FMA Bulletin

Oct. 2010InsIde thIs Issue:

2011 Legislative session Preview

successful ehR selection

FMA/uM Practice Management Program

snapshots from Annual Meeting

ReMIndeR!It’s membership renewal season

2

educAtIonA snAPshot oF AnnuAL MeetIng 2010

hundreds of Florida physicians came together in orlando Aug. 13-15 for the FMA’s Annual Meeting, a yearly celebration of medicine. Members from across the state gathered at the scenic hilton Bonnet creek to hear health care experts discuss the future of medicine, to enhance their practice management skills and to connect with their peers. the event also served to honor Madelyn e. Butler, M.d., who was installed as the 2010-11 FMA President.

3

FMA Partners with uM school of Business Recognizing that good business practice enhances the practice of good medicine, the FMA established a partnership with University of Miami School of Business to develop a Practice Management Certificate course. This intensive certificate program is specifically designed to benefit solo practitioners/practice owners, employed physicians and medical staff who don’t have time to earn an MBA, yet seek to sharpen their knowledge and skills to manage their medical practices more effectively.

The FMA and UM offered the inaugural course in conjunction with FMA Annual Meeting, Aug. 12-13, 2010. Twenty-four physicians, one medical student and 15 office staff members assembled to earn their practice management certificate and CME. The FMA was proud of the stellar performances of the University of Miami’s exceptional faculty and staff, Stephen Ullmann, Ph.D., Sheryl Alonso, Ph.D., Vincent Omachonu, Ph.D., Andy Leone, Ph.D., attorney William Spratt, Esq., and David Lecón, M.A., J.D.

here are just a few things that our attendees had to say about the actions they plan to take upon returning to their practices:

• Look at practice culture/tone

• Modify/clarify job descriptions

• Periodically get coding audit of charts to verify compliance

• Use decision-making talk for new interns

• Do a patient satisfaction survey and work with the front office

• Start a business projection on major decisions

• Implement a “secret shopper”

Please e-mail education@medone.org or call the FMA Education Department at 1(800) 762-0233 to learn more about this opportunity to improve your practice.

Above: Steven Ullmann, Ph.D., of the UM School of Business hands a certificate to FMA member Michael J. Gordon, M.D., of Sarasota, during the FMA/UM Practice Management Certificate course in August. At far right is UM medical student Marek Hirsch.

Left: The University of Miami’s David Lecón presents FMA member Tricia Andrews-Jenkins, M.D., with her practice management certificate.

educAtIonA snAPshot oF AnnuAL MeetIng 2010

4

Medicaid will be a hotly contested issue during the 2011 legislative session. A determined faction in the Legislature will continue its push to hand over the Medicare program to the managed care companies. The FMA will fight to ensure that physicians will have the ability to control their practice and not be forced into Medicaid HMOs. As we continue the fight and gear up for session, the following are a few figures to consider:

Medicaid: Looking Ahead to the 2011

Legislative sessionAccording to the Agency for Health Care Administration (AHCA), to raise physician Medicaid fees to 100 percent of Medicare rates, the Agency would require an estimated additional $1,769,747,924. This estimate is based on the Aug. 2010 Social Services Estimating Conference for fiscal year 2011-2012.

Physician services make up only

5 percent of the Medicaid budget.

o Hospital inpatient services – 17.42 percento Nursing home care – 14.65 percento Prescribed medicine drugs/Part D – 8.6 percent

• Mandatory services (as required by the federal government) account for 49.93 percent of the Medicaid budget. Some of the mandatory services include:

o Physician serviceso EPSDT/child health checkupo Private duty nursingo Family planningo Home health careo Hospital inpatiento Hospital outpatiento Transportationo Skilled nursing facilityo Personal care services

• Optional services (those not required by the federal government) account for 56.07 percent of the Medicaid budget. These are the services most often targeted by the Legislature when it seeks to reduce the Medicaid budget. Some examples include:

o Adult dental serviceso Birth center serviceso Hearing serviceso Vision serviceso Chiropractic serviceso Community mental health serviceso Hospice careo Optometric serviceso Podiatry serviceso Primary care case management (Medipass)o State mental hospital services

• In 2005, Florida’s rate for new pediatric patients was $50.60, significantly lower than several comparable states:

o Georgia: $76.53o Arizona: $59o South Carolina: $99o California: $57o Arizona: $95.36

• There were, however, a few states with lower rates:

o New York: $30o New Jersey: $32o Texas: $48

In F

LOrI

DA,

Med

icai

d co

vers

:

27% of children

51.2 % of deliveries

63 % of nursing home days

LegIsLAtIve MeMBeRshIP

5

ReAP the MeMBeRshIP BeneFItsLegIsLAtIve MeMBeRshIP

Coding and reimbursement Assistance

When FMA member Philip Moyer, M.D., F.A.C.S., hit a wall with two insurance contracts, Medical Economics Specialist Susan Franz intervened successfully on his behalf to get them completed. “Because of her dedication and diligence, I can assure you that I will remain a lifetime member of the Florida Medical Association,” Dr. Moyer wrote.

Every day, the FMA’s Medical Economics Department advo-cates for physicians having insurance reimbursement issues or coding problems. If you’re a member, Susan and Registered Medical Coder Leslie Barber stand ready to help you or your practice administrator. Call them at 1 (800) 762-0233.

Complimentary CME CoursesFMA Members receive FREE online CME at www.fmaonline.org, including the state-mandated* courses for Florida licensure.

• Prevention of Medical Errors* – 2 AMA PRA Category 1 creditsTM

• Domestic Violence* – 2 AMA PRA Category 1 creditsTM

• HIV/AIDS – 1 AMA PRA Category 1 creditTM

• End-of-Life Care – 3 AMA PRA Category 1 creditsTM

• Cause of Death Tutorial – 1 AMA PRA Category 1 creditTM

** DOs must complete a live Prevention of Medical Errors course, which is offered at FMA Annual Meeting.

ReMIndeR! It’s membership renewal season. call us or visit our website to renew your membership for 2011.

6

MedIcAL econoMIcsehR: Four Requirements for success

setting the right ehR goals: The goal in implementing an EHR is to improve patient care.1

3

2

4Purchasing the right ehR product: Purchasing the right product is essential to achieving meaningful use. First, the product must be certified. The requirements for certification will increase every two years, so it is important to evaluate the future development plans of potential vendors to ensure they will remain certified. Some physicians may need to go beyond the minimum requirements to maximize the EHR system’s value.

correctly implementing the ehR: Staff must be able to make full use of the system’s capabilities. The right implementation involves setting goals for benefits and adjusting processes and organizational governance to achieve these goals. It is essential to recognize that achieving meaningful use of a system involves significant changes in care delivery that must be physician-led.

correct use of the ehR: Use of the EHR must be incorporated into the routine care process in order to meet meaningful use. It is recommended that clinical professionals utilizing the EHR complete at least 90 percent of care-related electronic tasks. There must be direct evidence of role-based use by clinicians. (e.g., physician order entry, e-prescribing, RN medication administration documentation, pharmacist sending pharmacy alerts, etc.). All quality reporting should be fed by electronic clinical documentation. The revenue cycle process should be integrated into the EHR, and evidence of benefit (alerts that result in change order, number of chronic care patients that meet criteria for appropriate care, etc.) should be monitored in the system.

Want more on Meaningful Use? See the november 2010 issue of Florida Medical Magazine.

the FMA will provide nine regional Best Practice selection workshops and six Implementation workshops in october and november. Please check with your county medical society or visit www.fmaonline.org for a list of schedules, times and places.

FMA vendoR sPotLIght

For more information, contact Shelly Hakes, Director of Society Relations at (800) 741-3742, Ext. 3294 or visit us at www.firstprofessionals.com.

In a MEDICaL MaLPRaCTICE CLaIM:Be ready for anything and everything.

You save lives. We save livelihoods.

Decades of experience, true financial stability, and a tough-as-nails defense team make First Professionals a well-rounded — and yes, affordable — choice when it comes to protecting your medical reputation and career. No other Florida medical malpractice provider knows the industry quite like we do, nor do they defend our doctors with as much tenacity. We’re committed to protecting you and everything you’ve got, with everything we’ve got.

Endorsed by

Significant discounts available for eligible FMA members.

FMA7.5x4.75.indd 1 10/1/10 11:40:37 AM

7

First Professionals Insurance company

FMA vendoR sPotLIght

First Professionals has maintained a commitment to its policyholders through its corporate philosophy to aggressively defend non-meritorious claims. Through its partnership with the FMA, First Professionals is dedicated to protecting the professional reputations and personal assets of Florida physicians. In terms of Florida-specific experience, no other professional liability company comes close.

For more information about this endorsed program, contact First Professionals Director of Society Affairs Shelley Hakes at 1(800) 741-3742 or Hakes@fpic.com.

As the Florida Medical Association’s endorsed carrier for medical professional liability, First Professionals Insurance Company is committed to organized medicine.

With more than 30 years of experience, First Professionals is the largest and longest-serving medical professional liability insurance carrier in Florida. It also has experience to effectively protect and defend health care providers. The benefits of coverage are clear:

• Financial strength that provides unparalleled ability to protect policyholders.

• Claims staff with an average of 26 years of experience.

• Legal defense coverage investigations by the Florida Board of Medicine and other state and federal agencies at no additional charge.

• In 2009, First Professionals won 85 percent of cases.

• In 2009, First Professionals managed more claims than its nearest two competitors combined.

• Extensive risk management products and services available at no extra cost.

• First Professionals set the standard for comprehensive binding arbitration programs.

• Florida policyholder retention rate of 97 percent.

FMA BulletinHelping Physicians Practice Medicine

1430 Piedmont Dr. E. 8