Welcome New Members

Our membership continues to grow! Take a look at the list of healthcare professionals and students who have recently joined NCMGMA (January 5, 2019 through January 24, 2019):

Active

Elisa Barnes, Carolina Women’s Health, PA, Raleigh, NC
Geoffrey Norwood, East Carolina Anesthesia Associates, Greenville, NC
Sheri Raymer, Eagle Physicians, Greensboro, NC
Nurys Rivera, Carolina Family Health Centers, Inc, Wilson, NC

Affiliate

Nate Culp, McGriff Insurance Services, Winston-Salem, NC
Brunson DePass, Physicians Wear Medical Linen Service, Columbia, SC
Jason Deshayes, Elliott Davis PLLC, Raleigh, NC
Debra King, monocleHR, llc, Apex, NC
Jann Martin, TriMed Technologies, Corp., High Point, NC
Caleb Reyes, CORA Physical Therapy, Raleigh, NC
Kathie Walsh, DocuRep, Wake Forest, NC
Maria Yeremin, CORA Physical Therapy, , SC
Todd Zempel, Gordon Asset Management, LLC, Durham, NC

Corporate Active

Mario Aguilar, UNC Physician’s Network, Raleigh, NC
Ardith Charles-Harris, Physicians East, Greenville, NC
Claudia Dean, NHRMC – PQP, Wilmington, NC
Kathy Garner, The Carolina Clinic, Chapel Hill, NC

Student

Brenda Bradrick, University of North Carolina, Charlotte, Midland, NC

Medical Practice Issues to Watch in 2019

Originally published in the January 9, 2019 issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

Medical Practice Issues to Watch in 2019

2019 promises to be another busy year in healthcare. The 2018 midterm elections shifted the balance of power in Washington as Democrats now hold the gavel in the U.S. House of Representatives, creating a divided Congress with the Republican-held Senate. MGMA has identified the following legislative and regulatory issues critical for medical practices in the coming year. We will keep members apprised of key developments in these areas and their impact on medical practices and will continue to advocate for policies that enable practices to thrive in their mission to furnish high-quality, cost-effective patient care.

1. HHS doubles down on risk

Despite an anemic pipeline of new voluntary Medicare alternative payment models (APMs) trickling out of the Department of Health and Human Services (HHS), Secretary Alex Azar is planning a new approach to accelerate participation in risk-based APMs. Forgoing incremental implementation, the Secretary is expected to unveil new mandatory models in 2019 and to emphasize performance-based risk as a necessary component of any new APM.

MGMA strongly supports voluntary participation in APMs when it makes financial sense for individual practices and disagrees with the Secretary that the way to expedite the move to value-based care is to mandate participation. We will continue to advocate for new opportunities for practices to participate in voluntary APMs and for development of more physician-led models.

2. Regulatory relief from government burdens

It is expected that Congress and the Administration will continue to work toward reducing the regulatory burden on medical practices participating in government healthcare programs. The Centers for Medicare & Medicaid Services’ (CMS’) “Patients Over Paperwork” initiative is one such example. However, this has translated into only modest relief for practices thus far, as 88% of MGMA members polled reported an increase in overall regulatory burden last year. MGMA will continue to make regulatory relief a top advocacy priority in 2019. Keep up with our efforts at mgma.com/regrelief.

3. Kicking back the Stark Law

As part of the effort to accelerate payment innovation, HHS leaders pledge to revisit antiquated fraud and abuse rules such as the Stark Law and Anti-Kickback Statute. In 2019, watch for proposed rules that expand exceptions and safe harbors to protect value-based arrangements and benefit providers willing to take on performance-based risk.
While a push to simplify Medicare compliance rules is welcomed, it is likely that congressional intervention will be necessary to achieve meaningful reform. It remains to be seen if Congress will also prioritize this issue in 2019.

4. Surprise! Here is a medical bill you didn’t expect

Medical practices can expect to see a push to curb surprise medical bills, including efforts to empower patients and consumers through improved access to healthcare cost information. The sticker shock of surprise hospital bills continues to make headlines and draw bipartisan attention in Congress, making this issue ripe for legislative action in 2019.

5. A spoonful of new regulations to help drug prices go down

With a new Congress and support from the Administration, reducing Medicare drug prices is on the action list for 2019. For physician-administered drugs, one proposal seeks to curb the price of drugs in Part B by tying prices to a new International Price Index, create new private-sector vendors to supply practices with drugs, and set drug administration cost as a flat fee. CMS is also looking to give Part D drug plans greater flexibility to negotiate drug prices in protected classes.

6. The stakes are higher in MIPS

Implementation of the Merit-based Incentive Payment System (MIPS) continues to ramp up. In 2019, MIPS performance will determine whether clinicians receive a positive or negative payment adjustment of up to 7% on 2021 Medicare reimbursement. Medicare is accelerating cost accountability for MIPS clinicians by increasing the cost component to 15% of the overall MIPS score and introducing episode-based measures. The performance threshold required to avoid a payment penalty also doubles from 15 to 30 points in 2019. With more on the line this year, it is critical that MGMA members prepare their practices for success. Visit mgma.com/macra for helpful resources.

7. Data interoperability a priority for feds

The Office of the National Coordinator for Health Information Technology (ONC) is expected to release regulations to meet requirements of the 21st Century Cures Act and facilitate improved data sharing between healthcare entities. ONC will define and seek to discourage “information blocking,” develop a framework to facilitate data movement between heath information exchange entities, and release specifications for the use of apps to foster data exchange between different providers and between providers and patients. The goal of using apps, a component of MIPS and Stage 3 Meaningful Use, is to permit practices to efficiently and securely move administrative and clinical data via their EHR.

8. Cybersecurity continues to be a top practice concern

Medical practices can be a prime target for phishing and other cybersecurity attacks because they possess valuable information assets (patient clinical and financial data) and often have inadequate cybersecurity protections. HHS’ HIPAA enforcement arm is expected to ramp up audits and fines in 2019. Medical practices should protect both their data and business continuity by completing a comprehensive risk assessment, identifying vulnerable areas of the organization, and taking the steps necessary to mitigate risk. Check out MGMA security resources to prepare your practice this year.

9. Site-of-service payment differentials remain a target

Policymakers will continue the trend toward site-neutral payments with the goal of equalizing Medicare payments for the same services across clinical sites. Medicare expanded this policy through 2018 rulemaking by phasing-in payment reductions for clinic visits at hospital outpatient departments (HOPDs), including HOPDs excepted from previous site-neutral payment rules. In addition to saving money for patients and the government, site-neutral payments are viewed as a policy lever for increasing market competition, eliminating the incentive for hospitals to purchase freestanding clinics and leveling the playing field.

10. “Repeal and replace” is out, “Medicare for all” is in

This shift in power within Congress will recast the role the federal government plays in healthcare in 2019. With “Medicare for all” a key platform for many progressives during the 2018 primaries, the politicized debate over a single-payer health system shows no signs of slowing down and will likely gain steam ahead of 2020 elections.
Passage of any major health reform bill is highly unlikely anytime soon. However, as presidential contenders begin campaigning for the 2020 primaries, universal healthcare will almost certainly become a point of debate.

NCMGMA Call for Annual Conference Speakers

NCMGMA’s Annual Conference is set for May 8-10 in Wilmington and we are looking for presenters who can speak on an assortment of leadership and management topics. We received such positive reviews from our Fall Conference Peer-to-Peer sessions we’re looking to continue these short-sessions in 2019 in Wilmington.

Please see the list of educational focus areas below. If interested, you can email Melissa@ncmgm.org and provide your topic, a short session description and the time frame you are able to present (15 or 30 minutes). Please let us know of your interest by December 30, 2018.

Educational Focus Areas

  • Operations Management
    • Physician Recruitment
    • Business Intelligence
    • Online Reputation Management
    • Managing Patient Satisfaction
  • HR Management
    • Diversity in Healthcare
    • Winning Unemployment Claims
  • Risk & Compliance Management
    • Compliance Audit
    • Peer Review
    • Disruptive Physician
    • Risk Management
  • Patient Centered Care
    • Deescalating Situations
    • Service Recovery
    • Telemedicine
  • Organizational Governance
    • Running an Effective Meeting

Again, please let us know prior to December 30th of your interest in presenting by sending an email to Melissa@ncmgm.org with the topic, session description and also the time-frame you’d be able to present in (15 or 30 minutes). Once submission closes, your information will be reviewed by the NCMGMA Conference Committee. All interested parties will be contacted no later than January 31st.

Check out the NCMGMA Fall Conference Recap!

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Members of the North Carolina healthcare management community came together in Charleston to connect, experience and learn at the North Carolina Medical Group Management Association (NCMGMA) Fall Conference, held October 17-19, at the Charleston Marriott. We would like to take this opportunity to thank all of our attendees, exhibitors and sponsors for supporting this event and making it the success that it is.

This year, we were excited to bring in nationally-recognized speaker Britt Berrett to talk about his game-changing book Patients Come Second: Leading Change by Changing the Way You Lead, and he did not disappoint. Britt’s general sessions and breakout were very well received. “Very good speaker. Keeps the audience engaged,” and “Britt did a great job, I’d listen to him speak again,” were just a couple of the survey responses we received regarding Dr. Berrett’s session.

Other highlights from the conference included the Wednesday opening session, “Peer-to-Peer Sessions: 15-Minute Management Methods,” and the Thursday in-depth interview with Dr. Mandy Cohen, Secretary of the NC Department of Health and Human Services, by professional interviewer Matt Hanis of The Business of Healthcare. “Excellent idea and would love to see more of these “short,” but incredibly relevant lessons. It’s the NCMGMA version of Ted Talks. We have a wealth of knowledge within our organization. I see this as a great way to tap in to it,” was said of the 15-Minute Management Sessions event and “This was great. I liked the interview structure,” was remarked of the Dr. Mandy Cohen session.

2018 Annual Award Winners

Along with our educational sessions and healthcare products and services exhibit hall, we also presented our annual awards. This year’s winners were:

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Practice of the Year
Gastroenterology Associates of the Piedmont, P.A. (GAP)

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(L-R): Michelle Torak, FACMPE (GAP), Jack Busic, Jr. (First Citizens Bank), Anne Hill (GAP), Willonda H. Thomas, MBA (Cancer Services) and Todd Pittman, CMPE (Alliance Urology)

President’s Award
Joni Brantley of Nash OB-GYN Associates, PA

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(L-R): 2018 President’s Award winner Joni Brantley and 2018 NCMGMA President Sandra Jarrett, FACMPE

Kim Harrah Becker Volunteer Award
Linda Wooten of Novant Health Salem Family Medicine

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(L-R): Pam Saunders and NCMGMA Leadership Council member Todd Pittman, CMPE, accept the Kim Harrah Becker Volunteer award on behalf of Linda Wooten

Event Photos

Follow this link for the complete 2018 Fall Conference Flickr album

Upcoming Events

Watch your email and the NCMGMA website for information coming soon on the following 2019 events:

  • Advocacy Days
    March 13, 2019
    Raleigh, NC
  • Annual Conference
    May 8-10, 2019
    Wilmington, NC
  • Fall Regional Education Days
    Fall 2019
  • Monthly Webinars
    Offered throughout 2019