May 29, 2007

IN THIS ISSUE

Editor's Column: Walk Softly And Carry A Big Stick
WSU May Seek Broader Affiliations In Wake of MSU Vote
DMC Says GME Quality Will Be Protected
Text Of MSU Board Of Trustees Resolution
WSU School Of Medicine Commencement Info
 

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Editor's Column: Walk Softly And Carry A Big Stick

By JOSEPH WEISS, MD
A new Medicare acronym –PQRI- deserves our attention.  PQRI stands for Physician Quality Reporting Initiative. PQRI signals that the Centers for Medicare and Medicaid Services (CMS) is serious in its intent to add pay-for-performance to the equation for Medicare physician payments.

CMS stresses that PQRI represents the first step to reach the pay-for-performance goal. In PQRI, CMS allows individual physicians to voluntarily report up to three quality measures. In return for this effort, physicians may earn a bonus that, in theory, can reach as high as 1.5 percent of their Medicare payments. CMS explains the details of this reporting in its Web site,  www.cms.hhs.gov/PQRI.

The site begins with a historical review of the federal legislation and CMS philosophy behind the present effort to implement pay-for-performance. The subsequent pages enumerate the specific reporting measures from which a physician can choose. The Web site then gives instructions on how to report quality measures via electronic billing. This information is both detailed and technical. Physicians likely will need their billing person with them to understand those pages. The Web site concludes with the bonus formula so a physician can calculate how much he or she could conceivably receive in extra payments.

Some DMN readers may scoff. The Democratic-controlled Congress has expressed an attitude toward pay-for-performance ranging from skepticism to disdain. Pay for performance will go nowhere, they say.

Readers should consider that pay-for-performance also provides a way for the federal government to pay physicians less. Eventually that opportunity will gain the attention of any Congress. Furthermore, the experiments of CMS often make their way into the policies of the Blue Crosses, Aetnas and UnitedHealthcares that rule the private health care market.

The time and money the medical profession puts into PQRI will not be wasted. We should anticipate that payors, whether government or private, will soon make it mandatory that a request for reimbursement be accompanied by what that payor deems as required quality reporting. In this case the cost of indifference will be dangerous ignorance.

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WSU May Seek Broader Affiliations After MSU Vote

The following is the text of an e-mail widely distributed after the May 18 Michigan State University Board of Trustees vote to approve a satellite medical school campus for the MSU College of Osteopathic Medicine on the Detroit Medical Center campus and at Macomb Community College.

(May 18), after many weeks of broad community discussion, the Michigan State University Board of Trustees voted to expand the MSU College of Osteopathic Medicine to the campus our School of Medicine shares with the Detroit Medical Center (DMC).  The depth of the support expressed for Wayne State University and its School of Medicine was very heartening, and I want to thank everyone who made the effort to stay informed and to speak out on behalf of our colleagues and students.  We had hoped that the MSU Board would delay its decision pending the outcome of a comprehensive review that is being undertaken by the panel formed by Detroit Renaissance and the Detroit Regional Chamber and led by former US Congressman and State Senator Joe Schwarz, M.D.

We remain concerned that the decision to add MSU osteopathic students to a system that is already strained for teaching capacity may force us to find alternative training facilities for our students. As we have stated in all of our communications about this issue, we are fully committed to providing the best possible education to our medical students and we will do what is necessary to maintain the quality of that education. 

Wayne State University will continue to work closely with the newly commissioned panel as it undertakes a thorough examination of health care delivery and medical education in our region.  We will keep you apprised of pertinent developments and look forward to your continued support.

Sincerely,

Irvin D. Reid, PhD

President, Wayne State University

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DMC Says GME Quality Will Be Protected

The following is a communiqué issued by the Detroit Medical Center two days prior to the Michigan State University Board of Trustees vote on approving satellite medical school campuses on the DMC campus and at Macomb Community College for the MSU College of Osteopathic Medicine.

(On May 16), the Detroit Medical Center (DMC) reinforced its commitment to medical education at DMC hospitals. The health system is excited about the opportunity to be a satellite site for the Michigan State University College of Osteopathic Medicine (MSUCOM) as well as continue its longstanding relationship with the Wayne State University School of Medicine. If DMC is selected as a satellite site for MSU, it presents an opportunity to further medical education in the city of Detroit and expand medical education at DMC Sinai Grace Hospital and DMC Huron Valley Sinai Hospital. There is significant capacity, not currently used by Wayne State University, at both hospitals to provide teaching sites, patients and physician educators for students and residents.

“Sinai Grace is on the upswing,” said Conrad Mallett, Jr., president, DMC Sinai Grace Hospital. “The possibility of providing medical training for MSU students is a great opportunity to continue to stabilize the hospital and strengthen it as a community-based and academic facility. We assure Wayne State University students that their positions will not be jeopardized. This will be a win-win situation.”

“DMC Huron Valley-Sinai Hospital is already a host for osteopathic residences and is a site for clinical rotations for MSUCOM students,” says Jack Belen, DO, director of Medical Education, Internal Medicine Program Director, Chief of Medicine at DMC Huron Valley-Sinai Hospital, “DMC’s proposal is to expand an already existing program where currently Wayne State does not send any students.”

The DMC Administration and Board of Trustees have pledged that Wayne State University and Graduate Medical Education programs will not be jeopardized. According to John Haapaniemi, DO, president, DMC Medical Staff, several cities in the United States have four or more medical schools. “With the double threat of the economy and a looming physician shortage, we should work together in effort to help solve the challenges ahead. Becoming a satellite site for the MSU Osteopathic School of Medicine is a step in the right direction for Detroit and this region.”

If selected, the MSU program at DMC would be structured as follows:

First- and second-year student classroom teaching will be held at DMC’s former site for Hutzel Hospital. The available and vacant space would be leased by MSU.

Third- and fourth-year student rotations will be held at DMC Sinai Grace Hospital and DMC Huron Valley Sinai Hospital, not on DMC’s main campus. Both hospitals have significant capacity to provide teaching sites, patients and physician educators. The training program would be led by private osteopathic physicians. “Three quarters of the physicians at DMC are private docs that can provide teaching opportunities,” said Dr. Haapaniemi.

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Text Of MSU Board Of Trustees Resolution

Expansion of the College of Osteopathic Medicine

in Southeast Michigan

May 18, 2007

The following is the text of the resolution approved by the Michigan State University Board of Trustees.

WHEREAS, the Michigan State University College of Osteopathic Medicine is one of only four medical schools in the State and the only college of osteopathic medicine, and has a tradition of training physicians who choose in large numbers to practice in the State after graduation; and

WHEREAS, the Michigan State University College of Osteopathic Medicine is the number one ranked college of osteopathic medicine in the nation and ranked fifth among all medical colleges, allopathic and osteopathic, in the area of primary care by US News and World Report, and the College is the top osteopathic college in the nation in amount of NIH research funding; and

WHEREAS, the Blue Ribbon Physician Workforce Committee predicts that Michigan will face a shortage of approximately 4500 physicians by the year 2020 given current rates of graduation and out-migration of physicians; and

WHEREAS, the College of Osteopathic Medicine, in partnership with hospitals across the State, has developed a Statewide Campus System that currently comprises 26 partner institutions providing clinical education opportunities to students, interns and residents affiliated with the College, and an increase in class size will directly benefit all present partners of the Statewide Campus System and all potential future partners selected to membership within the Statewide Campus System by the established processes; and

WHEREAS, the College of Osteopathic Medicine Statewide Campus System has endorsed expanding the enrollment of the College; and

WHEREAS, Michigan State University is committed to improving the vitality of health care in both the urban and suburban centers in Southeast Michigan and has reviewed proposals from 16 groups in the region to partner with the University in pre-clinical osteopathic education; and

WHEREAS, the Michigan Osteopathic Medicine Advisory Board has expressed its support for the “expansion of the MSU College of Osteopathic Medicine in Southeast Michigan at a site that will benefit the College, its partners in the region area, the osteopathic profession and the State,” and has passed a resolution to that effect; and

WHEREAS, the College Advisory Council of the MSU College of Osteopathic Medicine has endorsed the expansion of the first and second year curriculum into Southeast Michigan to “provide curricular innovation and meet the needs of our Statewide Campus System hospital partners” and to “further expose our students to different cultural and socioeconomic groups;” and

WHEREAS, the Oakland County osteopathic community, both physicians and hospitals, has been an important partner of the College of Osteopathic Medicine in medical education for many years, and Michigan State University is committed to strengthening its relationship with that community in the education of third and fourth year medical students, interns, and residents through the Statewide Campus System; and 

WHEREAS, the Macomb County osteopathic community has also been a long-time partner of the College of Osteopathic Medicine at Michigan State University and the University is committed to strengthening its relationship with the physicians and hospitals in the county; and

WHEREAS, Michigan State University has a long-time commitment to the City of Detroit and continues to partner with the city as it pursues programs in economic development, community programming, improved education, and social services; and

WHEREAS, Michigan State University recognizes that Wayne State University has made substantial and meaningful contributions in providing medical education opportunities in Michigan and particularly in the City of Detroit, and that MSU is committed to continuing to work with WSU in the spirit of the University Research Corridor to further our collective interests; and

WHEREAS, Michigan State University recognizes the valued contributions of the Macomb University Center and its role in higher education in Michigan; and

WHEREAS, Michigan State University recognizes the valued support of the Detroit Medical Center to medical education in Michigan and its contributions to the health of its citizens; and

WHEREAS, the Detroit Regional Chamber and Detroit Renaissance have created a panel to study ways to improve collaboration between local health systems, doctors, schools, and research facilities, and the University welcomes the panel’s input as it extends osteopathic medical education in Southeast Michigan pursuant to this Resolution,

THEREFORE BE IT RESOLVED THAT: the Michigan State University Board of Trustees endorses the administration’s selection of the Detroit Medical Center and the Macomb University Center as preferred partners in the education of first and second year medical students in Southeast Michigan and directs the administration to complete negotiations with these partners. 

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WSU School Of Medicine Commencement Info

This year's keynote speaker will be Dr. Risa Lavizzo-Mourey. She is a world-renowned physician in the field of public health. She is the CEO and President of the Robert Wood Johnson Foundation, one of the most widely-known philanthropic health care organizations in the United States.

The WSU School of Medicine commencement ceremonies will take place at 2 p.m., June 5, at the Fox Theatre.  

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