments to strengthen California’s Medi-Cal and Denti-Cal provider network and improve patient access to care. Investing tobacco tax revenues as the voters intended will lead to better health outcomes for Medi-Cal and Denti-Cal enrollees and result in long-term savings to the state.
2. Op-Ed: American Health Care Act won’t help patients access doctors or receive affordable, quality care
By Ruth Haskins, M.D., President of the California Medical Association
Long before President Donald Trump campaigned to fully repeal the Affordable Care Act (ACA), the California Medical Association (CMA) has been fighting for access to health care for all Californians.
CMA, which represents over 43,000 physicians across all modes of practice, believes access depends on affordable, quality coverage and reflects the ability of patients to secure appointments with doctors (promptly) for preventative care and when catastrophic circumstances occur.
On March 6, the U.S. House of Representatives’ Republican leadership, with the support of the White House, unveiled the first draft of the “American Health Care Act” (AHCA) as an answer to their promise to repeal and replace the ACA.
While we’re pleased the bill includes an expansion of Health Savings Accounts (HSAs) and state innovation grants, we’re concerned that the current proposal does nothing to improve access to doctors through payment rate increases or network adequacy requirements. And, if federal Medicaid funding is reduced through a per capita cap or other means, this will result in millions losing health care while shifting the burden to the states and ultimately to doctors who are on the front lines caring for patients.
To read the full op-ed by Dr. Haskins, click here.
The House Republicans' ACA repeal and replace bill – the American Health Care Act (AHCA) – is headed to the House floor for a vote as early as next week. Congressional leadership is aiming to pass the bill before the April spring recess – and they need to hear from you today!
The AHCA would make finding a doctor even more difficult – the current legislation does nothing to improve access to doctors by addressing the low Medicaid rates or requiring that health plans have adequate physician networks.
What’s more, the nonpartisan Congressional Budget Office (CBO) unveiled the impact of the AHCA, and the prognosis isn’t good:
- 24 million Americans would lose insurance coverage over the next decade (14 million next year alone). What’s more, the tax credits are age-based, not income-based, and inadequate to help older, sicker and low- to moderate-income families afford insurance.
- Medicaid funding is cut by $880 billion, which would doom California to low physician payment rates and higher hurdles or patients to access care. The bill shifts the financial burden to the states, low- to moderate-income working families, seniors – and ultimately physicians, who are on the front lines caring for these patients every day.
Most of the 5.3 million Californians who gained coverage under Medicaid and Covered California are also at-risk, particularly in the Central Valley and northern rural regions of California, where as many as 75 percent of the residents are newly insured. If you’re a practicing physician in either region, it’s especially important to contact your Representative.
It’s important that Congress makes changes to the legislation to improve access to doctors, ensure that currently covered Californians do not lose coverage, and guarantee that insurance is affordable and meaningful.
You'll be connected to the American Medical Association's (AMA) "Patients Before Politics" site, then click on "Physicians: Take Action," where you will be linked to your representative to send an email.
4. "Digital Innovator" and physician Wendy Sue Swanson, M.D., to speak at 2017 Leadership Academy in San Diego
The California Medical Association, along with our national presenting sponsor, The Physicians Foundation, is pleased to announce that Wendy Sue Swanson, M.D., Chief of Digital Innovation at Seattle Children’s Hospital, has joined our dynamic lineup of featured presenters at the 2017 Western Health Care Leadership Academy. Dr. Swanson will speak about leveraging the wisdom of clinicians, patients and researchers to transform health care delivery in the digital age.
This outstanding event—ideal for physicians, nurses, medical practice managers, hospital chiefs of staff, medical and specialty society officers and executives, and more—will take place May 5-7, 2017, at the Marriott Marquis San Diego Marina.
In addition to Dr. Swanson, the program also features notable speakers like physician and author Abraham Verghese, M.D., MACP; veteran National Public Radio science correspondent and award-winning science TV journalist, Ira Flatow; and television contributors Paul Begala and Hugh Hewitt.
Just announced! Conference breakout sessions
The 2017 Western Health Care Leadership Academy offers six educational tracks for easy navigation. Sessions are designed to be educational for all attendees, so mix and match workshops for a meaningful program that fits your needs. Tracks include:
- Running Your Practice
- Improving Quality of Patient Care
- Future Trends in Health Care
- Physician Leadership
- Organizational Leadership
- Student and Resident Future Leaders
Register today with the VIP Upgrade and enjoy special benefits, including express conference check-in, preferred seating, and "up close and personal" experiences with Drs. Verghese and Swanson, where you will have the chance to ask questions face-to-face in an exclusive setting.
The 2017 Western Health Care Leadership Academy continues its mission of providing information and tools needed to succeed in today’s rapidly changing health care environment. Attendees will hear from the experts and leaders of change. The conference will examine the most significant challenges facing health care today and present proven models and innovative approaches to transform your organization’s care delivery and business practices.
For more information and to register, visit www.westernleadershipacademy.com.
The Centers for Medicare and Medicaid Services (CMS) announced that it is now accepting hardship exceptions from the meaningful use requirements of the electronic health record (EHR) incentive payment program for the 2016 reporting year. Physicians who can show that demonstrating meaningful use would result in a significant hardship can apply for a one-year exception and avoid a negative payment adjustment in 2018. The deadline to apply is July 1, 2017.
To be considered for an exemption (to avoid a payment adjustment), you must complete a hardship exception application and provide proof of the hardship. If approved, the hardship exemption is valid for one payment year. You would need to submit a new application for subsequent years.
Physicians who have never before successfully attested to meaningful use under the EHR incentive program and are transitioning in 2017 to the new Merit-Based Incentive Payment System (MIPS) may also apply for a one-time hardship exception to avoid a 2018 payment adjustment.
The exception deadline for physicians transitioning to MIPS is October 1, 2017.
For more information and applications, click here.
On March 17, 2017, the 50 physician members of the California Medical Association (CMA) Council on Legislation (COL), chaired by Valencia Walker, M.D., met to discuss and recommend positions on legislation that would impact physicians and the practice of medicine in California.
In the weeks leading up to COL, after the deadline for bill introductions, a list of relevant bills was circulated to COL members with recommended positions from CMA staff. Any questions, points of clarification, need for additional information or suggested changes in bill positions are brought to the floor of COL, where a robust discussion takes place.
"The dedication and commitment displayed by so many who take time away from their practices to participate in shaping the future of health and medicine in California is humbling and inspiring," Dr. Walker said. "The Council on Legislation meeting is a great opportunity to witness passionate and smart dialogue about issues affecting every family and every individual in California. As we work together to formulate CMA's stance on state legislation, the breadth of expertise demonstrated by our physicians and staff exemplifies the best of democracy in action."
All of the recommended positions taken by COL will be presented to the CMA Board of Trustees for finalization on April 18. These then become CMA’s official positions throughout the current legislative cycle.
The California Medical Association (CMA) has released its 2017 Model Medical Staff Bylaws. These bylaws are the definitive guide for medical staffs, providing details on professional and legal structures to support effective medical staff operations and self-governance.
The model bylaws are fully annotated to provide background information on critical provisions, including explanations of relevant state and federal laws, hospital accreditation standards, and other explanatory information.
The 2017 Model Medical Staff Bylaws are available free to any medical staff with an active membership in CMA’s Organized Medical Staff Section (OMSS). If your medical staff is not already an OMSS member, you can join by completing and submitting the OMSS membership application at www.cmanet.org/omss.
The model bylaws are also available to non-OMSS members for a fee. For more information, visit CMA's online resource library.
Contact: CMA member help center, (800) 786-4262 or email@example.com.
The California Department of Public Health (CDPH) has awarded 12 grants to local community organizations to fund opioid safety activities. Among the recipients were three of the California Medical Association's component medical societies—Alameda-Contra Costa Medical Association's Community Health Foundation, San Diego County Medical Society and Sierra Sacramento Valley Medical Society.
These grants are part of the state’s multi-agency effort to prevent deaths and injuries caused by opioid misuse. These awardees will be implementing comprehensive local opioid safety coalition activities beginning June 2017 through February 2019. These coalitions will focus on several core program elements:
- Safe opioid prescribing and naloxone co-prescribing
- Communications and media messaging
- Health care policy development and adoption
- Increased access to medication assisted treatment
- Safe disposal and storage of prescription medication
- Data analysis and reporting
The issue of opioid-related misuse, abuse and overdose continues to be a major policy issue at the federal, state and local level. According to the Centers for Disease Control and Prevention, there has been a documented increase over the last decade in opioid overdoses. From 2000 to 2014, nearly half a million people in the United States died from drug overdoses, with prescription opioids and heroin as the main drugs associated with overdose deaths.
These grants will be used to reduce the number of opioid overdose incidents, deaths and unsafe opioid prescriptions in targeted California counties.
A recent study on prediabetes and medical expenditures confirms that preventing the onset of type 2 diabetes can reduce annual health care costs by thousands of dollars per patient and generate large positive returns on investment (ROI) for health systems, insurers and employers.
Researchers in the study, published in Population Health Management, used individual-level claims data from more than 8,000 commercially insured adults to estimate medical expenditures among individuals with prediabetes. Data on expenditures were combined with findings from previous studies to estimate net savings and ROI if they were to participate in a Centers for Disease Control and Prevention (CDC)-recognized diabetes prevention program (DPP).
Based on an analysis of the data, researchers found that:
- Patients who develop diabetes are very costly. Expenditures during the one-to-three-year period following HbA1c screening are one-third higher for those who develop diabetes. That amounts to an annual average of $2,671 per patient.
- Preventing diabetes is more than a vital public health solution—it’s an effective financial strategy. Because the annual cost differential for patients who develop diabetes is significant, “The three-year ROI for a National DPP is estimated to be as high as 42 percent,” wrote the study’s authors, Tamkeen Khan, Ph.D.; Stavros Tsipas; and Gregory Wozniak, Ph.D., all of the American Medical Association (AMA).
- Diabetes prevention programs are still one of the best solutions for improving health outcomes and reducing burdensome medical expenditures. In fact, patient participation in a CDC-recognized DPP in a community-based or primary care setting costs between $400 and $500 per person—far less than the average annual medical care expenditure savings. Not to mention previous research confirms that the impact of these programs extends beyond dollar signs: People who complete DPPs are one-third less likely to develop type 2 diabetes after 10 years.
Using results from this analysis and findings in previous studies, the study authors estimated just 14 percent of patients who complete a DPP will be diagnosed with diabetes within three years, compared with 29 percent of those who do not participate.
DPPs in California: The California Medical Association's plan to prevent diabetes
These recent findings underscore precisely why AMA and the California Medical Association (CMA) have partnered to advance patient participation in DPPs throughout our state and galvanize support for community-based interventions.
More than 86 million Americans are living with prediabetes, but most of them are unaware. In California alone, an estimated 13 million adults have the condition, putting them at high risk of developing type 2 diabetes without intervention.
"The diabetes epidemic is out of control and getting worse. In California, diabetes rates have increased by 35 percent since 2001," says CMA President Ruth Haskins, M.D. "In partnership with AMA, we are working hands-on with California's physicians to implement meaningful diabetes prevention efforts to improve the health of Californian's and ultimately improve the health of people across the country.”
The partnership is part of Prevent Diabetes STAT, a strategic effort launched by AMA in collaboration with the CDC in 2015 to engage more Americans with prediabetes and slow the progression of type 2 diabetes.
Calculate DPP savings for your patient population
An online tool from AMA helps employers, insurers, health systems and others to calculate net savings and ROI for their sample populations. Play with this calculator to see how upping the share of your patients who enroll in a DPP can have a sizeable effect on the number who develop diabetes and how much money can be saved through prevention.
To learn more about CDC-recognized Diabetes Prevention Programs, plan to attend CMA's April 26 webinar, "Aligning Clinical Practice with Diabetes Prevention: Screen, Test and Refer," available free to everyone.
For more diabetes prevention resources from AMA and CMA, visit www.cmanet.org/diabetesprevention.
On Friday, thousands of medical school students and graduates in the United States and around the world learned the specialty and location of the residency programs where they will train for the next three to seven years. According to the National Resident Matching Program, the 2017 Match Day for graduating medical students was the largest on record, exceeding the more than 42,000 applicants who registered for the 2016 Match.
Despite the high numbers of candidates matching with residency programs this year, inadequate funding for residency programs in California also meant that hundreds of graduating medical students didn’t find a residency slot to continue their training here in the golden state – forcing talented young doctors who want to stay and practice in California to other states and communities.
In 2016, the California legislature passed a budget that included historic support for and expansion of primary care graduate medical education (GME) in medically underserved areas, committing to invest $100 million over three years ($33 million each year) in health care workforce funding. Unfortunately, Governor Jerry Brown is proposing to eliminate the first year of that funding in his 2017-2018 state budget, and has discontinued any additional funding in the future for this purpose. The California Medical Association (CMA) believes these proposed cuts are short-sighted and reckless, and would exacerbate our state's already serious access to care problems.
"Californians born here and educated here – even at UC medical schools – may end up matching in far-away cities, away from the communities they’ve grown up around and trained to care for, and some may not end up matching at all," says Nuriel Moghavem, a fourth-year medical student at Stanford University School of Medicine and a CMA trustee. Moghavem was one of the lucky ones who #MatchedinCA. "We’re effectively exporting medical students. It’s a problem that California can fix, but Governor Brown’s budget proposal for 2017, unfortunately, takes us a step backward instead."
CMA will be working through the state budget negotiation process to restore this critical funding. We are also urging physicians, residents and medical students to ask their legislators to oppose Governor Brown’s budget proposal to eliminate physician workforce funding.
The 2017 Match results also come at a time when the survival of a program that is vital to building the primary care physician workforce is at stake. Authorization and funding for the program — the Teaching Health Center Graduate Medical Education Program—expires Sept. 30.
Established by the Affordable Care Act to build the primary care physician workforce, the teaching health center program provides graduate medical education funds directly to community-based residency programs. Since their launch, teaching health centers have drawn strong student interest. In the 2014-2015 academic year, the programs received more than 100 applications for each available residency position.
CMA has called on Congress to make the Teaching Health Center Graduate Medical Education Program a permanent program that is supported through Centers for Medicare & Medicaid Services graduate medical education funding.
Medical students: Were you #MatchedinCA?
Now that you've discovered where you’ll spend the first few years of your career, CMA wants to hear from you. In our incredibly diverse state, we know our future doctors have amazing stories to tell. Whatever your specialty and wherever you ended up, we’d love to hear about it! Go ahead and take a breather first, then email us at firstname.lastname@example.org if you'd like to be featured on our website.
And for the lucky students who end up with California residencies, we’d love to see a Tweet or Facebook post with a photo or video, using the hashtag #MatchedinCA.
Group Health Insurance: No matter what changes occur with federal health reform, the California Medical Association (CMA), working with Mercer, can offer you best-in-class group health insurance products and services and make your ride through these turbulent times as smooth as possible.
The best news is that you don’t have to change the plan(s) that you are currently involved with for your small group health plan. If you have Kaiser, Anthem Blue Cross, Blue Shield of California, United Healthcare, Aetna or California Choice (the private health care exchange), you can assign Mercer as your broker of record, keep your plan and support CMA at the same time!
If you would like to consider other options, Mercer can prepare a report for you that illustrates all of the available plans in your area and work with your group in moving to another plan, if it makes sense for you.
All we need is your policy number, insurance company name and name of your business to prepare a signature ready broker of record letter for submission to your current insurance company appointing Mercer as your broker of record.
For more information on the CMA sponsored health insurance programs right now, contact Mercer at (800) 842-3761 or CMACounty.Insurance.email@example.com.
Programs Administered by Mercer Health & Benefits Insurance Services LLC • CA Insurance License #0G39709 • 79013 (3/17) Copyright 2017 Mercer LLC. All rights reserved • 777 South Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • CMACounty.Insurance.firstname.lastname@example.org •