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SlitLamp provides illuminating e-news for Colorado ophthalmologists. It keeps you in the know on the evolving Colorado health care scene by detailing the latest legislative and regulatory happenings. It also spotlights the information and resources you need for your practice.

 

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Top tags: advocacy  health plans  2014 legislative session  Avastin  MACRA  practice management  AAO  Coffman  compounding  CSEPS Connect  FDA  health advisory alert  HIPAA  IPAB  legislator  Medicaid  Medicare  member meeting  mergers  MIPs  pay issues  payer issues  payment reform  PDMP  QPP  reimbursement  repackaged drugs  US Congress 

Stepping up efforts to prevent opioid abuse

Posted By Chet Seward, Sunday, October 15, 2017

By the time you read through this newsletter another person will have died from a drug overdose in the USA; one every 10 minutes or 63,000 people every year. The problem knows no regional, gender, age, income or other bounds. It is an an epidemic claiming more lives than at the height of the HIV/AIDS crisis in 1995, and odds are that you, your family or your friends have been affected. In 2016 504 Coloradans died because of opioid overdoses. But strikingly, as Director of the Colorado Consortium for Prescription Drug Abuse Prevention Robert Valuck, PhD, RPh, FNAP, notes, for every one death there are 10 treatment admissions for abuse, 32 ER visits for misuse or abuse, 130 people who abuse or are dependent and 825 non-medical users. Last, but certainly not least, 70% of non-medical opioid users get their drugs from the medicine cabinet. Excess supply of prescribed opioids left in the medicine cabinet is being diverted and is helping to drive the epidemic. 

It's overly simplistic to point to one solution to this multi-faceted problem, but physicians in general and ophthalmologists specifically can take steps to help prevent and reduce this scourge.

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The 21st century health care revolution

Posted By Chet Seward, Sunday, October 15, 2017
 
Dr. Williams reviews marketplace trends. 

The September CSEPS Connect event on the ins and outs of private equity firms purchasing ophthalmology practices was a rousing success. The room was packed and attendees stayed late to continue the conversation with AAO Past-president and EyeNet Editor Ruth Williams, MD, about this new trend and the larger evolutions occurring across ophthalmology. 

What began with the premise of why venture capitalists have their sights set on ophthalmologists, grew into an expansive, integrated and interactive presentation about how eyeMDs can help lead the current health care revolution. Dr. Williams reviewed the impacts of rapidly changing marketplace, increasing prices and decreasing reimbursements, demographic demands, evolving requirements due to the multi-generational workplace and the pervasive impacts of disruptive technology. Any one of these is a challenge, but taken together they represent a complex crux of questions about what to do next in order to survive. Dr. Williams’ expertise and experience shown through here with practical tips, real-world examples and much-needed perspective to remain curious, creative and committed to excellence whether you are pursuing a marriage with a venture capital firm or managing an independent practice. Check out her full deck here.

CSEPS thanks Dr. Williams for her dynamic leadership and her tireless willingness to share insights and perspectives to help colleagues.

CSEPS members pack the room to discuss why private equity firms are buying eyeMD practices and more.

 

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New CSEPS strategic plan

Posted By Chet Seward, Sunday, October 15, 2017
 
Leonard Seibold, MD,
president-elect 

CSEPS has a new strategic plan to help guide the organization into the future and stay focused on what is important to Colorado ophthalmologists. The plan, which was approved by the CSEPS board of directors during their meeting in September, is informed by the past, balanced by present needs of the profession in Colorado and focused on a future of the only organization in the state dedicated to championing Colorado’s ophthalmology priorities. It is the result of months of work, a statewide membership poll and dedicated time by your board of directors.

The plan continues to center on advocacy, communication and education, the top three identified priorities of members. It also seeks to keep the Colorado eyeMD community connected through social events and grounded through a new program to give back to the community through charity care.

As your CSEPS president-elect, I’m excited about the new plan and I encourage you to review it. I am always interested in hearing what you think, so send me a note about why the new plan is important to you and how you would like to help turn this plan into a reality. I look forward to hearing from you.

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Resolving Medicaid payment problems

Posted By Chet Seward, Sunday, October 15, 2017
In March of this year Colorado Medicaid officially switched over to new vendor (DXC Technology) to administer claim payments. The build up to and roll out of the system have been riddled with issues that have caused many problems for ophthalmologists. After hearing from numerous practices and discussing the issue further, the CSEPS board of directors joined other physician organizations in calling for immediate changes to resolve systems issues and interest payments to physicians for late payment of clean claims. CSEPS has heard from some members that are owed more than $100,000 in unpaid claims and as a result have had to divert staff, take out loans, skip personal paychecks and quit participating in Medicaid. In spite of efforts to lay blame elsewhere, the state continues to be pilloried for these ongoing problems, with regular media exposes and biting legislative hearings documenting the systemic problems within the system. CSEPS continues to work in concert with other specialty societies and the state medical society to get these issues resolved. Members are encouraged to visit the special “Known Issues & Updates” web page that Medicaid has developed. If your practice is experiencing dire problems with Medicaid billing and payment issues then please contact CSEPS Executive Director Chet Seward.

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Call for nominations: President-elect

Posted By Chet Seward, Sunday, October 15, 2017

CSEPS is seeking nominations for president-elect. The term for this position is calendar year 2018. The position will assume the presidency in 2019. 

Help lead CSEPS and Colorado ophthalmology into the future. Submit your nominations or self-nominations to cseps@cms.org by November 15. A member-wide election will be held later this year. Contact CSEPS Executive Director Chet Seward if you have any questions.

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The demise of MIPS: Don’t believe the hype

Posted By Chet Seward, Sunday, October 15, 2017
While the blogosphere lit up in early October after the Medicare Payment Advisory Commission (MedPAC) recommended that the Merit-based Payment System (MIPS) should be scraped, Colorado ophthalmologists should not be fooled. The fact that MedPAC argued that MIPS will be hard pressed to make meaningful change (something many ophthalmologists already know), the prospect that Congress will take up their recommendation is not only worrisome but also unlikely. As AAO recently noted, MedPAC’s replacement recommendation to penalize physicians who do not move to alternate payment models (APM) is fraught with challenges for most ophthalmologists given the lack of eye-care specific APMs. That said, the current Congressional gridlock dims any immediate changes to the program. For now, don’t believe the hype and keep working on your MIPs scores.

Tags:  MACRA  MIPs 

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Repealing IPAB: The fight continues

Posted By Chet Seward, Wednesday, August 9, 2017

The ongoing existence of the Independent Payment Advisory Board (IPAB) provision of the Affordable Care Act has hung like a Sword of Damocles over the heads of ophthalmologists and other physicians for years. CSEPS has remained part of the fierce and focused fight to repeal IPAB, which is a panel of presidential appointees with the ability to arbitrarily enact payment cuts to physicians and other providers if Medicare's growth rate exceeds a statutory threshold.

The latest advocacy push was by a group of more than 700 organizations, including CSEPS and the American Academy of Ophthalmology, opposed to IPAB. Using a co-signed letter, the group pressed members of Congress to support existing, bi-partisan legislation to repeal IPAB.

While the Medicare Board of Trustees recently released a report that per capita Medicare spending did not exceed the statutory threshold that triggers IPAB provisions this year, the threat is very real next year

CSEPS will continue the fight to repeal IPAB in order to continue to ensure access to care for patients. Watch for action alerts in the future.

Tags:  advocacy  IPAB 

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Don't be a QPP laggard

Posted By Chet Seward, Wednesday, August 9, 2017

A recent survey of practicing physicians regarding Medicare’s new Quality Payment Program (QPP) showed that “fewer than one in four physicians feel well prepared to meet its requirements in 2017.” That’s not a very rosy picture given the seismic changes that QPP will have on physician practices. 

While it is true that QPP represents the biggest change to Medicare physician payment in decades, there are things that you can and should be doing to succeed within the program. Most ophthalmologists will participate in the Merit-based Incentive Payment System (MIPs) and AAO has developed an incredible set of resources for your immediate use in EyeNet’s MIPS Manual 2017. Local Colorado resources and information updates, including QPP Fast Facts, can also be found at the Colorado Quality Payment Program Coalition. These changes are too big to dawdle over. Take advantage of these resources today.

Tags:  MACRA  QPP 

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Free small provider HIPAA training

Posted By Chet Seward, Wednesday, August 9, 2017
The U.S. Department of Health and Human Services, Office for Civil Rights (OCR), Rocky Mountain Region, will be presenting FREE training in Grand Junction and Denver in August and September. The purpose of the presentation - titled "Privacy, Security, and Breach Notification Rules: HIPAA for the Small Provider" - is to help small health care providers that are covered entities understand their regulatory obligations under HIPAA. OCR will cover a number of topics such as an individual's right of access, safeguarding protected health information, the business associate agreement requirement, and risk analysis/risk management.

Grand Junction
Aug. 25, 2017, 8 a.m. - 12 p.m.
Wayne Aspinall Federal Bldg
Conference Room
400 Rood Avenue
Grand Junction, CO

Denver
Sept. 8, 2017, 8 a.m. - 12 p.m.
Byron Rogers Federal Bldg
Aspen/Pine Room, Floor 16
1961 Stout Street
Denver, CO

Space is limited; registration is required and is first-come, first-served. Register by emailing Scott Grayson at Scott.Grayson@hhs.gov or Hyla Schreurs at Hyla.Schreurs@hhs.gov. Please indicate the location of the presentation you will attend as other programs will be held in Wyoming, Utah, North Dakota, South Dakota, and Montana.

Tags:  HIPAA 

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What’s in it for me? What’s in it for you?

Posted By Chet Seward, Wednesday, May 24, 2017

Rebecca Braverman, MD, CSEPS AAO Councillor
“What’s in it for me?” was the answer I received when I asked a young physician if they were going to join their state ophthalmological society after graduation. I was shocked by the response. When I was a resident, everyone joined their state societies upon completing their training. Times have changed. Even the AMA struggles with declining membership. Personally, I am grateful for all the opportunities CSEPS has given me including support for participation in the AAO Leadership Development Program (LDP). I felt compelled to dedicate my LDP project to help CSEPS and to answer the question “what’s in it for other CSEPS members?” 

I worked closely with CSEPS leadership and Kupersmit Research to develop an online poll of Colorado ophthalmologists for use by CSEPS to improve our services and inform our strategic planning. Sixty-eight respondents completed the survey and the majority were active CSEPS members (90%). Nearly two-thirds of respondents felt CSEPS had a positive impact on the practice of medicine for ophthalmologists in Colorado. Respondents reported advocacy efforts at the state capital as the most valuable service offered by CSEPS. OMIC risk management discounts, education/communication about the changing healthcare environment and opportunities for social networking were also highly rated. Areas for improvement included interest in more social events, an increased online presence and more opportunities to participate in charitable eye care across Colorado. A summary memo detailing the results of the poll can be found here

So, “what’s in it for you?” as a CSEPS member? A lot!

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