WE PERMANENTLY ELIMINATED THE SGR
2015 SDcms Annual Report
A 21% cut to physicians’ Medicare payments was set to take place on April 15, 2015. Instead, HR 2 — the monumental, bipartisan Medicare SGR Payment Reform and CHIP Reauthorization Act — was passed by the House of Representatives 392–37, by the Senate 92–8, and signed by the president, providing positive annual payment updates of 0.5% starting July 2015 and lasting through 2019. SDCMS and CMA extend a sincere thank you to all member physicians for the extraordinary campaign this last decade to end the SGR, holding Congress’s feet to the fire to develop a comprehensive bill to reform Medicare physician payments. The unity within organized medicine finally put this over the finish line. Moreover, Senators Feinstein and Boxer and 52 out of 54 members of the California congressional delegation voted to support physicians — a direct result of long-term SDCMS and CMA advocacy. Many will claim credit, but let there be no doubt that SDCMS-CMA member physician dues dollars made this happen. Combine this huge SGR win with the victories on Proposition 46, GPCI, arresting the Medi-Cal cuts for three years, preventing any Medi-Cal clawbacks, stopping scope of practice expansions — the list could go on — and the message could not be any clearer: Nonmember physicians have received significant value from member dues dollars; please join your fellow physicians who have contributed to these successes by becoming an SDCMS-CMA member today!
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2015 SDcms Annual Report
LEGISLATIVE ADVOCACY SDCMS’s Legislative Advocacy Trips in 2015: • On April 14, 2015, eight SDCMS physicians joined more than 400 others from across California for CMA’s 41st annual Legislative Advocacy Day in Sacramento to speak with legislators and their senior staff about healthcare issues that affect their practices and the future of medicine. • SDCMS took two groups of medical students to Sacramento in 2015 to meet with legislators, and joined the San Diego Regional Chamber of Commerce during its legislative trip to Washington, DC. CMA Sponsored Legislation in 2015 to … • Increase California’s tobacco tax and allocate those funds to tobacco prevention and education. • Provide oversight for allocation of funds raised for Medi-Cal use. • Repeal cuts to Medi-Cal provider reimbursement rates. • Allow NPs and PAs, under physician supervision, to sign POLST forms. • Require healthcare service plans to honor assignment of benefit agreements. • Close a loophole allowing health insurers to choose the regulator with which to file their PPO products. • Enable grants to residency programs in areas with the greatest need. • Require health insurers to pay providers for telephone and telehealth services. • Require employers and insurers to disclose payment methodologies for those involved in providing medical services to injured workers. • Provide treating physicians fair payment.
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MAY 2016
SDCMS Physicians and Staff at CMA’s House of Delegates in Anaheim
STOPPING UNSAFE SCOPE EXPANSIONS Thanks principally to CMA advocacy, Senator Hernandez pulled both his scope expansion bills, which would have allowed NPs to practice independently and given optometrists the ability to do ophthalmologic surgery.
PROTECTING MICRA A California court ruled against a constitutional attack on MICRA thanks in large part to an amicus brief filed by CMA.
CAL MEDICONNECT SDCMS actively participates in the Coordinated Care Initiative Advisory Committee to improve the delivery of healthcare and long-term services and supports to San Diego County seniors and persons with disabilities. In 2015, SDCMS continued to help members, their offices, and their patients navigate Cal MediConnect, along with CMA, whose valuable “Cal MediConnect Physician FAQ” resource teaches physicians what they need to know to keep their patients and to bill for the dual-eligible population.
CURES PROTECTING THE PUBLIC HEALTH • CMA Leads Save Lives California Coalition Initiative to Raise State’s Tobacco Tax by $2 per Pack • Governor Brown signed CMA-sponsored legislation to make California one of three states not to offer a personal belief or religious exemption for required vaccinations — a perfect example of CMA’s using its influence to impact public health.
• CMA convinced the DOJ to delay the final rollout of CURES 2.0 by six months due to browser requirement concerns that could have cut off access for thousands of prescribers and dispensers. • In the final days of the 2015 legislative session, after the DOJ still had not identified and implemented a streamlined CURES application and approval process, CMA secured the extension of the registration deadline to July 1, 2016.
MEDI-CAL • In June The San Diego Union-Tribune published “Medi-Cal Boom Brings Capacity Questions,” with SDCMS communications director, Sherry Franklin, MD, interviewed. • CMA closely monitored DHCS’s temporary conversion of incoming ICD-10-coded claims to ICD-9 for problems. • SDCMS’s Dr. Ted Mazer was interviewed for PBS’s “Giving Millions More Access to Care, Medicaid Expansion Strains California’s Health System” Report. • CMA pushed for a permanent and significant Medi-Cal funding increase at the Legislature’s special session on Medi-Cal financing. • CMA joined the Save Lives California coalition to raise the state’s tobacco tax and improve public health, with money generated directed to Medi-Cal and to smoking prevention, cures, and strengthening a healthcare system strained by tobacco-related disease. • A broad CMA-led coalition rallied thousands at the state capitol on June 2 to support fully funding Medi-Cal. • CMA sponsored bills to increase Medi-Cal rates. • CMA submitted a letter to CMS requesting an assessment of MediCal rates. • A CMA-led coalition introduced legislation to increase Medi-Cal rates to Medicare levels.
HOSPITAL MEDICAL STAFFS • SDCMS attended 24 hospital general staff and medical executive committee meetings in 2015 with updates on physician issues unfolding locally, across the state, and in Washington, DC. • CMA released its 2015 annotated model medical staff bylaws free to members.
After soliciting physicians’ input on SB 128, CMA removed its opposition to physician aid in dying in 2015. CMA had longstanding policy in opposition to PAS and had successfully helped defeat previous efforts to legalize it in the state legislature and through the ballot. However, recognizing that views on many social issues have shifted in the years since that policy was fully debated and adopted, and aware of data suggesting that opinions within the physician community itself may have changed, CMA’s Council on Ethical Affairs and Council on Legislation reassessed CMA policy and made recommendations to the CMA board of trustees to modify its policy on PAS / PAD.
ICD-10 RESOURCES • Surviving ICD-10: An FAQ for Physician Practices • ICD-10 Transition Guide: What Physicians Need to Know • Discounted ICD-10 Education and Training • On-demand ICD-10 Overview Webinar • ICD-10 News Alerts, Webpages, Resource Centers • One-on-One Assistance Through SDCMS’s Physician Advocate • ICD-10-CM Code Set Boot Camps at SDCMS • ICD-10 Ombudsman Established Directly Resulting From CMS’s Meeting With CMA
STOPPING HEALTH PLAN ABUSES • CMA stopped a massive transfer of negotiating power from physicians to health plans by defeating AB 533. • The DOJ adopted and the Office of Administrative Law approved CMA’s recommendations that insurers be required to have clear, publicly available criteria over who is included in a network, and that insurers demonstrate comprehensive quality assurance programs in many areas related to directories and networks. • CMA filed an amicus brief in the California Supreme Court to urge a fair and just interpretation of provisions within the Knox-Keene Act that permit health plans to delegate payment responsibility to risk-bearing organizations. • CMA helped physicians understand their rights and options after Anthem again unlawfully pursued physicians for payment refunds.
YOUR SUPPORTING OFFICE MANAGER • SDCMS Conducted Our 3rd Biennial Medical Office Salary Survey in 2015 • Congratulations, Deann Cooper, RN, SDCMS’s 2015 Results Are In! Outstanding Office Manager of the Year — Nominated by Dr. Ted Mazer, 28-year Member of SDCMSSDCMS has welcomed member physician office managers and practice administrators to participate in its private SDCMS Office Manager Forum, enabling office managers to build a community of mutual support since 2012.
official publicatio n of SDcMS January 2016
back office position
certified medical assistant
department lead
clerical position
front desk position
insurance biller
it tech
licensed vocational nurse
• Know Your Participation Status Toolkit • Exchange Resource Center • Preparing for Changes in 2015 Tip Sheet • Insurer Contacts and Qualified Health Plan Insurance Carriers • Office Placard • Understanding the Grace Period • Plan Names, ID Cards, Provider Directory Reference Guides • FAQs for Patients in English and Spanish
data entry
front office position
insurance claim tracker
medical assistant
insurance verifier
nurse practitioner
Our Medical Office Salary Survey
office manager
physician assistant
procedure scheduler
“Physicians Unite d for a
COVERED CALIFORNIA RESOURCES
2015 SDcms Annual Report
PHYSICIAN AID IN DYING
patient collection rep
registered nurse
surgery scheduler
healthy san diego”
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2015 SDcms Annual Report
SDCMS YOUR PHYSICIAN
ADVOCATE AT WORK
BIDDING FAREWELL TO OUR LONGTIME CEO In 2015, your SDCMS physician advocate solved more than 550 SDCMS member physician problems, including saving a member $80,000 who had been chasing his ACA primary care rate increase for crossover claims since 2013; helping a member overturn the findings of a Meaningful Use audit and allowing him to keep his $18,000 incentive; assisting a member in getting his medical license renewed and saving him several weeks of not being able to practice medicine or see patients; saving a member $40,000 who was getting nowhere with his missing Medi-Cal reimbursements; and getting a group’s new physician onto their Medi-Cal contract, which was holding up his hospital privileges.
RESIDENTS & MEDICAL STUDENTS • In conjunction with UCSD, SDCMS held two “Making Your Way After Residency” workshops in 2015 with nearly 150 resident and young physicians attending. • SDCMS president, Dr. William Tseng, led the UC San Diego School of Medicine commencement and White Coat ceremonies. • Congratulations to medical student Stephanie D. Garcia for her National Medical Fellowships California Community Service-Learning Program award!
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MAY 2016
After more than 14 years as SDCMS CEO, Tom Gehring retired on December 31, 2015. We thank Tom for his dedication to SDCMS’s noble vision of “Physicians United for a Healthy San Diego,” and we wish him Godspeed, fair winds, and following seas.
official publication of SDcMS OctOber 2015
InfectIous DIsease Just One Passenger Away
“Physicians United for a healthy san diego”
COMMUNICATING TO, FOR, AND
FROM PHYSICIANS
• San Diego Physician delivers SDCMS’s message to more than 9,000 physicians in the county every month, along with more than 400 legislators, journalists, hospitals, libraries, and others. • SDCMS published 22 issues of our “News You Can Use” e-newsletter, reaching 9,000+ recipients every two weeks.
EVENTS & SOCIALS • SDCMS held five physician socials and networking opportunities around the county in 2015, each a rousing success! • SDCMS’s 2015 White Coat Gala was held on June 13 to honor our SDCMS Foundation, to thank outgoing president, J. Steven Poceta, MD, and to welcome incoming president, William T-C Tseng, MD, MPH. Almost 200 people attended, including Representative Scott Peters, Senator Marty Block, and Assemblymembers Lorena Gonzalez, Shirley Weber, and Rocky Chavez. • The Top Doctors celebration was held October 10 to benefit your SDCMS Foundation — almost 300 people attended.
4%
Rent: 12% Credit Card/Bank Charges: 1% Insurance: 1% Miscellaneous Expenses: 2% Telephone: 1% Staff Time G&A: 8%
7%
Foundation
CMA Commissions
2015 SDcms Annual Report
2014–15 FISCAL SDCMS YEAR FINANCIALS
income
26%
16%
Advertising & Sales
20%
Communications
Infrastructure
56%
15%
5%
Dues
Governance
Foundation
17%
5%
13%
Advocacy
Investments
6%
Physician Database
11%
Benefits
Physician Engagement
Expenses SEMINARS & WEBINARS
2013: 2,813 2012: 2,683 2011: 2,670 2010: 2,652
2009: 2,578 2008: 2,562
2015: 3,002 2014: 2,961
Grand Total SDCMS Membership for 2015: 5,455
2007: 2,419 2006: 2,390 2005: 2,195 2004: 2,163
MONITORING SAN DIEGO’S PHYSICIAN WORKFORCE
Regular Physician Members: 3,002 Resident Physician Members: 1,344 Medical Student Members: 368 Retired Physician Members: 741
2003: 2,056 2002: 2,029
More than 130 physicians and office staff attended SDCMS’s seminars, webinars, and workshops in 2015: • Workshops: Advocacy Training, Breaking Bad News, ICD-10-CM (3), Leader’s Toolkit (3), Legal & Financial Literacy, Media Training, Preparing to Practice (2), Taming Outlook, Work-Life Balance • Seminars & Webinars: Covered California, Disciplinary and Termination Practices, HIPAA (2), Hiring for Your Practice, Meaningful Use, Medicare (4), OSHA, Revenue Cycle Management, Sexual Harassment, Social Media, Water Reuse & Purification Project, Worker’s Compensation
SDCMS MEMBERSHIP INCREASES FOR 14TH YEAR IN A ROW!
SDCMS conducted its seventh biennial physician workforce and compensation survey in 2015, yielding valuable data and insights for our San Diego County physician community, as well as local and state legislators.
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