MMA News
MMA in Action
Some of the recent ways MMA staff and members have worked for physicians in Minnesota.
- Last month, MMA President Patricia Lindholm, M.D., and about a dozen health care leaders met with Centers for Medicare and Medicaid Services Administrator Don Berwick, M.D., to showcase health care innovations in Minnesota.
The meeting included U.S. Rep. Betty McCollum, Sen. Al Franken, and representatives from the YMCA, Minnesota Hospital Association, Park Nicollet Health Services, Twin Cities Medical Society, HealthEast Care System, HealthPartners, Bethesda Hospital, Fairview Health Services, Mayo Clinic, and Sanford Health.
Berwick listened to the health care leaders talk about ways they had improved care or lowered costs by reducing hospital readmissions, decreasing the use of ventilators, implementing health care homes, and improving care coordination. He told the group that he considers Minnesota a font of innovative ideas and has been impressed with the state’s collaborative health care environment and progress in areas such as diabetes care.
Lindholm says she was impressed by the ability of providers such as Essentia Health and Hennepin County Medical Center, which serve large populations of Medicare and Medicaid enrollees, to both improve care and achieve savings through better care coordination.
“It was a real opportunity to get some face time with these important leaders and give them the 20,000-foot view of some of the health care innovations that are occurring in Minnesota,” she says.
See more photos at www.facebook.com/mnmed.
- MMA Director of State and Federal Legislation Dave Renner met with state Sen. John Harrington (DFL-St. Paul) August 16, as part of the MMA’s District Dialogue program.
- Karolyn Stirewalt, J.D., MMA policy counsel, represented the MMA at the Board of Medical Practice meeting August 6.
MMA Supports Mayo in U.S. Supreme Court Case
In August, the MMA agreed to join an amicus brief in support of Mayo Clinic in the case Prometheus Laboratories v. Mayo Collaborative Services, which will be argued before the U.S. Supreme Court next year. The case stems from a seven-year dispute over an issue relating to patent infringement. Prometheus Laboratories owns a patent that, if enforced, would restrict physicians from offering a diagnostic metabolites test for the drug azathioprine, which was created by Prometheus. A ruling in favor of Prometheus also could further restrict physicians from conducting research on how patients metabolize the drug.
Prometheus’ test measures metabolite levels in patients taking thiopurine drugs, then correlates those levels with the drug’s efficacy. Mayo developed its own test, which measured the same metabolites. Mayo says its method uses different levels to determine toxicity. Mayo has argued that the patent is illegal because natural phenomena (such as digestion) are not patentable. Mayo won at the district court level. But Prometheus appealed, and the case was overturned by the Federal Circuit Court of Appeals.
The MMA and the AMA Litigation Center will be joining the American College of Medical Genetics, the American Society of Human Genetics, the Association of Professors of Human and Medical Genetics, and potentially others in filing the amicus brief this month.
Nominees for MMA Offices Announced
The MMA Board of Trustees accepted the Nomination and Leadership Development Committee’s slate of nominees during its July meeting. Nominations will remain open until the MMA House of Delegates convenes on Thursday, September 15. The House of Delegates will elect its officers, AMA delegates, and trustees on Friday, September 16, during the MMA’s Annual Meeting in Duluth.
The nominees are:
President-Elect: Dan Maddox, M.D.
Treasurer: David Westgard, M.D.*
Speaker of the House of Delegates: Mark Liebow, M.D.*
Vice Speaker of the House:
Robert Moravec, M.D.*
At–large Trustee:
Macaran Baird, M.D.
AMA Delegates:
Ray Christiansen, M.D.*
Sally Trippel, M.D.*
Paul Matson, M.D.*
AMA Alternate Delegates:
John Abenstein, M.D.*
David Estrin, M.D. *
Steve Darrow, M.D.
Will Nicholson, M.D. (completion of the term of Blanton Bessinger, M.D., through 12/31/12)
MMA Board of Trustees:
Beth Baker, M.D.,
Twin Cities District*
Michael Heck, M.D.,
Northeast District*
Donald Jacobs, M.D.,
Twin Cities District*
Marilyn Peitso, M.D.,
North Central District
Phillip Stoltenberg, M.D.,
Twin Cities District
Doug Wood, M.D,
Southeast District*
Roy Yawn, M.D.,
Southeast District
The MMA would like to thank Blanton Bessinger, M.D., and Anthony Jaspers, M.D., who will be leaving the AMA Delegation, for their many years of service.
*Candidate for re-election
Physicians to Debate Nearly 30 Resolutions
The MMA’s 158th House of Delegates will consider nearly 30 resolutions at this year’s annual meeting September 15-16 in Duluth. Taking action on resolutions, which help shape MMA policy and the overall direction of the organization, is the main work of the House of Delegates.
Resolutions are debated in reference committees, which then recommend action by the House of Delegates. The House can vote to adopt or not adopt a resolution, refer a resolution to the Board, or amend or adopt a substitute resolution.
During the meeting, the House will consider resolutions on issues that represent the diverse opinions of MMA members. This year, the House will consider resolutions that call for the MMA to do the following:
- Develop and introduce legislation that makes it illegal in the state of Minnesota for physicians to be employed by health care corporations that are not physician-owned or physician-directed (R105);
- Support the reform of the malpractice system to a collaborative law approach in which there is a voluntary, contractually based dispute-resolution process for parties who seek to negotiate a resolution of perceived medical error rather than having a ruling imposed by a court or arbitrator (R107);
- Evaluate alternatives to standardized statewide quality measurement and reporting and include methods for individual clinics/medical groups to measure and report on clinical topics that address their practice’s needs based on their patient populations and gaps in care (R200);
- Support annual screening for Chlamydia among all males and females 15 to 25 years of age with repeat screening at the discretion of the physician (R201);
- Recommend that all worksites in Minnesota provide a 10-minute physical activity video for optional participation by their employees (R202);
- Develop a depression-care guideline (R204);
- Pass legislation requiring anyone who provides vaccines to patients to enter that data into the Minnesota Immunization Information Connection registry (R206);
- Support a requirement prohibiting prior authorization requirements for generic medication (R207);
- Support legislation prohibiting those younger than 18 years of age from using tanning beds (R209);
- Study the ramifications of including a public option plan as part of a state insurance exchange (R300);
- Adopt as policy that reimbursement for consultation codes should be restored by all payers, including the Centers for Medicare and Medicaid Services (R303);
- Support legislation to provide wellness incentives for all Medical Assistance recipients (R305);
- Work to require that all pharmacy benefit plans provide coverage for at least one inhaled steroid and one short-acting beta adrenergic inhaler in their formularies and pay for one rate-controlled spacer (R306);
- Bring a resolution to the AMA that one of the ultimate goals of health care reform should be that all Americans have a medical home relationship with a primary care provider (R308);
- Support the Minnesota Health Plan, which provides universal, publicly funded health care for all Minnesotans (R309).
Making Hospital Readmissions RARE
With the launch of the statewide RARE (Reduce Avoidable Readmissions Effectively) campaign this summer, Minnesota physicians joined with hospitals and long-term care providers to reduce avoidable readmissions. The goal is to reduce such readmissions by 20 percent (about 4,000 total) by the end of 2012, thus lowering the state’s preventable readmissions rate from 5.8 percent in 2009 to 4.6 percent by the end of 2012. In addition to improving outcomes for patients, reducing readmissions by 4,000 would save commercial insurers an estimated $30 million annually and Medicare even more.
Nearly one in five Medicare patients discharged from Minnesota hospitals is readmitted within 30 days. Although the readmission rate for commercially insured patients is lower than for Medicare patients, the number of preventable readmissions is still significant. Eighteen states have lower readmission rates than Minnesota, according to Medicare data.
The RARE campaign will focus on developing comprehensive discharge plans and easing the transition from hospital to home or a nursing facility. Some of the issues that will be addressed include transition care planning, medication management, patient and family involvement in discharge preparation, and communication among hospital and long-term care providers.
MMA Led the Way
The MMA was one of the first groups in the state to examine the issue of hospital readmissions. In 2009, the MMA and the Minnesota Council of Health Plans (MCHP) brought together leaders from hospitals, clinics, long-term care facilities, academic institutions, state agencies, and quality organizations, as well as payers and purchasers of health care, to identify the causes of readmissions and consider ways to prevent them. Throughout 2010, they reviewed the literature as well as Minnesota-specific and national Medicare data. The group decided to focus on improving readmissions rates by improving the health care community’s understanding of the causes of readmissions and sharing strategies for reducing preventable ones.
Efforts to reduce readmissions gained momentum following passage of the Patient Protection and Affordable Care Act. A provision in the law calls for the federal government to reduce Medicare payments by up to 3 percent by 2015 to hospitals with higher-than-expected 30-day readmission rates for patients who have been hospitalized for certain conditions. In 2011, the Institute for Clinical Systems Improvement decided to focus on hospital readmissions, and the MMA-MCHP effort evolved into the RARE campaign. As of mid-August, 51 Minnesota hospitals along with more than a dozen health plans, state agencies, home health agencies, nursing homes, and patient advocacy groups had signed onto RARE.