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August 2015

 

A Word from the President


Welcome to the August issue of NAMSS Gateway!

I am excited to announce that the NAMSS Board of Directors Elections will open in early September. The NAMSS Board of Directors leads and advises NAMSS initiatives such as the annual conference, education programs, and NAMSS PASS. The NAMSS membership looks to the Board as leaders in the field that can leverage their expertise to improve NAMSS programs in 2016 and future years. Nominations will be announced on September 9 and voting will be available until September 23.

All NAMSS member votes count towards the election, so please submit your ballot on or before September 23!

We have received highly qualified candidates for 2016 positions and look forward to our 2016 Board!

Linda Waldorf, BS, CPMSM, CPCS
NAMSS President
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Headlines


News From NAMSS
Register Now for the NAMSS 39th Educational Conference and Exhibition
The Recertification Application Has Moved Online!
Upcoming Webinars
NAMSS Joins IAMRA
AHLA Discounted Membership
Social Corner
Monthly Discount

Industry News
"Doctors Leaving Private Practice in Droves, Joining Hospitals, Report Says"
"Hospital Hiring of Physicians Drops Off for First Time in Years"
"3 Concerns to Address When Hiring Doctors to Work for Your Hospital"
"EKGs, X-rays and Heart Procedures--the Role of Non-Physicians Grows"
"ACOs Appear Unable to Incentivize Physicians to Limit Costs"
"Report Ranks Largest US Healthcare Staffing Firms"
"'Surgeon Scorecard' Measures Docs by Complications"
"5 Local Lawsuits Allege Surgeon Malpractice Cases"


News From NAMSS


Register Now for the NAMSS 39th Educational Conference and Exhibition



Join NAMSS from October 3-7 in Seattle, WA for the NAMSS 39th Educational Conference and Exhibition. The Educational Conference includes five days of networking and dedicated education sessions geared toward helping you grow as a leader in the industry. Register now and don't miss out on this educational opportunity!
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The Recertification Application Has Moved Online!

We've gone digital! All certificants due for recertification in 2015 are now able to submit recertification applications online! The application is now available at www.namss.org/recertification. Paper applications will no longer be accepted.

A full listing of those due for recertification in 2015 as well as 2015 Recertification Policies and Guidelines can be found at www.namss.org/recertification. All 2015 recertification applications must be submitted by December 1st, 2015.
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Upcoming Webinars

Attend a NAMSS PASS Training Webinar!
“Patient Safety: The Critical Role of NAMSS PASS”


The next webinar will be held on: Thursday, August 20 - 1:00 - 2:00 PM EDT

This is a new webinar focusing on Patient Safety and how NAMSS PASS is the critical solution to one of the on-going challenges we face as MSPs. When practitioners do not fully disclose their work history, MSPs are not able to verify what they don't know and places their patients and facilities at risk. This important webinar covers the critical role of how NAMSS PASS addresses this issue. This webinar is free and you will receive one CE credit for attendance.

Click here to register now and to view all upcoming webinar dates!

Allied Health Practitioners: The Next Frontier in Credentialing
August 25, 2015 from 2:00 – 3:00 pm ET
This webinar has been approved for 1.0 CE
Presented by Terra Purdy, MS

This presentation will explore the numerous types of Allies Health Practitioners and ways to credential them while meeting state and federal standards. It will examine the essential elements for initial credentialing of these unique providers and criteria for reappointment. By the end of the presentation, the audience will be equipped with a solid framework for credentialing Allied Health Practitioners.

Register Now!

Surviving a Survey
September 9, 2015 from 2:00 – 3:00 pm ET
This webinar has been approved for 1.0 CE
Presented by Pati Hildebrand, RN, MSN, CPHQ, CCS-P, FACHE, CPHRM, LSSBB, HACP

An announcement that CMS surveyors have arrived on site can strike fear into the hearts of the unprepared. This session will discuss specific Conditions of Participation (CoP) requirements that typically fall to Medical Staff Services (MSS) personnel, and will highlight additional requirements and activities that MSS personnel can do that will demonstrate excellence and a systems approach to surveyors.

Register Now!

An Advanced Look at the NPDB Guidebook
September 17, 2015 from 2:00 – 3:30 pm ET
This webinar has been approved for 1.5 CEs
Presented by Michael Callahan and Carol Cairns, CPCS, CPMSM

On April 6, 2015, the National Practitioner Data Bank issued its long awaited update to its Guidebook. The draft Guidebook was finalized after receiving numerous comments from many organizations including NAMSS, the AHA and the AMA. Since that time, NPDB representatives have sponsored two webinar programs, one for NAMSS and one for the American Health Lawyers Association, to address follow up questions and some concerns particularly with respect to a healthcare entity’s reporting requirements.

The purpose of this program is to focus on the key provisions of the Guidebook which address a providers’ query and reporting obligations. In addition to providing an overview of the final Guidebook, registrants will be able to answer the following standards and questions:

1. When is an “investigation” triggered according to the Guidebook which views this term “expansively.”
2. When does the imposition of a proctoring requirement become reportable?
3. If a physician is not aware that he is under an investigation but resigns, is this a reportable event?
4. Do I have to query the Data Bank for honorary and emeritus staff members even if they do not have clinical privileges?
5. Can a multi-hospital system share physician Data Bank reports who are on more than one medical staff?
6. How can the Bylaws be drafted to clarify when an investigation is and is not triggered consistent with Guidebook standards?

In addition to addressing these questions, registrants will obtain practical guidance on how to revise your Bylaws and policies, if necessary, to reflect Guidebook standards.

Register Now!
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NAMSS Joins IAMRA

NAMSS is excited to announce that it has recently joined the International Association of Medical Regulatory Authorities (IAMRA) as a Partner Member. The NAMSS Board of Directors has prioritized the building of relationships with like-minded industry organizations, and strongly believes that gaining access to the abundant resources through annual membership to this organization will benefit NAMSS and its members. Developed in 1994 by the FSMB as a series of bi-annual meetings for medical regulatory authorities, IAMRA was officially founded in September 2000 as a result of the participants' eagerness to foster international relationships among groups. IAMRA is challenged with creating a relevant, effective medical regulatory system that can address the dynamics of global and rapidly changing medical practice environments, technologies and health care delivery systems. IAMRA strongly believes that international cooperation is the key to enhancing the role of medical regulatory authorities as the primary vehicle for public protection in health care.

To learn more about IAMRA, visit www.iamra.com.
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AHLA Discounted Membership

NAMSS encourages you to take advantage of a joint membership initiative that enables NAMSS members to join AHLA at a heavy discount. AHLA's network of nearly 13,000 members, who practice in law firms, government, in-house settings, and academia, welcome NAMSS members to become a part of AHLA's Medical Staff, Credentialing, and Peer Review Practice Group. It's a win/win for AHLA members and a win/win for NAMSS members. As legal developments are on the rise, MSPs must keep up with regulatory compliance, legal liability, and lawsuits. When you become a member of AHLA, you will benefit by having access to up-to-date relevant healthcare law information that will help you implement efficient strategies to limit liability in your organization.

Visit the NAMSS website to read more about the benefits you'll receive by joining AHLA and to download the application. Discounted AHLA membership is only $110 for NAMSS members!
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Social Corner

Have you tried LinkedIn? It's a great resource to meet other MSPs and discover new opportunities available in the healthcare industry. Use the site to find a new job, connect with other professionals, or to gain valuable industry news by following leading organizations and companies in the field. Follow NAMSS on LinkedIn for association and industry news!


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Monthly Discount

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Industry News


Doctors Leaving Private Practice in Droves, Joining Hospitals, Report Says
Healthcare Finance News (08/03/15) Morse, Susan

According to a new Accenture report, mounting financial pressures are causing a growing number of U.S. doctors to leave private practice for hospital employment. Only 33 percent of physicians will remain independent by the end of next year, Accenture forecasts. That's down from 57 percent in 2000. In making the move to hospitals, 36 percent of physicians said reimbursement pressures was the primary reason, while 23 percent cited overhead costs. Meanwhile, 26 percent of the 194 independent doctors polled are choosing to opt out of Medicaid. Another 15 percent are forsaking health exchange plans and 3 percent are opting out of Medicare. The study further found that a growing number of independent physicians are experimenting with different staffing models -- 22 percent are reducing support personnel and 21 percent had extended office hours. Finally, independent physicians are creating new business models to stay competitive. According to the research, 17 percent of those polled are taking part in accountable care organizations and 7 percent are aligning to patient-centered medical home models. This was Accenture's third analysis of the U.S. market for independent physicians.
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Hospital Hiring of Physicians Drops Off for First Time in Years
Healthcare Dive (07/21/15) Henry, Julie

A new Merritt Hawkins study shows a drop-off in hospitals' hiring of physicians. Between April 2014 and the end of this year's first quarter, the physician recruitment firm reports that 51 percent of the 3,120 searches for physicians, nurse practitioners, and physician assistants were on behalf of hospitals and hospital-owned practices -- a decrease from the 64 percent of doctor searches by hospitals the previous two years. This marks the first drop researchers have seen since 2003-04, when hospitals accounted for just 11 percent of physician searches. The high rate of hospital closures is one possible reason for the drop, especially in rural areas. Other potential contributors range from budget sequestration and reductions in federal disproportionate share payments to states opting not to expand Medicaid and other healthcare organizations stepping up their physician recruitment efforts. Travis Singleton, senior vice president of Merritt Hawkins, does not believe this is the beginning of a trend. He concluded, "I won't be surprised if [hospital demand for physicians] goes back up" thanks to the Supreme Court's recent decision to uphold the federal premium subsidies under the Affordable Care Act.
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3 Concerns to Address When Hiring Doctors to Work for Your Hospital
Fierce Healthcare (07/28/2015) Finnegan, Joanne

A growing number of physicians are indeed trading the autonomy of private practice for the security of working in hospital-employed medical groups.  This has made physician employment one more major challenge for hospitals, states Navigant Healthcare's Dr. Paul Keckley, managing director in the company's healthcare practice.  He calculates that three in four medical residents will begin their career as employees of a medical group, hospital, or faculty plan.  Navigant surveyed administrators of 44 hospital-sponsored group practices what concerns them the most.  These listed three top concerns, which they said hospitals can do a better job managing. The first is operations.  The administrators say they are concerned about how to operate the group practice efficiently as payments shift from volume to value and the costs for information technology and labor increase.  Second, there is the matter of compensation.  One of the top concerns remains how to adequately compensate doctors in light of the change from production to performance.  Finally, administrators worry about how they will recruit new physicians to join the group and sustain growth.
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EKGs, X-rays and Heart Procedures--the Role of Non-Physicians Grows
USA Today (07/27/15) Ungar, Laura; Hoyer, Meghan

A USA Today analysis of federal data finds that nurse practitioners (NPs) and physician assistants (PAs) are a rapidly growing part of the medical marketplace, getting paid more often for procedures people generally associate with doctors such as electrocardiograms and pelvic exams. Some are even helping with heart bypasses.  Medicare billing records show 15 percent more nurse practitioners and 11 percent more physician assistants received payments in 2013 than the year prior for all types of care. Analysts say this trend reflects the rising influence of non-physician caregivers in a changing health care system marked by doctor shortages and now taxed more by a growing number of patients gaining insurance via Obamacare. The USA Today study further found that NPs are increasingly providing psychotherapy for Medicare patients and their families. Indeed, over 1,000 NPs billed for a total of nearly 200,000 psychotherapy visits during 2013. "We have many more psychiatrists not taking insurance," says Elizabeth Visone, a nurse practitioner in Connecticut who adds that NPs tend to provide mental health care to "the underserved, the disabled, and the elderly."
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ACOs Appear Unable to Incentivize Physicians to Limit Costs
Medscape (07/31/15) Pullen, Lara C.

Practices in affordable care organizations (ACOs) provide a slightly higher compensation for quality compared to practices in general. However, both ACO and non-ACO practices are similar in compensation based productivity and salary, indicating the incentives for ACOs may not be significant enough to encourage practices to change physician compensation policies. An analysis of ACOs published in the Annals of Family Medicine examined whether practices in ACOs use compensation policies that are different from non-ACO practices that assume substantial risk for primary care costs. The researchers found compensation for primary care physicians varied significantly across study practices. Physicians in both ACO and non-ACO practices without substantial risk for costs tend to receive 50 percent of their compensation from salary, less than half from productivity, and about 5 percent from quality and other factors.  In comparison, physicians not in ACOs with substantial risk for primary care cost received approximately 66 percent of their compensation from salary, nearly 33 percent from productivity and about 1 percent from quality and other factors.
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Report Ranks Largest US Healthcare Staffing Firms
Staffing Industry Analysts (08/05/15)

Staffing Industry Analysts' 2015 report on the largest healthcare staffing firms shows that AMN Healthcare Services Inc. ranks as the biggest in the United States. CHG Healthcare placed second, followed by Cross Country Healthcare. The study went on to provide rankings of the largest firms in four healthcare sub-segments: travel nurse, per diem nurse, locum tenens, and allied healthcare. By sub-segment, AMN Healthcare was also No. 1 as the largest travel nurse firm (20 percent market share) and as the largest allied healthcare staffing firm (5 percent). For its part, CHG Healthcare was the largest locum tenens firm in the U.S. (31 percent market share). Finally, Maxim Healthcare Services held the distinction of being the largest per diem nursing firm with 10 percent market share. This year's edition ranked 21 travel nurse firms that generated a total of $2.1 billion; a dozen per diem nurse staffing firms that generated $1.0 billion; 10 locum tenens firms that generated $1.9 billion; and, finally, 21 allied healthcare staffing firms that together generated $1.5 billion.
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'Surgeon Scorecard' Measures Docs by Complications
USA Today (07/14/15) Penzenstadler, Nick

A new calculation called the "Adjusted Complication Rate" is now being used to score surgeons against their peers. The statistic, developed by non-profit news outlet ProPublica, analyzes nearly 17,000 doctors performing low-risk, common elective procedures. It is causing debate among the surgical community because it could have long-ranging effects on surgeons across the country. If a surgeon appears on the list with a higher-than-average complication rate, it could impact payments and reputation. A preliminary analysis found that roughly half of the 3,575 hospitals observed had a surgeon performing a procedure at which they are a high risk. Many doctors are skeptical about whether or not the statistic can properly capture the vast array of risks involved with the patient population, and the model could even lead to doctors choosing lower-risk patients to boost their scores. Charles Mick, a spine surgeon in Massachusetts who helped develop the formula, said the statistic shouldn't be viewed as a scorecard. Instead, it should be regarded as a tool to improve care. "I'm hopeful hospitals will look at the data and look for other systems that could work for them," Mick said.
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5 Local Lawsuits Allege Surgeon Malpractice Cases
LoHud.com (NY) (07/31/2015) Robinson, David

The Journal News recently highlighted five cases that it uncovered in its investigations of Lower Hudson Valley (N.Y.) surgeons who had some of the highest complication rates in a database created by ProPublica. Four males and one female claimed their conditions worsened after operations. Eventually, all five sued. One such man was Antonio Autiero, who had four surgeries at Lawrence Hospital Center in Bronxville to treat an abscess over a two-year span. He returned each time for the same operation performed by Dr. Michael Kerin as his condition reportedly worsened. Autiero eventually got a fifth operation performed by another surgeon at Lawrence, and the whole "medical saga" left him with significant scarring and pain. He was unable to return to work. Meanwhile, Martin Watters of Tuckahoe filed a lawsuit against Kerin, Dr. Elizabeth Rocco, and Lawrence Hospital for failing to properly treat an infection. Two other men, Joseph Jennette of Westchester County and William McCormack of Bronxville, sued Kerin claiming they had to have appendectomies after supposedly having the same surgery. Kerin and Lawrence Hospital denied any wrongdoing in court documents that responded to the four lawsuits. As for the woman, Patricia Caulfield of Brewster sued Drs. Deborah Benzil and Marshal Peris and Mount Kisco Medical Group in 2014, claiming her spine was injured during a surgery the prior year. Her lawsuit stated Caulfield "will be prevented from and/or limited in her future employment and activities."
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