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August 2014

 

A Word from the President


Welcome to the August issue of Gateway, where you have direct access to the latest news from across the country.

Summer may be settling down, but the pace of the industry is still rapidly changing. In this issue, you’ll read about how the increasing number of healthcare related jobs has helped the entire U.S. rise out of the Great Recession, you’ll hear about the shift from traditional acute care settings to community care clinics and you’ll learn about a major launch from one of the nation’s largest health care insurers.

Although the early bird deadline for the upcoming conference has passed, I encourage you to register to attend the upcoming NAMSS Educational Conference being held October 4 – 8 in New Orleans, LA. If your facility is short on funding and you are looking for an alternate way to be a part of the event, register to attend virtually! The Virtual Conference offers real-time webcast sessions right to your computer. Visit the NAMSS website for more information.

As always, I hope you enjoy this month’s issue. Continue reading on for the latest industry news.

John Pastrano, BBA, CPCS, CPMSM
NAMSS President
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Headlines


News From NAMSS
Virtual Conference
Webinar Series - A Graduate Series on Advanced Practice Professionals
Update to the Certification Examinations and Recertification Information
AMA-OMSS Interim Meeting: Save the Date

Industry News
"Doctors Upset Over Skill Reviews"
"New NCQA Program Would Mesh Ambulatory Clinics, Medical Homes"
"Ambulatory Care Adds Jobs, Offsetting Hospital Hiring Losses"
"New Patient Physician Visits Slump in Spite of ACA Expansion; Medicaid Increases"
"Shocker: How SUNY Lost More Than $100M Mismanaging LICH"
"Docs Slam Recertification Rules They Call a Waste of Time"
"Scaling Down the Hospital"
"Increasing Health Care Jobs Helped Economy Rebound, but Growth Beginning to Slow"
"University Hospitals, Aetna Form Accountable Care Organization (ACO) in Cleveland"
"Study: EHRs Key to Improving Medication Reconciliation Processes"


News From NAMSS




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Virtual Conference

Can’t join us in New Orleans? Register for the Virtual Education Conference
Register today for the NAMSS Virtual Conference and let NAMSS bring the 38th Educational Conference directly to you. Broadcast live from New Orleans, the Virtual Conference offers 8 sessions providing up to 12 CE credits. Set up virtual access for your entire team and engage in this live online opportunity. Take advantage of this low-cost training approach that offers you and your staff the right level of training.
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Webinar Series - A Graduate Series on Advanced Practice Professionals

A Graduate Series on Advanced Practice Professionals: A Comprehensive Review of the Role and Use of Nurse Practitioners, Nurse Anesthetists, Midwives, Clinical Nurse Specialists, and Physician Assistants

This three-part monthly webinar series covers a broad range of issues affecting the expanding role and use of non-physician practitioners in the ever-evolving health care industry. Regardless of the traditional labels for non-physicians, this series addresses the most pressing and up-to-date aspects of Advanced Practice Professionals (commonly known as NPs, CRNAs, Midwives, and PAs). Specifically, participants will learn licensure and scope of practice; credentialing, privileging and competency assessment; and billing and reimbursement.

Session Titles:

Licensure and Scope of Practice: Things are Changing
August 26, 2014

The Credentialing, Privileging, and Competency Assessment: Is it Really that Different for Advanced Practice Professionals?
September 29, 2014

Billing and Reimbursement for Advanced Practice Professionals: Opportunities and Pitfalls
October 28, 2014

Visit the NAMSS website for more information about this series.
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Update to the Certification Examinations and Recertification Information

Effective fall 2014, all CPCS and CPMSM examinations administered will contain multiple choice questions with three possible answer options, a decrease from the present format of four. For more information regarding the 2014 CPCS and CPMSM examination content outlines, please visit our Candidate Handbook.

2014 Fall Testing Window:
Application Deadline: Friday, August 15
Testing Period: Saturday, October 11 – Saturday, November 1

All candidates due to recertify in 2014 must submit their recertification application by December 1, 2014. For more information, view the NAMSS Recertification page and/or the 2014 Recertification Policies & Guidelines.

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AMA-OMSS Interim Meeting: Save the Date

You and the representatives from your medical staff, group practice or other physician organization are invited to participate in the 2014 American Medical Association Organized Medical Staff Section (OMSS) Interim Meeting and education program. Join the AMA-OMSS from November 6-8, 2014 at the Hilton Anatole in Dallas, TX. Registration opens in September. Mark your calendars and visit the AMA-OMSS website for more information later this summer.
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Industry News


Doctors Upset Over Skill Reviews
Wall Street Journal (07/21/14) Beck, Melinda

The medical community has been locked in a debate regarding what board-certified doctors should be required to do to prove that their knowledge and skills are up-to-date. Besides holding a state medical license, nearly three-quarters of U.S. physicians are certified by two dozen privately run boards, signifying that they have mastered their area of specialty. These boards require their doctors to pass rigorous exams, generally once a decade, to stay certified. In recent years, they have also started requiring doctors to enroll in official Maintenance of Certification (MOC) programs in between exams to show they are committed to lifelong learning. The American Board of Internal Medicine put its new MOC requirements into effect earlier this year. Internists are required to earn points every two, five, and 10 years by completing so-called "modules" on practice assessment and medical knowledge. However, many doctors are deriding the MOC requirements as costly, irrelevant, and time-consuming. They further charge that they are mostly a money-making venture for the specialty boards.
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New NCQA Program Would Mesh Ambulatory Clinics, Medical Homes
Modern Healthcare (07/14/14) Herman, Bob

The National Committee for Quality Assurance (NCQA) last month pitched a new patient-centered medical home program. The target for the new program? Nontraditional ambulatory sites. Patricia Barrett, NCQA's vice president of product development, remarks, "We want to assess whether practice types like ambulatory care, urgent care centers, retail clinics, worksite clinics that aren't medical homes are really doing a good job of connecting patients back with primary care." NCQA's Patient-Centered Connected Care recognition program encompasses a half-dozen broad standards for ambulatory clinics, ranging from referral processes and patient engagement to tracking lab and imaging tests and the use of information technology such as electronic health records and electronic prescribing. The NCQA has come under scrutiny ever since a study was published in the Journal of the American Medical Association that found NCQA-recognized medical homes did not perform much better in quality metrics than did groups without NCQA recognition.
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Ambulatory Care Adds Jobs, Offsetting Hospital Hiring Losses
Crain's Detroit Business (08/04/14)

The latest round of federal employment data shows that strong ambulatory-care hiring offset job losses at hospitals and nursing homes during July, with overall health-care employment largely unchanged at 7,000 new jobs. Ambulatory care added a total of 21,300 jobs last month, growing 0.3 percent. The sector's employment gains were mainly among doctor's offices and home-care providers, which account for over 50 percent of ambulatory care's approximately 6.7 million jobs. The former added 7,500 jobs to bring their total employment to 2.5 million, while the latter added 5,200 jobs to their payrolls. By contrast, hospitals shed 7,100 jobs in July, the second month this year in which payrolls at such facilities contracted. Finally, nursing homes shed 5,200 jobs in July, as total nursing home employment amounted to 1.6 million.
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New Patient Physician Visits Slump in Spite of ACA Expansion; Medicaid Increases
Medical Economics (07/18/14) Verdon, Daniel R.

The Robert Wood Johnson Foundation and the electronic health record manufacturer athenahealth have released a report that describes the effects the Affordable Care Act is having on the number of new patients seeking care at physicians' practices, as well as whether more Medicaid patients are coming in for care. The report found that surgeons and several other categories of doctors saw the number of new patients they treated hold steady or even decline from January through May versus the same period last year. Among surgeons, 40.6 percent of the patients they treated were new patients, which was unchanged from January-May 2013. The report also found that surgeons and several other specialists have seen fewer patients overall from January to May of this year compared to the first five months of last year. Additionally, the report found that surgeons and other specialists who practice in states that expanded Medicaid are seeing two to three times more Medicaid patients compared to their counterparts in states that did not expand the program.
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Shocker: How SUNY Lost More Than $100M Mismanaging LICH
Brooklyn Eagle (08/05/14) Frost, Mary

The State University of New York (SUNY) has repeatedly stated that it had no choice but to shut down Long Island College Hospital (LICH) in Brooklyn and sell the property to a developer because the facility was losing millions of dollars each month. Now, however, a string of public filings, testimony, and documents recently obtained by the Brooklyn Eagle show that SUNY treated thousands of patients at LICH for free for nearly two years. During that time, it lost over $100 million in revenue that it is now scrambling to recover. Over the last two months, former LICH patients throughout Brooklyn have received bills for treatment at LICH that in some cases, go back, more than two years. Documents show that after assuming control of LICH in the spring of 2011, SUNY Downstate's failure at credentialing -- the filing of standard paperwork with insurance firms -- cost LICH at least $106 million, possibly more. Carrying out the credentialing process with insurers is one of the most basic steps to running any medical practice.
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Docs Slam Recertification Rules They Call a Waste of Time
Kaiser Health News (07/21/14) Rabin, Roni Caryn

Specialists warn that time-consuming and expensive new board recertification rules for physicians could force some practitioners out of business, and they could make it difficult to bring physicians to more rural areas. While certification has always been voluntary, and until the 1980s most medical specialties granted certification for life, most of the 24 specialty boards eventually began requiring recertification every seven to 10 years. The standards became even more stringent earlier this year for some specialties with the shift to continuous maintenance of certification activities, and state licensing boards require continuing medical education credits on top of that. Supporters argue that the new process, which requires physicians of all ages to complete a list of requirements every two or three years in order to maintain their certification, helps to ensure that doctors integrate the latest medical knowledge into their practices. Some critics, though, say the process is a waste of time, particularly when the nation faces a shortage of physicians. More than 16,000 physicians have signed an online petition calling on medical specialty boards to eliminate the new rules.
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Scaling Down the Hospital
Healthcare Finance News (07/24/2014) Andrews, John

Real estate experts say Medicare policy is encouraging shorter inpatient hospital stays and increased use of post-acute care, reducing the need for massive facilities. Tim Delgado of Read King Medical Development forecasts that "the future of new health care facility development will feature more retail-based facilities and 'community care clinics' that will house multiple programs, ranging from primary care, urgent and emergency care, physical therapy, imaging centers, outpatient surgery, and other programs that are under one roof with separate treatment areas." One result of the forced migration of patients outside of hospitals is the empowerment of physicians. "The pursuit and employment of physicians and physician groups will continue to grow," Delgado predicts. "This shift to employment means that providers will need to add new facilities in the areas where these physicians practice."
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Increasing Health Care Jobs Helped Economy Rebound, but Growth Beginning to Slow
Birmingham Business Journal (Alabama) (08/01/14) Alexander, Alan

The health care industry has created more jobs in the last six years than the entire United States. According to numbers compiled by Dan Diamond, managing editor of The Daily Briefing, the health care industry has gained 1.45 million jobs since June 2008 compared to the U.S. economy gaining 1.37 million jobs during that same time span. Since February 2010, health care has been responsible for 1 in 9 newly created jobs. Unfortunately, that growth seems to be tapering. Last month, health care added just 7,000 jobs while the United States gained approximately 202,000.
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University Hospitals, Aetna Form Accountable Care Organization (ACO) in Cleveland
Cleveland Plain Dealer (OH) (07/18/14) Zeltner, Brie

University Hospitals (UH) and Aetna, the nation's third-biggest health insurer, in July launched an accountable care organization collaboration (ACO) aimed at coordinating care and cutting costs for participants enrolled in the insurer's health plans. The ACO covers approximately 22,000 Aetna members who presently receive care from UH doctors. This marks UH's sixth ACO in Ohio and Aetna's fifth. ACOs are a cost-saving method of delivering care by a network of hospitals and physicians created by the Affordable Care Act. The primary objective of an ACO is to trim costs with better communication among all the parties involved in a patient's care, as well as by advocating wellness and preventive care. Participants in the Aetna and UH collaborative ACO will not have to switch doctors, notes Nitin Bhargava, president of Aetna's Ohio operations.
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Study: EHRs Key to Improving Medication Reconciliation Processes
iHealth Beat (07/29/14)

According to a National Institute for Health Care Reform study, hospitals can reduce the amount of problems in patient medications at admission and discharge by using electronic health records (EHR). The study involved interviewing hospital executives and clinical EHR users at 19 hospitals and health systems across the country. The interviews revealed: many hospitals have some form of access to external EHRs, but usage was sparse; hospitals with processes that were fully electronic at admission or discharge had implemented EHR medication reconciliation modules; and hospitals with processes that were fully electronic at discharge used their EHR to electronically generate more user-friendly discharge instructions and electronic prescriptions. The researchers recommended engaging doctors, increasing access to accurate medication histories, refining the usability of EHRs, and sharing patient information with future providers.
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