August 2015 | Physician Magazine

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CMA WORKS WITH CMS TO MITIGATE MEDICARE ICD-10 DISRUPTIONS

REPORTING ON THE ECONOMICS OF HEALTHCARE DELIVERY

A PUBLICATION OF PNN www.PhysiciansNewsNetwork.com

CONNECTED CARE medical devices | remote patient monitoring | data analytics

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Association (AMA) and other medical associations – has secured provisions that will ease

“ICD-10 Transition Guide”

this transition, particularly for physicians in practices with limited resources.

to help practices of all switch to the new ICD-10

announced that it will provide a one-year grace period during which it will allow for

coding system. The guide

flexibility in the Medicare claims payment, auditing and quality reporting processes as

will answer frequently asked

the medical community gains experience using the new ICD-10 code set. The ICD-10

questions and includes

implementation date of October 1, 2015, has not changed.

CMA’s “ICD-10 Transition Preparation Checklist” to

THE CHANGES ANNOUNCED INCLUDE:

help ensure the transition is

CLAIM DENIALS: Medicare review contractors will not deny claims based solely on the Volume 146 Issue 8 specificity of the ICD-10 diagnosis code as long as a valid code from the right family of

a smooth one. The guide is free to members-only at

codes is used. Moreover, physicians will not be subject to audits as a result of ICD-10

www.cmanet.org/icd10.

coding mistakes during the grace period. QUALITY REPORTING: Physicians also will not be penalized under the quality reporting

ICD-10

programs for errors related to the additional specificity of the ICD-10 diagnosis code, again as long as a code from the correct family of codes is used.

What

established time limits because of administrative problems, such as contractor system malfunction or implementation problems, advance payment may be available to keep resources flowing to physician practices. ICD-10 COMMUNICATION CENTER: CMS will set up a communication center to monitor the implementation of ICD-10 in an effort to quickly identify and resolve issues related to

6

the transition. As part of the center, CMS will have an ICD-10 ombudsman to help receive and triage physician and provider issues.

tion Pre

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ICD-10

ADVANCE PAYMENTS: If Medicare contractors are unable to process claims within

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6 ICD-10 Employing Advanced Practice Providers: For the latest ICD-10 news and updates, see CMA’s resource page at www.cmanet.org/icd10.

42

14 CMA Works with CMS to Mitigate Medicare ICD-10 FALL 2015 Disruptions

SAN JOAQUIN PHYSICIAN

COVER STORY

8 CONNECTED CARE

We offer real-world practice management tips on some of the key components of connected care — from medical devices and remote patient monitoring to electronic health records and their linked elements of interoperability and analytics. Find out what those means for you in terms of helping you make the transition into a connected care practice. We’ll also provide some legal, practical and reimbursement issues to think about.

AUGUST 2015 | TA B LE OF CONT ENT S

sizes successfully make the

Thanks to CMA advocacy, the Centers for Medicare & Medicaid Services (CMS) recently

Balancing Benefits and Potential Malpractice Risks

FROM YOUR ASSOCIATION 4 President’s Letter | Peter Richman, MD 16 CEO’s Letter | Rocky Delgadillo

Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright ©2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 9001 7. Advertising rates and information sent upon request.

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specialty and practice setting as well as medical students, interns and residents. For more

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than 100 years, LACMA has been at the forefront of current medicine, ensuring that its members are represented in the areas of public policy, government relations and community

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County and with the statewide California Medical Association, your physician leaders and staff strive toward a common goal– that you might spend more time treating your patients and less time worrying about the challenges of managing a practice.

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LACMA’s Board of Directors consists of a group of 30 dedicated physicians who are working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, Director of Governance, at lisa@lacmanet.org or 213-226-0304.

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Premiums are based in part on age. The longer you wait, the higher your premium rate may be. You’ve worked hard all your life to provide a good standard of living for you and your family and KEEP your current lifestyle in retirement. But long-term care costs can get in the way. If you develop a debilitating long-term condition, you may need long-term care. Once you’re 65 years old, Medicare will help pay your medical costs. But Medicare does not pay full benefits for extended-care, assisted-care facilities, custodial care or nursing home facility expenses. If you need this type of care, you could face big expenses: • The national average cost of a year in a nursing home is $87,600.* • The 2014 median annual cost for an assisted-living, one-bedroom apartment with a private bath, or a private room with a private bath was $42,000.* Many of us think Medicare is going to cover long-term care expenses, but find the coverage very limited. That’s why millions of responsible Americans help protect their lifestyles with long-term care insurance. But finding the right protection isn’t easy. It’s tough to compare policies with different benefits, features, limitations, costs, spouse coverage and more. The Los Angeles County Medical Association/CMA can help, with a special benefit for members: Long-Term Care Resources, a unique long-term care buying service. This program allows you to work with a long-term care insurance representative who will give you all the information about benefits and rates of different, highly rated long-term care providers. Call Long-Term Care Resources today to receive information at 800-616-8759, or visit www.myltcplan.com/lacma. * Genworth 2014 Cost of Care Survey, February 2014, https:// genworth.com/corporate/about-genworth/industry-expertise/costof-care.html, viewed 1/27/15

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P RES IDEN T ’S LET T ER | P ET ER RIC H M AN, M D

T H E G R E E C E F I N A N C I A L crisis is seemingly resolved and Grexit has been averted. Greece borrowed from the EU to maintain a standard of living that its own economy was incapable of sustaining. The people felt they deserved the best. The borrowing raised salaries, benefits and pension payments to which the people became accustomed. The Greece national debt rose from 22.6% of GDP in 1980 to 177% of GDP in 2015. When creditors would no longer roll over debt, the scheme came crashing down. (The creditors are at fault as well for not doing due diligence and loaning money to a country that could not afford the future payments.) Greece has agreed to raise taxes, cut benefits, lay off government employees, privatize functions and reduce pensions up to 40%. This will reset the economy to a level sustainable by indigenous growth and begin to pay back an exorbitant debt that should be reduced. The United States has its own approaching version: Medicarexit. Medicare payments have been rising to an unsustainable level. In 2010 Medicare and Medicaid payments alone represented 4.4% of GDP. This number is expected to rise to 12% of GDP in 2050. Medicare, Medicaid, CHIP and healthcare subsidies currently account for 24% of the federal budget. A nearly threefold increase in the next 35 years will bankrupt the country. The U.S. Government borrows money (our national debt is now at 101% of GDP) to pay for a standard of living and benefits to which we have become accustomed. Obamacare enacted insurance reform and greatly expanded the insurance rolls. It also calls for payment reform and structural changes for the healthcare system. It has not been cost neutral as promoted and in fact is bringing sig-

4 P H Y S I C I A N M A G A Z I N E | AUG US T 2015

nificant cost increases. For 2015, overall insurance costs are rising 2% to 5% with plan rates varying from -14% to +50%. Obamacare rates are parallel to overall private insurance increases. Bringing in 32.2 million new patients and instituting and integrating EMR would never be paid from “fraud, abuse and waste� savings. Those projected savings have eluded every government agency since the Founding Fathers. Obamacare, however, has withstood two constitutional challenges and remains in force. Having medical coverage for the population of the wealthiest country is a noble goal. At some point, our debt payments will become too burdensome for our economy, and adjustments will be made. Taxes will rise and benefits will be reduced. Our national standard of living will be decreased. To avert this crisis, many scenarios have been devised. (Obamacare shifted the cost curve but only for a few years.) Freezing overall Medicare expenditures and giving the money to states as block grants achieves this goal for the federal government but leaves the cost savings implementation to the states. Freezing Medicare expenditures to a sustained growth rate (SGR) was attempted only for doctors, and it was never implemented. A Medicare sequestration would force limits on all sectors of healthcare. How the limits would be absorbed is not delineated. Lastly, insurance coverage could be modified to bring expenditures in line with budgeted income. As stated, the ACA model may shift the cost curve for a few years once fully implemented. Additional changes will still be necessary. Many physicians are frustrated with the initial steps of Obamacare. There will be many more changes as the system evolves. We as physicians cannot stand by and let others dictate policy and procedures that affect our daily lives and that of our patients. Nor can we wait until a financial crisis is imminent before we become involved intimately in the formulation of future healthcare policy. Being a member of LACMA and CMA allows members to have a significant voice in the process.


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RIS K T IP | ADVAN CED P RACT ICE P ROVIDERS

P R AC T I C E S A N D H O S P I TA L S that employ advanced practice providers (APPs), including

nurse practitioners and physician assistants, can experience many benefits, such as lower operating overhead, increased physician time with patients, and improved patient education and satisfaction. However, employers of APPs should consider implementing effective risk management measures to help ensure that the benefits of using APPs are not at the expense of increased liability exposure. An APP is often covered under the physician’s or hospital’s malpractice insurance policy under vicarious liability coverage. APPs can be held directly liable for their own acts or omissions, but, in addition, under the legal theory of vicarious liability, physicians and hospitals can also be held liable for the actions of their employees, including APPs. Therefore, the physician or hospital is often named in malpractice claims involving their APPs. To help decrease liability risks, the employing physician or hospital should have a written policy outlining the APP’s scope of practice. This policy should be signed by the APP and other staff members annually. In putting together this policy, it is important to know the laws in your state that govern the scope of practice of APPs. Other suggestions to decrease liability risks include: • Ensure that all newly hired APPs undergo orientation with the practice or hospital. • When scheduling appointments, staff should inform patients when they are being scheduled with an APP. If that patient requests to see his or her physician, the staff should provide the patient with that option. • Make certain APPs wear identification that indicates their name and their job title. • Develop treatment guidelines and clinical triggers for physician consultation. Meet with the APPs regularly to discuss their roles and expectations within the practice, and document these meetings. • Regularly review the charts, including prescription monitoring, of patients seen by the APPs. • Make sure that all staff members, including APPs, have adequate professional liability coverage. For nonemployed APPs, liability coverage should be equal to what the physician or practice carries. To read case studies about employing APPs and for detailed risk management checklists, download The Doctors Company’s guide to an APP preventive action and loss prevention plan at http://ow.ly/OxqBm. -------------------Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.

6 P H Y S I C I A N M A G A Z I N E | AUG US T 2015


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F EAT U RE | C ONNEC T ED C ARE

CONNECTED CARE

medical devices | remote patient monitoring | data analytics BY MARION WEBB

8 P H Y S I C I A N M A G A Z I N E | AUG US T 2015


AUG US T 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 9

C ONNEC T ED C ARE | F EAT U RE

It’s common knowledge that the more engaged and “connected” patients are with their physicians, the more compliant they tend to be with treatments and medical advice, resulting in better outcomes, lower healthcare costs and reduced hospital readmission rates. In this issue, we’ll provide you with real-world practice management tips on some of the key components of connected care — from medical devices and remote patient monitoring to electronic health records and their linked elements of interoperability and analytics. Find out what these means for you in terms of helping you make the transition into a connected care practice. Finally, we’ll also provide some legal, practical and reimbursement issues to think about.


F EAT U RE | C ONNEC T ED C ARE

According to Jan Oldenburg, a senior manager in Ernst & Young’s Advisory Health Practice, in this digital age, patients want to use their smartphones, apps and instant access on the Internet to connect with their physicians, as reported in Physicians Practice. They also want to gain access to their health records and play a more active role in their own health management, Oldenburg told Physicians Practice. To find out exactly what patients are interested in, Oldenburg and her colleagues on the HIMSS (Healthcare Information and Management Systems Society) Connected Patient Committee, created a survey asking health consumers what they’d like to see improved in their personal health engagement. The findings on a scale of one to five (with five being the highest) showed that consumers were very interested in the following four criteria:

what health consumers want

• Being able to make, cancel and view appointments online; • Being able to refill prescriptions online;

• Being able to complete a pre-visit form; and • Being able to research health issues online. Furthermore, 84% of respondents noted that they would like the healthcare system to be more consumerfriendly, with 75% saying they’d like to be able to see all clinical data in one place. To make this happen, Oldenburg suggests that medical practices evaluate their digital tools and “think beyond basic requirements of meaningful use.” Eligible professionals need to demonstrate meaningful use of certified electronic health records to qualify for an incentive payment through the Medicare EHR Incentive Program administered by the Centers for Medicare and Medicaid Services. Oldenburg believes that revamping work flow and incentives to support digital tools, and having staff and physicians encourage their use is also critical, as reported in Physicians Practice on April 15.

analytics and interoperability

Oldenburg also noted that the recently proposed rule by the Centers for Medicare and Medicaid Services to adjust the requirement in the Stage 2 rules (one of the meaningful use requirements) from a 5% threshold of patients downloading, viewing and transmitting their electronic health data to just one patient is “not enough.” “(One patient) does not make it an organizational priority . . . and say that you’ve embraced this and made a cultural change,” Oldenburg told Physicians Practice. Other experts agreed that while many practices have already or are still investing in electronic health 1 0 P H Y S I C I A N M A G A Z I N E | AUG US T 2015

record (EHR) systems, the continuing drive to connective care should be part of their consideration in EHR implementation. Achieving meaningful use is a big part of the equation, but not everything. With some 71.4 million people in the United States turning 65 or older by 2029 and an expected shortage of 20,400 primary care doctors by 2020, reducing the need for office visits and hospitalization will be paramount to reduce costs, Charles Settles, a product analyst at TechnologyAdvice, wrote in an article that appeared on June 26 in Physicians Practice. Settles cited studies that show that these aging baby boomers have higher rates of chronic disease, more disability and lower self-rated health than members of previous generations. Moving to an outcome-based reimbursement model, he said, is seen as a way to control costs and to incentivize improved outcomes. The key to ensuring that outcome-based reimbursements are fair to physicians is having accurate analytics. This, in turn, would require the creation of a nationwide patient database (that would also include healthy individuals) and allow tracking of such metrics as mortality rates, average life expectancies and medication efficacies. But this could only be realized if EHR vendors solved their interoperability issues, or ability of health information systems to work together and across organizational boundaries, which, according to the experts, is unlikely in the near future. The good news is that there are certain EHR “add-ons” available today that can help doctors create efficiencies in their own practices today and for the future. In particular, there are three solutions that can help boost medical practices today, according to an article in Physicians Practice from May 21.

“add-ons” that help create efficiencies

1. Scanning - Adding a scanning system is a great way to create a digital archive of patients’ insurance information, their contact details, and their HIPAA consent forms. This also helps the front-office staff resolve problems, such as with insurers, faster. 2. Practice Management System - To streamline billing and scheduling, a practice management system that includes both is a good fit. The key is to use one vendor to avoid duplicating data, and while this may initially be costly, it will save money and time in the long run, the experts noted. 3. Data Analytics - Data analytics should be on the short list as it can take revenue cycle data and pair


remote monitoring

One solution that already exists to successfully capture data of individuals is the use of remote monitoring through implantable and wearable devices,

according to TechnologyAdvice analyst Settles. He said implantable and wearable devices have the potential to save millions of dollars by reducing hospitalization and providing comprehensive real-time monitoring of physical activity, vital signs and other metrics. Many experts feel that the data derived from such devices will play a pivotal role in managing chronic care patients. Danny Sands, chief medical officer at Conversa Health Inc., during a presentation at the HIMSS Conference in Chicago in April, noted that such data will likely also be key for primary care offices. Sands told Physicians Practice that while fitness trackers enjoy greater popularity with consumers, he cited a study that showed that health monitoring devices tracking chronic disease patients will be far more valuable for doctors. According to a pilot study of 1,300 chronic disease patients Conversa Health did in partnership with an adult primary care practice, 73% of patients completed one or more digital checkups, 81% stayed engaged after the first checkup, and 29% had a clinical intervention. He noted that many issues that required intervention had to do with medication adherence that could be fixed with a quick call. Also, 72% of patients stayed on track or even im-

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C ONNEC T ED C ARE | F EAT U RE

it with data from the clinical side of a practice to see how the practice is really taking care of its patients, the experts noted. This, in turn, allows physicians to make better decisions about what changes are needed to improve the delivery of care, improve patient outcomes and decrease cost of care. With a data analytics system, practices also have greater insight into which patients are using their patient portal successfully and align resources to make the patient portal more user-friendly. According to Daniel Carlin, MD, founder and CEO of WorldClinic, an elite telemedicine concierge practice (as quoted in Forbes Magazine), a platform that integrates telemedicine calls, episodes and data into a secure medical record system should also include a wellness checklist with follow-up capabilities. This, according to the article, is in contrast to the Dial-a-Doc model, which provides simple episodic urgent care calls but lacks continuity for complex or chronic issues.


Leveraging Enterprise-Wide MDI for a Patient-Centric Approach to Care BY JANET DILLIONE

Medical device integration (MDI) is a hot topic in healthcare, though the concept itself has been around for years. Several factors are driving MDI higher on the list of priorities for hospitals, including the maturation of EMR systems and the associated Meaningful Use requirements, concerns over patient safety related to manual data entry errors, Virtual ICU applications for remote patient monitoring and alarm management system implementation to address patient safety concerns. Properly implemented, a comprehensive enterprise-wide MDI solution can also provide the foundation for smart alarms and predictive analytics to aid in early intervention and clinical decision support, provided it is capable of collecting the high-fidelity, low-latency data needed to enable these types of advanced capabilities. Implementation of an enterprise-wide, interoperable MDI platform presents multiple challenges. Here are some key considerations to take into account: • Think Long Term. Consider not just where you are now, but where you might be in the future. Is the MDI platform capable to scale and adapt to your evolving needs? As new devices, technologies and physiological measurements emerge, will it be able to support them quickly and cost-effectively? • Moving Together. Broad, multi-disciplinary involvement is critical for a successful MDI implementation. Governance needs to be adaptive and to understand that the solution must contribute to the comprehensive assessment and treatment of a patient throughout the continuum of care. • Consider Workflow. Every technology has a “people component.” How will an enterprise-wide MDI platform impact clinical workflows? How does the solution deal with mobile devices that are not mounted at the bedside? You don’t want clinicians spending time connecting and assigning devices when they should be focusing on the patient. • Avoid Regulatory Pitfalls. The FDA recently reaffirmed their guidance that systems relied upon to provide timely clinical intervention must have Class II clearance, including all intermediary third party applications. Make sure MDI solutions you are considering have clearance for this intent. • Go Big (Data). Don’t just consider MDI to push device data into an EMR at 1-minute increments. Make sure you capture all highfidelity data available from your devices – as mentioned earlier, this is critical for emerging real-time applications such as Alarm Management, Virtual ICU or predictive analytics. MDI holds a great deal of potential for hospitals and health systems to create the right infrastructure to improve patient safety, outcomes and both patient and staff satisfaction. By making the right choices today, provider organizations will be well positioned to support evolving needs for years to come. Janet Dillione is CEO of Cardiopulmonary Corp., in Milford, CT. Its flagship Bernoulli Enterprise system provides an extensible platform for medical device connectivity, alarm management, clinical surveillance, virtual ICU and analytics. Ms. Dillione has more than 25 years of experience leading global teams in the development and delivery of healthcare technology and services.

1 2 P H Y S I C I A N M A G A Z I N E | AUG US T 2015

proved during the pilot. When it comes to implementation of connected care and the convergence of digital health, Apple Inc. and Google are also major game players. Apple’s HealthKit, a software framework used to aggregate data from health and fitness apps on smartphones, for instance, has led more than 20 large healthcare systems, including Cedars-Sinai in Los Angeles and UCLA Health, to test the software, Physicians News Network reported on May 11. In some cases, the healthcare systems have opened their EHRs to HealthKit, allowing patients to directly share unfiltered data with their doctors. Given the increase in the number of chronic disease patients and the need to better engage with patients, doctors who provide “light touches” with relevant patients via remote monitoring will be part of the wave of the future, Sands said.

tracking patient-generated health data

To successfully acquire patient-generated health data, Sands and other experts have put forth some key recommendations: • Make sure acquiring patient-generated health data fits into your daily workflow. • Ensure that received information is automated. • Make it simple for patients to provide the data and easy for physicians to use it. • The data should not overwhelm the physician. • Have an appropriate care team staffing in place. “Too much information is not a good idea, but if you can help create information from the data, then it will be useful,” Sands was quoted as saying. As with all new technologies, connected care raises concerns, particularly on the reimbursement, legal and regulatory fronts, which will affect doctors. According to the Alliance for Connected Care, “to achieve the promise of connected care in our healthcare system, there must be renewed urgency among policy makers to develop a regulatory structure that enables safe and accessible use of technology.” All experts agreed that the wave of patients walking into their practices looking to stay engaged via remote monitoring and smartphone applications will only get bigger. To help you navigate this sea change, look for the October issue of Physician Magazine, where we will dive deeper into mobile health, talk about what it means for your practice, and also identify the top physician apps to help you better connect and engage with your patients.


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CMA Works with CMS to Mitigate Medicare ICD-10 Disruptions CMA PUBLISHES With implementation of the ICD-10 code set just around the corner, many physicians have been understandably wary about the transition and the potential for payment disruptions and claims processing errors that could interfere with patient care. Fortunately, the California Medical Association (CMA) – working closely with the American Medical Association (AMA) and other medical associations – has secured provisions that will ease this transition, particularly for physicians in practices with limited resources. Thanks to CMA advocacy, the Centers for Medicare & Medicaid Services (CMS) recently announced that it will provide a one-year grace period during which it will allow for flexibility in the Medicare claims payment, auditing and quality reporting processes as the medical community gains experience using the new ICD-10 code set. The ICD-10 implementation date of October 1, 2015, has not changed.

ICD-10 TRANSITION GUIDE CMA has published the “ICD-10 Transition Guide” to help practices of all sizes successfully make the switch to the new ICD-10 coding system. The guide will answer frequently asked questions and includes CMA’s “ICD-10 Transition Preparation Checklist” to

THE CHANGES ANNOUNCED INCLUDE:

help ensure the transition is

CLAIM DENIALS: Medicare review contractors will not deny claims based solely on the

a smooth one. The guide is

specificity of the ICD-10 diagnosis code as long as a valid code from the right family of

free to members-only at

codes is used. Moreover, physicians will not be subject to audits as a result of ICD-10

www.cmanet.org/icd10.

coding mistakes during the grace period. QUALITY REPORTING: Physicians also will not be penalized under the quality reporting programs for errors related to the additional specificity of the ICD-10 diagnosis code, again as long as a code from the correct family of codes is used.

ICD-10

ICD-10 What

ADVANCE PAYMENTS: If Medicare contractors are unable to process claims within established time limits because of administrative problems, such as contractor system malfunction or implementation problems, advance payment may be available to keep resources flowing to physician practices. ICD-10 COMMUNICATION CENTER: CMS will set up a communication center to monitor the implementation of ICD-10 in an effort to quickly identify and resolve issues related to the transition. As part of the center, CMS will have an ICD-10 ombudsman to help receive

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and triage physician and provider issues. For the latest ICD-10 news and updates, see CMA’s ICD-10 resource page at www.cmanet.org/icd10. 1 4 P H Y S I C I A N M A G A Z I N E | AUG US T 2015

42

SAN JOAQUIN PHYSICIAN

FALL 2015


2015 ICD-10-CM Code Set Boot Camps DISCOUNTED

ICD-10 EDUCATION AND TRAINING FOR MEMBERS

Recognizing that health care providers need help with the transition, CMA, AMA and CMS are also working to make sure physicians and other providers are ready for the October 1, 2015, transition to the new ICD-10 code sets. CMA, in partnership with its local county medical societies and the California Medical Group Management

Association, is offering two-day ICD-10 code set seminars around the state. The two-day boot camps include 16 hours of intensive general ICD-10 code set training, along with hands-on coding exercises. To view the available dates and locations, visit CMA’s ICD-10 event calendar at www.cmanet.org/aapc-icd10. In addition to the two-day code set boot camps, CMA has negotiated deep discounts on other ICD-10 training courses through AAPC. For details, visit www.cmanet.org/aapc.

Sav eu

2015 ICD-10-CM Code Set Boot Camps p to

CMS and AMA will also be offering webinars, educational articles and national provider calls to help physicians and other health care providers prepare for the transition. For more information, see CMS’s ICD-10 provider page at www.cal.md/cms-icd10 and AMA’s ICD-10 web page at www.cal.md/AMAICD10.

$40

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Learn to code for ICD-10-Clinical Modification (ICD-10-CM) and prepare for the ICD-10 Proficiency Assessment. Training is led by a certified AAPC instructor and is provided onsite in a classroom format. Conducted over two days, attendees will receive 16 hours of intensive general ICD-10 code set training along with hands-on coding exercises.

WHAT’S INCLUDED:

TRAINING FOCUSES ON:

• 16 CEUs

• ICD-10 format and structure

• AAPC ICD-10-CM Code Set Course Manual

• Complete in-depth ICD-10 guidelines

• AAPC ICD-10-CM Code Set Draft Book

• Nuances found in the new coding system, with coding tips

• AAPC Online ICD-10-CM Proficiency Assessment (Required for current AAPC CPCs to maintain their credential)

• Access to AAPC’s Online ICD-10-CM Assessment Training Course through December 31, 2015

PRICING: • $399 for CMA members & members’ staff • $499 for CA-MGMA members • $599 for non-members

LOCATION/DATES

*Comparable AAPC ICD-10 Boot Camp Costs $799

Santa Maria . . . . . June 8-9

San Jose . . June 30-July 1

Sacramento . . . .July 15-16

Modesto . . . . August 12-13

Fresno . . . . . . . June 15-16

Redlands . . . . . . . .July 7-8

Roseville . . . . . August 4-5

Redding . . . . August 24-25

Napa. . . . . . . . . June 18-19

Los Angeles . . . . . .July 8-9

Stockton. . . . August 10-11

Eureka . . . . . August 26-27

Irvine . . . . . . . . June 23-24

Santa Rosa. . . . .July 13-14

San Diego . . . . June 25-26

Torrance . . . . . . .July 14-15

(French Camp)

*Dates and locations subject to change. Please check www.cmanet.org/AAPC-ICD10 for updated information and new boot camps being added.

REGISTER: CALL (800) 786-4262 OR VISIT WWW.CMANET.ORG/AAPC-ICD10 INFORMATION: CALL JULI REAVIS AT (916) 551-2046 OR EMAIL JREAVIS@CMANET.ORG

For more information about CMA, please visit: www.cmanet.org

SIGN UP FOR ICD-10

For more information about these and other CMA member discounted course offerings from AAPC, please visit: www.cmanet.org/AAPC

NEWS ALERTS The CMA website allows registered users to create custom content alerts on the topics that are of interest to you. Once signed up, you will be notified any time there is new content posted in one of your areas, including ICD-10 issues. To sign up, go to www.cmanet.org and visit your account dashboard, click on “My Alerts,” then select “ICD-10.”

AUG US T 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M For more information about CMA, please visit www.cmanet.org or call 800.786.4262 SAN JOAQUIN PHYSICIAN 43

FALL 2015

15


AS S OC IAT ION H AP P ENINGS | LAC M A NEWS

CEO’s LETTER

T H I S S U M M E R , L A C M A physicians have won yet another victory in doing the right thing for their patients and the California community.

We thank all of our physicians who have supported LACMA’s efforts and taken the time to

contact their legislators in support of SB 277, which removes the personal belief exemption for vaccines and reduces preventable disease outbreaks in our communities.

On June 30, Gov. Jerry Brown signed SB 277 into law, and as of January

2016, parents will be absolutely required to ensure that their children receive all mandatory vaccines, unless medically exempt, regardless of their religious or philosophical views.

This is exciting news, and now LACMA is inviting all members to reward

those physicians who are also making a difference in our communities.

We are asking all LACMA members to nominate individuals you believe have

made exemplary contributions in providing and improving access to quality healthcare in LA County.

We encourage everyone to participate in this important process, which cul-

minates in LACMA’s biggest annual celebration dinner — the 2015 L.A. Healthcare Awards dinner.

Please take a look at the categories and criteria to nominate outstand-

ing physicians online at lahealthcareawards.org and submit the nomination forms and accompanying narrative responses via email to Ann D’Amato at ann@3dnetworkscorp.com. The deadline for submissions is Tuesday, Sept. 15.

Finally, if you’re a graduating resident or physician looking for employment

or services, you don’t want to miss LACMA’s upcoming Job Fair, which will be held from 5-9

p.m. on Sept. 16 at the Sofitel Los Angeles at Beverly Hills. 8555 Beverly Blvd., Los Angeles, CA 90048.

We hope you enjoy the rest of your summer.

Back to school is just around the corner, and we will do our part to provide you with all

the supplies, education and up-to-date information you need to grow your practices and be in the know. Regards,

Rocky Delgadillo Chief Executive Officer

1 6 P H Y S I C I A N M A G A Z I N E | AUG US T 2015


NEW Resource Centers Your LACMA/CMA Membership at work

CME Resources

Legal Resources

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www.lacmanet.org/LegalResources

Physicians are required to complete 50 CME hours during every two-year licensure period. LACMA & CMA understand your need for easily accessible and convenient CME programming, and offer you a variety of resources to help you reach your educational requirements.

CMA’s Center for Legal Affairs helps CMA members comply with laws and regulations that impact the practice of medicine. In addition, LACMA & CMA provide you with countless legal resources—all at your fingertips: 

CMA’s Legal Information Helpline

CME Tracking & Credentialing provided by CMA’s partnership with the Institute for Medical Quality

Health Law Library

Health Contract Analyses

Online CME Resources

Payor Contract Resources

LACMA CME-Accredited Events

LACBA’s Lawyer Referral System

CMA’s On-Call Index

Career & Professional Development

Jury Duty Concierge

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LACMA & CMA’s professional resources are all aimed towards supporting your career and professional goals. Whether it be finding a new career path or a qualified staff member to join your practice, to reaching your leadership potential, LACMA is here to help. 

LACMA’s Career Center & Job Board

Media Training

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We’ve simplified our Jury Duty process so that you can complete your request online and receive SMS text updates. 

Reduce your call-in days from 5 to 1

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TRACY ZWEIG ASSOCIATES, INC. • Physicians • Nurse Practitioners • Physician Assistants LOCUM TENENS PERMANENT PLACEMENT 800-919-9141 • 805-641-9141 FAX: 805-641-9143 email: tzweig@tracyzweig.com www.tracyzweig.com

OPPORTUNITY WANTED

RADIOLOGIST

Board certified. Have own malpractice insurance. Available for part-time position or film reading. Call 310-477-4257.

FAMILY MEDICAL AND INTERNAL MEDICINE IN VISTA AND RIVERSIDE

TRACY ZWEIG ASSOCIATES, INC. • Physicians • Nurse Practitioners • Physician Assistants

Located in Vista, California, Vista Community Clinic is a private, nonprofit outpatient community clinic located in North San Diego County serving people who experience social, cultural or economic barriers to health care in a comprehensive, high quality setting. POSITION: Full-time, Part-time and Per Diem Family Medicine Physicians and Internal Medicine Physicians. RESPONSIBILITIES: Provides outpatient care to clinic patients and ensures quality assurance. Malpractice coverage is provided by Clinic. REQUIREMENTS: California license, DEA license, CPR certification and board certified in family medicine. Bilingual English/ Spanish preferred. CONTACT US: Visit our website at www.vistacommunityclinic.org Forward resume to hr@vistacommunityclinic.org or fax resume to 760 414 3702. EEO/AA/M/F/Vet/ Disabled

LOCUM TENENS PERMANENT PLACEMENT 800-919-9141 • 805-641-9141 FAX: 805-641-9143 email: tzweig@tracyzweig.com www.tracyzweig.com

CONSULTING & SERVICES

Shorr Healthcare Consulting

Consultants to Healthcare Providers

Practice Appraisal & Sales Partnership Buy-In / Buy Out Supporting Southern California Physicians Since 1983 Call for a Courtesy Consultation

818-693-7055

avishorr@gmail.com

REACH THOUSANDS OF SOUTHERN CALIFORNIA PHYSICIANS

Place Your Ad Today!

ONLINE. IN PRINT. ONE PRICE. PhysiciansNewsNetwork.com 1 8 P H Y S I C I A N M A G A Z I N E | AUG US T 2015


PM Marketplace IN THE NEXT ISSUE

Financial Planning &

Retirement

Surgeons Needed for Expanding Nationwide Surgical Practice • Full or part-time positions • Competitive Pay • Add revenue to your current practice

• Flexible schedule, complete autonomy • No Call

PLEASE CONTACT US FOR MORE INFORMATION: Phone: 1-877-878-3289 Fax: 1-877-817-3227 or email CV to: Jobs@AdvantageWoundCare.org

www.AdvantageWoundCare.org

ADVERTISER INDEX Diowave Laser Systems..................................................................................................... C4

Fenton Law Group.............................................................................................................13

Mercer.................................................................................................................................3

Office Ally........................................................................................................................ C3

S. M. Rezaian, M.D..............................................................................................................5

UC Irvine...........................................................................................................................11

UCLA...................................................................................................................................7

Wells Fargo....................................................................................................................... C2

AUG US T 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 1 9

C LAS S IF IEDS | JOB B OARD

TO PLACE A CLASSIFIED AD VISIT WWW.PHYSICIANSNEWSNETWORK.COM OR CONTACT DARI PEBDANI AT DPEBDANI@GMAIL.COM OR 858-231-1231.


Specializing in the field of specialties

When you’re responsible for hiring healthcare professionals, you need the expertise of the Los Angeles County Medical Association Career Center. As a member of the National Healthcare Career Network, the LACMA Career Center gives you access to the best source of local and national candidates—its more than 250 member associations and professional societies. Save time and money by reaching the right people faster when your job is posted throughout a nationwide network that reaches over two million professionals dedicated to careers in healthcare. When you want the best, go where the best are: the LACMA Career Center

Visit careers.lacmanet.org to get started



Can your practice afford NOT to have the

DIOWAVE LASER SYSTEM? Diowave High Dose Laser Therapy (HDLT) devices now offer physicians and therapists a painless, non-surgical and side effect-free treatment for conditions previously refractive to traditional medical care. Results come from the laser’s ability to “bio-stimulate” tissue growth and repair. This results in accelerated wound healing with a dramatic decrease in pain, inflammation and scar tissue formation. Unlike all other treatment modalities, laser therapy actually “heals” tissue and is a powerful non-addictive form of pain management.

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