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Medigram - February 7, 2008


TOP STORY

HHS Secretary awards Wisconsin Healthcare Value Exchange with special distinction

Department of Health and Human Services Secretary Mike Leavitt was in Madison last week to recognize the formation of the Wisconsin Healthcare Value Exchange (WHVE). The Society is one of seven members of the newly organized group, which received special federal distinction for its strong commitment to improving quality and value in health care.

Secretary Leavitt designated the WHVE and 13 other “Community Leaders” as the country’s first Chartered Value Exchanges (CVE) for their work to implement cutting-edge, collaborative methods to transform health care at the local level. Other members of the Wisconsin Healthcare Value Exchange are the Wisconsin Hospital Association, MetaStar, the Wisconsin Health Information Organization, The Alliance, the Business Health Care Group and the Wisconsin Collaborative for Healthcare Quality.

“These pioneers are at the forefront of a nationwide movement to transform our current health care sector into a patient-focused marketplace,” Secretary Leavitt said. “Together we are building the foundation of a transparent system that empowers consumers to seek high-quality health care at competitive prices.”

As a Chartered Value Exchange, the WHVE will receive access to Medicare provider performance information for their communities and be part of a nationwide learning network that will provide peer-to-peer learning experiences and access to experts.

CVEs represent one of a number of initiatives undertaken by HHS to implement a bold vision for health care reform built on four cornerstones:
  • Advancing interoperable health information technology;
  • Measuring and publishing quality information to enable consumers to make better decisions about their care;
  • Measuring and publishing price information to give consumers information they need to make decisions on purchasing health care;
  • Promoting incentives for quality and efficiency of care.
For more information, please visit http://www.hhs.gov/valuedriven.

NEWS BRIEFS

Fee assessment notification for Wisconsin-licensed physicians on the way

The Wisconsin Department of Health and Family Services (DHFS) is reminding Society members that it will soon be mailing fee assessment notices to all Wisconsin-licensed physicians as required by state law. Some physicians will not be sent letters because their assessments have already been paid by the health care organizations with whom they are affiliated.

It is important to note that this annual assessment is not related to state licensing fees but is a separate fee required under Chapter 153, Wis. Stats. The fee was established to support the costs of utilizing health care information for health care quality and safety improvements, but as noted in this January 17 letter from Society Board Chair Thomas Luetzow, MD, to DHFS Secretary Kevin Hayden, there are a number of issues surrounding the continued collection of this fee. The Society is quite interested to learn more about how the Department is using these monies and whether continued assessment is justified. (Click here to access the Legislative Audit Bureau Letter Report referred to in Dr. Luetzow's letter.)

The assessment amount for State Fiscal Year 2008 is $70. To learn more about this requirement and who is exempt from it, visit the DHFS Web site at this link: http://dhfs.wisconsin.gov/healthcareinfo/assess/phys/faq.htm

For more information, e-mail Mark Grapentine.


The check could be in the mail

Health care professionals who were insured through The Wisconsin Health Care Liability Insurance Plan (Plan) may be eligible for a share of an existing surplus.

The Plan’s Board of Governors has directed the Plan to distribute surplus funds, which exist thanks to prior years’ favorable experience. The surplus is a combination of premiums paid and investment income on those premiums. Policies that may be affected were issued to provide coverage in one or more of the following years: 1975-1979, 1984-1992, 1997, 1998 and 2002.

The Plan has been working since last March to identify and locate all eligible recipients. The Plan issues shares of the surplus directly to individual health care professionals insured through the Plan, even if the premiums were originally paid by another party (i.e., facility, employer).

If you were insured by the Plan for any of the years listed above and have not been contacted, you are encouraged to call 715.842.6418 or e-mail whclip@wausau.com to see if you are eligible for a portion of the surplus.


Physician musicians in Brown County raise money for childhood safety

When they’re not saving lives, they’re enriching them with a little music. Brown County physicians are performing on Saturday, February 9 at St. Norbert College in DePere, in a fundraiser for the Center for Childhood Safety. The Brown County Medical Society Alliance is coordinating the event, courtesy of sponsors Heid Music and Steinway & Sons.

Tickets are $85 each or $75 each for groups of eight or more. Thirty dollars of each ticket is tax-deductible. To order, call 920.403.3950 or 800.762.2699. Click here for more information.


February 13 WCRI webcast to include Wisconsin findings

The Workers Compensation Research Institute (WCRI) will present key findings in a February 13 webcast. The briefing will include results from the eighth edition of the annual WCRI CompScope™ multistate benchmarks study, comparing the workers' compensation system performance for 14 states, including Wisconsin. In addition, this briefing will feature findings from other WCRI studies, including benchmarks of medical costs and utilization.

The webcast begins at 9:30 a.m. and is expected to last approximately 90 minutes, which includes time for a Q & A with the reports’ authors. The cost is $35 for WCRI members, $50 for nonmembers, and there is no charge for public officials. To participate, complete this on-line registration form. You are encouraged to register early. WCRI will e-mail instructions, the link you will need to access the webcast and a toll-free phone number. For more information, e-mail Sarah Solorzano or call her at 617.661.9274.


Join a Strategic Council

The Wisconsin Medical Society is seeking members for the following Strategic Councils:
  • Health Care Ethics (formerly Ethics and Judicial Affairs)—Issues include physician professionalism, pharmaceutical gifts, interprofessional code for physicians and attorneys, cloning/embryonic research and end-of-life care.
  • Health Care Access (formerly Health Care Access and Financing)—Issues include review of health system reform proposals, increasing access to health care, Medicare and Medicaid reimbursement, medical malpractice issues and administrative costs.
  • Health Care Quality and Population Health (formerly Health of the Public)—Issues include patient-centered medical care, public/patient safety, population health and occupational health.
  • Policy Panel—This panel reviews existing five-year policies for germaneness and continued alignment with the Society’s Strategic Plan. The council will craft new policies based on referrals by the Board of Directors and House of Delegates and recommendations from the Strategic Councils.
  • Legislation—This council plans, organizes, and implements programs to protect and preserve the legislative, socioeconomic and political interests of Society members.
Council members are appointed to three, three-year terms (or a total of nine years). At the end of each three-year term, members have the option of continuing. Society members may also participate in Council discussions on a topic-by-topic basis. These opportunities will be published in Medigram. Non-member experts may be invited to participate depending on the topic. To promote continuity and history, no ad hoc members will be included on the Policy Panel.

If you are interested in being appointed to a Council, please contact Merry Earll at 866.442.3800 or 608.442.3766 by March 7, 2008.

CAPITOL INSIDER

Various cost ‘transparency’ bills abound in Capitol

As the State Legislature heads toward the end of its regular session in mid-March, various bills aimed at providing patients with health care cost information will soon receive public hearings in the Capitol.

Senator Jim Sullivan’s (D-Wauwatosa) Senate Bill 377, Rep. Steve Wieckert’s (R-Appleton) Assembly Bill 729 and a still-to-be-introduced proposal from Rep. Leah Vukmir (R-Wauwatosa) all would require physicians to provide patients with various cost information related to procedures, services or diagnostic tests.

Rep. Vukmir’s effort is titled “The Patients’ Right to Know Act,” and states that there is “general, bipartisan consensus that tools like these help put patients in charge of their health care while encouraging them to become more conscious of health care costs.” While the general consensus indeed agrees that cost information can be valuable, policymakers also need to acknowledge that health care costs can vary widely based on the patient and the care needed. The Society has partnered with various health care entities across the state to coordinate the physicians’ message to our state policymakers and to explain the real-world effects of these bills.


Supreme Court election April 1

While the national race for president has dominated most election headlines and stories, an important race for a seat on the state’s Supreme Court headlines Wisconsin’s general election on April 1. Sitting Justice Louis Butler will face Barron County Circuit Court Judge Mike Gableman.

If you haven’t paid much attention to this race, there is still time to familiarize yourself with the two candidates. While government’s involvement in your practice has generally come from the executive and legislative branches of government, the judicial branch is becoming more of a factor.

Wisconsin Supreme Court justices are elected to 10-year terms, so your vote on April 1 could have long-lasting impact. To learn more about the candidates, visit their Web sites: There are only two candidates for the seat, so this race will not be on the ballot for Wisconsin’s February 19 primary.

For more information about either of these issues, e-mail Mark Grapentine.

EDUCATIONAL PROGRAMS

Mastering Medicare in 2008

The Wisconsin Medical Society is partnering with WPS-Medicare in March to bring you the most recent changes to Medicare Part B policies, procedures and reimbursement for 2008. Mastering Medicare in 2008 is a full-day seminar that will break down the Medicare changes that will affect your office related to coding, billing and reimbursement. You will also have the opportunity to get any last-minute NPI questions answered prior to the May 23, 2008 implementation date. A general “open – forum” style Q&A will wrap up this session allowing you to get all of your current Medicare questions answered.

Click here for locations, fees and registration information for this seminar. Click here to learn more about additional educational opportunities available through the Society’s Education Department.

QUALITY CORNER

Health literacy practices in primary care settings: Examples from the field

Low health literacy is widespread among U.S. patients, yet limited research has been done to assess the effects of health literacy practices designed to combat the problem, particularly among safety-net providers in primary care settings. A new Commonwealth Fund report presents findings from a 2005 study in which the Association of Clinicians for the Underserved first did an online survey of health care facilities across the country and then followed it up with visits to five selected sites for staff and patient interviews. The study identified five health literacy practices that staff considered especially valuable for their group's patients and potentially applicable to other clinics: a team effort, beginning at the front desk; use of standardized communication tools; use of plain language, face-to-face communication, pictorials, and educational materials; clinicians partner with patients to achieve goals; and organizational commitment to create an environment where health literacy is not assumed. To read the report, click here.

FAQ

Question:
In reference to the Medical Decision Making (MDM) section of E/M coding, can the amount and/or complexity of data reviewed by a physician “count” as 3 points if he or she ordered a specific radiology test and also performed direct visualization of image, tracing, specimen, etc.?

Answer:
WPS Medicare Part B “counts” no official “points” or “bullets” in the determination of Medical Decision Making (MDM). However, in such a case as the one described, both the ordering of the test and the direct visualization of the image, tracing or specimen, etc. would be taken into consideration in the determination of the amount and/or complexity of the data reviewed.

For answers to other Frequently Asked Questions about coding matters and more, click here to review our Education Department’s FAQ archive, or e-mail efaq@wismed.org.