August 2008 | Back to Table of Contents

MMA News

Physicians Briefed on Health Care Reform

Physicians from Hennepin Faculty Associates (HFA) got the inside story on the state’s new health care reform bill at the MMA’s first Advocacy Rounds program in July. The event, which was held at Hennepin County Medical Center, was hosted by MMA Trustee Donald Jacobs, M.D. The purpose was to brief HFA physicians on the health care reform bill and to hear their ideas, concerns, and hopes for the future.

Most questions from the audience focused on a provision in the bill that pays physicians for providing health care homes, otherwise known as medical homes. Physicians are expected to receive about $50 per patient per month for coordinating care of patients with chronic medical conditions, although the amount hasn’t been set yet. The law says payment should be tied to the complexity of a patient’s care, so fees could be substantially lower or higher, depending on the patient.

Pathologist Brad Lindsey, M.D., questioned whether that was enough of an incentive to attract more physicians to primary care. MMA CEO Robert Meiches, M.D., who presented at the session, said it’s unclear whether it would attract physicians to those specialities but added that paying for care coordination is a move in the right direction.

Others questioned whether people enrolled in public programs would be required to choose a medical home. Meiches said the state’s public health insurance programs will encourage enrollees to select a medical home but won’t mandate it. Neither will it make the homes gatekeepers. “There are no financial incentives for the people delivering primary care to either withhold care or provide more care,” he said.

Meiches explained that the commissioners of health and human services will develop medical home certification standards for clinics by July 2009 that the state will use as a condition for reimbursement starting in 2010. “It is going to start with the state, and then the state mandates that the commercial insurers will, at least, have to offer an option for including medical homes in their plans,” Meiches said.

The MMA plans to hold more than a dozen Advocacy Rounds across the state. Watch for a session near you or contact Kathy Messerli, MMA director of member relations, at kmesserli@mnmed.org or 800/342-5662.

MMA Board Rules on Resolutions, Re-elects Chair

The MMA Board of Trustees took action on several resolutions referred to it by the 2007 House of Delegates at its July 12 meeting in Roseville.

It also re-elected Michael B. Ainslie, M.D., to another term as chair.

During the meeting, the board:

• Approved R208, which encourages physicians to utilize written agreements when entering into collaborative management plans with advanced practice registered nurses. The MMA will provide educational materials to help physicians craft these agreements.
• Resolved that the MMA encourage insurers and health plans to make available online user-friendly information about their enrollees’ coverage and drug benefits, and that the MMA will submit a similar resolution to the AMA. This was in lieu of R202, which called for insurers to make details about patients’ coverage and benefits available to them before and after doctor visits
• Deferred consideration of R314, which calls for the MMA to work to reduce the disparities in health outcomes suffered because of unequal treatment of marital status for same-sex partners in Minnesota by supporting equality in laws that affect that status. The resolution also calls on the MMA to ask the AMA to reduce such disparities and study the issue. The board deferred consideration because the AMA is considering a similar resolution
• Did not adopt R101, which called for the MMA to say that physician executives have a moral and ethical responsibility to consider the social impact of accepting excessive compensation packages. The board was not convinced of a correlation between executive physician compensation packages and a negative effect on patients.
• Did not adopt R201, which called for patients to have access to all provisions of agreements between insurers and providers that affect their care. It also called on clinics and provider organizations to disclose their policies on salary contingencies and pay-for-performance bonuses. The board concluded that current law addresses the issue of enrollee access and, after some discussion, decided that payment disclosure might negatively affect the physician-patient relationship.

House, Senate Override Bush Medicare Veto

Better late than never. After failing to stop a 10.6 percent cut in Medicare payments to physicians by July 1, Congress finally prevented it from going into effect by overriding President Bush’s veto of H.R. 6331 on July 15. Bush said he vetoed the bill because it weakened the Medicare Advantage program by reducing the amount of subsidies that insurers get in exchange for offering the plans.

Instead of a 10.6 percent reduction in payments, the Medicare Improvements for Patients and Providers Act of 2008 provides doctors with a 0.5 percent increase for the next 18 months. The Centers for Medicare and Medicaid Services (CMS) has stated it will automatically reprocess any claims paid since July 1.

The bill traveled a bumpy road before becoming law. The Senate failed to pass it by one vote before the July 4 holiday. But several Republican senators switched their votes after Sen. Ted Kennedy, D-Massachusetts, made a dramatic appeal, and it became clear the bill was going to pass by a veto-proof margin.

All members of the Minnesota delegation voted to override the veto. In the earlier votes, Rep. Michele Bachmann was the only member of the Minnesota Congressional delegation to vote against the bill.

Although the bill stops draconian cuts for now, Congress still failed to fix the flawed sustainable growth rate formula that results in an annual cut for doctors. The projected cut in 2010 will be roughly 20 percent. “We really appreciate the support of Minnesota’s Congressional delegation, but Congress has to get out and do its job,” says MMA President James J. Dehen Jr., M.D. “The cuts are not right, they are not sustainable, and they need to be fixed.”

The AMA reported that campaigning by physicians and seniors caused a noticeable shift in Congress’ sense of urgency about the problem. Hundreds of physicians responded to MMA Action Alerts sent out about the cut.

Save the Date: MMA Annual Meeting

The 155th Annual Meeting of the Minnesota Medical Association will be held in St. Paul September 17-19.

The Annual Meeting allows Minnesota physicians to come together as the MMA House of Delegates to debate actions and policies put forward by component medical societies, specialty societies, and individual delegates.

To become a delegate, MMA members should contact their component medical society, specialty society, or section.

This year, the MMA will again offer several educational sessions during the meeting. The courses are open to all physicians.

To learn more, visit www.mmaonline.net, click on the annual meeting promotion box on the home page.

Nominees Announced

The MMA Board of Trustees accepted the Nominating and Leadership Development Committee’s slate of nominees for MMA officers and AMA delegates during its July meeting. Nominations will remain open until the MMA House of Delegates convenes on Thursday, September 17. The nominees are:

President-elect
Benjamin H. Whitten, M.D.

Secretary-Treasurer
David E. Westgard, M.D.

Speaker of the House of Delegates
Lyle J. Swenson, M.D.*

Vice Speaker of the House
Karen Dickson, M.D.*

AMA Delegates
Kenneth W. Crabb, M.D.*
John M. Van Etta, M.D.*
Paul Matson, M.D.*

AMA Alternate Delegates
Benjamin H. Whitten, M.D.*
Blanton Bessinger, M.D.*
David Luehr, M.D.

*Candidate for re-election

Streamlined Credentialing Is On the Way

Minnesota’s health care organizations are moving forward with a centralized, web-based clearinghouse for the information used to credential doctors.

The Board of Directors of the Minnesota Credentialing Collaborative (MCC) met for the first time July 22 to start the process of launching an affordable, online, easy-to-use way to prepare, save, and send credentialing applications to health plans, hospitals, and other provider organizations.

The MCC, sponsored by the MMA, the Minnesota Hospital Association, and the Minnesota Council of Health Plans, has been developing the new system for several years.

After a phased implementation this fall, the system is expected to be up and running by January 2009. The web-based application will be available to all practitioners, clinics, hospitals, and health plans.

Once a provider’s information is entered into the secure website and is error-checked, it will be stored in a secure database, so it can be quickly accessed and updated the next time it is needed. The information then can be forwarded to the selected health plans and/or hospitals electronically. The hospital or health plan can bring the data into their systems for further processing.

The MCC will not verify the data on the electronic application, nor will it be involved in the decisions made regarding credentialing or privileging.

A work group is designing a data conversion option, so that data that is currently available within clinics, health plans, or hospitals can be uploaded into the system, eliminating, when possible, the need to re-enter information.

Individuals who wish to help test the system or who would like more information about the new credentialing tool, including pricing details, should contact George Lohmer at glohmer@mnmed.org or 612/362-3746.

Physicians Join TriCare Network

Minnesota physicians have responded in large numbers to a call from the MMA and others to treat soldiers returning from Iraq and Afghanistan.

In 2006, state health care and military leaders became concerned that soldiers returning from overseas conflicts might not have access to physicians because only 1,500 Minnesota doctors accepted TriCare, the health plan for active-duty soldiers, National Guard and Reserve members, and retired members of the military and their eligible family members.

Today, about 6,500 Minnesota physicians accept TriCare, according to Scott Celley, vice president of external affairs for TriWest HealthCare Alliance, which administers the health plan on behalf of the U.S. Department of Defense. “We are very pleased with the progress that has been made,” he says. “We think we have a very robust network to care for military veterans, National Guard members, and their families.”

Celley also says he was relieved Congress stopped the scheduled decrease in reimbursement for Medicare and TriCare, since such a cut would have weakened the network. “It was very much our view that if Congress had not reversed the cut, we would have seen a significant exodus of providers,” he says.

Although the recruitment drive was a success, TriCare still encourages physicians to join its network of providers. Celley says more physicians are needed today than in the past because the program has been expanded to include National Guard members and their families. About 65,000 Minnesotans are now eligible for the benefit.

To learn how to join the TriCare network, call 651/662-3484.