Takeaways from Physician Partners’ 12th Annual Membership Celebration

June 4, 2015

Event Recap: “Medicare Changes / New Opportunities” – Thursday, May 14, 2015

Presentation by Special Guest Speaker – Tom Gehring (CEO – San Diego County Medical Society)

Tom covered the major issues impacting physicians at the national, state, and local level. Main focuses included the Affordable Care Act, passage of the recent bill to eliminate the SGR, and problems with Medi-Cal funding.

1. What does the elimination of the SGR mean for physicians?

There are two main things that DID happen with the elimination of the SGR:

Congress finally got rid of the widely-hated sustainable growth rate (SGR) law. This came just hours before doctors faced a 21% Medicare pay cut.
The current reimbursement schedule will be replaced with a new system based on “quality, value, and accountability.” The problem with this Alternative Payment Model (APM): Nobody knows what it is, or how it will work!

There are two main things that did NOT happen:

No change to the GPCI (Geographic Practice Cost Index), so for San Diego, physician contracts will continue to be based on a geographic index that is completely outdated
ICD-10 did not get postponed

2. How is the implementation of the ACA trending, and what are the implications?

According to Tom Gehring, “ACA = Dead Man Walking”

All of the ACA health plans are basically the same, except for the deductibles (which you – the practice – are responsible for collecting).
More mandated coverages = pay increases for patients. The older end up paying less, and the younger end up paying more.
The uninsured rate has dropped 11.9% as of the end of March 2015; however, many of those who signed up actually were assigned to MediCal, which still has inherent problems, beginning with low physician participation due to low physician reimbursement.

3. What is the prognosis for restoring Medi-Cal funding to a reasonable level?

The number of providers participating in Medi-Cal has dropped. The big test for restoring Medi-Cal funding to a reasonable level will be the receptivity of Brown administration officials. So far, Governor Jerry Brown has refused to reverse Medi-Cal funding cuts and has tried to diminish expectations for new spending in the budget.

4. What other imminent legislation will affect the practices of physicians?

Legislation could have a significant impact on private-practice physicians in that increased costs due to legislative action could ultimately force physicians to leave their own practice and potentially join a larger practice/group.

5. The Alternative Payment Model (APM) proposed to replace the current combination of incentive programs (MU, PQRS, et al) has positives and negatives.

Positives:

Formulated by a committee of physicians
Includes a potential 5% physician bonus
Is not a zero-sum/cost-neutral program like the current PQRS/CM (bonuses to some mean reductions to others)

Negatives:

It’s completely undefined at present
Interim solution – MIPS, could result in 9% reduction for physicians who do not meet criteria

New incentive programs:

PQRS, MU, and VBM end after 2018, replaced by MIPS (Merit-based Payment Incentive System), which is the transitional stage between the current incentives and the APM. MIPS physician assessments will be based on 4 metrics: quality, resource use, meaningful use of EHR, clinical practice improvement activities.

Presentation by Michael Couris, MD & Dustin Brown (COO – Physician Partners)

Physician Partners continues to provide exciting marketing & technology solutions exclusively for its physician members to support the viability of their medical practices.

1. Practice Marketing (NEW Practice Websites, Patient Tools, News Posts, and more!)

Dustin introduced the new practice websites, now available on myQcare.com. These pages allow you to add patient forms / downloads, original clinical news posts, social media links, and more! Enhanced SEO and patient search by city is coming soon!

2. Clinical Connectivity (LabCorp, Quest, Imaging Healthcare Specialists)

Increase your medical practice productivity for both physicians and administration, save time and money, and securely request lab and radiology data by using Clinical Connect powered by Health Gorilla. Get Started / Learn More

3. Meaningful Use & PQRS Support (Solutions to avoid Medicare payment penalties)

Natalie Nelson (Physician – Physician Partners) will be presenting monthly webinars on PQRS beginning in July. Reminder – make sure you’re on our mailing list to receive invitations to all of our special events, webinars, and for up-to-date news.

4. Bottom Line Savings (Office Supplies, Medical Supplies, Credit Card Processing)

Physician Partners continues to provide cost savings for the services your practice uses most. To request more information about a particular service or product, please submit a Member Benefits Request.

Congratulations to our door prize winners:

Dr. Cyrus Torchinsky – Android Tablet (provided by Health Gorilla)

Dr. Angela Chang – $50 Restaurant Gift Card (provided by Physician Partners)

Michelle, office staff at Emily’s Medical Group – $50 Restaurant Gift Card (provided by Physician Partners)

Dr. Russell Edwards – Cookbook signed by Chef Michel Stroot (provided by Physician Partners)