MOA TRIAD Volume 26, Number 3, 2015

TRIAD Summer 2015 VOLUME 26 ISSUE 3

THE AWARD WINNING JOURNAL OF THE MICHIGAN OSTEOPATHIC ASSOCIATION

in this issue:

• modifications to meaningful use • audits only happen to other people • security assessments – don’t be that guy • doctors in private practice are adapting • social media tips

STAY ON THE ROAD TO

ICD-10

OCT 1, 2015

STEPS TO HELP YOU TRANSITION The ICD-10 transition will affect every part of your practice, from software upgrades, to patient registration and referrals, to clinical documentation and billing.

CMS can help you prepare. Visit www.cms.gov/ICD10 to find out how to: •

Make a Plan—Look at the codes you use, develop a budget, and prepare your staff

•

Train Your Staff—Find options and resources to help your staff get ready for the transition

•

Update Your Processes—Review your policies, procedures, forms, and templates

•

Talk to Your Vendors and Payers—Talk to your software vendors, clearinghouses, and billing services

•

Test Your Systems and Processes—Test within your practice and with your vendors and payers

Now is the time to get ready. www.cms.gov/ICD10

Official CMS Industry Resources for the ICD-10 Transition

www.cms.gov/ICD10

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TABLE OF CONTENTS

FEATURES 8

Modifications to Meaningful Use

10

Audits Only Happen to Other People

12

Security Risk Assessments— Don’t Be That Guy

18

Doctors in Private Practice Are Adapting

20

Social Media Tips to Grow Your Practice

DEPARTMENTS 5

President’s Page

26

Dean’s Column

27

Advertiser Index

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Symposium for Primary Care Medicine Friday & Saturday, November 20-21, 2015

The Diamond Banquet Center Connected to the Hyatt Place Hotel At the Suburban Collection Showplace, Novi, Michigan For Physicians, Physician Assistants and Nurses: 17.0 Category 1-A AOA CME | 17.0 AMA PRA Category 1 Credit(s)™ Specialty Credits Issued: Internal Medicine | Family Medicine Featuring a Self-Guided Wound Care Workshop Sponsored by:

College of Osteopathic Medicine

Registration Opens August 17, 2015 Please Call (248) 471-8350 or visit http://www.botsford.org/physicians/

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PRESIDENT’S PAGE

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t has already been an exciting summer for the osteopathic profession and the MOA. Recently, one of our members, Dr. Stephen R. Bell, was appointed to the Michigan Prescription Drug and Opioid Abuse Task Force. The task force was created by Governor Rick Snyder and is chaired by Lt. Governor Brian Calley. Dr.

Bell also works on the MOA’s own Opioids Ad Hoc committee and they are working hard to bring our osteopathic ideals into the conversation of opioid abuse. Through the Ad Hoc

ROBERT G.G. PICCININI, D.O., DFACN

committee, we have developed and submitted a set of recommendations to the Governor’s task force. I would like to congratulate the Ad Hoc committee and Dr. Bell on their quick response to this issue. During my term, I want to focus on raising awareness of the importance of osteopathic ideas are to our communities.

in this issue of triad, we are focusing on the challenges of practice management…

In this issue of TRIAD, we are focusing on the challenges facing practice management.

When a D.O. graduates from medical school and decides to open their own practice, they are simultaneously starting two jobs, a doctor and businessperson. One issue facing our profession today is the doctor is only trained extensively in one of those jobs. Recently, advances have been made to the education process and D.O.s are able to learn about these business practices before they open a practice of their own. There is also an increase in education for practice manager professions. With these opportunities, doctors are able to have a dedicated manager to take care of the business of the practice so they focus on caring for the patient. These advances are what make the osteopathic profession so strong.

As technology and regulations change, osteopathic physicians face a moving target whether they manage their own practices or work with practice managers. The MOA wants to be a resource where answers can be found and physicians can focus on what they do best—practice medicine.

ROBERT G.G. PICCININI, D.O., DFACN, IS THE PRESIDENT OF THE MICHIGAN OSTEOPATHIC ASSOCIATION AND MAY BE REACHED BY EMAIL AT: RGGPICCININI@GMAIL.COM.

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Recruiting is hard work.

We can help.

Medical Opportunities in Michigan connects Physicians, Physician Assistants & Nurse Practitioners with Michigan’s healthcare employers.

Private practice memberships begin at $500.

MOM is a service of the Michigan Health Council.

800-479-1666 6

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miMOM.org

Customized Health Plans Available exclusively to MOA members, the MOA Insurance Team (MIT) specializes in assisting physicians in selecting health benefits for their practice, employees and families. Their expertise guides physicians through the complex process of selecting the best product at the best price.

The MIT consists of your personal benefits team working with you and your staff throughout the year providing ongoing support such as: communication packages, customized renewals, benefit clarification and claims resolution.

This team approach focuses on partnering with you to provide direction and comprehensive solutions through the maze of insurance choices available today.

Your choice.

Your plan.

Your Michigan Osteopathic Insurance Team (MIT) offers discounted insurance for medical malpractice, life, long term care, long/short term disability, home, auto and much more!

Our Portfolio of Insurance • Health Insurance including Small Group, Medicare, Individual and Freestanding, Multiple Carriers • VSP Vision Plans • Delta Dental Options • Medical Malpractice, Professional Liability • Life Insurance • Long-Term Care Insurance • Long- and Short-term Disability, Group and Individual Options • Home and Auto Insurance • MOA Prescription Rx Drug Card

Learn more at http://mi-osteopathic.org/Insurance!

Call us at 800-657-1556 today for a quote!

Powered by the Michigan Osteopathic Association and Association Benefits Company TRIAD, SUMMER 2015

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M I CHI GAN

O S T EOPATH IC

ASSOC IATION

The Michigan Osteopathic Association’s Practice Solutions Program (PSP) offers expertise in the areas that affect your business. The PSP uses the collective strength of the MOA to bring solutions to our members from experienced providers with cost-effecting pricing. In this issue of the Triad we offer articles from our PSP partners that focus on a proactive approach.

The PSP brings MOA members business solutions in the following areas: Information Technology Insurance Legal Services Meaningful Use & EHR Selection Revenue and Quality An hour with the PSP team could save you thousands of dollars!

Call (800)657-1556 today for a complimentary practice consultation For more information visit: www.mi-osteopathic.org/PSP

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P S P: M E A N I N G F U L U S E / E H R

MODIFICATIONS TO MEANINGFUL USE

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n April of this year, “Modifications to Meaningful Use in 2015 through 2017” proposed rule was released by CMS. This proposed rule modifies the reporting period to a rolling 90 days along with other changes to align the Meaningful Use program with the proposed Stage 3 rules. This is only the first step and is a proposed rule (not final) and likely won’t be finalized until August. This proposed rule is designed to lower the Meaningful Use performance bar as was so often requested across the industry.

Among many major program changes, the rule proposes allowing a continuous 90-day reporting period in 2015, reducing the overall number of measures, and removing measures that are redundant, duplicative, or have reached widespread adoption. For example, under current Meaningful Use requirements, 5% of patients need to send the provider a secure message; under the proposed rule, providers only need to prove that the capability was enabled during the reporting period.

Among the many changes that are aimed at aligning practices with quality pay-for-performance programs the CMS proposed rule for 2015 blends the Stage 1 and Stage 2 measures into one set of measures with multiple exclusions and alternative measures: No core and menu measures, rather: • 9 required EP measures + 2 public health/registry reporting measures • 8 required EH measures + 3 public health/registry reporting measures.

CMS proposes removing the requirement to report on the following measures: • Demographics • Vital Signs • Smoking Status • Clinical Summaries • Structured Lab Results • Patient Lists • Patient Reminders*EPs Only • Summary of Care • eMAR**EHs Only • Advanced Directives** EHs Only • Electronic Notes • Imaging Results • Family Health History • Lab Results to Providers** EHs Only In the world of CMS policy making, the public must be given a period of time (typically 60 days) to comment on proposed policy. It then typically takes at least another 60 days for comments to be reviewed and incorporated into a final rule. Until the program changes are finalized, you should continue on the current course as planned.

Another significant change this year is the U.S. Health and Human Services Department’s Office of Inspector General has begun random audits of individual providers to determine if they met the Meaningful Use requirements.

The policy to “protect the integrity of the Department of Health and Human Services (HHS) programs”. As part of this policy the Office of Inspector General (OIG) will be conducting random 2-3 week on-site HIPAA audits for practices participating in MU and other

Medicare/Medicaid incentive programs.

In the past Figliozzi requested copies of the Security Risk Analysis but only checked to make sure that risks were known, addressed or had a corrective action plan. The OIG has now been tasked with diving much deeper into the SRAs to ensure that the policies and procedures are actually carried out.

The complete details of these audits have not yet been released to the public but according the OIG will focus on these primary areas of interest: • • • • • • • • • • •

EHR risk assessment, audit & reports EHR security plan Organization chart Network diagram EHR websites & patient portals Policies & procedures System inventory Tools to perform vulnerability scans Central log & event reports EHR system users List of contractors supporting EHR & network perimeter devices

The OIG specifically states they will address vulnerabilities in electronic health records such as whether covered entities and business associates, such as cloud services and other “downstream service providers,” adequately secure electronic patient protected health information created or maintained by certified EHR technology.

Please check upcoming issues of TRIAD for the latest on this proposed rule, and for other information and resources that are useful to your practice.

This article was crafted by Elevation Healthcare™– the preeminent resource for operationalizing and achievement of MU, PQRS, VBM, PCMH and PCSP, and practice productivity enhancement post-EHR install. www.elevationhc.com.

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P S P: I N F O R M AT I O N T E C H N O LO G Y

AUDITS ONLY HAPPEN TO OTHER PEOPLE...

BY LAURA LOVETT, CPC, CPMA, CPC-I, CANPC, CEMC

Saying the word “audit” in a room full of physicians has a tendency to suck all the air out of the room for a few heartbeats. Then the excuses and rationales start flowing: “They are only looking at the big groups.”; “You only get audited if you bill a bunch of 5’s. I’m safe because I mostly bill 3’s.”; LAURA LOVETT, CPC, CPMA, CPC-I, CANPC, CEMC

What are the odds they would ever look at me?” I could go on but I think you get the idea.

T

he reality is there are no “other people”; the population of providers that can be audited is made up of every single provider that submits claims to the payers that are auditing. Payers have the right to audit

claims they have received. So instead of fearing the unknown or ignoring the inevitable, take control.

Do your own internal audits.

Keep up to date with the rules and regulations related to the services you are providing.

Educate yourself and your staff.

Continue monitoring and educating.

The adage “ignorance of the law is no excuse” is unfortunately very applicable in the healthcare industry. While most providers didn’t go into clinical practice so they could do a bunch of paperwork, it is the way of the world we work in. Healthcare is a business. Healthcare providers are required to know their business. The closest you can get to audit proof is having a thorough understanding of your business and keeping tabs on the status through an active compliance plan.

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the reality is there are no “other people”; the population of providers that can be audited is made up of every single provider that submits claims to the payers that are auditing.

The closest you can get to “audit proof” is having a thorough understanding of your business and keeping tabs on the status through an active compliance plan.

Think of internal audits as the equivalent to an office visit for your patients but for your practice. There are essentially 2 types of office visits, well care visits and problem visits. Every patient you see starts out as a new patient and depending on whether or not they have any current complaints; they are either a well care visit (i.e. annual physical) or problem visit. This is your baseline audit, maybe you know there are some concerns (problem visit) or maybe there are no concerns (well care visit). If everything turns out fine in a well care visit, you have the patient come back in a year or PRN for any problems in between. If a problem is present or discovered, you address it and set a

follow-up appointment. The same concepts should hold true for compliance audits. What happens to patients who don’t follow medical advice and don’t receive appropriate follow-up? What do we call those patients? Non-compliant…

Do what is medically necessary to take care of your patients. Document what you do. Code based on documentation. And keep tabs on your business through a compliance plan. The goal for our business should be the same as for our patients, to remain healthy and viable for as long as possible.

LAURA LOVETT IS A DATA INTEGRITY & COMPLIANCE CONSULTANT AT THE RYBAR GROUP, SPECIALIZING IN THE AREA OF PROFESSIONAL SERVICE CODING, AUDITING AND EDUCATION. SHE CAN BE REACHED AT 810.853.6173 OR VIA EMAIL AT LLOVETT@ THERYBARGROUP.COM

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P S P: I N S U RA N C E

MISSING, POORLY EXECUTED OR OUT-OF-DATE SECURITY RISK ASSESSMENTS —

DON’T BE THAT GUY

BY ANNE HEIN, MELISSA OTTINGER AND HOLLY STANDHARDT

Its an ever-evolving process that can trip up even the savviest health care provider during a meaningful use audit – the security risk assessment. According to EHRIntelligence.com, the failure rate for Stage 1 meaningful use audits is around 22 percent for eligible professionals and 5 percent for eligible hospitals.

Insufficient documentation is often to blame.

T

he Health Insurance Portability and Accountability Act (HIPAA) Security Rules requires covered entities and business associates such as eligible professionals, clinics, health plans, etc., to conduct a security risk assessment of their organization at least annually, but more frequently if needed. It’s important because according to HealthIT.gov, a risk assessment helps an organization ensure it’s compliant with HIPAA’s administrative, physical and technical safeguards.

A risk assessment also helps identify areas where an organization’s protected health information (PHI) could be at risk.

Specializing in all aspects of healthcare law, including: Healthcare business transactions including contracts, corporate formations, mergers and acquisitions Stark and fraud and abuse analysis RAC, Medicare, Medicaid and other third party payor audit defense Proactive compliance programs for RAC and Medicare Audits Physician Hospital Organizations, Physicians Organizations and Accountable Care Organizations Regulatory compliance Billing and reimbursement issues Provider participation and deselection matters Licensure and staff privilege matters Defense of civil and criminal healthcare fraud issues

WACHLER & ASSOCIATES. PC 210 E. Third St., Suite 204, Royal Oak, MI 48067 P: 248-544-0888 F: 248-544-3111

www.wachler.com 12

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A missing, poorly executed or out-of-date risk assessment puts a provider at risk for multiple penalties including meaningful use audit failure and citations from U.S. Department of Health and Human Service’s Office for Civil Rights for not complying with HIPAA. It’s a tricky requirement because every time a practice makes a policy change or new technology is implemented, the security risk assessment must be updated. Something as simple as not clearly identifying vendor name of the electronic health record (EHR) can result in the auditor ruling the security risk assessment as invalid.

A security risk assessment must be completed, updated or reviewed prior to the end of a meaningful use reporting period. And be aware, it is more than a checklist. A security risk assessment must include identification of all deficiencies, a mitigation plan and an implementation plan.

Audits can happen up to six years after an attestation is submitted. If audited, a practice may have as little as two weeks to submit documentation. Failing an audit not only may result in financial penalties, but also may put a prac-

The biggest thing auditors are looking for are discrepancies (i.e., if what was submitted during attestation matches what was actually done). If a provider is audited, the documents that must be submitted will fall into one of three categories: • Proof the EHR system used to meet meaningful use requirements is certified • Documentation that quality measure, core and menu objective data were accurate • Proof a security risk assessment was conducted and a corrective action plan was drafted So “don’t be that guy” that skims over the security risk assessment requirement, and make sure your practice’s security risk assessment is in order. There are many free resources available, including a video on security risk analysis from HealthIT.gov and guidance on risk analysis from the U.S. Office for Civil Rights (HHS.org/ocr).

If you would like help understanding the steps necessary for a security risk assessment, or help preparing for an audit, contact MPRO’s consulting services manager Sylvia Roemer at sroemer@mpro.org or 248-465-7420.

tice at risk for incurring future audits.

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MICHIGAN HOUSE OF DELEGATES ATTEND AMERICAN OSTEOPATHIC ASSOCIATION (AOA) ANNUAL BUSINESS MEETING Delegates participate in voting on policy, AOA Board of Trustees Elections, Michigan caucus dinner and President’s Inaugural Ceremony.

Dr. Gorz, Dr. Christensen, Dr. Hunt and guests at inaugural ceremony

Dr. Ognjan, Dr. Kovala, Dr. Bombard, Dr. Anderson

Dr. Botz speaking to AOA House of Delegates

AOA House of Delegates

Michigan Delegates at caucus dinner 14

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116TH ANNUAL MICHIGAN OSTEOPATHIC ASSOCIATION SPRING SCIENTIFIC CONVENTION In May, over 700 DOs gathered in Dearborn, Michigan to earn AOA Category 1-A credits, participate in a House of Delegates assembly, network and celebrate at the Presidential Inaugural Reception.

Guests at Presidential Inaugural Reception

Student DO, Bo Pang, Dr. Gorz, Dr. Haidar

Dr. Perrotta, Dr. Loniewski and Dr. Ognjan

Dr. Piccinini and Dr. Robbins

Dr. Abramson, Student DO Kevin Leikart and guest

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PROUD PARTNERS: MICHIGAN OSTEOPATHIC ASSOCIATION AND MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE

2015 Resident of the Year Award recipient Emily Burk and MOA Executive Director Kris Nicholoff

The Michigan Osteopathic Association is proud to partner with Michigan State University College of Osteopathic Medicine on a number of events and projects throughout the year including the MSUCOM Welcome Picnic, Convocation and White Coat Ceremony and

MSUCOM students at Welcome Picnic.

the Student Liaison Committee.

The MOA also awards an annual Resident of the Year Award to recognize an outstanding osteopathic resident from Michigan who exemplifies compassion and commitment to patients and their community with professionalism while carrying out the osteopathic philosophy.

MSUCOM Student Liaisons with MOA staff.

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11th Annual Autumn ScientiďŹ c Convention

November 6-8, 2015 - Amway Grand Plaza Hotel - Grand Rapids, MI To register, visit: www.mi-osteopathic.org/gr2015 - Call: 517.347.1555 ext. 112 TRIAD, SUMMER 2015

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REMAINING INDEPENDENT: HOW DOCTORS IN PRIVATE PRACTICE ARE ADAPTING IN THE CHANGING ENVIRONMENT

BY BILL FLEMING, SENIOR VICE PRESIDENT AND REGIONAL OPERATING OFFICER, THE DOCTORS COMPANY

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H

ealthcare is undergoing historic change—a transformation that is highlighted by the unprecedented trend toward consolidation. At The Doctors Company, in the past decade, the percentage of member doctors in groups of one to five physicians has decreased from nearly 70 percent to slightly over 50 percent. Over the same period, the number of members in groups of 100 or more has doubled.

Robert Jackson, MD, MMM, a family medicine physician at Western Wayne Physicians in Allen Park, is one doctor who is determined to remain independent. “Inherently, I know my patients are better served by me being in private practice,” he says.

Dr. Jackson and other independent physicians face many challenges, particularly increased financial and regulatory pressures. “As fee structures evolve, physicians need tools to understand how to thrive in the new financial models,” says Paul MacLellan, CEO of Medical Advantage Group, a leading healthcare consulting and management company headquartered in East Lansing and a wholly owned subsidiary of The Doctors Company.

“When I first started my practice, I had an average of 2.5 full-time employees per physician,” Dr. Jackson says.

“Today, I have four employees for each physician in my practice. I now need staff to do referrals, I need staff to do quality initiatives, and I need staff to deal with computers. All the initiatives that I need to participate in take away from my margin, a margin that is already too low.”

William Starbird, MD, FAAFP, a family medicine physician at North Branch Family Healthcare in North Branch, identifies emerging technologies as one of the bigger hurdles independent doctors face. “We must stay up to date on the changing technologies,” he says.

“Down the road, these technologies will be a huge benefit. Unfortunately, right now, they are not. For example, electronic medical records are fragmented since they are not connected, and many can’t talk with each other. It places a lot of burden on physicians to try to master the electronic format and practice medicine at the same time.

You have to make a conscious effort to do it.”

Several years ago, Dr. Jackson adapted his practice to get more profit from his health plan relationships by taking on managed care risk and becoming one of the first Patient-Centered Medical Homes (PCMH). In the future, “we may have to form groups of primary care physicians so we can deliver more services, such as urgent care center, care manager, dietician, diabetes educator, health coaches, and fitness instructors,” Dr. Jackson says. “These are services that I believe need to get delivered in the PCMH.” Even for independent physicians, Dr. Starbird says, the future of care will involve coordination and integration.

“In the future, the model of healthcare will change dramatically. It will be more team-based, with the physicians being the ‘conductor’ of the healthcare orchestra to make sure the patient is managed correctly and making sure we are using all resources available, such as using evidence-based care. We must rely on nurse practitioners, mid-level

practitioners, and home healthcare due to the changing population.”

Medical Advantage Group specializes in assisting physicians to thrive in independent medicine, providing tools that help doctors improve performance, adopt healthcare technology, participate in managed care contracts, and achieve clinical integration. “We work to understand the contracts physicians are in and the changes needed in the practice to thrive in those contracts,” MacLellen says. “Between the commercial payers and CMS, the complexity is enormous. We sort through the endless rules and reports and help focus on the top few changes that will increase the physician’s revenue. Most often the changes are around office workflow and technology.”

Recently, Medical Advantage Group developed a new solution to help physicians improve efficiency and patient care. “Our new centralized team of clinicians serves as an extension of our physicians for patients that need the most help,” MacLellen says. “Dieticians, social workers, pharmacists, registered nurses, nurse practitioners, and physician assistants work with our physicians and with their patients to manage those who most need help in efficiently using the system.”

For his part, Dr. Jackson plans to spread the message about the key role independent doctors play in healthcare.

“I will continue to talk to health plans and government officials in any way that I can to communicate the value of private practice and primary care.”

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SOCIAL MEDIA TIPS GROW YOUR PRACTICE WITH SOCIAL MEDIA

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n the hectic world of a physician, it can sometimes be hard to establish a strong relationship with clients. Patients come at infrequent times, schedules don’t allow for time to chat and, or course, there’s a job to be done. Fortunately, social media allows for an opportunity of connectivity with patients that extend beyond their visits.

One of the easiest and most effective venues to reach this specific audience is Facebook. The

BY VIRGINA BERNERO

site has wide user base, extending from high schoolers to senior citizens and many other demographic variances. This gives physicians the opportunity to go to one place to reach clientele rather than target them in multiple locations online.

A Facebook page can be used in conjunction with an existing website or as a standalone location for information from a physician or practice. If a website does already exist, it is important to link back frequently to drive traffic to that source. Someone is much more likely to login to their Facebook page and see a physician’s post rather than to visit the website on their own. Use the platform’s built-in audience to your advantage.

Social media accounts also give physicians a chance to stay top-of-mind. Flu season? Post about getting a flu shot or reminder to take extra vitamin C. Pages should share interesting medical news, updates on services, office closing reminders or healthy tips for patients. All of these interactions, even if passively scrolled past, keep a positive and relevant connection past the office doors.

It is important to remember that while information can be pushed through to patients, communication can come from both sides. Each physician user can choose to handle medical questions as they choose, but private message follow up is recommended for privacy. Conversations about less sensitive topics should be encouraged with timely responses. Give followers a reason to comment with intriguing posts.

The opportunity that social media creates for physicians is a strengthened relationship with patients, potential clients and the community. It places the desired information in a virtual atmosphere that is likely a part of the audience’s everyday routine. When used appropriately, having a social media presence can help to grow a physician’s practice with new clients, partnerships and reinforcing the relationship with existing patients.

VIRGINIA BERNERO IS THE ASSISTANT TO THE DIRECTOR OF ADMINISTRATION FOR THE MICHIGAN OSTEOPATHIC ASSOCIATION. SHE HAS WORKED WITH A BROAD ASSORTMENT OF SOCIAL MEDIA PLATFORMS, TARGETING VARIOUS AUDIENCES. IF YOU HAVE ANY QUESTIONS, CONTACT HER AT VBERNERO@MI-OSTEOPATHIC.ORG.

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DEAN’S COLUMN PREPARING FOR PRACTICE MANAGEMENT

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’ll be honest; we teach many things in medical school, but we don’t have a specific course in practice management. It’s not because we don’t view it as an important topic, but mostly because we’re challenged enough in fitting in all of the information that a young doctor will need to get a good start on his or her career.

From learning about and understanding the body and its myriad systems and responses

BY WILLIAM STRAMPEL, D.O.

to exploring career development; from working with patients to taking part in community service, we put many expectations and time commitments on our students.

While we may not offer an entire course, I would argue that there are elements of practice management education woven throughout the MSUCOM experience. Students get introduced to concepts that relate to practice management in the medical ethics, professionalism

While we may not offer an entire course,there are elements of practice management education woven throughout the MSUCOM experience.

and law course and in aspects of the osteopathic patient care course series.

In addition, in serving on a student organization board, our future doctors may be called on to handle volunteer staff scheduling for a health fair. They might be called on to serve as the organization’s treasurer – handling income and paying expenses. In their community service activities they might be required to input patient health records into an electronic system.

I realize this is still a long way from what they’ll be called on to do when they move into a leadership role in their practice, but we do what we can to provide every experience that we can offer to help develop future leaders and managers.

One exciting new option that we have for students who want to establish not only a strong base in medicine, but also foundations in management, leadership and strategy is a joint degree in partnership with the MSU Broad College of Business.

This dual degree will enable eligible students to earn both a D.O. and an MBA degree within the span of five years. It’s not an option that everyone will want to choose, but for those who see themselves moving into administrative roles in the future, it will give them a sound basis in both business and medicine.

While it might not be front and center in our curriculum, practice management is never out of the picture.

WILLIAM STRAMPEL, D.O., IS DEAN OF THE MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE. HE CAN BE REACHED AT PAT.GRAUER@HC.MSU.EDU.

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ADVERTISERS Beaumont Group................................................................ 4 TRIAD STAFF John Sealey, D.O, FACOS and Kevin Leikert, OMS-II, Editors-in-Chief William Strampel, D.O., Contributing Editor Kris T. Nicholoff, CEO and Executive Director Lisa M. Neufer, Director of Administration Todd Ross, Manager of Communications Cyndi Earles, Director, MOA Service Corporation Marc A. Staley, Manager of Finance Wendy Batchelor, Manager of Physician Advocacy Carl Mischka, Advertising Representative 2014-15 BOARD OF TRUSTEES Robert G.G. Piccinini, D.O., dFACN, President Bruce A. Wolf, D.O., President-Elect Lawrence L. Prokop, D.O., Secretary/Treasurer Myral R. Robbins, D.O., FAAFP, FACOFP, Immediate Past President Michael D. Weiss, D.O., Past President Department of Membership Director Robert G.G. Piccinini, D.O., dFACN Department of Membership Co-Directors David Best, D.O., Patrick Botz, D.O. and Ryan Christensen, D.O. (IR) Department of Insurance Co-Directors Lawrence J. Abramson, D.O., MPH and Craig Glines, D.O., MSBA, FACOOG Department of Education Co-Directors Jeffrey Postlewaite, D.O. and Duncan McGuire, Student Doctor

Centers for Medicare.......................................................... 2 Health Law Partners PC.................................................... 20 Kerr Russell........................................................................ 4 Michigan Health Center..................................................... 6 MOA Fall 2015 Convention............................................. 13 MSU College of Osteopathic Medicine.............................. 14 Oakland University............................................................ 6 Pinkus Derma..................................................................... 6 The Doctors Company..................................................... 24 Wachler & Associates PC................................................. 14 David M. Wells, JD........................................................... 14

Department of Professional Affairs Co-Directors Myral R. Robbins, D.O., FAAFP, FACOFP and John W. Sealey, D.O. Department of Judiciary and Ethics Co-Directors John W. Sealey, D.O. and Michael D. Weiss, D.O. Department of Public Affairs Director David Best, D.O. The osteopathic profession in Michigan is made up of osteopathic physicians, osteopathic hospitals and an osteopathic medical school. This TRIAD stands together to serve our patients and one another. TRIAD, the official journal of the Michigan Osteopathic Association, serves Michigan’s osteopathic community, including its osteopathic physicians, hospitals, medical school and patients.

The Michigan Osteopathic Association will not accept responsibility for statements made or opinions expressed by any contributor or any article or feature published in TRIAD. The views expressed are those of the writer, and not necessarily official positions of MOA. TRIAD reserves the right to accept or reject advertising. The acceptance of an advertisement from another health institution or practitioner does not indicate an endorsement by MOA. TRIAD (ISSN 1046-4948; USPS 301-150) is published quarterly by the Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Periodical postage paid at Okemos, MI 48864 and other post offices.

Subscription rate: $50 per year for non-members. All correspondence should be addressed to: Communications Department, Michigan Osteopathic Association 2445 Woodlake Circle, Okemos, MI 48864 Phone: 517.347.1555 Fax: 517.347.1566 Website: www.mi-osteopathic.org Email: moa@mi-osteopathic.org POSTMASTER: SEND ADDRESS CHANGES TO TRIAD, 2445 WOODLAKE CIRCLE, OKEMOS, MI 48864. ©2015 MICHIGAN OSTEOPATHIC ASSOCIATION

FOR ADVERTISING INQUIRIES, PLEASE CONTACT CARL MISCHKA AT 888.666.1491 OR VIA EMAIL AT CMISCHKA@MI-OSTEOPATHIC.ORG TRIAD, SUMMER 2015

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UNWAVERING

WE ARE UNWAVERING IN OUR MISSION TO DEFEND, PROTECT, AND REWARD THE PRACTICE OF GOOD MEDICINE New healthcare delivery models bring new medical malpractice risks. That’s why you can’t afford to be wrong in your choice of malpractice insurer. The Doctors Company relentlessly defends, protects, and rewards the practice of good medicine.

We provide unmatched coverage to 76,000 members nationwide.

When your reputation and livelihood are on the line, choose the insurer that stands with doctors.

Join your colleagues—become a member of The Doctors Company.

CALL OUR EAST LANSING OFFICE AT 888.896.1868 OR VISIT WWW.THEDOCTORS.COM

MISSION