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February 2015
DecisionHealth

 

A Word from the President


Welcome to the February issue of NAMSS Gateway! As always, we continue to provide news and information that may be of interest to you.

We are excitedly awaiting the upcoming NAMSS Regional Education Summit being held March 13-14, 2015, at the Westin Peachtree Plaza in Atlanta, Georgia. This event offers the perfect opportunity to prepare for your future NAMSS certification exam, whether you are taking the Credentialing Specialist (CPCS) Certification exam or the Medical Services Management (CPMSM) Certification. The Regional Education Summit is also great for learning more about credentialing and accreditation standards. I hope you will take advantage of this wonderful learning opportunity! Visit the NAMSS website to learn more and register.

Please enjoy this issue of Gateway!

Linda Waldorf, BS, CPMSM, CPCS
President
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Headlines


News From NAMSS
Register for the NAMSS Regional Education Summit
Upcoming Webinars
Remember to Renew Your Dues for 2015!
Attention State Association Leaders!
The NAMSS Certification Exam Applications Have Moved Online

Industry News
"Emergency Regulation Requiring Health Insurers to Have Sufficient Medical Providers Goes Into Effect Immediately"
"Health Care Staffing Takes Center Stage as Demand for Clinicians Surges"
"Doctors Want Employment, Not Marcus Welby Life"
"Physicians Prevail in Complex Suit Against Hospital Board"
"Foreign Worker Regulations Could Stop U.S. Doctors From Staffing Windsor's New Cardiac Lab"
"Hospital Controller Job Changes Amid Healthcare Industry Shifts"
"Doctors Engulfed in Spine Surgeon Saga"


News From NAMSS


Register for the NAMSS Regional Education Summit

Gain in-depth knowledge and prepare for certification in Atlanta during two-day educational events March 13-14. Register by Friday, February 20 to receive the Early-Bird Rate! As an added bonus, when you register you will also receive a free study guide to enhance your workshop experience. Review for the upcoming certification exams and learn more about the credentialing process with the NAMSS Regional Education Summit.

The NAMSS Regional Education Summit features three interactive workshops that are tailored to your needs:

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Upcoming Webinars

NCQA Credentialing Standards and Update
March 5, 2:00 – 3:30 pm ET
Frank Stelling
Assistant Director of Policy, NCQA
1.5 CE Credits

Join NAMSS for a live webinar focused on the National Committee for Quality Assurance (NCQA) standards. Speaker Frank Stelling will dive into the topics of your choosing and provide real-time insights on the NCQA standards that could affect your facility. NAMSS is looking to tailor this presentation around your needs. Please email education@namss.org with the questions and topics you’d like covered in this webinar and register now by clicking here!
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Remember to Renew Your Dues for 2015!

NAMSS Members – It’s that time of the year again! Renew your NAMSS dues by logging into your account on the NAMSS Website and selecting “Renew your NAMSS Membership.” Maintain your membership in a network of over 5,000 MSPs across the country! If you require a paper renewal invoice to submit a personal or facility check, you can move through the renewal process online and select the “pay by check” option at checkout.
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Attention State Association Leaders!

As we move into the new year, we would like to take this opportunity to remind you to contact the Executive Office with any leadership changes that are slated to take effect in 2015, as well as your local conference dates for 2015. Please refer to this page on the NAMSS website to double check who we have on file as your President and President-Elect. Any and all changes should be sent by email to Andrew Miller at amiller@namss.org.
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The NAMSS Certification Exam Applications Have Moved Online

We’ve gone digital! CPCS and CPMSM exam applications are now available electronically on the NAMSS website. To access the online applications, please visit the appropriate link:

CPCS

CPMSM

Paper applications will be accepted through the spring 2015 testing window only.

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Industry News


Emergency Regulation Requiring Health Insurers to Have Sufficient Medical Providers Goes Into Effect Immediately
California Department of Insurance (02/02/15)

Emergency regulations issued by California Insurance Commissioner Dave Jones establishing stronger requirements for health insurers to create and maintain medical provider networks to provide timely access to medical care were approved by the Office of Administrative Law and went into effect Feb. 2. Jones issued the emergency regulations at his inauguration last month, after pledging to continue his first-term commitment to take action on behalf of consumers in his second term. "When patients need medical care, it is critically important that there are sufficient primary care doctors, specialists, hospitals, and surgical centers in the health insurer's network to provide timely access to medical care," said Jones. "Getting more Californians signed up for health insurance is critically important, but it's not enough just to get people an insurance card, there have to be sufficient numbers of doctors, hospitals, and clinics behind the insurance."
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Health Care Staffing Takes Center Stage as Demand for Clinicians Surges
AMN Healthcare Services News Release (01/29/15)

Demand for health care professionals surged suddenly in the middle of 2014 and shows no sign of abating this year, says Ralph Henderson, president of health care staffing at AMN Healthcare. Henderson told attendees at the Talent Management Alliance's 5th Annual People in Healthcare conference that hospitals and health systems need to get ready for an era of high demand by assessing long-range workforce needs and identifying expert partners to support strategic planning. Demand is rising not only for the most common and familiar specialties, but also for new and emerging roles such as care coordinators, documentation specialists, telehealth-trained physicians, and chief experience officers.
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Doctors Want Employment, Not Marcus Welby Life
Forbes (01/13/14) Japsen, Bruce

Two recently released physician recruitment studies show that very few young doctors are interested in starting their own solo practice anymore, instead preferring to become employees of a larger group, a hospital, or even working for the government. Just 2 percent of residents polled prefer a "solo setting" as their first practice, according to a survey of doctors-in-training in their final year of residency by MerrittHawkins. More and more physicians are finding they can achieve a better work-life balance by working for someone else. Meanwhile, a December survey by competing physician recruiter, The Medicus Firm, found that 36 percent of physicians in practice said they would be "very likely" to at least consider a government practice opportunity. "Of all the government-employed options, working for the VA health system was the most favored choice," noted Medicus Firm President Jim Stone. In addition to a more rounded lifestyle, doctors also cited the need to invest in electronic health record systems and related technology to new payment models as reasons for not going it on their own.
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Physicians Prevail in Complex Suit Against Hospital Board
Healthcare Dive (01/21/15) Zieger, Anne; Williams, Katie Bo

The Minnesota Supreme Court last month ruled that the doctors who sued their hospital's board of directors have the standing to do so, decreeing that medical staff bylaws are "an enforceable contract between members of a medical staff and a hospital."? The three-year-long case, which finally reached the Minnesota Supreme Court in 2014, pitted the Avera Marshall Regional Medical Center's board against the medical staff. At the facility, the medical staff was tasked with physician credentialing, peer review, and quality assurance. To change the medical bylaws, a two-thirds majority vote was required. However, in early 2012, the hospital administration autonomously made changes, which prompted a couple of physicians to file the lawsuit. After being handed defeats in earlier court rulings, the plaintiffs were granted a victory with the state Supreme Court's decision.
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Foreign Worker Regulations Could Stop U.S. Doctors From Staffing Windsor's New Cardiac Lab
Windsor Star (Canada) (01/28/15) Spalding, Derek

Staffing the expanded cardiac catheterization lab in Windsor, Ontario, has been tricky due to Canada's cumbersome foreign worker regulations. It has been six months since Windsor Regional Hospital (WRH) celebrated an C$18-million investment from the provincial government to expand cardiac care. Since then, officials have struggled to lure doctors from the United States in the wake of the federal government introducing stricter regulations to its temporary foreign workers program in 2013. "It was a burdensome and cumbersome process before and the changes just created even more bureaucracy," lamented Jessica Bennett, director of medical affairs at WRH. Construction of the 24-hour cardiac lab is still expected to start later this year.
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Hospital Controller Job Changes Amid Healthcare Industry Shifts
Healthcare Finance News (01/20/15) Ullman, Kurt

The role of hospital comptroller is evolving from just internal and external financial reporting to establishing and integrating new controls as hospitals adopt new payment models and technology. "A controller's function is to take actions controlling expenses for a hospital," says Mark Norrell, a lecturer in health management and policy at Indiana University Bloomington's School of Public and Environmental Affairs. "For the last decade, organizations have cut costs inside the walls of the institution and have cut all there is. Additional savings will come through efficiencies of scale brought about by mergers and acquisitions." Hospitals are adopting enterprise resource planning systems to automate workflow across all finance functions in multiple systems. Tom Feuerstein, vice president of financial reporting and operations at the NYU Langone Medical Center, concludes, "Instead of just taking care of debits and credits, they now need to know how IT systems work in a very intimate way. Their job has become understanding the entire enterprise and how transactions are accumulated and processed."
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Doctors Engulfed in Spine Surgeon Saga
USA Today (01/11/15) Ellis, Jonathan

More than a dozen doctors representing two South Dakota hospitals have been named as defendants in federal lawsuits charging that they acted in bad faith by permitting a spine surgeon to perform surgery at the hospitals. The doctors in question served on the committees that approved surgical privileges at Avera Sacred Heart and Lewis & Clark Specialty Hospital, both in Yankton, S.D. They allegedly extended Dr. Allen Sossan privileges to perform complex spine surgeries, despite knowing that he had a history of performing unnecessary surgeries and other unprofessional conduct. Both Avera Sacred Heart and Lewis & Clark have also been named as defendants. The federal cases are in addition to the more than 30 other lawsuits brought in state court by Sossan's former patients or loved ones of patients who passed away after undergoing surgery. Sossan has settled other cases, including most recently in November. The lawsuits have led to the release of dozens of documents that typically are not public, including memos and board meeting minutes.
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