High Deductibles: What They Mean for Patients and Physicians

MMS NEWS AND ANNOUNCEMENTS

New MMS report on the impact and implications of high-deductible health plans

The MMS has published an informational report on the prevalence and impact of cost-sharing, particularly high-deductible health plans, in Massachusetts. Assessment of the Impact of High-Deductible Health Plans on Patient Health and the Financial Impact on Medical Practices is designed to guide physician policy and advocacy efforts at the state and federal levels. The report outlines policy options that could help protect patients and physicians from further growth in cost-sharing, encourages conversations between physicians and patients about costs, and promotes advocacy for more equitable and durable means of controlling medical spending. The impact of cost sharing on patients and physicians is also explored in the Summer issue of Vital Signs: Patients are Feeling Crushed By Health Care Cost Sharing: How Can Physicians Be Part of the Solution? (Illustration: Chris Twichell, MMS)

New MMS resource on drowning prevention and water safety

Summer is here, and people are flocking to the water. More than 3,500 people in the US die in drowning accidents each year, most of them in May–August. In children aged 1–14 years, drowning is the second leading cause of unintentional death. The MMS has produced a new guide for patients and parents to inform and remind them of the dangers of drowning. This downloadable resource for providers and patients addresses drowing prevention, what to do in an emergency, and where to find further resources and training.

Independent reports anticipate significant reductions to MA health insurance coverage and increased costs under AHCA or BCRA

Reports from the Robert Wood Johnson Foundation and the Urban Institute predict state-by-stage changes in coverage and spending if the ACHA (passed by the House of Representatives) or BCRA (being considered in the Senate) become law. State-by-State Coverage and Government Spending Implications of the Better Care Reconciliation Act anticipates that passage of the BCRA would result in 109,000 people in Massachusetts losing health coverage, mostly from the nongroup insurance market, and estimates that the Commonwealth would have to increase its own spending by 14.2 percent to maintain the Medicaid expansions. The Impact of the AHCA on Federal and State Medicaid Spending and Medicaid Coverage: An Update predicts that Massachusetts could see substantial reductions in coverage —including a 26 percent reduction in nonelderly Medicaid enrollment—in order to maintain current state spending on pre-ACA eligible populations.

Massachusetts makes progress on prescription opioids

Prescription opioid use may be falling more quickly in Massachusetts than in other states, a new report from Blue Cross Blue Shield suggests. According to the Health of America report:

• Fourteen percent of Blue Cross members in Massachusetts filled an opioid prescription in 2015, compared to 21.4 percent nationwide
• Two percent of MA members received high-dose, long-duration opioid treatment in 2015, the second lowest in the country; nationally, 8.3 percent of members received this treatment, which is associated with higher rates of opioid use disorder
• 6.1 in every 1,000 MA members were diagnosed with an opioid use disorder in 2016, compared to 8.3 per 1,000 members nationwide
• Eighty-four percent of MA members who were diagnosed with an opioid use disorder in 2016 received medication-assisted treatment, the second highest nationwide

The MMS is working to address the opioid epidemic through opioid prescribing guidelines and has trained more than 10,000 providers on opioid prescribing, in addition to advocating for partial-fill legislation and the mandatory use of MassPAT, the state’s prescription drug monitoring program. Read more about the Blue Cross report (Boston Business Journal).

Reminders! MACRA, RPBO, and more

AMA video shows physicians how to avoid Medicare payment penalties

The AMA and the MMS are looking to help physicians avoid a negative Medicare payment adjustment in 2019—an effort that may be particularly relevant to physicians who have not previously participated in Medicare reporting programs, and/or physicians in smaller practices. The AMA has  new materials available on its website, including:

• A short video: One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting.
• A sample CMS-1500 claim form
• Links to quality measures on the CMS website
• A link to the CMS MIPS eligibility tool

Free personalized assistance from MMS for practice MACRA/MIPS strategies

Join us for FREE personalized assistance in developing your strategy for MACRA MIPS implementation in your practice. The program includes Mapping out MIPS: Keys to Success in 2017, which outlines measure selection and reporting requirements. It is designed for providers who are MIPS eligible and required to report for 2017 ( check MIPS reporting requirements). Space is limited. Dinner is provided. The session will be led by Yael Miller, MBA, Director of Practice Solutions & Medical Economics at MMS, and Leila Volinsky, MHA, MSN, RN, Program Administrator at Healthcentric Advisors. Healthcentric Advisors is a CMS contracted organization and supports practices of all sizes in preparing for MIPS implementation. They have been helping hundreds of clinicians prepare for MACRA, and want to help you.

Two sessions will be held—July 11 or July 27, 2017, 5:30-8:00 p.m.—at MMS Headquarters, Waltham (participants need attend only one session); register here. Your registration should include at least one clinician and one colleague/team member responsible for reporting. Questions? Please email Justin Sacramone at jsacramone@healthcentricadvisors.org or Yael Miller at ymiller@mms.org.

Join the QPP Open Call sessions for expert guidance

Join the New England QIN-QIO's Quality Payment Program (QPP) team as they review frequently asked questions about participation in the Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). These calls will include time for open discussion and sharing about all things QPP. The calls are open to providers, clinicians, office managers, practice administrators, quality improvement specialists, and anyone else who is involved in quality program reporting. Calls will be offered bimonthly on the following dates, 11:30 a.m.—12:30 p.m.:

• Wednesday, July 12
• Wednesday, July 26
• Wednesday, August 9
• Wednesday, August 30

Sign up for calls here. An email with instructions will be sent the day before the call. Questions? Contact Leila Volinsky at lvolinsky@healthcentricadvisors.org.

MassHealth ACO providers need RBPO certification: Learn the process

Find out whether or not RBPO certification applies to you. This one-hour webinar is designed to help carriers and provider organizations learn the Risk-Bearing Provider Organization certification process that relates to the development of MassHealth ACO contracts. The webinar, by the Division of Insurance, answers these questions:

• Which entities currently have Risk Certificates?
• Do related provider organizations need to obtain a new RBPO certificate?
• What’s the process for organizations to file?
• What’s the process for the Division to review applications?

How to participate:

• Webinar: Thursday, July 6, 2017 (1PM to 2PM); join the meeting
  • Meeting number 622 364 129
  • Meeting password Vm9TMf9d
  • Also dial 1-877-820-7831 and enter Participant Code 627192 to join the call that will be part of the webinar
  • To join from a video system or application, dial 622364129@massdoi.my.webex.com

Questions? Contact Niels Puetthoff at niels.puetthoff@state.ma.us or (617) 521-7326, or Kevin Beagan at kevin.beagan@state.ma.us or (617) 521-7323.

Honors, accolades, appointments, publications? Share your news in Vital Signs

Vital Signs, the monthly print and online newsletter of the MMS, has two new columns—and we need you to fill them. Members on the Move lists your professional news, such as joining a new hospital, opening a practice, or a recent promotion. Honors and Accolades is where we share your other achievements: board appointments, speaking engagements, community outreach, or published works. We are currently seeking submissions for the September issue of Vital Signs. Please include your full name and title, medical school with graduation year, residency institution, hospital affiliation, recent update, and a high-resolution headshot. Send submissions to vitalsigns@mms.org by July 10, 2017 (for the September issue). 

Educational programs and events

Unless otherwise noted, all events are held at the MMS Headquarters, 860 Winter St., Waltham, MA. View our full calendar of upcoming live CME activities. 

Norfolk County Safe Prescribing and Dispensing Conferences
Thursday, September 14, 2017, 8:00 a.m. – 3:30 p.m.
Randolph, MA
Open to all Norfolk County registered prescribers and pharmacists

The above activity has been approved for AMA PRA Category 1 Credit™ 

Featured new online CME activities – Risk Management credit 
Comprehensive Cannabis Curriculum (Modules 1–5 now available)

• Module 1: Endocannabinoid System and Phytocannabinoids
• Module 2: Guidance on the Recommendation of Medical Cannabis
• Module 3: Cannabis Products, Modes of Administration, Dosing Considerations & Contraindications
• Module 4: Cannabis – Physiologic and Cognitive Effects
• Module 5: Cannabis Use and Mental Health Effects  

The above activities have been approved for AMA PRA Category 1 Credit

Marijuana in MA: Here's what you need to know about the potential changes to the new law Behind closed doors, Massachusetts lawmakers are scrambling to change the new marijuana law. The main questions are how many changes they plan to make and how big they go in overhauling or tweaking the voter-approved law.