August 7, 2006

Editor's Column: BCBS Is Here To Help Us -- Run For Your Life!
Saving Lives, Saving Dollars Draws Criticism, Raises Questions
Examine Stem Cell Ethics In Traverse City
Group Managers' Conference Explores Political Updates
State Seeks MMGMA Members For Medicaid Focus Groups
MSMS News & Notes

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Editor's Column:
Run For Your Life!

By JOSEPH WEISS, MD

New from BCBS: sending interviewers to our offices to determine how BCBS can help us. Specifically, BCBS wants to know what it can do to so we can become more efficient in seeing patients, improving the quality of our work, raising our standard of practice, and reaching a higher level of performance.

Likely to date, BCBS is disappointed in physicians’ response. What we want from BCBS to heal itself not us. The way BCBS can best help us is to become a better insurance carrier: handle our claims quicker and bring consistency and timeliness to their replies to our inquiries. We want them to refrain from strategies like extending TRUST contracts to administrative agreements and from fighting us in federal court.

We have a better way to improve ourselves: our colleagues and our patients. It is the standards and expectation of our fellow practitioners and our patients that move us. Physicians change, in earnest, to keep the respect of the physicians and patients they work with. We learn from each other through meetings, conversation, and our journals.

BCBS, just do your insurance work better. It is between ourselves that we will change. We will use our own resources to better our work, inform our patients, adapt to cutting edge technology, and meet the public’s changing expectations.

Saving Lives, Saving Dollars Draws Criticism, Raises Questions

By PAUL NATINSKY

The Greater Detroit Area Health Council has secured $1.2 million of its $1.5 million budget for this year and reported several happenings regarding its Saving Lives, Saving Dollars initiative, including having received a Community Foundation for Southeastern Michigan grant being selected by the Robert Wood Johnson Foundation for a "Regional Market Pilot" initiative intended to improve the quality of ambulatory chronic illness care, publicly report provider performance and promote consumer demand for higher quality care. The RWJ Foundation will provide funding and technical expertise for its initiative.

GDAHC has also proposed and is developing a Physician Leadership Council composed of 20-25 physicians who work in a broad range of settings. The leadership council is expected to meet at least twice a year to identify and discuss issues that concern the member physicians and their colleagues.

That was the good news John Kerr delivered to the WCMSSM Executive Council at its July 12 meeting. Kerr is executive vice president at GDAHC. What he heard back from meeting attendees was support for the authority's goals for its Saving Lives, Saving Dollars program, but many questions and criticisms about its approach.

The program's goals include achieving 100 percent adherence to selected clinical guidelines and producing savings of $500 million over three years or reducing the rate of increase in health care expenditures by 1-3 percent.

DMN Editor Joseph Weiss, MD, told Kerr, "Your voice is lost in the crowd." He said payers such as Blue Cross and Blue Shield of Michigan claim their efforts are driving the Saving Lives, Saving Dollars program and disagreed with Kerr's assertion that coordination was needed among different groups working on different parts of the standards. "Everyone is doing the same thing," said Dr. Weiss, "washing hands, advocating antibiotic IVs before surgery."

Chris Bush, MD, said the program is a good idea, but it is funded by business interests that are in a rush to use whatever data is readily available to declare one hospital better than another.

"Will there be consensus on pay-for-performance (standards) or will each health plan devise their own and have physicians running every which way?" asked WCMSSM Immediate Past President Federico Mariona, MD.

"You're going to reward groups for providing the best data, not making a difference in the health of their patient population," said Dr. Susan Adelman.

Amid the stern criticism, Dan Michael, MD, pointed out that WCMSSM members are not "obstructionists" regarding the Saving Lives, Saving Dollars program and in fact "support the concept." He did, however, point out that there was "precious little data" to supporting the effectiveness of such programs.

Examine Stem Cell Bioethics: Sept. 29-30, Traverse City

What impact will human embryonic stem cell research have on the future of medicine? What are the bioethical considerations surrounding these brave new frontiers in science and in the development of potential therapies for severe human diseases? The 10th Annual MSMS Conference on Bioethics - scheduled for Friday and Saturday, September 29-30, at the Grand Traverse Resort in Traverse City - will examine these questions and others surrounding the complex and controversial issue of human embryonic stem cell research.

Among the many great guest speakers will be:
William May, PhD, Former Member of the President's Council on Bioethics; Professor Emeritus of Medical Ethics, Southern Methodist University; and Founding Member, Hastings Center for Bioethics

Sean Morrison, PhD, Director, Center for Stem Cell Biology, Life Sciences Insitute, University of Michigan

Christopher Thomas Scott, Executive Director, Program on Stem Cells and Society, Stanford University Center for Biomedical Ethics

This conference has been approved for a maximum of 10 hours of Category I CME credit.

Fees: $175 for members, $250 for non-members, $100 for spouses. For details or to register, contact Angie Kemppainen at (517) 336-5724 or akemppainen@msms.org.

Group Managers Conference Features
Political Updates, Office Solutions

The Michigan Medical Group Management Association will host its popular Fall Conference Wednesday-Friday, September 27-29, at the Ypsilanti Marriott at Eagle Crest.

In addition to a number of networking and recreational events, this year's conference will feature great topics and speakers such as these:

Retirement & Fringe Benefit Plans for Medical Practices -
Reviews, Developments & Issues
John H. McKendry, Jr., JD, Warner Norcross & Judd LLP

The Art of Hiring
MMGMA Past President Liz Sayre-King, MSW, FACMPE

Keeping Your Practice Healthy
(or Living with Regulation While Avoiding an Ulcer)
William F. Jessee, MD, FACMPE, FACPM, President and CEO, Medical Group Management Association/MGMA Center for Research, American College of Medical Practice Executives

Really Off the Record with Senior Capitol Correspondent Tim Skubick: An Insider's Take On All Things Political This Election Year
Tim Skubick, Senior Capitol Correspondent and Host of Off the Record

Cultivating Your People
Lori-Ann Rickard, JD, Firm Principal, Rickard & Associates, PC

Managing Your Most Important Asset
Medical Records Implementation of Image-Based Technology for Release of Information in the Hybrid Record Environment - Daniel Bailey, President, Bactes Imaging Solutions, Member of Association of Health Information Management and MGMA

The Top 5 Ways an Experienced Administrator Can Use Financial Benchmarking
Donald J. McAnelly, CPA, & Gray Tuttle, CHBC, The Rehmann Group - Healthcare Management Advisors

Discounts are available for registrations received before September 9. For details, visit www.michmgma.org or contact Sherry Barnhart at (517) 336-5786 or sbarnhart@msms.org.

State Seeks MMGMA Members For Medicaid Focus Groups

The Michigan Department of Community Health (MDCH) is interested in obtaining feedback from Michigan Medical Group Management Association (MMGMA) members regarding the development of the new Medicaid claims processing and information retrieval system called Community Health Automated Medicaid Processing System (CHAMPS).

MDCH is forming focus groups made up of MMGMA members from around the state. The CHAMPS focus groups will meet quarterly during the next three years in a variety of regions across Michigan. Learn more about CHAMPS at http://www.michigan.gov/mdch/0,1607,7-132--145006--,00.html or http://www.michigan.gov/documents/July_2006_164416_7.pdf.

To date, MMGMA members from Grand Rapids, Kalamazoo, Ann Arbor, and Berrien Springs have signed up. In addition, MDCH would like to develop focus groups in Detroit, Flint and/or Bay City, Traverse City, and the Upper Peninsula. The sign-up deadline is Tuesday, September 5. To sign up for a focus group, email MMGMA Secretary Bonnie Cochran at bacochran@earthlink.net , and include your name, address and telephone number.

For more information about MMGMA, visit www.msms.org and click on "Medical Group Managers," or contact Sherry Barnhart at (517) 336-5786 or sbarnhart@msms.org.

MSMS News & Notes

Medicaid Increase on Horizon for Physicians
According to a tentative budget agreement in the state legislature, $16 million has been allocated for Medicaid fee increases paid to physicians. In addition, eligibility has been left largely intact, meaning that there will not be a loss of coverage by patients who rely on Medicaid for coverage. This funding likely will be applied to a limited set of codes. The $16 million represents approximately a 2-percent increase in the overall funding for physician services. The agreement has passed the legislature and has been sent to the governor for her signature. For more information, contact Colin Ford at (517) 336-5737 or cford@msms.org.

Pressure Needed on House Medicare Effort
MSMS and the AMA urge you to contact your US Representative today and ask him or her to join Congresswoman Nancy Johnson (R-CT) and Congressman Ben Cardin (D-MD) in urging House leadership to prevent 2007 Medicare physician payment cuts by signing on to their letter. (View the letter: visit www.msms.org and click on "Advocacy," then "Medicare.") This House action follows a successful effort in the Senate, where 80 Senators, including Sen. Carl Levin (D-MI), signed on to a similar letter to Senate leadership from Sen. Debbie Stabenow (D-MI) and Sen. Jon Kyl (R-AZ). Visit http://action.msms.org to send a letter to your representative. For details, contact MSMS Executive Director Kevin A. Kelly at (517) 336-5742 or kkelly@msms.org.

MSMS Supports Residents Following DMC Residency Closure
The orthopedic residency program for the 2006-07 educational year has been discontinued at the Detroit Medical Center. MSMS strongly encouraged the hospital to assist in promptly transferring residents to alternate accredited programs as soon as feasible, with the least disruption to training, and permit GME funding to follow the displaced resident. MSMS also contacted the residents, offering them professional support during their transition. MSMS is in communication with the Wayne State University School of Medicine to discuss the closure's broader implications. The AMA also passed a resolution designed to better protect residents in the event of a program closure. For details, contact Rebecca Blake at (517) 336-5729 or rblake@msms.org.

The Evolution Has Begun at www.msms.org
The MSMS website is all new and more capable and expandable than ever before. The new site offers a personalized home page based on your selected interests; user-friendly navigation, quick links, and a handy "tool box;" more frequently updated content; powerful search feature with PDF search capability; enhanced security with no need for Social Security Number log-in; automated password and username reset tools; "Email an Article" and "Print this Page" conveniences; secure course registration and online dues payment; and much more. Visit the new site today for a chance to win a free 60GB iPod! What do you want to see when you log on to www.msms.org? Contact Shaun Lynch at (517) 336-5712 or slynch@msms.org.

Capitol Check-Up: Wednesday, September 13, Lansing
Join MSMS, the MSMS Alliance, the Michigan Medical Group Management Association, and public health officials on Wednesday, September 13, 12:00-4:00 p.m. at the Radisson Hotel in Lansing to meet with lawmakers and explore these topics: Future of Health Care in Michigan; Safe, High-Quality, Accessible Care for All Patients; Insurance Reform; Scope of Practice Legislation; Election Preview; Future of Michigan Medicaid; and more. MSMS will schedule visits with legislators prior to the formal program. Take this opportunity to meet with your local legislator and discuss pending legislation. MSMS will provide briefing materials. Fees: $10. For more information or to register, contact Angie Kemppainen at (517) 336-5724 or akemppainen@msms.org.

This publication brought to you by Natinsky Publishing Network.

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