2018 January AANnews by American Academy of Neurology

VOLUME 32 · ISSUE 1 · January 2018

PLAN YOUR ANNUAL MEETING EXPERIENCE New Mobile App

Annual Meeting Deadlines

Download the new AAN Conferences Mobile App at AAN.com/view/MobileApp to put all the information you need to make the most of your 2018 Annual Meeting experience conveniently on your iPhone, iPad, or Android.

Hotel Deadline: March 2 Early Registration Savings Deadline: March 29

Visit AAN.com/view/AM18 today!

Browse program details, speakers, and social/networking events Access program slides and syllabi Search scientific abstracts Create an itinerary and customize your schedule View room locations and hotel map Submit your program evaluations to earn CME Explore the Los Angeles City Guide The AAN Conference Mobile App is sponsored by Sunovion Pharmaceuticals Inc. 

AANConferences

AAN SCORES VICTORIES IN FINAL MEDICARE PHYSICIAN FEE SCHEDULE

2018 PRACTICE MANAGEMENT WEBINAR SERIES KICKS OFF ON JANUARY 23

Each year, the Centers for Medicare & Medicaid Services (CMS) issues regulations that impact how physicians are paid. On November 2, 2017, CMS issued its final rule updating payment policies and rates for physicians paid under the Medicare Physician Fee Schedule (MPFS) in 2018.

The AAN’s series of practice management webinars for 2018 begins this month with helpful tips and insights for neurologists in small and solo practice.

Last August, the AAN submitted comments to the agency advocating on behalf of our members

Continued on page 12

Through Their Eyes: Recollections of Past AAN Presidents

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No Small Feat: Personally and Professionally Succeeding in Small and Solo Practice January 23, 2018 12:00 p.m.–1:00 p.m. ET

Deadline to Register: January 22 Faculty: Teryn Clarke, MD, and Gurdesh Bedi, MD

MIPS Reporting: Out with the Old Year, in with the New

Continued on page 15

16 Take Your Career to the

Next Level with Leadership University Offerings

›

AANnews · January 2018

CONTENTS

NEWS BRIEFS

Cover Plan Your Annual Meeting Experience AAN Scores Victories in Final Medicare Physician Fee Schedule 2018 Practice Management Webinar Series Kicks off on January 23

Policy & Guidelines Academy Issues Updated Practice Guideline on Mild Cognitive Impairment · · · · · · 10 Relationships Are Vital Currency in DC Dealing · · · · · 10 Capitol Hill Report · · · · · · · · 13

President’s Column Personalization Among Top Accomplishments for You as We Kick off 2018 · · · · · · · · · ·3 Through Their Eyes Through Their Eyes: Recollections of Past AAN Presidents · · · · · · · · · · · · · 4 Tools & Resources AAN Publishes Quality Measurement Set for Children/Adults · · · · · · · · · · ·7 Academy Acts on Solo and Small Practice Task Force Recommendations · · · · · · · · 7 Use These AAN Neurology Quality Improvement Measures in Your Practice · · · ·8 MIPS Reporting: Out with the Old Year, in with the New · · · · ·9

Conferences & Community Live Well Programs Emphasize Self Care for Effective Patient Care · · · · · · 14 Take Your Career to the Next Level with Leadership University Offerings · · · · · · · 16 Diversity Leadership Participant Takes Valuable Experience Back to Workplace and Beyond · · · · · 18 Education & Research Plan Ahead for UCNS 2018 Deadlines · · · · · · · · · · 19 ‘Sweeping Changes’ Come to Neurology Journal · · · · · · · · 20 Careers · · · · · · · · · · · · · · · 21

AAN press releases based on Neurology ® journal studies have received major media coverage this fall. The press release titled “Study: Risk Factors on Rise Among People with Stroke” was covered by numerous outlets, including National Public Radio (NPR) as well as local public radio stations across the country after AAN President Ralph L. Sacco, MD, MS, FAHA, FAAN, a co-author on the study, did an interview with Miami public radio station WIOD. The press release titled “Inflammation in Middle Age May Be Tied to Brain Shrinkage Later” received coverage from the New York Times and New York Post, among others. The press release titled “For Women, High Blood Pressure in Your 40s May Be Tied to Increased Risk of Dementia” was covered by United Press International (UPI) and others. U.S. News and World Report and other publications covered “Back on Ice, But Young Hockey Players’ Brains Still Recovering from Concussion.”

American Brain Foundation Welcome New American Brain Foundation Board Members! · · · · · · · · · · · · · 22 Dates & Deadlines · · · · · · · · 23

The Vision of the AAN is to be indispensable to our members. The Mission of the AAN is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction. Contact Information

For advertising rates, contact:

American Academy of Neurology 201 Chicago Avenue Minneapolis, MN 55415

Eileen R. Henry Wolters Kluwer Health | Medical Research Lippincott, Williams & Wilkins

Phone: (800) 879-1960 (toll free) (612) 928-6000 (international) Email:

memberservices@aan.com

Website: AAN.com

Phone: (732) 778-2261 Email: Eileen.Henry@wolterskluwer.com

AAN Executive Director: Catherine M. Rydell, CAE Editor-in-Chief: John D. Hixson, MD Managing Editor: Angela Babb, CAE Editor: Tim Streeter Writers: Ryan Knoke and Sarah Parsons Designers: Siu Lee and Jim Hopwood Email: aannews@aan.com

AANnews is published monthly by the American Academy of Neurology for its 34,000 members worldwide. Access this magazine and other AAN publications online at AAN.com/go/elibrary. The American Academy of Neurology ’ s registered trademarks and service marks are registered in the United States and various other countries around the world. “American Brain Foundation” is a registered service mark of the American Brain Foundation and is registered in the United States.

President’s Column

PERSONALIZATION AMONG TOP ACCOMPLISHMENTS FOR YOU AS WE KICK OFF 2018 Happy New Year! We have a big year ahead as we begin 2018 and what better way to kick off the new year than with unveiling a brand new resource to be indispensable to our members. Enhancing your member experience has taken a generational leap with the launch of our redesigned Sacco AAN.com website, now available to you after two years of planning, development, and member feedback. The goals of this totally re-engineered website are to develop a personalized, mobile-optimized, and memberfocused website, integrating the vast array of AAN resources with improved usability through a clear navigation and powerful search platform that spans all Academy websites. We know that time is precious. In this fast-paced world with big data and the rapid expansion of neurological knowledge, we want to do everything we can to help you be as efficient as possible. The Academy has so many helpful resources and we want all of our members to be able to access what they need and when they need it most. This includes streamlining our communications to you so they are customized and relevant to your own work. Whether you are looking for the latest evidence-based guidelines to practice high-value care for your patients, the latest article in one of our journals, updates on meetings designed to get you the latest information on a particular topic, or news about our fight to reduce regulatory burden, we want you to be able to rapidly access all of this information in a more personalized format. Once you log in, the new website is optimized to your member profile to display information, products, programs, and services

tailored based on a member’s career stage, setting, specialty interest area, and past and current activities with the AAN. The personalization includes CME and credit tracking, Synapse conversations, and conference attendance. We are unaware of any other medical association currently offering this level of personalization on their website. Key features of the personalized homepage include: Issues or opportunities of interest to you will be featured in the main image of the homepage. Your current CME credits through the AAN will be displayed through a feed from the AAN’s NeuroTracker. Highlights of essential programs, products, and services for your career stage. Topics of interest to you will be displayed in the Latest News area. Your interest areas also will be displayed in the Guidelines area. The AAN has made personalization a major priority for many of our digital strategies to better connect with our members. We will continue to personalize emails, e-newsletters, and digital advertising based on your member profile. In addition, we continue to personalize print mailings, as well as web applications, so they are relevant and more meaningful to you. I want to especially thank all of the volunteer members and AAN staff who have worked tirelessly to bring all of this innovation to our members. The website redesign is just one of the major achievements completed by the Academy in 2017. Here are some of the other significant accomplishments that we can celebrate from last year: Demonstrated AAN value to members by reaching a 95-percent retention of US neurologist members Surpassed 1,000 in advanced practice provider membership Expanded the Axon Registry® to reach 120 sites, many of which are solo and small practices Provided grants to neurologists through the AAN Hurricane Relief Fund for Affected Neurology Practices, as well as support for the Puerto Rico Neurology Residency Program Embraced innovative redesign of all Academy publications, including Neurology ® Achieved record attendance at the AAN Annual Meeting in Boston and Fall Conference in Las Vegas Continued on page 6

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AANnews • January 2018 3

Through Their Eyes

THROUGH THEIR EYES: RECOLLECTIONS OF PAST AAN PRESIDENTS Jerome B. Posner, MD; and H. Richard Tyler, MD, FAAN.

Joseph M. Foley, MD, FAAN / President 1963–1965 This is an excerpt from an interview conducted in 2011 with Foley, former chair of the Division of Neurology at Case Western University Medical School and a past president of the American Neurological Association. The interviewers were Lanska (DL) and Barbara W. Sommer (BS). Foley passed away in 2012.

1973: Drs. Paul Yakovlev, Russell N. DeJong, Adolph Sahs, A.B. Baker (front); Joe Brown, Joe Foley (rear)

This year, the AAN celebrates its 70th anniversary serving neurology professionals in the United States and worldwide. AANnews will publish a series of interviews conducted in recent years with Academy presidents. The interviews were conducted by Douglas J. Lanska, MD, MS, MSPH, FAAN, chair of the recently formed AAN History and Archives Committee, members of the AAN History Section, and Academy staff. “The Academy has a rich history serving the needs of neurology,” said Lanska, “and we want to make it more accessible

The new AAN History and Archives Committee includes Douglas J. Lanska, MD, FAAN, chair; Sandra F. Olson, MD, FAAN; Stephen G. Reich, MD, FAAN; and Christopher J. Boes, MD, FAAN. Not pictured is Peter J. Koehler MD, PhD, FAAN.

AANnews • January 2018

BS: Was there a need for the Academy? Would you talk about that a little bit? JF: I think there was. I think neurology had been growing in numbers and influence. I think they needed some pressure group to put them before the [United States] Congress and all the rest. That was really the origins of founding of the Academy.

to our members. We have refurbished the Academy’s history web page at AAN.com/membership/history. New interviews of past presidents will be posted monthly. We invite members to acquaint or reacquaint themselves with how the AAN grew from a conversation BS: To come before the Congress? between the JF: In part, yes. legendary Dr. BS: What do you A.B. Baker and mean by that? his University of Minnesota JF: We appeared resident Dr. Joseph before congressional Resch, its humble committees to beginnings in 1948 advance the causes of with 50 charter neurology. members, and how DL: There are stories Drs. Joseph M. Foley and Douglas J. Lanska it has responded that Forster and at the 2011 interview. with increasing Baker actually flew to sophistication to a widening array of Washington to champion support for needs by neurologists. We have much to academic program development. be proud of, and much to look forward to.” JF: That’s right. And I think they The History webpage also includes did a good job of it. They would transcripts of interviews conducted sometimes sound somewhat by the Oral History Work Group with aggressive. Sometimes very neurology leaders, including former past unpleasant in their dealings with presidents Joseph M. Foley, MD, FAAN, other people but, on the whole, I Maynard M. Cohen, MD, FAAN, Lewis P. think they did marvelous work. Rowland, MD, FAAN, and Stanley Fahn, DL: They helped get NIH funding MD, FAAN; former editor-in-chief of as well. Neurology Robert B. Daroff, MD, FAAN; JF: Yes, indeed. They were very active Sami I. Harik, MD, FAAN; William M. in that. And Adolph Sahs, who was in Landau, MD, FAAN; M. Marsel Mesulam, that group as well. MD, FAAN; Brenda Milner, PhD, ScD;

DL: They facilitated development of NIH funding for academic programs. JF: Exactly. DL: Do you think that changed how neurology functioned around the country? JF: Oh, I think, no question. But I think also the recognition of some of the—particularly dementia and particularly epilepsy—I think these programs needed a big boost. As a result of the Academy, I think they got that boost. DL: Do you think it would ultimately have come as well from the ANA [American Neurological Association] or do you think it needed the Academy to accomplish that? JF: I think it needed the Academy to accomplish it. The ANA was a pretty set organization. They didn’t move forward very much. BS: It was more selective in its membership too, so it had a smaller base. JF: Yes, selective. DL: The political role that the Academy had earlier on and, to a degree continues today, I think, was largely the brainchild of Baker, was it not? JF: Oh, yes. Abe Baker was a very aggressive political animal. BS: Do you think he saw the future or began to think about how neurology could develop? JF: I did. I think he knew it when he was a medical student. He was always passionate about the development of neurology…. DL: Not only was Baker supportive of a political role, but he also had some strong views on how neurology should be involved in rehabilitation of patients with neurological diseases. JF: That’s right, exactly right. DL: In fact, at one point, you said that his view was that neurologists “must never relinquish to anyone the final responsibility for rehabilitation of the patient.” JF: Did I really?

DL: Yes.

CG: How did you get involved with the AAN? How did you start in this?

JF: My God, every so often I said something sensible, didn’t I? [laughs]….

MC: Abe told me. [laughs] BS: How did he tell you?

DL: There are several different versions of how the “Four Horsemen” came to be for the Academy. Do you recall any of that?

MC: You see, I was working with him before this whole thing happened. I just kind of got drawn in. CG: Did you have any early duties that you remember? Any specific assignments related to the American Academy [of Neurology]?

JF: Who were they? DL: The “Four Horsemen” are considered to be Baker, Forster, Sahs, and DeJong.

MC: Oh, sure… I, and three other people, started all this whole thing of these courses and everything. That was the beginning. Abe started the courses…and he [served as chair of the Special Courses Committee] for 20 years and then I did it. That’s how we did it.… We kept adding all these things that are present today…. I remember Nelson [Nelson G. Richards] who was the president right after me and was particularly an advocate for practitioners. This was a fellow who was picking at me all the time, of all the years that we were there….

JF: I know that Baker and Sahs especially were very energetic, very aggressive, sometimes objectionably so in the minds of some people. DeJong settled very quickly into the editorship of the journal. BS: What about Forster as one of the “Four Horsemen?” JF: I knew Forster when I was a medical student. BS: Why was he considered one of the “Four Horsemen” of the AAN? JF: Because I think he had the political awareness to organize things, get things before the Congress, and create something that had not been there before.

CG: Nelson? MC: Yeah, Nelson. When we first got together, I said, “Look, you have been picking at me through all of this. What I want is uniformity. I want you and I to accept—to work out

Foley talks about his associations with neurology pioneers Derek Denny-Brown, Houston Merritt, and Raymond Adams, and his harrowing experience serving as a medic with the first wave of soldiers landing on D-Day. Read the complete interview at bit.ly/2zHSRLD.

Maynard M. Cohen, MD, FAAN / President 1981–1983 Cohen came to the University of Minnesota— and A.B. Baker—after 1985: AAN Presidents Nelson G. Richards (1983-1985), Maynard M. Cohen WWII. He worked with (1981-1983), Melvin Greer (1985-1987). Baker for 20 years before going to Rush everything in which we are doing and University. He was interviewed in 2012 it comes out as one thing.” He was by Christopher G. Goetz, MD, FAAN, (CG) ecstatic. He was absolutely ecstatic. and Barbara W. Sommer (BS). Cohen His help with Continued next page passed away in 2014.

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AANnews • January 2018 5

Through Their Eyes

President’s Column

PERSONALIZATION AMONG TOP ACCOMPLISHMENTS FOR YOU AS WE KICK OFF 2018 continued from page 3

Drs. Maynard M. Cohen and Christopher Goetz at the 2012 interview.

the people who were the doctors, not the researchers— they realized that [the AAN] had something for the doctors too. He went everywhere with me. He never missed anything. His final word was, “Anybody who tries to get between us will hear about it.” [laughs] CG: That is a wonderful story. It shows how you faced a challenge, how you faced that dichotomy of spirits. And you’re right, when you sit down and talk, you can come up with a unified—maybe not always uniform—but unified presentation. And that builds and, of course, leaves a future legacy because, then, your tenure is all the longer. It is his tenure plus your tenure and then you pass the baton. MC: I never thought that he would come to it. But he jumped at it. He wanted to be loved. CG: Maybe Abe said the same thing about you. [laughs] Being included is an important part of advancing. BS: As you think about the Academy and the education, it seems that the education program really made a difference. MC: You see, what I was trying to do was to unify. Not only him, but unification of the whole thing [AAN educational effort]. And I wanted the whole thing to be close. It could be large, but it could be close…. Read the complete interview with Cohen, where he shares more about working with Baker, his views on mentorship, and his unique connection with Norwegian neurology at bit.ly/2j9wOqX. 

Established a Drug Pricing Task Force to address the high costs of neurologic drugs and influenced Congress to start a congressional investigation into high drug costs for multiple sclerosis Launched a Health Disparities Task Force to develop recommendations and direction to address these growing gaps in patient care Created the AAN Principles for Health Care Delivery to address health care reform Published three studies in Neurology ® on neurologist burnout through the AAN Wellness Task Force Implemented task force recommendations to address gender disparities through education, promotion of the issue, and leadership opportunities Collaborated with others to address regulatory burden, improve reimbursement, and modify MOC requirements Expanded our AAN Leadership Programs to 10 different programs, the newest of which focus on practicing neurologists and helping neurologists build resiliency in their lives Our AAN Board is finalizing its strategic plan and goals for 2018—the 70th anniversary of your AAN. We added some 2,000 new members last year, bringing our total membership to 34,000 worldwide. Personalization of your experience is just one of the new ways we can make your AAN membership more relevant to you. As the largest association of neurological professionals, we have many strategic initiatives to help you provide high-value care and enhance member satisfaction in the evolving health care environment. Clearly, the proven value and importance of the AAN to the neurology profession has grown in tandem with our membership growth. As we continue to expand on A.B. Baker’s vision 70 years ago to meet your needs today—and tomorrow—we hope you will mark this anniversary by becoming more engaged with the Academy, using your membership to the fullest, and continuing to share your thoughts and concerns with leadership so we can be ever more responsive to your needs and position you for success throughout your career. Thanks for your help and I’m looking forward to a great year ahead. 

Ralph L. Sacco, MD, MS, FAHA, FAAN President, AAN rsacco@aan.com @DrSaccoNeuro on Twitter

AANnews • January 2018

Tools & Resources

AAN PUBLISHES QUALITY MEASUREMENT SET FOR CHILDREN/ADULTS A new quality measurement set was developed through a partnership with the Child Neurology Society. The executive summary was published online ahead of print in Neurology ® on December 15, 2017. Some of the measures don’t have an upper age limit restriction and therefore also apply to adult populations as well as children. The quality measures that pertain specifically to children are: First Line Treatment for Infantile Spasms Screening for Co-morbid Conditions of Tic Disorder or Tourette Syndrome Management of Co-morbid Symptoms of Tic Disorder or Tourette Syndrome BoNT-A for Spasticity and Dystonia Genetic Testing for Global Developmental Delay

The quality measures that pertain to children AND adults are: Rescue Seizure Therapy for Children with Epilepsy Time to Third Line Therapy for Refractory Convulsive Status Epilepticus Neuropsychological/Neurodevelopmental Screening in Epilepsy Behavioral Therapy for Chronic Tic Disorder or Tourette Syndrome Transition from Pediatric Neurology to Adult Neurology Psychological Interventions for Chronic Headache View the executive summary at Neurology ® and the full measure specifications on AAN.com . For more information, contact Erin Lee at elee@aan.com or (612) 928-6020. 

ACADEMY ACTS ON SOLO AND SMALL PRACTICE TASK FORCE RECOMMENDATIONS In 2016, the Solo and Small Practice Task Force appointed by then-President Terrence L. Cascino, MD, FAAN, made recommendations to help the Academy improve its support for members working in these environments. Below is an update on implementation of some of the high priority recommendations.

Advocating for reduced administrative burdens on physicians should remain a top priority for the AAN. We were effective in achieving regulatory relief for small practices in the final 2018 Medicare Fee Schedule and QPP rules.

Continue to ensure that the views of members in solo and small practice are reflected in AAN regulatory review and comment letters. We emphasize this viewpoint in most of our letters and inperson meetings.

Consider new heading on AAN.com for practice content. The newly redesigned AAN.com includes a top navigation drop down titled “Practicing Neurologists and Administrators.”

Create practice@aan.com. This new, regularly monitored email inbox dedicated to help answer practice management related questions launched July 31 and has received 67 inquiries. The most frequent questions were related to coding (38), practice management (16), general (9) and regulatory (4).

Establish Practice Ambassador Program visits to small and solo practices. The primary purpose of this program is to observe neurologists in small and solo practices. We want to gain firsthand knowledge of challenges, successes, and concerns of these members, who were encouraged to candidly share their perspectives and offer recommendations. Feedback is provided to the Academy to adapt our products to ensure they are meaningful and useful to neurologists in small/solo practice. These visits took place between August and November 2017: Location

Type of Practice

Setting

Hazel Crest, IL

Small group

Suburban

Northbrook, IL

Small group

Suburban

Astoria, NY

Solo

Urban

New York, NY

Solo

Urban

Las Vegas, NV

Solo

Suburban

Newport Beach, CA

Solo

Suburban

Boone, NC

Small group

Rural

The leadership team is evaluating visit reports and participant feedback to determine how to move forward with the program in the future. 

Tools & Resources

USE THESE AAN NEUROLOGY QUALITY IMPROVEMENT MEASURES IN YOUR PRACTICE As a Qualified Clinical Data Registry (QCDR), the AAN’s Axon Registry® can include more quality measures than other MIPS reporting methods available to neurologists. All of the measures included are relevant to neurology and give providers a wide breadth of measures to select directly related to their practice. Measure Domain

Measure Detail

ALS

End of Life Planning Assistance*

Child Neurology

Infantile Spasms*

Child Neurology

Querying for Co-morbid Conditions of TD and TS*

Child Neurology

Botulinum Toxin Serotype A (BoNT-A) for Spasticity or Dystonia*

Cross-cutting

Falls: Screening for Fall Risk

Cross-cutting

Falls: Risk Assessment

Cross-cutting

Falls: Plan of Care

Cross-cutting

Documentation of Current Medications in the Medical Record

Cross-cutting

Advanced Care Plan

Cross-cutting

Closing the Referral Loop

Dementia

Staging of Dementia

Dementia

Functional Status Assessment

Dementia

Screening for Depressive Symptoms

Dementia

Education and Support of Caregivers for Patients with Dementia*

Dementia

Safety Concern Screening and Follow-up for Patients with Dementia*

DSP

Diabetes/Pre-diabetes Screening for Patients with DSP

DSP

Screening for Unhealthy Alcohol Use with Counseling

Epilepsy

Seizure Frequency and Seizure Etiology (Paired Measure)

Epilepsy

Screening for Psychiatric or Behavioral Health Disorders

Epilepsy

Counseling for Women of Childbearing Potential with Epilepsy

Essential Tremor

Annual Assessment of Essential Tremor Severity*

Falls

Querying About Falls for Patients

Headache

Medication Prescribed for Acute Migraine Attack

Headache

Quality of Life Assessment for Patients with Primary Headache Disorder

Headache

Overuse of Neuroimaging for Patients with Primary Headache and a Normal Neurological Examination

Headache

Overuse of Barbiturate and Opioid Containing Medications for Primary Headache Disorders

Multiple Sclerosis

Exercise and Appropriate Physical Activity Counseling for Patients with MS

Multiple Sclerosis

Current MS Disability Scale Score*

Giant Cell Arteritis

Absence of Fellow Eye Involvement After Corticosteroid Treatment*

Ocular Myasthenia Gravis

Improvement of Ocular Deviation or Absence of Diplopia or Functional Improvement*

Parkinson’s

Psychiatric Disorders or Disturbances Assessment for Patients with PD

Parkinson’s

Querying About Sleep Disturbances

Parkinson’s

Querying About Symptoms of Autonomic Dysfunction

Parkinson’s

Cognitive Impairment of Dysfunction Assessment for Patients with PD*

Parkinson’s

Falls Outcome for Patients with PD*

Parkinson’s

Rehabilitative Therapy Options*

Sleep

Assessment of Sleep Symptoms

*New to the Axon Registry in 2018

All measures in the Axon Registry are useful for neurology quality improvement purposes. If you’re looking for ways to track neurology-specific quality measures for your practice, visit the AAN webpage to see how the Axon Registry can help you. Review below the variety of options you can chose from.

AANnews • January 2018

The Axon Registry also has created a portal for the implementation of three Patient Reported Outcomes (PRO). The PROMIS-29, Quality of Life Epilepsy, and PHQ-9 PROs have been implemented for providers to use. The AAN’s Quality and Safety Subcommittee and the Registry Committee select the measures to be implemented into Axon. On an annual basis, the AAN will work to add more measures and PROs into the Axon Registry to ensure that is useful to as many Academy members as possible. If you are interested in joining the Axon Registry, please check out our website. If you have questions or would like to provide input about quality measures, contact registry@aan.com. 

MIPS REPORTING: OUT WITH THE

OLD YEAR, IN WITH THE NEW

January marks the first month of the 2018 performance period for the Quality Payment Program and specifically the Meritbased Incentive Payment System (MIPS). To avoid a penalty this year, you must achieve 15 points across all four MIPS performance categories. You can position yourself for success by starting to collect quality measures (a full year is required). The Centers for Medicare & Medicaid Services (CMS) will be measuring performance on cost starting this month, too, but you don’t have to submit anything extra for this category. Benchmarks for measures will be available online in January. Even though 2017 is over, you still have a chance to submit measures to CMS for the 2017 performance year to avoid a penalty in 2019. As long as you have collected one quality measure by December 31, 2017, you can earn three points and avoid a negative payment adjustment in 2020. CMS will open its attestation portal on qpp.cms.gov in January 2018. The final day to submit 2017 data is March 31, 2018. For more information and to see a listing of neurology-specific quality measurements, visit AAN.com/MACRA. 

AANnews • January 2018 9

Policy & Guidelines

ACADEMY ISSUES UPDATED PRACTICE GUIDELINE ON MILD COGNITIVE IMPAIRMENT The AAN published “Practice Guideline Update: Mild Cognitive Impairment” online ahead of print in Neurology ® on December 27; it will appear in the January 16, 2018, print issue. This guideline focuses on prevalence and treatment of mild cognitive impairment (MCI), and finds that there Petersen is strong evidence that MCI prevalence is high in the general population, with prevalence increasing for every five-year age group, starting at age 60 years. Furthermore, MCI is likely to progress to dementia unless further investigation uncovers a reversible cause for the condition, such as treating a sleep disorder. Moderate evidence shows that people diagnosed with MCI can benefit from regular physical exercise. The confidence in the evidence is low that targeted cognitive interventions, taken as a group, may help improve performance on some cognitive measures, but there is little functional benefit. “It is notable that, although we have seen abundant published research on therapies for MCI since the original guideline, there have been no known pharmacologic therapies for which evidence of lasting benefit has been demonstrated in welldesigned studies,” said Ronald C. Petersen, MD, PhD, FAAN, lead author of the guideline. “We suspect that many persons with MCI would be good candidates for such clinical trials of prospective new therapies.” Read the guideline and access PDF summaries for clinicians and patients, and a slide presentation set, on AAN.com . For more information, contact Julie Cox at jcox@aan.com or (612) 928-6069. 

RELATIONSHIPS ARE VITAL CURRENCY IN DC DEALING By Derek Brandt, AAN Senior Congressional Affairs Representative

Relationships are the lifeblood of Capitol Hill. Whether a bill becomes law hinges as much on who champions the proposal as whether the idea has merit. A successful champion must have solid relationships and reputations with members of the Congress, congressional staff, and with key stakeholders in Washington. This is equally true for lobbyists advocating for issues as it is for the members of Congress who introduce legislation. For this reason, I spend a great deal of time developing and maintaining relationships both on and off Capitol Hill. I meet regularly with congressional staff in their Capitol Hill offices, with members of Congress primarily at political fundraisers, and with other influential lobbyists at various coalition and strategy meetings. Personal relationships with congressional leadership are essential, but having relationships with a wide range of senators and representatives is important because you never who is going to be helpful. Lawmakers often have personal connections to an issue—making it more likely that they will support or even lead an issue. For example, I was talking one day with Rep. Morgan Griffith of Virginia, who I’ve known since he was a freshman in 2011. I simply asked if he had any experience with stroke. Rep. Griffith perked up and explained that he had witnessed the “miracle drug” tPA firsthand when he served in the Virginia House of Delegates. At that time, a colleague of his suffered a stroke, but fortunately a neurologist who also served in the House of Delegates was on hand to recognize the symptoms and rush the person to the hospital. Thanks to tPA, the individual had fully recovered within days. This conversation led Rep. Griffith to become the lead sponsor and a passionate advocate for the Furthering Access to Stroke Treatments (FAST) Act—legislation that would allow Medicare stroke patients to receive a stroke consult via telemedicine.

Brandt, left, with Sen. John Hoeven (R-ND); AAN member William D. Schnapp, MD; and Sen. John Thune (R-SD).

AANnews • January 2018

Having relationships with other is critical and should be prioritized lobbyists is also critical because little ahead of other meritorious programs. gets done in Washington based on the Fortunately, these efforts have paid voice of one or two stakeholders. To be off. Each year, at the same time successful, organizations like the AAN other programs have been cut or strengthen their positions by forming eliminated, funding for the BRAIN coalitions with other interested Initiative has increased—from $80 stakeholders to advocate in support million in its inaugural year to a or opposition of an idea. The AAN is a proposed $400 million for FY2018. member of many coalitions on issues These efforts occur in DC, but some such as addressing drug pricing, of the most impactful relationships reducing regulatory burdens, and occur when a constituent gets to advocating for cognitive specialists. Sen. Ron Wyden (D-OR),left; Brandt with Sen. Mark Warner (D- know a member of Congress back Each coalition consists of different VA); and Sen. Jon Tester (D-MT), right. home. Constituents have more access stakeholders—who band together out to lawmakers and their staff than a lobbyist can ever have. of mutual interest and are more powerful as a combined force. Neurologists speaking directly to members of Congress and One coalition the AAN leads supports the Brain Research congressional staff provide great credibility and give the AAN a through Advancing Innovative Neurotechnologies (BRAIN) big voice on important issues. Initiative at the NIH. Each year, this coalition generates I encourage you to consider building your cosponsorship by dozens of members of Congress and letters own relationships with your state and federal in support of increased funding for this program. I remember representatives by attending their town halls, the first year we circulated the letter it was difficult to get visiting their local office, or even traveling to signatures, because we had to first educate congressional Washington, DC. As you do, I hope you’ll keep offices on the importance of the BRAIN Initiative. But each me up-to-date at dbrandt@aan.com , and subsequent year became easier, thanks to the relationships we follow the AAN by reading Capitol Hill developed. We also meet face-to-face with key congressional Report and my Twitter feed appropriation staff regularly to stress why the initiative @DerekBrandtDC. 

AANnews • January 2018

Policy & Guidelines

AAN SCORES VICTORIES IN FINAL MEDICARE PHYSICIAN FEE SCHEDULE continued from Cover to reduce the regulatory hassles facing neurologists in the Medicare program. In addition, we met with CMS throughout the year to advocate for reduced burdens on neurologists and their patients. We are pleased to see CMS finalize through this rule many of the proposals backed by the AAN aimed at reducing administrative hassles.

Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging Delayed Until 2020 CMS further pushed back its proposal to delay implementation of the AUC Program, which is now set for January 1, 2020. This is Evans a victory for neurology as the AAN directly asked CMS to delay implementation beyond 2018. CMS also finalized to pay claims for advanced diagnostic imaging services regardless of whether they have information regarding the AUC consultation. “The delayed implementation of the AUC program is a huge win for neurologists,” said David A. Evans, MBA, chair of the AAN’s Practice Management & Technology Subcommittee. “This program would have put additional administrative burdens on physicians at the same time most are focused on successful participation of MACRA/QPP. We will continue to advocate for the delay of this program until the workflow is seamlessly integrated into EHRs and there is no additional financial or administrative burden on neurologists.”

Coding and Reimbursement Changes CMS projects that overall allowed charges for neurologists will remain neutral in 2018. A permanent CPT code, 99483, will be available for the assessment of and care planning for patients with cognitive impairment. The AAN worked as part of a multi-specialty coalition to develop the code and advocate for the reimbursement of this service, which should help patients with dementia gain access to valuable medical care.

Evaluation and Management Comment Solicitation CMS believes that E/M documentation guidelines should be substantially revised. This will require a multi-year, collaborative effort among stakeholders—including the AAN, which plans to take an active role in the process. The agency previously noted that revised guidelines could both reduce clinical burden and improve documentation in Cohen a way that would be more effective in clinical workflows and care coordination. To achieve this goal, CMS is seeking input on specific changes

AANnews • January 2018

that should be taken to reform the guidelines, reduce burdens, and better align E/M coding and documentation with the current practice of medicine. This call for feedback gives the AAN another opportunity to demonstrate the value of cognitive services provided by neurologists during E/M encounters. The AAN looks forward to participating in the re-evaluation process in the coming years. “It is critical that the clinical note reflect relevant and patientcentric information,” said Bruce H. Cohen, MD, FAAN, the Academy’s CPT advisor and chair of the Coding Subcommittee. “The existing E/M coding requirements do not align well with the current practice of neurology, and have the unintended consequences of leaving the visit note potentially filled with errors and less relevant. Previous proposals to review E/M guidelines placed the burden of documentation on the quality and depth of medical decision-making aspect of the note—something that is useful for the entire treatment team and patient. Another challenge is that physicians perform necessary work outside of the hospital ward and ambulatory office. The inter-service care time that has been built into the E/M codes is out of touch with today’s practice of neurology. Patient care suffers without this physician work between office visits. Because our specialty cares for many highly complex patients with mobility disorders making frequent office visits difficult, our specialty is hit hardest when it comes to lack of recognition of this necessary inter-service care. We are working with other professional organizations to create new codes that account for physician work that does not fit into the typical hospital or ambulatory setting.”

Physician Quality Reporting System (PQRS) and Electronic Health Record (EHR) Reporting Requirements Reduced Several of the AAN’s suggested changes regarding the PQRS and EHR reporting programs have been finalized by the agency because of our advocacy efforts. Specifically, CMS will retroactively change the current PQRS policy for the 2018 payment year, which requires the reporting of nine measures across three National Quality Strategy domains. Instead, CMS will only require the reporting of six measures for the PQRS. A similar change in clinical reporting requirements is also finalized under the Medicare Electronic Health Record Incentive Program (“Meaningful Use”) for the 2018 payment year, which is also now changing under the new Advancing Care Information section of Merit-based Incentive Payment System (MIPS).

Changes to 2018 Value Modifier CMS finalized changes to the policies for the 2018 Value Modifier to provide a smoother transition to the new MIPS component of the Quality Payment Program. The agency will reduce the payment penalty for not meeting minimum quality reporting requirements and will hold harmless all physicians who met minimum quality reporting requirements from any 2018 payment year penalty for performance under quality-tiering for the last year of the program. The AAN worked closely with CMS to advocate for this specific proposed change.

Request for Information on Reducing Regulatory Burdens Previously, CMS requested feedback on solutions to better achieve transparency, flexibility, program simplification, and innovation. This will inform the discussion on future regulatory action related to the Physician Fee Schedule. The agency stated that it wishes to start a national conversation about improving the health care delivery system; how Medicare can contribute to making the delivery system less bureaucratic and complex; and how CMS can reduce burden for clinicians, providers, and patients in a way that increases quality of care and decreases costs. The AAN solicited ideas for regulatory, sub-regulatory, policy, practice, and procedural changes to better accomplish these goals. 

CAPITOL HILL REPORT Capitol Hill Report presents regular updates on legislative and regulatory actions and how the Academy ensures that the voice of neurology is heard on Capitol Hill. It is emailed to US members twice monthly and is posted at AAN.com/view/ HillReport. Below are some recent highlights.

AAN, CMS Discuss Burdens of Prior Authorization In late November, the AAN joined a small group of medical societies focused on regulatory relief to discuss prior authorization in Medicare Advantage. We met with several staffers from CMS, including the agency’s Deputy Administrator, Demetrios Kouzoukas. We presented CMS with information about the burdensome impact of prior authorization on neurologists in the Medicare Advantage program. Many prior authorization requirements appear to be deliberately designed to dissuade physicians from ordering medically necessary services. This has a direct and negative impact on patient care. We asked CMS to issue guidance addressing the appropriate use of prior authorization by Medicare Advantage plans and the requirements that must be met if it will be used as a utilization control tool. We also asked CMS to increase its oversight, including the use of audits, of these plans’ adherence with existing prior authorization requirements.

AAN Member Elected Governor of Virginia AAN member and child neurologist Lt. Gov. Ralph Northam, MD, was elected to be the 73rd governor of Virginia, the highest elected public office ever held by a neurologist. Northam has been an AAN member since 1990. The new Democratic governor, who will take office this month, was first elected to the Virginia State Senate in 2007, and elected lieutenant governor in 2013. Look for a comprehensive article on the rise of this neurologist to governor in a future issue of Neurology Today ®. 

AANnews • January 2018 13

Conferences & Community

LIVE WELL PROGRAMS EMPHASIZE SELF CARE FOR EFFECTIVE PATIENT CARE Tuesday, April 24 1:00 p.m.–1:45 p.m. Complementary Therapies in Parkinson’s Disease Veronica Santini, MD 2:00 p.m.–2:45 p.m. Dancing with Parkinson’s Disease Diviya Kaul, MD Wednesday, April 25 2:00 p.m.–2:45 p.m. Resilience for the Neurologist Justin T. Jordan, MD Thursday, April 26 12:00 p.m.–12:45 p.m. The Purpose Checkup—Find Meaning, Live Longer, Better Richard Leider, Founder, Inventure, The Purpose Company

Get inspired, motivated, and educated about the importance of taking care of both your physical and mental health at the 2018 Annual meeting experiential learning area Live Well: Taking Care of Your Patients Starts with Taking Care of You. This fun, informative, and highly interactive area will offer more than 50 presentations throughout the week in a variety of formats that will focus on the importance of exercise and nutrition interventions for personal well-being and treatment for your patients. Look for small group sessions, panel discussions, interactive demonstrations, and more. Highlights include: Saturday, April 21 3:00 p.m.–3:45 p.m. How Your Social Life Might be Helping (or Harming) Your Brian Joel A. Salinas, MD Monday, April 23 1:00 p.m.–2:00 p.m. Perception Is Reality: Are Neurologists Helping Patients Live Well with Dementia? Daniel C. Potts, MD, FAAN; Neelum T. Aggarwal, MD

DON’T MISS THESE OTHER EXCITING LIVE WELL OFFERINGS! Free water bottles Massage chairs Daily morning yoga Acupuncture demonstrations Step challenge daily prizes Afternoon meditation Relaxation space More

For full presentation schedule and descriptions, visit AAN.com/view/AM18. 

“It’s so refreshing to see and experience this level of acceptance of mindfulness and general wellness practices at the Academy.”

~ 2017 Annual Meeting Attendee

April 21–27 • Los Angeles

AANnews • January 2018

2018 PRACTICE MANAGEMENT WEBINAR SERIES KICKS OFF ON JANUARY 23 continued from Cover New Changes for 2018

Clarke

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Responding to members’ evaluations, practice management webinars are moving to a panel model, which will provide more perspectives on the information in the webinar. This should make the information applicable to more members regardless of their practice level. We also are providing access to a Synapse online community page for members to ask further questions, whether they participate live or watch the recorded webinar.

Subscribe to All Webinars for Best Member Value

The AAN’s practice management webinars provide the valuable insights and tools you need to navigate through the ever-changing health care landscape! Single webinars are $99 but AAN members get the greatest value with the $189 subscription to all 10 live one-hour webinars. All webinars include access to presentation slides and recordings. Visit AAN.com/view/pmw18 to learn more and register, or contact Jessica Nickrand at jnickrand@aan.com . 

RESERVE THESE DATES ON YOUR CALENDAR FOR THE 2018 PRACTICE MANAGEMENT WEBINARS January 23 February 20 March 20 May 1

No Small Feat: Personally and Professionally Succeeding in Small and Solo Practice Successfully Participating in MIPS Getting Paid for Your Time, All of the Time Building Better Care Teams: Integrating APPs into Your Practice

May 22

Managing Headache Without Giving Yourself One: Using Tools and Technologies for Better Practice Management

June 19

5 Benchmarks That Can Make or Break Your Practice

August 21

Improving Patient Access, Engagement, and Care

September 25 October 23 November 20

Using Guidelines and Measures to Become a Better Neurologist How Does Health Services Research Help Me? Improving Payer Relationships

AANnews • January 2018 15

Conferences & Community

TAKE YOUR CAREER TO THE NEXT LEVEL WITH LEADERSHIP UNIVERSITY OFFERINGS Build your leadership skills to take your career to the next level! The AAN’s Leadership University course offerings at the 2018 Annual Meeting have something for everyone, at every career stage. Choose from courses designed for women or those focused on leadership challenges in practice to courses open to anyone who wants a deeper understanding of their strengths and how to use them to work more effectively. Note that many of these courses require advance registration. Visit AAN.com/View/LeadershipUniversity to learn more and to secure your spot.

Women in Leadership Saturday, April 21 7:00 a.m.–4:00 p.m. Directors: Janice M. Massey, MD, FAAN; Orly Avitzur, MD, MBA, FAAN; Keri Bischoff; and Julie Anderson This customized program will help participants understand how they uniquely influence and lead and reveal a personalized look at leadership style. Presenters will identify common experiences and leadership issues using personal stories of women in neurology. Through interactive conversation and guided exercises, participants will create a customized Strengths-based Leadership Statement: Your guide to being the best leader you can be. No two leaders are alike, and no two challenges will be solved in the same manner. We approach each situation in our own way, seeing the world through our own lens. The language of Strengths will help you understand how you’re wired to come at the world so that you can lead more intentionally and effectively.

Leadership Challenges in Practice Saturday, April 21 12:00 p.m.–4:00 p.m. Director: Brad C. Klein, MD, MBA, FAAN Neurologists face more challenges than ever to be successful in clinical practice. In either employed or private practice models, leadership skills have a positive

AANnews • January 2018

impact on individual and organizational success. This program will discuss relationship development and communication techniques to improve leadership effectiveness within an organization of any size, as well as tools to successfully negotiate with health care systems, insurers, and regulatory agencies; refine analytical skills to properly implement an economical and useful EHR system; evaluate and improve work flows and processes to increase new sources of revenue; and increase patient/provider satisfaction while meeting regulatory demands.

The Most Important Tool in Your Black Bag: Gallup StrengthsFinder Assessment

Being a Resilient Leader: How Do You Lead the Change?

workshop, Gallup-certified consultants will share a language for understanding your unique strengths, which has powerful application for well-being and happiness. Through customized exercises, materials, and conversations, this interactive workshop encourages a new perspective through your own unique lens. Using the science behind the StrengthsFinder™ assessment, we’ll discover your top five talent themes and a positive language to leverage what’s right and share ways this approach can change the culture of your organization through engagement, which leads to increased productivity, patient satisfaction, and peer understanding.

Sunday, April 22 1:00 p.m.–5:00 p.m. Directors: Heidi B. Schwarz, MD, FAAN; and Jennifer Rose Molano, MD, FAAN The issue of burnout is prevalent in medicine and neurology, with personal, professional, and organizational implications. We all have the potential to be leaders of change in our work units and organizations to promote wellness and resilience. Those efforts can fuel policy changes at a state and national level. In this interactive course, faculty will share the current knowledge and creative approaches to addressing factors contributing to burnout in the work unit and organization, as well as the economic argument for institutions to address burnout. Small group sessions will allow participants to use this information to formulate their own plan for promoting resilience and how to advocate for this. A panel of current leaders who have addressed these issues in their own practice/organization will share their interventions including successes and roadblocks.

Sunday, April 22 1:00 p.m.–5:00 p.m. Directors: Keri Bischoff and Julie Anderson Back by popular demand, this is the foundation for all AAN strengths learning in neurology. In this customized

Continuing Your Leadership Journey: Uncharted Waters Monday, April 23 1:00 p.m.–3:00 p.m. Director: Barbara L. Hoese You’ve committed to leadership. Now what? After successfully completing the AAN’s leadership program, you set off equipped with new skills for leading. As you increased your proficiency with those skills, you took on great leadership roles. Along with those new opportunities, you ran into a roadblock

or two that you hadn’t encountered before. You may be realizing it’s time to refresh your skills and to take your leadership to the next level. Reconnect and learn from each other’s experience on the path to a higher level of leading. Bring a challenge that you are currently facing and get ideas on how to see your issue in a different light, reframe it into an opportunity, and create new solutions.

Educators’ Leadership Course Saturday, April 21 1:00 p.m.–4:00 p.m. Director: Jaffar Khan, MD, FAAN Neurology clerkship and program directors are among the most important gatekeepers of our pipeline to careers in neurology. In many cases, these education leaders are responsible for the first contact with potential candidates for the future workforce in neurology. This course is designed to optimize the skill set of these influential leaders.

Mitigating the Impact of Unconscious Bias Workshop Monday, April 23 1:00 p.m.–4:00 p.m. Director: Laraine Kaminsky During this informative, participatory, and engaging workshop, faculty will explore the science of unconscious bias, with a specific focus on the impact of bias and resulting disparities in the health care sector. The facilitator will define and explain the differences between bias and unconscious bias.

Leadership in the Era of Burnout: A Practical Approach to Becoming a True Physician Leader

This highly interactive program will consider the strategies for finding and creating new opportunities for leadership in one’s career and life. Leaders from private practice and academia will share their perspectives and consider ways of setting and reaching new goals. This workshop will bring together people from many career stages to consider how one can shift gears and pursue highly productive, generative, and creative activities as a practitioner, educator, or researcher. Issues including mentoring, global opportunities, focusing on your mission, fostering diversity, and supporting your passion will be covered in panel discussions with neurologists “who have been there,” discussion with facilitator Richard Leider of “Life Reimagined,” and breakout groups.

Tuesday, April 24 1:00 p.m.–3:00 p.m. Director: Terrence L. Cascino, MD, FAAN The challenge of being a leader is complicated by a high rate of burnout. This course will examine how to lead effectively and at the same time promote wellness, as well as what it means to be a true physician leader and how to develop into one.

Mentoring…Growing the Next Generation of Neurologist Tuesday, April 24 1:00 p.m.–3:00 p.m. Director: Joanne Smikle, PhD

Leadership Strengths in Neurology: The Data, Tools and Practical Application of Strengths for Leadership, Team Building, and Personal Development

This session focuses on the competencies required to build strong developmental relationships, emphasizing factors required to successfully build mentoring relationships with physicians or staff from different settings and at different stages of practice. Faculty will explore the distinctions between coaching and mentoring, provide a framework for building a solid mentoring relationship, and offer approaches for maximizing the mentor/mentee relationship.

Wednesday, April 25 1:00 p.m.–5:00 p.m. Directors: Keri Bischoff and Julie Anderson This workshop builds on the foundational learning from the prerequisite course The Most Important Tool in Your Black Bag: Gallup StrengthsFinder™ Education Workshop. Participants will learn to understand the practical and specific application of Strengths. Presenters will share current Strengths data in the field of neurology to address your unique needs through interactive and guided discussions and a highlight of tools to improve relationships and maximize team productivity. Written exercises, a personalized Strengths Development poster session, directed conversations, customized materials, and advanced StrengthsFinder tools will create selfunderstanding and an appreciation for how you, uniquely, come at the world, bringing you to a more nuanced realization of how you lead and how those around may approach the same goals in very different ways. 

Advanced Leadership Training: Preparing for Your Career’s Insurmountable Opportunities Wednesday, April 25 1:00 p.m.–5:00 p.m. Director: Robert C. Griggs, MD, FAAN

AANnews • January 2018 17

Conferences & Community

DIVERSITY LEADERSHIP PARTICIPANT TAKES VALUABLE EXPERIENCE BACK TO WORKPLACE AND BEYOND A crucial aspect of the AAN’s strategy is to engage members from underrepresented minority groups through leadership opportunities that provide participants with specialized mentoring and coaching to enhance their career development and expand their professional networks. Leacock For 2017 Diversity Leadership Program graduate Rodney Leacock, MD, the experience did just that: provided a new perspective on how to look at diversity within his own Palmetto Health–USC workplace community. “I work with all types of people who are very unique indeed, regardless of cultural and ethnic heritage, age, disability, gender, educational background, social status or religious preference,” said Leacock. “Fortunately, at a personal level we can work together most of the time and have found ways to overcome some of the challenges when needed to maintain the team spirit.”

the AAN headquarters. It was empowering and gratifying, and a major highlight!” “It is now time for me to share my Diversity Leadership Program experience with my colleagues and to reach out to our leadership at Palmetto Health–USC and the community,” added Leacock, who has already received recognition with a nomination for the Man of Impact Award with the Palmetto Health System—an honor that recognizes male employees who are making a difference within the workplace and community. Added Leacock, “I am looking forward to fostering the growth and development of subsequent Diversity Leadership Program and/or other Academy members, and to promote the AAN mission.” The Diversity Leadership Program is open to talented and highly motivated individuals from underrepresented communities—at any stage in their post-residency career—who are committed to the profession of neurology and to providing high-quality patient-centered care. Only by encouraging and

Building a new network of colleagues who share a common goal through the nine-month program was a key takeaway for Leacock. “We learned about each other, formed a new network of people beyond the scope of daily lives, comradery, vision, purpose, perseverance, and leadership. I appreciated the true supportiveness and altruistic nature. The AAN headquarters felt more like a village and family gathering connecting to our past, present, and future leaders.” As one of 10 participants Front Row: Michelle Bell, MD; Omotola Hope, MD, MS; Roy Hamilton, MD, MS, FAAN, FANA; Natividad Stover, MD in the prestigious Back Row: Jose Posas, MD; Erika Marulanda-Londono, MD; Rodney Leacock, MD; Cumara O’Carroll, MD; Richard Young, MD, FAAN program, Leacock received personalized developing a more diverse membership can neurologists be mentoring, coaching, and leadership training with both AAN equipped to lead, represent, and serve our increasingly diverse leadership and staff, as well as the opportunity to contribute to patient population. Learn more at AAN.com/view/Diversity.  a group project that was then presented to the AAN Board of Directors. “In addition to the coaching, mentoring, and ability to learn and apply the principles of self-reflection and social awareness, one of the most valuable aspects of the program was having the opportunity to present before the AAN Board and staff at

AANnews • January 2018

Education & Research

PLAN AHEAD FOR UCNS 2018 DEADLINES Don’t miss out on opportunities for fellowship training program accreditation, certification, or recertification through the United Council for Neurologic Subspecialties (UCNS) for 2018. Applications for Headache Medicine certification and recertification examinations are available now. The practice track pathway is available in 2018. The early deadline to apply without a late fee is April 2, 2018, and the exam is scheduled for the week of October 8–12, 2018. Next month, applications will be available for both Autonomic Disorders and Behavioral Neurology & Neuropsychiatry exams, with an early deadline of May 1. The Autonomic Disorders exams are scheduled for the week of November 5–9, 2018. The Behavioral Neurology & Neuropsychiatry certification and recertification exams are scheduled for the week of November 12–16, 2018. Applications for accreditation for fellowship training programs are accepted every June 1 and December 1.

AAN ANNUAL MEETING:

SHINING THE SPOTLIGHT ON YOUR CAREER REGISTER NOW This [meeting] provided so many fundamentals that I need in everyday practice. —Advanced Practice Provider Member

For more information, visit UCNS.org . 

I especially liked the experiential learning areas. They really captured the kinetic energy of the meeting. —Neurologist Member

I’m going to tell my fellow residents to go to the Annual Meeting. It’s a fantastic networking and educational opportunity. I plan to go for years to come. —Junior Member

APRIL 21–April 27, 2018 ADVANCING NEUROLOGY. ADVANCING YOU.

Education & Research

‘SWEEPING CHANGES’ COME TO NEUROLOGY JOURNAL The AAN’s flagship scientific publication Neurology ® has undergone a significant makeover that debuts this month, perhaps the most extensive since “the green journal”—so called for its once solid-color cover—premiered in 1951. “Readers will note sweeping changes in Neurology as of the January 2, 2018, issue,” foretold Editor-in-Chief Robert A. Gross, MD, PhD, FAAN, and Managing Editor Patricia K. Baskin, MS, in an October special editorial. They explained that these changes “were carefully considered Gross as the editors reimagined the journal in the context of changes in scientific publishing in general, and supported by extensive research in readers’ habits and preferences. The most notable changes occur both in print and online, for which there are new designs, the result of two years’ work and crafting. For print, we are publishing articles in a short format, allowing a more comprehensive reading experience in a shorter time. For the online, canonical version of the journal, we are now able to accommodate longer full articles. Along with the new design and format of the reimagined journal, the editors and editorial board have put in place new policies on data availability.”

Short-article Format For one year, the journal will pilot the electronic-long-papershort (ELPS) model of publishing all research articles in the publication. Short-form articles include what is known, main results, confounding factors, and generalizability. Other articles, such as editorials, guidelines, Views & Reviews, and Clinical/Scientific Notes, will continue to be published full length in the print version. The short-article format debuted in the September 6, 2016, issue of the journal.

Full-length Expanded Online Article Format Because of savings gained with short-form articles in the print version, the journal’s online publication will accommodate longer articles with more extensive citations. The word length for Neurology research

AANnews • January 2018

articles will increase from 3,000 to 4,500 words, the allowed number of tables or figures will increase from five to seven, and the allowed number of references will increase to 50. The maximum length of Views & Reviews articles will increase from 3,500 to 5,000 words. This should satisfy authors who have stated they cannot fully describe their research within the previous print page-limit restrictions.

New Print and Web Designs Extensive research and member feedback has guided the redesign of the journal and its web component to be both visually attractive and more user-friendly.

New Policy on Data Availability Neurology has adopted a new policy to help ensure greater transparency of the data supporting an article and reproducibility of studies. Although Neurology has always expected authors of our published articles to share data with fellow researchers, it had no written policy. Learn more about the new Neurology policy at bit.ly/2yaxdP0. 

AAN.com/careers

Visit the AAN’s Neurology Career Center to view hundreds of additional jobs and sign up for customized, confidential notifications when positions of interest are added.

Neurologist Boarded in Sleep Medicine, General NeurologistFocus on Headache,General Neurologist, Neurohospitalist, Neurobehavioralist, Neurobehavioralist with focus on Dementia, Psychiatrist/Neuropsychiatrist We are a private practice multispecialty group in North San Diego County consisting of Twenty-One physicians, 2 Neuropsychologists, 1 Psychiatrist, and six Physician Assistants, practicing in a number of different disciplines. Our practice includes multiple fellowship trained and boarded subspecialists with expertise in neurophysiology, epilepsy monitoring, sleep medicine, headache medicine, stroke care, neuro-rehabilitation, neuropsychology, movement disorders, and psychiatry. We have a sleep lab and four offices in the region. We practice at Scripps Memorial Hospital Encinitas-Acute Inpatient Rehab, Scripps Memorial Hospital in La Jolla, California, Palomar Pomerado Hospital in Escondido and Poway California, as well as Tri City Medical Center in Oceanside, California. We have affiliations with all the major health systems in San Diego including Scripps, UCSD, Sharp and Kaiser. This practice has been in existence since 1977 and is well positioned in the community to provide neurological

services. Most partners have academic appointments at UCSD as volunteer faculty. We have a busy clinical trials practice. Our practice has grown out of a desire to combine the benefits of private practice with elements of research and academics. Our desire is to attract several BC/BE, highly qualified, energetic and motivated physicians for our Multidisciplinary Neurology practice as we continue to grow. We are recruiting for the following positions: Neurologist Boarded in Sleep, Neurohospitalist, General Neurologist, Neurologist with focus on Headache/Migraine, Neurologist with focus on movement disorders, Neurobehavioralist and a Neurobehavioralist with focus on Dementia, as well as a Neuropsychiatrist/Psychiatrist. There is partnership opportunity. Our practice has had Electronic Health Records for many years, we are Joint Commission accredited. You can visit our website at www.neurocenter.com. Please email CV directly to vtibbs@neurocenter.com as well as rossies@neurocenter.com. Subject line should read: CV, your name and the position you wish you apply for. I.e. CV, John Smith M.D., General Neurology/Sleep Medicine.

AANnews® Classified Advertising The AAN offers a complete package of print, online, and in-person recruitment advertising opportunities. Visit careers.AAN.com for all AAN options, rates, and deadlines.

d copy for the March 2018 print edition of AANnews A must be submitted by February 1, 2018. The same deadline applies to changes/cancellations. he American Academy of Neurology reserves the T right to decline, withdraw, or edit advertisements at its discretion. Every care is taken to avoid mistakes, but the responsibility for clerical or printer errors does not exceed the cost of the ad.

American Brain Foundation

WELCOME NEW AMERICAN BRAIN FOUNDATION BOARD MEMBERS! In its push for growth, the American Brain Foundation continues to expand its board of directors and to develop a balance of neurologists and non-neurologists to provide impactful leadership and ambassadorship. Congratulations to these four new board members, who will begin their first two-year terms on January 1, 2018.

David Eagleman, PhD David Eagleman, PhD, is a neuroscientist, writer, and entrepreneur. He is an adjunct professor at Stanford University, as well as the creator and presenter of the Emmy-nominated PBS television series, “The Brain.” He has written several internationally bestselling books; his latest is The Runaway Species, which explores the neuroscience behind human creativity. Eagleman is also invested in the intersection of neuroscience and the law and, in this capacity, he directs the Center for Science and Law. He is a Guggenheim Fellow, a council member in the World Economic Forum, and a Goldman Sachs Innovator of the Year.

James A. Essey James A. Essey is president and CEO of The TemPositions Group of Companies, one of the nation’s largest regional staffing firms. His mother had ALS, and his family established and funds the Sheila Essey Award for ALS Research in her honor. A leader in his industry, Essey rose to become chairman of the American Staffing Association. He currently serves as chair of its Legal/Legislative committee and negotiated special provisions in the ACA for the industry. His community involvement has included service on the boards of the Eastern Region DARE program, the NYC Metro Chapter of the Young Presidents’ Organization, and the Hunter College Elementary and High School PTAs, where he served each as president for three years. He was presented with the Corporate Leadership Award by NY Youth at Risk for “creating opportunities that contribute to the growth and development of young people.” Essey holds a BA from Trinity College, a General Course degree from the London School of Economics, and an MBA from Harvard University.

Shafali Jeste, MD Shafali Jeste, MD, is a behavioral child neurologist specializing in autism and related neurodevelopmental disorders. She is an associate professor in psychiatry, neurology, and pediatrics in the UCLA David Geffen School of Medicine, and a lead investigator within the UCLA Center for Autism Research and Treatment (CART). After earning a BA in philosophy from Yale University in 1997 and her MD from Harvard Medical School in 2002, Jeste completed a residency in child neurology and a fellowship in

AANnews • January 2018

behavioral child neurology at Children’s Hospital, Boston. She has served on the board of the Child Neurology Foundation and received its Researcher-in-Training Award. She was also a recipient of the American Academy of Neurology’s Clinical Research Training Fellowship, and currently serves on the Academy’s Science Committee. Jeste recently was elected to the Board of the International Society for Autism Research (INSAR).

Edgar Kenton III, MD, FAAN, FAHA Edgar Kenton, MD, is the president of Kenton Consulting Group and an expert in stroke and neurological disease. Educated at Cornell Medical College and trained at Thomas Jefferson University, Kenton is certified by the American Board of Psychiatry and Neurology. He previously served as chief of neurology for the United States Air Force at March Air Force Base in California and as chief of the division of neurology at Lankenau Hospital in Philadelphia. He has served on the board of the American Academy of Neurology and chair of the AAN Practice Committee. He is a past president and director emeritus of the American Board of Psychiatry and Neurology. Most recently, Kenton served as the director of neurology and co-director of neurosciences for the Geisinger Health System in Danville, PA, and the Director of the Geisinger Health System Stroke Program. He is a recipient the AAN Outstanding Leadership Award, the American Heart Association Distinguished Service Award and its Lifetime Achievement Award. A longtime supporter of the American Brain Foundation, Kenton has been instrumental in creating the foundation’s Calhoun Fund, which supports the development and mentoring of African American neurologists and neuroscientists. 

Dates & Deadlines

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JANUARY 3

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MARCH 2

Early Registration Deadline: 2018 AAN Breakthroughs in Neurology Conference Orlando, FL AAN.com/view/Breakthroughs

RITE Administration

2018 Neuro Film Festival Video Submission Deadline NeuroFilmFestiva

Early Registration Deadline: Career Essentials Conference Orlando, FL AAN.com/view/CareerEssentials

FEBRUARY 20 Webinar: Successfully Participating in MIPS (Register by February 19) AAN.com/view/pmw18

JANUARY 12–15 2018 AAN Breakthroughs in Neurology Conference Orlando, FL AAN.com/view/Breakthroughs

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MARCH 20 Webinar: Getting Paid for Your Time, All of the Time (Register by March 19) AAN.com/view/pmw18

APRIL 21–27 AAN Annual Meeting Los Angeles, CA AAN.com/view/18AM

JANUARY 13–15 Career Essentials Conference Orlando, FL AAN.com/view/CareerEssentials

JANUARY 23 Webinar: No Small Feat: Personally and Professionally Succeeding in Small and Solo Practice (Register by January 22) AAN.com/view/pmw18

January 12–15, 2018 • Orlando, Florida

January 13–15, 2018 • Orlando, Florida

Translating Today’s Discoveries into Tomorrow’s Clinics

Foundation for Your Future

AAN.com/view/Breakthroughs

AAN.com/view/CareerEssentials 23

A study conducted in Italy of 617 people with Parkinson’s found that approximately 50% experienced symptoms of OFF within 5 years of diagnosis.1 OFF periods can occur throughout the day, can be unexpected and may appear more often over time.1-3 In a 2014 survey of > 3,000 people with Parkinson's, two-thirds of respondents reported having more than two hours of OFF time per day.4

OFFmatters.com PD5817 7/17

1. 2. 3. 4.

Stocchi F et al. Parkinsonism Relat Disord. 2014;20(2):204-211. Stacy M et al. Mov Disord. 2005;20(6):726-733. Stacy M et al. www.medscape.org/viewarticle/701955. 2009. Accessed April 2017. The Michael J. Fox Foundation Survey of Parkinson’s Patients’ Off Time Experience, July 2014.