WAFP July 2017 Newsletter

Dynamic Academy

Vision 2020 Offers Members Opportunities for Leadership and Advocacy Skill Development

WAFP Well-Represented at National Conference

AAFP Now Accepting Nominations for Commissions, AMA Delegation, ABFM Director

WAFP Speaks with HCA on Washington’s Medicaid Transformation Demonstration Project

Local chapter news

Members in the News

Advocacy

Senate Moves On After Health Care Votes Fall Short

Health of the Public

Five Cases and Three Deaths from Hantavirus in Washington

HCA Won’t Terminate Medicaid Coverage for Incarcerated People

CDC: Opioid Prescriptions by County Varied Widely in 2015

ACIP Again Recommends Against LAIV for 2017-2018 Flu Season

Workforce and Education

Suicide Prevention CME Now Available Online or In-Person

Bill Phillips Retires as T.J. Phillips Professor

PNWU Holds Commencement; 38 Graduates Headed to Family Medicine

AAFP Awards 2017 FMIG Program of Excellence to UWSOM, WWAMI

TRUST Scholars Graduate; RUOP has Banner Year

Practice Transformation

MIPS Corner: Countdown to the Quality Payment Program (QPP)

Practice Transformation Learning Conferences to be Held in Tacoma, Moses Lake

Healthier Washington Releases New Resources for Stakeholders, Tribal Partners

 

Vision 2020 Offers Members Opportunities for Leadership and Advocacy Skill Development

The Washington Academy of Family Physicians Foundation is offering WAFP members a leadership and advocacy skill development opportunity with the launch of Vision 2020.

WAFP Foundation Vision 2020The program is designed to assist practicing family physicians in developing leadership and communication skills to enhance their success at work, in the community, or in WAFP policy development and advocacy opportunities. The Foundation will make $1,500 stipends available to up to six WAFP members in 2017-2018 to be utilized in a training program or course of their choice.

The application process is simple. Submit a letter of interest along with your CV and a brief application form. The letter of interest should:

  • Identify the proposed course, training or experience
  • Explain how you will use the grant funding (e.g., tuition, registration, lodging, travel with anticipated expenses allocated)
  • Describe how the proposed opportunity will enable you to become a more effective leader or advocate for family medicine in Washington state

The Foundation is interested in funding opportunities that will enhance the skills of WAFP members to become effective leaders in and/or advocates for family medicine. Members are encouraged to propose programs, events or courses in the letter of interest applying for Foundation support with a description of how the proposed activity will enhance ability to perform in leadership or advocacy.

Some examples of potential training opportunities:

Deadline to apply is September 30, 2017. Applications will be reviewed by the WAFP Foundation Scholarships and Awards Committee. Submit applications to info@wafp.net. PDFs are encouraged.

Learn more at wafp.net/wafp-foundation/vision-2020.

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WAFP Well-Represented at National Conference

WAFP representatives to the National Congress of Family Medicine Residents and National Congress of Student Members kept busy during the congress’ meeting over the weekend.

The congresses took place as part of the National Conference in Kansas City, MO.

In all, Washington members introduced or co-sponsored six resolutions. Here’s a look at each, along with how they fared.

NCFMR

  • Supporting the Reduction of Adverse Childhood Experiences, by Taneev Escamilla, MD, of Washington, and Lauren Williams, MD, of Minnesota. The resolution asks the AAFP to support legislation to fund community efforts and interventions aimed at preventing and reducing adverse childhood experiences. Adopted substitute resolution.
  • Harm Reduction Strategies to Prevent Opioid Overdose-Related Events, by David Kennedy, MD, of Washington. The resolution asks the AAFP to evaluate data regarding buprenorphine-first programs and safe injection sites as harm-reduction models to reduce mortality from opioid-related deaths. Adopted as amended on the floor.
  • Supporting Family Physicians in Advocating for Healthier Practice Environments, by Escamilla, Williams and Chetan Patel, MD, of Georgia. The resolution asks the AAFP to consolidate resources into a toolkit to assist family medicine physicians in advocating for more sustainable practices in their hospitals, clinics and other practice settings. Not adopted.
  • Include the Papaya Workshop for Uterine Aspiration in the AAFP National Conference of Family Medicine Residents and Students, by Nicole Roth, MD of Washington; New York members Amrita Seehra, MD, Rafael Frias, MD, and Ruchi Mathur, MD; Illinois member Kristina Dakis, MD; and Pennsylvania member Jenna Fox, MD. The resolution asks the AAFP to support an annual papaya workshop for uterine aspiration for residents and students at both the National Conference and the Congress of Delegates. Not adopted.

NCSM

  • Expanding “Housing First” Programs for People Experiencing Homelessness, by Paige Ely, Roxanne Hicks and Lara Wilson, all of Washington. The resolution asks the AAFP to advocate for the expansion of housing-first programs. Adopted substitute resolution.
  • Maximizing Representation of Racial and Ethnic Health Subpopulations in Data, by Dylan Nehrenberg of Washington state; Linda Ataifo, Emmeline Ha and Jamie Majdi of Washington, DC; and Lucia Xiong of New Mexico. The resolution asks the AAFP’s Center for Diversity and Health Equity create a public statement of support for changes to data collection so that subpopulations are identified in order to acknowledge and mitigate distinct health disparities. It also asks the AAFP to advocate expansion of certain federal government data in the same way. Adopted substitute resolution.

Also, Nehrenberg ran for the student position on the board of directors of the Society of Teachers of Family Medicine. WAFP provided a letter of recommendation as well. Ranjani Natarajan of New York was elected to the position.

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AAFP Now Accepting Nominations for Commissions, AMA Delegation, ABFM Director

The AAFP has begun accepting nominations for 23 openings on its commissions, six AMA delegation positions and the ABFM director.

All nominees are required to receive a WAFP Board of Directors nomination, fill out an online AAFP form, submit a photo and fill out a conflict of interest form. If you are interested in being nominated, please contact info@wafp.net.

AAFP’s seven commissions each have multiple openings with terms that expire in 2021; those seven commissions are Continuing Professional Development (three openings); Education (three); Finance and Insurance (two); Governmental Advocacy (three); Health of the Public and Science (five); Membership and Member Services (three); and Quality and Practice (four). Submit your name for a commission position or learn more about the nomination procedures.

There are six slots on the AAFP delegation to the AMA. Delegates are expected to attend the AMA’s annual meeting in Chicago in June, as well as the AMA’s interim in November. Nominees are expected to also be members of the AMA; to have attended at least one AAFP Congress of Delegates meeting and at least one national AMA meeting; to be serving or have served in a national leadership position with AAFP; and to be free of conflicts of interest that could preclude appropriate representation to the AMA. Submit your name for consideration, learn more about the nomination process or learn more about being an AMA delegate.

One five-year term on the ABFM board is available. Applicants must be active AAFP members with at least one re-election to membership; have a substantial amount of clinical experience devoted to family medicine; demonstrate leadership and understanding in the philosophy of family medicine; and be free of conflicts of interest that could preclude appropriate representation to the ABFM. Submit your name for consideration or learn more about the nomination process.

The WAFP deadline for applicants is Friday, Sept. 8, and the AAFP deadline for applications is Oct. 15.

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WAFP Speaks with HCA on Washington’s Medicaid Transformation Demonstration Project

In a recent teleconference, members of WAFP leadership discussed their ideas regarding the planning and implementation of the state’s Medicaid Transformation Demonstration activities.

WAFP leaders spoke with consultants retained by the Health Care Authority in conjunction with the demonstration project, and submitted written comments in advance of the teleconference.

Echoing concerns articulated since the launch of the Healthier Washington and the Medicaid Transformation projects, WAFP expressed again that its input about the need to consult with family physicians about how to best implement care delivery change — rather than determine the program elements and then roll it out in a mandatory fashion — has fallen on deaf ears.

The programs could have substantial impact on family physicians and their patients throughout the state. Additionally, WAFP noted its concern about potential local variations among the nine regional accountable communities of health, as well as whether the project measures and compensation programs will complement — or compound — new demands being made of physicians by MACRA and other transformation efforts underway.

WAFP looks forward to continued collaboration efforts with the HCA and its partners as the transformation of care delivery unfolds in Washington state.

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Local Chapter News

The Inland Northwest Chapter will hold its summer picnic at Splash Down Waterpark in Spokane Valley on Thursday, Aug. 3. Entrance to the park and a barbecue at 6 p.m. are free to all Inland Northwest members. RSVP to jordan.storhaug@providence.org and include how many people will be attending.

If your chapter has upcoming meeting information, let us know! Email Brian Hunsicker at brian@wafp.net with details, and we’ll be sure it shows up here.

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Members in the News

  • Bob Lutz, MD, MPH (photo courtesy of the Spokane Regional Health District)

    Bob Lutz, MD, MPH (photo courtesy of the Spokane Regional Health District)

    Bob Lutz, MD, MPH, has been named health officer at Spokane Regional Health District. A few weeks after his appointment, Lutz talked with the Spokesman-Review about his background and the role of public health.

  • University of Washington medical student Judy Han, part of the Rural/Underserved Opportunities Program, was featured in the Cut Bank (MT) Pioneer Press. Han is shadowing Michael D’Ambrose, MD, in Cut Bank, about 110 miles northwest of Great Falls near the Blackfeet Indian Reservation.
  • Geoff Jones, MD, was mentioned in the Spokesman-Review’s Business Beat after being named assistant dean for Eastern Washington within the UWSOM-Gonzaga University Regional Health Partnership. Jones was WAFP’s 2016 Family Physician of the Year.

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From left, Sens. Susan Collins (R-ME), John McCain (R-AZ) and Lisa Murkowski (R-AK)

From left, Sens. Susan Collins (R-ME), John McCain (R-AZ) and Lisa Murkowski (R-AK)

Senate Moves On After Health Care Votes Fall Short

Efforts to repeal and replace the Affordable Care Act came to a dramatic end: In a late-night vote on July 28, three Republican senators — Sens. Susan Collins (ME), John McCain (AZ) and Lisa Murkowski (AK) — voted against a final version of legislation designed to dismantle the ACA. Their votes, along with unified Democratic opposition, were enough to sink the bill and effectively end Republicans’ seven-year quest to upend the ACA.

Though President Donald Trump has urged the Senate to continue working toward repeal, Senate Republicans appear to have little appetite for continuing the fight.

“It is time to move on,” Senate Majority Leader Mitch McConnell (R-KY) said after the decisive vote.

Both parties are now expected to begin negotiations on changes to the law. An analysis by the New York Times found that three key areas to make the law more effective and financially stable would be to stabilize the market and reduce unease among insurers; to reduce prescription drug prices; and to reduce the coverage gap of those people who live in states that did not expand Medicaid but are not eligible for subsidies to help them buy private coverage. More than 2.6 million Americans live in that coverage gap.

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Five Cases and Three Deaths from Hantavirus in Washington

The Washington State Department of Health reports that, as of early July, five cases of hantavirus have been reported around the state, resulting in three deaths. The five cases are the most in the state since 1999.

The deaths occurred in Franklin, King and Spokane counties. An additional case was reported in King County along with another in Skagit County.

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HCA Won’t Terminate Medicaid Coverage for Incarcerated People

The Washington State Health Care Authority has implemented a new policy to suspend, rather than terminate, Medicaid coverage for individuals in prison or jail. The goal is to provide better support for incarcerated individuals when they re-enter the community.

The new policy is the result of action by the Washington Legislature in 2016. The legislation, introduced by Sens. Steve Conway (D-Lakewood), Jeannie Darneille (D-Tacoma), Steve O’Ban (R-Lakewood) and former Sen. Linda Parlette (R-Wenatchee), passed unanimously through the House and Senate and was signed by Gov. Jay Inslee (D).

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CDC: Opioid Prescriptions by County Varied Widely in 2015

New research by the Centers for Disease Control and Prevention shows that opioid prescribing has declined annually since 2010 but, as of 2015, remains high and can vary widely from county to county.

Counties with higher prescribing rates tended to have a greater percentage of non-Hispanic white residents; have a greater prevalence of diabetes and arthritis; be in small cities of big towns; and have higher rates of unemployment. A map prepared by the CDC shows high rates in large swaths of Appalachia, particularly Tennessee; all of far northern California; more than half of Nevada; and eastern and southwest Oregon to be prominent areas of high prescribing rates.

Washington counties with high prescribing rates — defined as 959 to 5,543 morphine milligram equivalents (MME) — include Asotin, Benton, Clallam, Columbia, Cowlitz, Garfield, Grays Harbor, Lewis, Lincoln and Pend Oreille. Counties with the lowest prescribing rates (0.1 to 453 MME) are Adams, King, Klickitat, Skamania and Wahkiakum.

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ACIP Again Recommends Against LAIV for 2017-2018 Flu Season

Citing reduced efficacy, the CDC’s Advisory Committee on Immunization Practices (ACIP) is again recommending against the use of live attenuated influenza vaccine (LAIV) for the 2017-2018 flu season. ACIP made the same recommendation a year ago.

ACIP also will revise its current influenza recommendation for pregnant women. The previous recommendation referred specifically to using inactivated influenza vaccine; that language will be revised to include any recommended, licensed and age-appropriate influenza vaccine except LAIV.

“This recommendation hasn’t really changed, it’s just been broadened to include all types of influenza vaccine (trivalent or quadrivalent IIV or recombinant) except LAIV,” Pamela Rockwell, DO, AAFP’s liaison to the ACIP for this meeting, told AAFP News.

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Suicide Prevention CME Now Available Online or In-Person

Washington’s state-mandated suicide prevention training requires physicians to have six hours in training. Kaiser Permanente is now offering free, online CME that will allow physicians in Washington to complete their training.

The Washington State Department of Health 2017 Model List includes a range of other options to fulfill the state’s training requirement. There are online and in-person courses, as well as courses intended for non-physician audiences. Most of the courses are fee-based.

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Bill Phillips Retires as T.J. Phillips Professor

William Phillips, MD, MPH (left) with UWSOM Department of Family Medicine Chair Paul James, MD

William Phillips, MD, MPH (left) with UWSOM Department of Family Medicine Chair Paul James, MD

Bill Phillips, MD, MPH, has announced his retirement from the Theodore J. Phillips Endowed Professorship in Family Medicine at the UW School of Medicine. He has held this position since 2010 and retired in June, though he will continue teaching and research part-time as clinical professor emeritus. Phillips was the second holder of the T.J. Phillips Professorship, following John Coombs, MD, who served from 1998 to 2009. UWSOM Department of Family Medicine Chair Paul James, MD, and UWSOM Dean Paul Ramsey, MD, have begun the search for the new T.J. Phillips Professor.

The Professorship was created as a joint endeavor between the Department of Family Medicine and the Washington Academy of Family Physicians Foundation. It recognizes the accomplishments of the founding chair of the department, Theodore J. “Ted” Phillips, MD, and supports the strong links he forged between the family medicine department and community physicians.

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PNWU Holds Commencement; 38 Graduates Headed to Family Medicine

PNWU’s commencement was held earlier this spring, and the school’s Class of 2017 include 133 graduates. Thirty-eight of them are bound for family medicine residencies.

Of those heading into family medicine, three won awards:

  • Erin DePrekel, DO, was awarded the Dr. & Mrs. Fred C. Tinning Osteopathic Principles and Practice Award in honor of Melicien Tettambel, DO, PhD.
  • Katie Camarata, DO, won the Touch Community Service Award (Silver).
  • And Stacey Rittmueller, DO, won Student DO of the Year.

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AAFP Awards 2017 FMIG Program of Excellence to UWSOM, WWAMI

The AAFP has named the FMIG at the University of Washington School of Medicine and WWAMI Programs as one of its 10 Programs of Excellence for 2017.

The award recognizes a school’s distinction in several key areas, including the FMIG structure and operation; community service; exposing students to family medicine and family physicians; promoting the value of family medicine as primary care; professional development; and measures of success.

During the 2016-17 school year, the FMIGs at the six WWAMI sites — Seattle; Spokane; Laramie, WY; Anchorage, AK; Bozeman, MT; and Moscow, ID — sought to coordinate activities. That led to procedure demonstrations and residency panels being broadcast to all six locations instead of being limited to a single site.

Olivia Rogers, from the Laramie FMIG, submitted the application to AAFP. She also serves as the leader of the FMIG Steering Committee.

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TRUST Scholars Graduate; RUOP has Banner Year

Seventeen members of the UWSOM’s Targeted Rural and Underserved Track (TRUST) graduated this spring, the highest number in the program’s history, reflecting Idaho’s first graduating class contribution. The Idaho graduates joined their counterparts from Washington and Montana at the TRUST Scholar Graduation, held at the Seattle Public Library, and later the main UWSOM graduation ceremony.

This summer, the Department of Family Medicine’s Rural Underserved Opportunities Program (RUOP) placed a record 164 students with continuing support of the students provided by the WAFP Foundation. To accommodate the growth, clinical deans and RUOP placement coordinators recruited 51 new preceptors.

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MIPS Corner: Countdown to the Quality Payment Program (QPP)

The countdown to the Quality Payment Program is on. Program deadlines are approaching quickly and our goal is to help you be successful with the program. Here are a few ways to prepare for success:

Review Possible Changes for the 2018 Performance Period 
The Centers for Medicare & Medicaid Services issued a proposed rule on the QPP. The proposed changes are intended to simplify reporting requirements, ease eligibility requirements and provide more support to clinicians — especially small, independent and rural practices. Learn more about the proposed rule.

MIPS Tips 
If I attest successfully in the Medicaid EHR Incentive Program for 2017, do I still need to participate in the QPP to avoid negative payment adjustments to my Medicare Part B allowed charges in 2019?

Yes. Eligible clinicians in the QPP do not receive any credit for participation in the Medicaid EHR Incentive program as they did for the Medicare EHR Incentive program and are not protected from the QPP negative payment adjustments.

If one eligible clinician (EC) in the group must meet the base score requirements for the Advancing Care Information (ACI) category, do all members of the group have to meet all of the measures for ACI or will it suffice if only one EC in the group meets the ACI requirements?

No. As long as you report as a group, all ECs are assessed as a single entity instead of multiple entities. This means that if one EC has reportable data on the ACI category, and the other ECs in the group don’t, the group can report on the data provided by the one EC, and it will “count” as data for the group. – From the CMS Quality Payment Program Service Center.

Upcoming Webinars
National Webinar: The Mechanics of MIPS Data Submission Options
August 1 or 3, 2017
Register for August 1, 2017
Register for August 3, 2017

Partner Webinar: CMS’ Proposed Changes to the QPP Program
August 1, 2017
Register Today

QPP MIPS Moments Tutorial: Incredible Improvement Activities
August 25, 2017
Register Today

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Practice Transformation Learning Conferences to be Held in Tacoma, Moses Lake

The Healthier Washington Practice Transformation Support Hub will host free, one-day conferences to learn best practices and strategies on practice transformation.

The first conference will be held Sept. 25 at Hotel Murano in Tacoma. A second conference will be held in Moses Lake at the Best Western Plus Lake Front Hotel on Oct. 26. Registration for both events is now open.

Value-based payment models and behavioral health integration are among the main topics of the conferences, with specific sessions on MACRA/MIPS, HEDIS metrics, practice-based and telemedicine-based strategies, and a bulling and sustainability workshop.

The University of Washington AIMS Center, Washington Health Alliance and Attune Healthcare Partners are partnering with the Practice Transformation Support Hub on presenting the conferences.

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Healthier Washington Releases New Resources for Stakeholders, Tribal Partners

Healthier Washington has released new resources about the Medicaid Transformation Demonstration.

Among them are two final protocols related to the Delivery System Reform Incentive Payment Program (DSRIP): a funding and mechanics protocol and a planning protocol.

Also concerning DSRIP, there is an initial release of a draft tribal protocol and a draft tribal projects overview.

Lastly, there are several new resources for Initiative 1 (transformation through Accountable Communities of Health), including a project toolkit, a demonstration glossary, a model ACH tribal collaboration and communication policy, and a FAQ.

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