2010

SDCMS

2010 ANNUAL REPORT

As you read about our 2010 accomplishments, we hope that you do so with a mixture of pride and hope — pride that as an SDCMS-CMA member physician you are fighting to protect what is important to you and your patients, and hope that our collective strength, vigilance, and dedication will continue to protect the noble profession of medicine.

“Physicians United for a Healthy San Diego”

ADVOCACY

SCOPE OF PRACTICE

POLICING THE HEALTH PLANS ➻➻Recouped for individual CMA members over $2.5 million from insurance companies by fighting payment denials, payment delays, and underpayments. ➻➻Obtained critical clarifications from Blue Cross on its “timely access” contract amendment. ➻➻Facilitated a letter of clarification from Blue Cross on its global surgery policy change. ➻➻Worked with TriWest to correct an error resulting in the underpayment of Rotateq vaccine. ➻➻Worked with Blue Shield to revise its consultation code policy. ➻➻Got United to change its coverage determination guideline related to rhinoplasty, septoplasty, and turbinate resection. ➻➻Assisted physicians forced by Blue Cross to sign separate contracts and accept reduced rates to continue to treat Blue Cross-insured Healthy Families and AIM patients. ➻➻Got United to revise its proposed coverage determination guideline so that it no longer required a CT scan if the patient refused the scan or if the physician believed it to be unnecessary. ➻➻Filed formal complaints with DMHC against Vantage IPA on behalf of two members, asking DMHC to obligate the IPA to pay all outstanding claims. ➻➻Got the California Office of Administrative Law to reject regulations that would have legitimized “discount health plan” referral services. ➻➻Filed a lawsuit against WellPoint, alleging that it colluded with Ingenix on a price-fixing scheme to set artificially low reimbursement rates for out-ofnetwork care.

PROTECTING CALIFORNIA’S PATIENTS

➻➻Hospitals and labor unions attempted three separate times in 2010 to exert control over the delivery of medicine by eroding California’s bar on the corporate practice of medicine — ALL DEFEATED! ➻➻Co-sponsored “truth in advertising” legislation (AB 583) to ensure patients understand who will be helping them with their healthcare — SIGNED BY GOVERNOR! ➻➻One-time MBC licensing fee credit of $22 at your next renewal. ➻➻Sponsored legislation (AB 1235) to improve an already robust peer review system to make it even more effective in ensuring high-quality care in California’s hospitals — Vetoed by Governor. ➻➻Won enhanced physician network adequacy requirements for insurers and reduced administrative burdens for physicians in DMHC’s “timely access” regulations. ➻➻Three-year drive to protect patients from unlawful rescissions of health insurance — SIGNED BY GOVERNOR! ➻➻Lawsuit to exempt the MBC from state furloughs — physician licensure backlog cleared! ➻➻Ongoing challenge to governor’s taking $6 million in physician license fees to help close 2008 budget shortfall. ➻➻Sponsored legislation (AB 2248) to clarify Maddy Fund (often a physician’s only source of payment for providing emergency care to the uninsured) reporting requirements and address accounting practice weaknesses — Vetoed by Governor. ➻➻Requested an audit of Medi-Cal’s TAR process and supported legislation to reform the process — Held Due to Budget Concerns. ➻➻Sponsored legislation (AB 2093) to ensure private insurers cover the full cost of providing vaccinations — Vetoed by Governor.

HEALTH REFORM »» »» »»

Had the rural states prevailed, i.e., had we not fought this fight, California’s physician reimbursements would have been cut by up to 22%.

Ensured health reform bills were amended to account for California’s socioeconomic differences, health status differences, and geographic differences in practice costs.

Published easy-to-readHEALTHREFORM and-digest 2010–18 timeHealth Reform Timeline for lines for healthcare reform, designed to tear out and post to the wall.

Developed a one-page question-and-answer summary of accountable care organizations (ACOs), and had CMA’s general counsel speak to SDCMS members on ACOs and medical foundations.

2011

2011-2018

The following health reform legislation changes are schedule between 2011 and 2018. To d to be implemented access a health reform timeline for 2010, please visit the May 2010 issue of San Diego Physician.

»»

2011

➻➻Pharmacists independently initiating and providing immunizations to children and adults — KILLED! ➻➻Physical therapists evaluating and treating patients without a physician diagnosis or referral — KILLED! ➻➻Nurse practitioners gaining admitting privileges — KILLED! ➻➻Optometrists lowering glaucoma treatment training standards — Working to Prevent. ➻➻Nurse anesthetists providing anesthesia without physician supervision — Filing a Lawsuit to Stop!

INSURANCE REFORM S:

• Health insurance prov iders that do not dedicate 85 per cent (largegroup market) or 80 p ercent (individual and small-grou p markets) of revenue to direct pa tient care must provide a rebate to enrollees.

LONG-TERM CARE INSURANCE:

• National, voluntary, long -term care insurance program estab lished.

TORT REFORMS:

• Five-year demonstration g rants awarded to states to develop, impl ement, and evaluate alternatives to cu rrent tort litigations. (NOTE: NOT A PPLICABLE FOR CALIFORNIA)

MEDICARE PRESCRIPTION

DRUGS:

• Pharmaceutical manufac turers required to provide a 50 percent d iscount on brand-name prescription s filled in the Medicare Part D coverage gap beginning in 2011.

• Federal subsidies for gene ric prescriptions filled in the Medicar e Part D coverage gap begun to be phase d in.

REIMBURSEMENTS TO PHYSICIANS:

• Ten percent primary care bonus for internists, geriatricians, fa mily physicians, and pediatricians fo r five years for whom primary care serv ices account for at least 60 percent of Med icare-allowed charges over a designated period of time.

• Ten percent general surge on bonus for general surgeons practicin g in health professional shortage are as for five years. (NOTE: NOT APPLI CABLE FOR CALIFORNIA)

REIMBURSEMENTS TO HOSPITALS:

• Medicare payments to qu alifying hospitals in counties with the l owest quartile Medicare spending for 20 11 and 2012 provided. (NOTE: NOT A PPLICABLE FOR CALIFORNIA)

MEDICAID:

MEDICAL HOMES:

• Demonstration program for primary care medical homes for p atients with multiple chronic conditi ons established.

• Physicians eligible for sha red savings bonus payments for med ical homes.

Insurance Reforms Tort Reforms

• Nurse practitioners and p hysician assistants may lead medic al homes but only if state scope-ofpractice laws allow it. (NOTE: NOT APP LICABLE FOR CALIFORNIA) • New Medicaid state plan option created to permit Medicaid enroll ees with at least two chronic conditi ons, one condition and risk of develop ing another, or at least one serious and persistent mental health condition to designate a provider as a medical hom e.

• States taking up the optio n provided with 90 percent FMAP fo r two years for health home related servi ces, including care management, care co ordination, and health promotion.

• Coverage for preventive s ervices, and preventive services cost-sh aring eliminated.

• Federal payments to states for Medicaid services related to healthc are-acquired conditions eliminated.

• State Balancing Incentive Program in Medicaid created to provi de enhanced federal matching paymen ts to increase non-institutionally based long-term care services.

Reimbursemen to Physicians ts Reimbursements to Hospitals

Medicare Prescription Drugs Long-Term Care Insuran ce

Medicaid

Medical Homes

ADVOCACY

Protecting Hospital Medical Staffs CMA published its 2010 Model Medical Staff Bylaws, the definitive guide for medical staffs, providing details on professional and legal structures to support effective medical staff operations.

PROTECTING MICRA ➻➻Defended the constitutionality of MICRA in court, filing an amicus brief and testifying before the appellate court in the case, which ultimately upheld the constitutionality of MICRA again. ➻➻Worked to ensure that federal health reform efforts did not undermine MICRA. ➻➻Made sure that every recommended candidate for the California Legislature, whether Republican or Democrat, supported MICRA. ➻➻Continue to be engaged on all levels in preparation for an expected attack on MICRA by trial lawyers in 2011–12, working with our partners to educate physicians, lawmakers, and the public about the importance of preserving this law.

FIGHTING TO FIX THE UNFAIR DESIGNATION OF SAN DIEGO AS A RURAL COUNTY ➻➻We were thrice within days, literally, of GPCI’s repeal in 2010, before concerns over ballooning deficits and political exigencies scotched final repeal. ➻➻The San Diego and Santa Cruz County-spearheaded federal lawsuit suing CMS for retrospective damages of more than $2 billion ($180 million for San Diego’s physicians) was remanded for mediation by the Ninth Circuit Court of Appeals and is still proceeding. We’re not there yet, but this will be the result of members’ dues dollars at work! ➻➻In January 2010, the Union-Tribune focused on GPCI in an editorial that asked Sen. Boxer and Sen. Feinstein to take up the issue. We’ve been lobbying and advocating for this fix for nearly eight years; this public recognition of the problem was welcome!

COMMUNITY ORGANIZATIONS

➻➻SDCMS worked closely with numerous area organizations to ensure the physician’s voice is a part of critical discussions being had and to add physician support to worthwhile causes, programs, and projects: • First 5 Commission • San Diego Childhood Obesity Initiative • Triennial Community-wide Needs Assessment • Mental Health America San Diego • Chamber of Commerce Healthcare Committee • Healthy San Diego • Medical Operations Center in Preparation for Countywide Disaster Response • UCSD Student-Run Free Clinic Project • The American Red Cross, San Diego/Imperial Counties Chapter

2009 Physician rce Workfo

rce SDCMS Physician Workfo and Compensation Survey

PHYSICIAN LEADERSHIP

By Tom Gehring, cEO and Executive Director, 18

San Diego county Medical Society

SDCMS published its fourth bi-annual workforce and compensation survey in 2010, including San Diego-specific physician salary data. Our ongoing workforce and compensation surveys have become critical tools in our discussions with lawmakers and decision makers.

March 2010 SAN DIEGO PHYSICIAN.OrG

HAITI

➻➻SDCMS physician James T. Hay, MD, was elected CMA presidentelect. ➻➻SDCMS physician Theodore M. Mazer, MD, was elected CMA vice speaker. ➻➻Two CMA physicians, Richard Pan, MD, and Linda Halderman, MD, were elected to the California Assembly.

PHYSICIAN WORKFORCE

Many SDCMS member physicians, including Dr. Brent Eastman, chief medical officer of Scripps Health, and Dr. John La Fata, internist and SDCMS-CMA member since 1981, joined the various medical response teams that went to Haiti to help the victims of its January 2010 earthquake. In addition, SDCMS worked with the American Red Cross to funnel financial gifts to its International Response Fund.

STOPPING MEDICARE CUTS ➻➻We were heavily involved in stopping the draconian cuts in Medicare rates in 2010. ➻➻Published an op-ed summation (“Health reform’s San Diego impact”) of what’s wrong with healthcare financing and why it matters to San Diego’s patients in the Union-Tribune.

STOPPING MEDI-CAL CUTS ➻➻Prevailed in multiple court cases in 2010 that held that the 2008 10% Medi-Cal reimbursement rate cut was illegal — a CMA-led coalition challenged the 10% cut in 2009, won, and returned $25.8 million to California’s physicians, roughly $3 million to San Diego County.

CALIFORNIA STATE BUDGET ➻➻Several major proposals CMA actively lobbied against did not make it into the final budget, including Medi-Cal copayments, reductions in Healthy Families eligibility, expanding the state sales tax to services (including physician services), and allowing the Franchise Tax Board to suspend professional licenses for nonpayment of taxes.

MEMBERSHIP

HIPAA

To help physicians understand their responsibilities under HIPAA and the HITECH Act, CMA updated several of its ON-CALL documents and hosted a “HIPAA Overview and Compliance: How to Be Compliant With Recent Changes” webinar, and SDCMS hosted its own “HIPAA Updates” seminar/webinar.

TOOLS TO PROTECT YOUR ABILITY TO SEE PATIENTS ➻➻Your SDCMS physician advocate helped hundreds of members enroll in PECOS, preventing their Medicare claims and orders from being rejected and ensuring money for their practices was not lost. ➻➻Hosted Palmetto’s medical director who gave a Medicare updates presentation and met one-on-one with members. ➻➻Published a number of guides, toolkits, and resources: • United Healthcare/Ingenix Settlement Guide to help physicians understand the settlement and what they needed to do to claim their share of the $350 million • California Physician’s Legal Handbook • PECOS Enrollment Guide • Red Flag Rule toolkits, webinars, and sample policies • Best Practices: A Guide for Improving the Efficiency and Quality of Your Practice • Managed Care Consultation Code Quick Reference Guide • Contracting Toolkit • Payer Contract Amendments Action Guide • Cal-Net IPA Physicians Guide • LaVida Medical Group — Important Changes: What They Mean to Your Practice • Payer Solvency Checklist • Blue Cross Important Changes: What They Mean to Your Practice • Monthly CMA Practice Resources e-newsletter ➻➻Partnered with DocSite to help members maximize their 2010 Medicare PQRI bonus and minimize the administrative hassle. ➻➻Helped members comply with a regulation requiring physicians to inform patients they are MBC-licensed.

RECOGNIZING YOUR OFFICE MANAGERS

SDCMS conferred its second annual “Outstanding San Diego County Medical Office Manager” award on Sue Rose, office manager for Dr. David Bodkin, in 2010.

SDCMS BENEFITS

➻➻SDCMS partnered with IronStone Bank to provide members no points on lines of credit and loans, ½ off points on commercial and construction real estate loans, no penalties on loan prepayment if paid by MD or MD business entity, free online banking, bank at work and courier service, waived ATM fees, and free first order of checks. ➻➻SDCMS partnered with DocBookMD® to provide a free subscription to an exclusive HIPAA-compliant professional network to connect, communicate, and collaborate via iPhones, iPads, and iPod Touches. ➻➻More than 800 SDCMS member physicians saved nearly $500,000 as a result of our 5% members-only discount on professional liability insurance with SDCMS-endorsed The Doctors Company. ➻➻SDCMS launched a pilot program that pays physicians’ annual dues for those doing business with an SDCMS-endorsed investment group. ➻➻In 2010, SDCMS hired Sonia Gonzales as your new medical office manager advocate. Sonia works alongside Marisol Gonzalez, your physician advocate, to provide full-time “concierge care” to your office manager. As an example, one of the 335 member problems they solved in 2010 resulted in a two-doctor group’s obtaining $114,000 in back payments and denied claims. ➻➻SDCMS partnered with Strategic HR Solutions in 2010 to provide members with solutions to their HR needs. ➻➻SDCMS’ endorsed partners continued to offer members and their practices significant savings on the cost of insurance, accounting services, security prescription pads, billing solutions, IT support, computer hardware, contract negotiations services, practice management consulting, banking, legal services, collections, and more. ➻➻SDCMS conducted a membership survey in 2010, asking our members, whom we serve, what they want us to be doing (or not doing).

HELPING MEMBERS TRANSITION TO EHRs AND GAIN FEDERAL FUNDING • Convened our second-annual SDCMS EMR trunk show: “How the Heck Do I Buy an EMR? Should I Buy an EMR? Which One?” • Led a coalition that was named a Regional Extension Center for California and that now, as CalHIPSO, assists physicians in the transition to EHRs. • SDCMS received a $25,000 grant from CalHIPSO to help physicians transition to EHRs. • Published “EHR Certification Process” for those members considering an EHR purchase.

• Published a guide to obtaining federal funding for electronic health records.

• Published Physician Guidebook to Meaningful Use. • Presented an “Electronic Health Records: Meaningful Use” webinar.

MEMBERSHIP

➻➻We offered our members myriad opportunities for professional development, helping you build skills and knowledge necessary for both personal development and career advancement: • two media training workshops, teaching physician leaders why “ummm” is not a verb • one advocacy training workshop • two “Leader’s Toolbox” seminars • one “Microsoft Outlook for Busy Docs” workshop • opportunities to join SDCMS’ board of directors and participate in its numerous committees and commissions

Promoting Member Physician Practices

➻➻A list SDCMS member physicians was published in San Diego Magazine’s May 2010 “Health Annex” for the second year. ➻➻Our 2010 response for “Physicians of Exceptional Excellence” (Top Doctors) was the largest in seven years of balloting — with over 13,000 votes cast by 880 physicians. ➻➻We published in 2010, for the first time, a free directory of all San Diego County physicians (with members highlighted). ➻➻We continue to provide members with a free listing of San Diego County physicians annually.

INFRASTRUCTURE

»» SDCMS customized, expanded, and fused our database in 2010, using the latest technologies and processes, and put it “in the cloud” — making our staff work more efficiently and connecting our data directly to our website. »» We brought our information technology hardware, software, and middleware to the leading edge in 2010. »» We hired a business manager to streamline operations and to allow your chief operations officer to get more time in the community.

SEMINAR, WEBINARS, AND WORKSHOPS

➻➻In 2010, approximately 1,000 member physicians and their office staff attended free of charge SDCMS’ 40+ seminars, webinars, and workshops. Our most popular included: ➻➻Even in these challenging economic times, we continue • The Family and to grow, giving us more resources for more advocacy and Medical Leave Act, more member support. the Americans * With Disabilities 2,652 2,578 2,562 Act, and Workers’ 2,390 2,419 Compensation Leave 2,029 2,056 2,163 2,195 Laws • Treating Patients Right 2002 2003 2004 2005 2006 2007 2008 2009 2010 • Medicare Changes for 2010 ➻➻We are now California’s second-largest county medical • ABCs of Workers’ society, and we’re growing faster than any of the others.

Compensation Billing ➻➻We were able, with our in• HIPAA Updates creasing numbers, to add two • Changes to Medicare directors to our board and one Regulations alternate director.

• Expert Witness, ➻➻We signed up 95 first-year Medical Board UCSD medical students at Interactions2,562 2,578 2,652 its student fair, ensuring the • The2,419 Employee’s Role 2,390 next generation of physicians in Decreasing Liability are engaged with organized Risks in the Physician 2,029 2,056 2,163 2,195 Office medicine.

2010 2002 2003 2004 2005 2006 2007 Outlook 2008 2009 • Microsoft for *This number does NOT include SDCMS’ 250 resident physician Busy Docs

SDCMS MEMBERSHIP # OF MEMBERS

Physician Professional Development

members or its 401 medical student members.

SDCMS REVENUES AND EXPENSES Physician Database 4%

SDCMS EXPENSES (FY 09-10)

Physician Engagement 6% Infrastructure 29% Governance 14%

SDCMS REVENUES (FY 09-10)

Benefits: 11% Communication 28%

Advertising 18%

Rent: 10% Copier: 1% Credit Card/Bank Charges: 2% Insurance: 1% Miscellaneous Expenses: 3% Telephone: 1% Staff Time G&A: 11%

Advocacy: 5% Specialty Societies: 1% Foundation: 2%

Investments 21% Dues 53%

Credit Card Commission 3% Sponsorships 1% Events 1% Foundation 2% Specialty Societies 1%

COMMUNICATIONS

SDCMS WEBSITE ➻➻ In 2010, we launched version three of our website — SDCMS.org — with a number of usability improvements and functionality enhancements. Following are a few of the ways you and your office staff can find support at SDCMS’ website: • Renew your membership online in less than five minutes.

• Access valuable members-only content (as well as your office staff).

• Send HIPAA-compliant messages to physicians and patients.

• Affect and effect legislation critical to your practice and your patients.

• Post your own classified ads free of charge.

• Search our FAQ database to find the answers you need.

• View all of SDCMS’ past seminars and webinars.

ENGAGEMENT

Engaging And Empowering Our Members ➻➻SDCMS sent teams of medical students and physician leaders on three separate occasions to Sacramento to meet with our eight California assemblymembers and four senators. ➻➻SDCMS sent a team of physician leaders to Washington, DC, to meet with each of our five congressional representatives, additional representatives heading various House committees, and the offices of California’s two U.S. senators. ➻➻SDCMS joined the San Diego Regional Chamber of Commerce on its annual trip to Washington, DC, along with other community leaders, to meet with each of our five congressional representatives. ➻➻SDCMS hosted two dinners for our former SDCMS presidents. ➻➻SDCMS organized three resident and young physician socials, each drawing between 50 and 100 attendees. ➻➻SDCMS organized three all-member socials, drawing approximately 50 attendees each. ➻➻SDCMS co-hosted one medical student social with CMA and AMA. ➻➻SDCMS hosted one e-townhall meeting to brief members on health reform, on California issues, and to answer questions. ➻➻SDCMS hosted one hospital chiefs of staff meeting. ➻➻SDCMS held its inaugural “White Coat Gala” (our re-christened annual installation dinner and dance), honoring our SDCMS leadership and Foundation, with 225 physicians, legislators, and community leaders in attendance — our largest installation in seven years. ➻➻SDCMS co-hosted its seventh “Top Docs Gala” with San Diego Magazine, attended by more than 300 physicians and community leaders. ➻➻SDCMS attended 33 general staff meetings and medical executive meetings at San Diego County hospitals, giving “10 Things in 10 Minutes: What Every Physician Needs to Know” presentations at many of them.

COMMUNICATIONS ➻SDCMS ➻ published an op-ed in the Nov. 7, 2010, Union-Tribune titled “Health reform’s San Diego impact.” ➻➻James T. Hay, MD, SDCMS past president and current CMA president-elect, published “Don’t Shortchange Seniors,” an op-ed in the March 21, 2010, Union-Tribune. ➻➻Your monthly San Diego Physician magazine continued to speak to and for all 8,500+ San Diego County physicians in 2010, with free classified advertising and discounted display advertising for members. ➻➻SDCMS emailed 28 issues of our commercialfree e-newsletter, “News You Can Use,” in 2010, which currently reached 4,000+ physicians and healthcare stakeholders in the region. ➻➻San Diego County’s media outlets continued to turn to SDCMS when looking for the physician’s perspective on stories, including: • Blue Shield’s announcement that it plans to hike premiums by an average of 30% • DMHC’s “timely access” regulations • polio’s continued existence • the role of nurse practitioners in the provision of healthcare • Doctors Express franchises opening in San Diego County • and more … ➻➻In 2010 you could begin following SDCMS on Twitter, getting the latest healthcare news and updates from SDCMS-CMA and respected media sources from across the country.

Getting The Word Out On Medical Issues

➻➻SDCMS worked with governmental and other organizations to promulgate information to physicians in 2010 on myriad medical topics, including: • Neisseria gonorrhoeae infections with azithromycin resistance • the pertussis epidemic • the new California Tdap policy • the measles cluster in San Diego County • wound botulism cases in San Diego • meningococcal disease in San Diego County • new glaucoma certification regulations, and more …

SDCMSF FINANCIAL SNAPSHOT

SDCMS FOUNDATION

2010 ANNUAL REPORT OUR MISSION:

“Addressing unmet healthcare needs for all patients and physicians through innovation, education and service.”

FY10 Assets: ➻➻Cash: $73,367 ➻➻Investments: $625,493 ➻➻Accounts Receivables: $55,811 ➻➻Contributions Receivable: $40,000 ➻➻Note Receivable: $41,596 ➻➻Equipment Net: $0 ➻➻Total: $836,267

Income Summary: ➻➻Grants: $603,865 ➻➻Contributions: $193,731 ➻➻Miscellaneous: $22,317 ➻➻Investment Income: $26,092 ➻➻Total: $846,005

Activities Summary: ➻➻Programs: $622,138 ➻➻Fundraising: $15,769 ➻➻Administrative: $32,833 ➻➻Total: $670,740

SDCMS Foundation Financial Review ➻➻Governance and Oversight: The Foundation received an unqualified opinion from the public accounting firm Leaf & Cole LLP, concluding another successful audit. The Foundation board met regularly and includes the following members for 2010–11 (the board has eight members with a quorum met of five members present): ➻➻Executive Committee: • Stuart Cohen, MD, President • Al Ray, MD, Treasurer and Secretary • Carol L. Young, MD, Immediate Past President • Tom Gehring, CEO ➻➻Board of Directors: • Ellen Beck, MD, Family Medicine, San Diego** (2nd term, expires 09/30/13) • Fran Butler-Cohen, CEO, Family Health Centers of San Diego (1st term, expires 09/30/12) • Eddie Canada, MD, Anesthesiology, San Diego** (1st term, expires 09/30/11) • Stuart Cohen, MD, Pediatrics, San Diego** (1st term, expires 09/30/12) • Tom Gehring, CEO, San Diego County Medical Society (no term limit) • Al Ray, MD, Family Medicine, San Diego** (2nd term, expires 09/30/12) • Will Tseng, MD, Internal Medicine, San Diego** (1st term, expires 09/30/12) • Carol L. Young, MD, Internal Medicine/Rheumatology, Escondido** (term expires 09/30/11) • James Hay, MD, Family Medicine (PASD Leadership Committee Chair and ad-hoc, nonvoting board member) ➻➻Operating Budget: Operating income increased in 2010 by 37 percent over the prior year, as the Foundation increased revenue and expenses to accommodate two new programs. SDCMSF closed the budget year with a balanced budget. ➻➻Investment Review: Through extreme turmoil in the financial markets, the Foundation adopted an investment policy to protect the corpus of investments and maintained a disciplined approach to asset allocation and management of the investments. Risk was reduced by employing a conservative reinvestment policy and shifting investments to U.S. Treasury Securities. Investments are reviewed monthly and approved by the board of directors. **The SDCMS Foundation bylaws state that at least one half (50 percent) of the directors elected shall be members of SDCMS. The board members with asterisks after their name/title are SDCMS members.

Connecting Patients With Donated Healthcare Services

BY THE NUMBERS

PASD

Project Access San Diego (PASD), San Diego County’s only comprehensive network of coordinated, donated healthcare services for medically underserved patients, currently has more than 500 physicians, nine surgery centers, and five hospitals in our network.

Since opening our doors in July 2009, PASD has coordinated more than $2 million in donated care for more than 600 patients. PASD Healthcare Partners Include: Anesthesia Consultants of California • Anesthesia Service Medical Group • Arthrex • Boston Scientific • Cardinal Health Radiopharmacy • Carlsbad Imaging Center • Carlsbad Surgery Center • Coast Surgery Center • Edward Ayub Orthopedic and Sports Physical Therapy • The Endoscopy Center • Escondido Surgery Center • Graybill Physical Therapy • Hanger Prosthetics and Orthotics • Imaging Healthcare Specialists • Kaiser Permanente • La Jolla Endoscopy Center • La Jolla Orthopaedic Surgery Center • Lab Corp • NeuroTrace Inc. • Northcoast Surgery Center • North County Radiology • Otay Lakes Surgery Center • Palomar Pomerado Health • Poway Surgery Center • Quest Diagnostics • San Diego Imaging • San Diego Outpatient Ambulatory Surgical Center • San Diego Pathologists Medical Group • San Dieguito Anesthesiology Medical Group • Tri-City Medical Center • University of California, San Diego • Western Diagnostic Imaging Center • Valley Radiology • XDI Radiology

➻$2 ➻ million in donated services ➻1,000+ ➻ specialty appointments ➻600 ➻ lives changed ➻500 ➻ physician volunteers ➻8 ➻ lives saved

SDCMSF Scholarship Program: Supporting Future Physicians “Through Project Access San Diego, Dr. Mihir Parikh donated his time and surgical facility at NVision to perform a pterygium surgery for uninsured patient Dominga Arzata.

IOP Ophthalmics also donated the graft to ensure the surgery was a success. Ms. Arzata is a patient from La Maestra Community Health Center in Fairmount.”

In 2010, SDCMSF supported the following future physicians: ➻➻Emerick Gallego-Arteche, 4th Year, UC San Diego School of Medicine ➻➻Gabriel Murillo, 4th Year, UC San Diego School of Medicine ➻➻Choung Dang, 3rd Year, UC San Diego School of Medicine ➻➻Ruben Carmona, 2nd Year, UC San Diego School of Medicine ➻➻Jessica Cruz, 1st Year, UC San Diego School of Medicine ➻➻Ronald Crater, UC San Diego Residency Program We look forward to seeing the future accomplishments of all of our scholarship winners who have demonstrated an outstanding commitment to our community.

EVALUATION: LOWERING COSTS AND HELPING PATIENTS ACHIEVE WELLNESS Program evaluation demonstrates that PASD is making a significant impact in lowering costs and achieving better health for patients.

Our patients report that they have fewer visits to the emergency department, fewer hospital stays, and fewer visits to their medical home clinic while also reporting better health status.

Specialty Care Access Initiative: Optimizing Specialty Care Resources in the Community Through a partnership with the Council of Community Clinics, we are working to increase access to specialists for all medically underserved patients. This includes recruiting physicians to volunteer at health centers and hosting specialty roundtables at SDCMS to promote referral efficiency and new referral guidelines for practicing primary care providers. In 2011, we will launch e-Consult, a system that will allow primary care physicians at the clinics to email a clinical question to a volunteer specialist, thereby potentially avoiding the need for a face-to-face visit.

Local Extension Center: Helping Physicians Achieve Meaningful Use of Electronic Medical Records In 2010, SDCMSF received federal grant support (through a subcontract) to provide technical assistance on electronic medical records. This four-year grant will allow SDCMSF to be a vendor-neutral resource for San Diego County physicians who are implementing an electronic medical record and/or working toward meaningful use.

The SDCMS Foundation relies on generous donations from organizations and individuals to support our work. We want to thank all of our donors for their contributions. The Foundation is a 501(c)(3) (tax ID number: 95-2568714), meaning all donations are tax deductible. If you are interested in supporting the work of the Foundation, please contact Lauren Radano at (858) 5657930 or at Lauren.Radano@SDCMS.org or visit our website at SDCMSF.org.