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September 2014




 

A Word from the President


Thanks for reading the September issue of NAMSS Gateway, providing you the latest and most relevant healthcare news.

You’ll find that patient safety is a strong theme in this issue—and not just in the terms we usually consider in our daily work. For example, one article discusses the dangerous effects of hospitals not using qualified medical interpreters, while another article warns of the threat that hackers pose to patient records. A third piece considers whether the move to ICD-10 could potentially lead to inaccurate patient safety data. As the gatekeepers of patient safety, we should do our best to stay informed of these potential threats, despite the fact that they may be “outside our jurisdiction.”

For those who will be attending the NAMSS Educational Conference being held October 4 – 8, I can’t wait to see you in New Orleans! If you haven’t registered for the event, there’s still plenty of time to do so. And, of course, if you’re looking for a lower-cost educational alternative, I encourage you to register for the Virtual Conference! Visit the NAMSS website for more information.

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

John Pastrano, BBA, CPCS, CPMSM

NAMSS President
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Headlines


News From NAMSS
Webinar Series - A Graduate Series on Advanced Practice Professionals
Virtual Conference
Update to the Certification Examinations and Recertification Information
Medical Staff Bylaws Webinar
The NAMSS Board of Directors Ballot is Coming!

Industry News
"New VA Secretary Says Hiring Spree Is Needed to Meet Patient Demand"
"Streamlined Doc-Licensing Process Offered to States"
"Medicaid Expansion Is a Windfall for Hospitals"
"Aetna Blazes ACO Trail in Arizona, Texas"
"Hospitals Often Ignore Policies on Using Qualified Medical Interpreters"
"Feds Reverse Course, Will Release Hospital Mistake Data"
"Where Have All the Rural Hospitals Gone?"
"Hackers Threaten Health Care Industry’s Patient Records"
"Medicare ACOs Can Learn Lessons from Earlier Demo Project"
"ICD-10 Move Could Lead to Inaccurate Patient Safety Data, Study Finds"


News From NAMSS




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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
Join NAMSS for Part II and Part III of a three-part webinar series exploring the expanding role and use of Advanced Practice Professionals in the ever-evolving health care industry. Purchase the entire series by visiting the NAMSS Store.

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
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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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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.

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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Medical Staff Bylaws Webinar

NYSAMSS, along with their Illinois and Massachusetts affiliates, is sponsoring a free two-part webinar presented by Michael Callahan, partner, from Katten Muchin Rosenman LLP. The sessions are entitled Medical Staff Bylaws-Compliance Gaps and Best Practices. These sessions will provide a review of common Medical Staff Bylaw provisions and identify typical compliance gaps; identify alternative provisions and recommendations to achieve compliance; identify best practices in the areas of pre-application, appointment and reappointment, exclusive contracts, corrective action, and hearings; recommend steps to take to maximize state and federal confidentiality protections for peer review and other patient safety activities; and recommend best practices in avoiding the need for formal corrective action, hearings and Data Bank reports.
Each session will offer 1.5 hours, for a total of 3 hours of NAMSS approved CEU. 

  • Part 1: Wednesday, September 10, 2014 1:00 pm – 2:30 pm CT
  • Part 2: Wednesday, September 17, 2014 1:00 pm – 2:30 pm CT

    Questions? Email Fiona Carlon at fiona.carlon@kattenlaw.com or call 312-577-8232
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    The NAMSS Board of Directors Ballot is Coming!

    The NAMSS Board of Directors ballot opens on October 13, 2014. NAMSS members will be electing a secretary-treasurer and directors-at-large. Be on the lookout for the ballot in your email!
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    Industry News


    New VA Secretary Says Hiring Spree Is Needed to Meet Patient Demand
    New York Times (09/08/14) Oppel Jr., Richard A.

    The U.S. Department of Veterans Affairs (VA) must hire tens of thousands of new doctors, nurses, and clinicians to serve its patients but has had trouble recruiting and retaining talent, according to VA Secretary Robert A. McDonald. The department had nearly 36,000 clinical provider vacancies in July and almost 46,000 vacancies across the entire veterans' health care system, a 15.5 percent vacancy rate. The precise number of clinician slots the agency already has the money to fill is not clear. In some parts of the country, the shortage of doctors and nurses has been acute, and the Department will have to compete in a tough job market to recruit talent. In Phoenix, for instance, where a waiting-list scandal at a VA medical center exploded into a national controversy, whistle-blower Dr. Sam Foote has attributed long wait times to a doctor shortage.
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    Streamlined Doc-Licensing Process Offered to States
    Modern Healthcare (09/05/14) Robeznieks, Andis

    The Federation of State Medical Boards has released model legislation that could be used to create a multistate agreement or "compact" system, under which doctors who are licensed in one state could use a streamlined process to be quickly licensed in another state. The move could facilitate the growth of telemedicine and speed increased healthcare access to residents in rural areas. The Wyoming State Board of Medicine spearheaded the effort. The legislation calls for at least seven states to participate in the compact and assign representatives to a governing commission. Once enough states have joined the effort, those participating would share credential and disciplinary information on physicians licensed by their states with other states to facilitate the speedy issue of licenses. The American Medical Association (AMA) has released a statement supporting the effort, with AMA President Robert Wah noting that the compact model "aligns with our efforts to modernize state medical licensure."
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    Medicaid Expansion Is a Windfall for Hospitals
    Bloomberg BusinessWeek (09/04/14) Tozzi, John

    A new report from PricewaterhouseCoopers Health Research Institute shows that for-profit hospitals have seen improvement in their financial returns as a result of Medicaid expansion, increasing the number of paying customers. The report shows better-than-expected financial returns during the first half of 2014. Researchers point out that one hospital chain, LifePoint Hospitals, posted a 30 percent decrease in self-pay patients whose care typically is written off as a loss. Tenet Healthcare, Community Health Systems, HCA, and Universal Health Services also received boosts to their bottom lines in states that expanded Medicaid. According to the PwC study, "Medicaid admissions in expansion states increased by a range of 10.4 percent to 32 percent across the country's three largest health systems since the start of the year." Meanwhile, uninsured admissions were down 47 percent.
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    Aetna Blazes ACO Trail in Arizona, Texas
    HealthLeaders Media (09/09/14) Cheney, Christopher

    Aetna has sealed an accountable care collaboration deal with Baylor, Scott and White Quality Alliance in North Texas. The collaboration will give Aetna Whole Health plan members access to more than 900 primary care physicians, 27 hospitals, 2,800 specialists, and six urgent care facilities in the Dallas/Forth Worth area. The partnership will be effective for self-insured customers beginning Oct. 1 and be marketed for fully-insured customers early next year. An Aetna spokesperson says the collaboration's main objectives are to achieve measurable advancements in patient care and satisfaction while controlling costs for its customers and members. Separately, Aetna and Banner Health Network recently reported a $5 million gain-sharing bounty last year from their Accountable Care Organization (or ACO) collaboration in Arizona.
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    Hospitals Often Ignore Policies on Using Qualified Medical Interpreters
    Modern Healthcare (08/30/14) Rice, Sabriya

    The Agency for Healthcare Research and Quality reports that language barriers put almost 9 percent of the nation's population at risk of an adverse health-related event. There are concerns that as the United States becomes more linguistically and culturally diverse, healthcare providers are relying too much on patients' family members and other nonprofessionals to discuss treatment plans with non-English-speakers rather than having professional interpreter and translator services available. Safety experts say most healthcare organizations caution against relying on relatives or clinical staffers who have not been certified as medical interpreters. But time pressures, a lack of knowledge about the availability of professional interpreters, and problems in arranging for interpreters often prompt hospital staff to overlook these policies. Researchers say it remains difficult to assess language-related errors, as patients with limited English proficiency are less likely to report such miscues. They say hospitals need to more closely track these patients and any errors associated with them, as well as better educate staff about the availability of professional interpreter services. Errors also could be reduced through standardized training and certification for medical interpreters.
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    Feds Reverse Course, Will Release Hospital Mistake Data
    USA Today (09/07/14) O'Donnell, Jayne

    The U.S. Centers for Medicare and Medicaid Services (CMS) will again make data on eight hospital-acquired conditions available on its website later this year. CMS stopped publicly reporting the information last month after denying in 2013 that it would do so. The data was still available to quality researchers, patient safety advocates, and consumers on a public spreadsheet. The move comes amid growing calls for increased transparency for hospitals. "I commend CMS for their commitment to transparency," The Leapfrog Group CEO Leah Binder stated earlier this past week. "This is good news for the public."
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    Where Have All the Rural Hospitals Gone?
    Fiscal Times (09/08/14) Respaut, Robin

    The number of hospitals in small, rural communities around the country are decreasing. Population declines in these areas come as the Affordable Care Act is putting pressure on hospitals in these settings to treat and release patients sooner. Meanwhile, some say more rural hospitals should be closed and replaced with clinics or modern ambulances, but that could be risky. Standard & Poor's says declines in the number of patients have put non-profit hospitals in dire financial straits. This all comes as Fitch Ratings reports that the Affordable Care Act is pushing patients out of hospitals and to clinics. Finally, recent data shows that the majority of the hospitals that have already closed were in states that had not expanded Medicare.
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    Hackers Threaten Health Care Industry’s Patient Records
    Boston Globe (09/06/14) Meyers, Jessica

    The latest great identity theft threat could come from a patients' doctor's offices or local hospitals. Criminals are stealing patient records to fake insurance claims, obtain prescription medication, or sell Social Security Numbers. The recent hack of 4.5 million patients' information from a Tennessee-based hospital network and the disclosure by federal officials that malicious software was installed on HealthCare.gov reveal the growing market for patient data, along with significant cybersecurity gaps within the health care industry. The FBI estimates that one health record sells for approximately $50 on the black market, much more than the few bucks needed to buy a credit card number. According to a report by Ponemon Institute, criminal intrusions in health care systems have increased nearly 100 percent over the past four years. Analysts at Ponemon and elsewhere warn that threats could get worse with the Affordable Care Act's online health insurance exchanges and the rise of digitalized records.
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    Medicare ACOs Can Learn Lessons from Earlier Demo Project
    Modern Healthcare (08/26/14) Evans, Melanie

    A new report that discusses the results of efforts to reign in costs and improve healthcare quality under the Medicare Physician Group Practice Demonstration could be used by the Centers for Medicare and Medicaid Services (CMS) to modify the accountable care program. The report found that the Medicare Physician Group Practice Demonstration was largely successful at driving down Medicare spending. The 10 participating medical groups reduced Medicare spending by 2 percent per person a year during the five-year demonstration. Medical groups took a two-pronged approach to reducing spending: one, focusing on hospitals, which are the most expensive places to treat patients; and, two, patients with complex conditions -- those who are chronically ill and those who are vulnerable to illness -- who are the most expensive to treat. The report further noted that the quality of care provided to patients improved overall, even at providers that saved the most money under the demonstration. One observer says these and other findings show that changes to the affordable care program could allow cost-saving strategies used by those who participated in the demonstration to flourish.
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    ICD-10 Move Could Lead to Inaccurate Patient Safety Data, Study Finds
    iHealth Beat (09/08/14)

    According to a study published in the Journal of the American Medical Informatics Association, transitioning to ICD-10 coding could negatively affect patient safety reporting and perceptions of hospital quality because of inaccurate comparisons between the new codes and those used under the ICD-9 system. U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. But the switch means that health care providers and insurers will have to swap out approximately 14,000 codes for 69,000 codes. Providers and payers are required to complete the transition by Oct. 1, 2015. According to the study, the transition between the systems could inadvertently increase the number of patient safety indicators (PSIs) and could increase the risks of under-reported safety incidents, unwarranted inflation of PSIs due to ICD-10's more specified codes, and increased variability of calculations.
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