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Alabama Physicians Represented at AMA Annual Meeting

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Alabama Physicians Represented at AMA Annual Meeting

CHICAGO – Physicians from Alabama were well represented at the American Medical Association’s meeting last week where discussions ranged from physician and medical student suicide to transparency in drug pricing.

Jorge Alsip, M.D., Delegation Chair, said the Medical Association’s members were represented by its eight-member delegation as well as by representatives from the state’s Medical Student Section, Resident Fellow Section, Young Physician Section, and Senior Physicians Section along with physician representatives from several specialty medical societies.

“During the five-day meeting, our delegation reviewed more than 250 reports and resolutions and offered testimony on issues of particular interest to Alabama physicians.” Dr. Alsip said.

Among the policies adopted or reaffirmed during the meeting were:

  • Eliminating the barriers to appropriate pain management created by insurers and pharmacy benefit managers, which make it more difficult for physicians to provide appropriate care to patients living with pain
  • Reaffirmation of the AMA’s strong opposition to physician-assisted suicide after the House of Delegates rejected a proposal by supporters of physician-assisted suicide to change AMA policy and have the organization take a neutral stance on the issue
  • A report calling for the AMA to conduct a study to identify the systemic patterns and risk factors that lead to burnout, depression and suicide among physicians, residents, and medical students and ultimately help prevent it.
  • New policy to improve the Affordable Care Act (ACA) while reaffirming the Association’s strong opposition to a single-payer approach to health system reform.
  • Strengthened the AMA’s long-standing support for transparency in drug pricing by adopting new policy to support the active regulation of PBMs under state departments of insurance and increased PBM transparency, including utilization, rebates and discounts, and financial incentives.
  • The need for the AMA to work with relevant stakeholders to support the extension of Medicaid coverage to 12 months postpartum to help address the rising maternal mortality rate.
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STUDY: Prior Authorization Hurdles Have Led to Serious Adverse Events

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STUDY: Prior Authorization Hurdles Have Led to Serious Adverse Events

FEB 5, 2019 CHICAGO — More than one-quarter of physicians surveyed, about 28 percent, report the prior authorization process required by health insurers for certain drugs, tests and treatments have led to serious or life-threatening events for their patients, according to new survey results released by the American Medical Association.

The AMA survey of 1,000 practicing physicians found that prior authorization continues to have a distressing impact on both patients and physician practices. Despite widespread calls for meaningful reform during the last two years, the survey illustrates that prior authorization programs and existing processes remain costly, inefficient, opaque, and hazardous in some cases.“The AMA survey continues to illustrate that poorly designed, opaque prior authorization programs can pose an unreasonable and costly administrative obstacle to patient-centered care,” said AMA Chair Jack Resneck, Jr., M.D. “The time is now for insurance companies to work with physicians, not against us, to improve and streamline the prior authorization process so that patients are ensured timely access to the evidence-based, quality health care they need.”

Critical physician concerns highlighted in the AMA survey include:

  • More than nine in 10 physicians (91 percent) say that prior authorizations programs have a negative impact on patient clinical outcomes.
  • Nearly two-thirds of physicians (65 percent) report waiting at least one business day for prior authorization decisions from insurers – and more than one-quarter (26 percent) said they wait three business days or longer.
  • More than nine in 10 physicians (91 percent) said that the prior authorization process delays patient access to necessary care, and three-quarters of physicians (75 percent) report that prior authorization can at least sometimes lead to patients abandoning a recommended course of treatment.
  • A significant majority of physicians (86 percent) said the burdens associated with prior authorization were high or extremely high, and a clear majority of physicians (88 percent) believe burdens associated with prior authorization have increased during the past five years.
  • Every week a medical practice completes an average of 31 prior authorization requirements per physician, which take the equivalent of nearly two business days (14.9 hours) of physician and staff time to complete.
  • To keep up with the administrative burden, more than a third of physicians (36 percent) employ staff members who work exclusively on tasks associated with prior authorization.

“The AMA is committed to attacking the dysfunction in health care by removing the obstacles and burdens that interfere with patient care,” said Dr. Resneck. “To make the patient-physician relationship more valued than paperwork, the AMA has taken a leading role by creating collaborative solutions to right-size and streamline prior authorization and help patients access safe, timely, and affordable care, while reducing administrative burdens that pull physicians away from patient care.”

In January 2017, the AMA with 16 other associations urged industry-wide improvements in prior authorization programs to align with a newly created set of 21 principles intended to ensure that patients receive timely and medically necessary care and medications and reduce the administrative burdens. More than 100 other health care organizations have supported those principles.

In January 2018, the AMA joined the American Hospital Association, America’s Health Insurance Plans, American Pharmacists Association, Blue Cross Blue Shield Association and Medical Group Management Association in a Consensus Statement outlining a shared commitment to industry-wide improvements to prior authorization processes and patient-centered care.

The AMA welcomes the opportunity to work collaboratively with health plans and others to create a partnership that lays the foundation for a more transparent, efficient, fair, and appropriately targeted prior authorization process. Please visit the AMA website to learn more about the organization’s ongoing collaborative efforts.

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AMA Rep Discusses Partnership with Medical Association during Opioid Council Meeting

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AMA Rep Discusses Partnership with Medical Association during Opioid Council Meeting

MONTGOMERY ─ Earlier this week, the Governor’s Opioid Overdose and Addiction Council met to discuss reports from various stakeholders and committees, but there was also a special guest speaker. Daniel Blaney-Koen, senior legislative attorney from the American Medical Association, joined the task force to discuss what the AMA is doing nationally with policy interventions to try and reverse the opioid epidemic as well as its partnership with the Medical Association with the development and promotion of a toolkit to provide more educational material to Alabama’s physicians.

According to Blaney-Koen, opioid prescriptions are decreasing nationwide, and Alabama has beaten the national average in reducing the number of opioids prescribed.

“We want to emphasize solutions,” Blaney-Koen said. “I’d rather emphasize solutions that can change the course of this epidemic. We all want this epidemic to end, and there is hope for optimism that it will. The unmet needs for treatment are what will sustain this epidemic, so evidence-based care and treatment is where we need to put our focus.”

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Alabama Physicians Attend AMA Meeting in Chicago to Discuss State of Health Care

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Alabama Physicians Attend AMA Meeting in Chicago to Discuss State of Health Care

Pictured from left in the back are Dr. Buddy Smith Jr., Dr. Jefferson Underwood and Dr. Jerry Harrison. In front from left are Dr. Steven Furr, Medical Student Delegate Hannah Ficarino from the University of South Alabama, Dr. Jorge Alsip and Dr. John Meigs.

During the AMA’s Annual Meeting held June 8-13, 2018, the House of Delegates debated a wide range of issues and adopted policies to expedite the free exchange of key patient data between EHR systems; to make e-prescribing of controlled substances and access to state PDMPs less cumbersome, and to reduce the MIPS reporting burden. The AMA also reaffirmed its strong opposition to the legalization of physician-assisted suicide and euthanasia.

Medical Association President Jefferson Underwood, M.D., joined the delegation in Chicago and represented Alabama physicians at the inauguration of the AMA’s new president, Barbara McAneny, M.D.

“The AMA House of Delegates is much like Congress in that the views of its members vary from region to region, and few members agree with every decision made by the organization. However, a state’s representation in the HOD is based on their number of AMA members, and Alabama along with the other Southeastern states are working vigorously to increase their AMA membership. I encourage our Medical Association members to also join the AMA, so we can have a greater impact on policy and help elect officers who share our views and values.” said Jorge Alsip, M.D., who chairs Alabama’s AMA Delegation.

Pictured are Association President Underwood and his wife, Sara.

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Metro Areas Increasingly Dominated by Single Insurance Companies

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Metro Areas Increasingly Dominated by Single Insurance Companies

In an analysis of competition in health insurance markets across the U.S., a study conducted by the American Medical Association found that in 169 of 389 metropolitan areas (43 percent), a single health insurer had at least a 50 percent share of the market. This represents an eight percent increase in such markets over just two years. The finding comes from the newly released 2017 edition of the AMA’s Competition in Health Insurance: A Comprehensive Study of U.S. Markets, which examines market concentration in 2016.

High market concentration tends to lower competition among commercial health insurers. These markets become ripe for the exercise of health insurer market power, which harms patients by raising premiums above competitive levels.

The AMA study presents the most comprehensive data on the degree of competition in health insurance markets across the country, and is intended to help researchers, policymakers and regulators identify markets where consolidation among health insurers may cause anti-competitive harm to patients and the physicians who care for them.

“After years of largely unchallenged consolidation in the health insurance industry, a few recent attempts to consolidate have received closer scrutiny than in the past, including the proposed mergers of Anthem and Cigna, as well as Aetna and Humana,” said AMA President David O. Barbe, M.D. “Previous versions of the AMA study played a key role in efforts to block the proposed mega-mergers by helping federal and state antitrust regulators identify markets where those mergers would cause anti-competitive harm.”

The 2017 edition of AMA’s Competition in Health Insurance: A Comprehensive Study of U.S. Markets offers the largest and most complete picture of competition in health insurance markets for 389 metropolitan areas, as well as all 50 states and the District of Columbia. The study is based on 2016 data on commercial enrollment in fully and self-insured health maintenance organization (HMO), preferred provider organization (PPO), point-of-service (POS), public health exchange and consumer-driven health plans (CDHP).

In addition to assessing competition in the commercial health insurance market at large, the study also separately examines competition for the main plan types, including HMO, PPO, POS, and the exchanges.

The prospect of future consolidation in the health insurance industry should be viewed in the context of the lack of competition that already exists in most health insurance markets. According to the AMA’s latest study:

  • A significant absence of health insurer competition was found in 69 percent of metropolitan areas. These markets are rated “highly concentrated” based on federal guidelines used to assess the degree of competition in a market.
  • In 43 percent (169) of metropolitan areas, a single health insurer had at least a 50 percent share of the commercial health insurance market, compared to 40 percent (156) in 2014.
  • Anthem has a bigger geographic footprint than any other health insurance company in the United States. Anthem was the largest health insurer by market share in 82 of 389 metropolitan areas examined by the AMA. Health Care Service Corp. was second with a market share lead in 42 metropolitan areas, followed by UnitedHealth Group with a market share lead in 26 metropolitan areas.
  • The 10 states with the least competitive commercial health insurance markets were: 1. Alabama, 2. Delaware, 3. Hawaii, 4. South Carolina, 5. Louisiana, 6. Michigan, 7. Kentucky, 8. Vermont, 9. Alaska, and 10. Illinois.
  • The commercial health insurance market in 27 states became more concentrated between 2014 and 2016.
  • The 10 states that experienced the largest increase in market concentration between 2014 and 2016 were: 1. Kentucky, 2. Alaska, 3. South Carolina, 4. Mississippi, 5. South Dakota, 6.Oklahoma, 7. Vermont, 8. Arkansas, 9. Nevada and 10. New Mexico.

Competition in Health Insurance: A Comprehensive Study of U.S. Markets is free to AMA members. The study is also available to non-members. To order a copy, visit the online AMA Store, or call (800) 621-8335 and mention item number OP427117.

Editor’s Note: Credentialed members of the media can obtain a free copy of the AMA’s newest study on competition in the nation’s health insurance industry by contacting AMA Media & Editorial at: (312) 464-4430.

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AMA Posthumously Honors Dr. Jeff Terry

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AMA Posthumously Honors Dr. Jeff Terry

During its recent Interim Meeting the American Medical Association posthumously awarded Dr. Jeff Terry the AMA Special Award for Meritorious Service in recognition of his contributions to the medical profession. Dr. Terry’s wife, Elizabeth, and their son, Dr. William J. Terry, Jr., accepted the award on behalf of the family.

Dr. Terry was nominated for this award by the Medical Association and also received endorsements from physician leaders across the country. U.S. Sen. Bill Cassidy (R-LA) offered the following tribute: “Beyond serving his family and community, Dr. Jeff Terry genuinely cared about the future of the medical profession. His contributions to the policy-making process were absolutely invaluable. I am privileged to say that Dr. Terry was a fellow American and a colleague as a physician. He was a blessing to many.”

Rep. Tom Price (R-GA) recently described Dr. Terry as “a consummate physician advocate for patients” who always punctuated his advocacy efforts by reminding him that “if we don’t get this right we will not be able to care for patients the way we should.”

Drs. Greg Cooper and Bill Clark, former Southeastern Delegation colleagues of Dr. Terry’s, offered the following endorsement: “We in the Southeastern Delegation will feel Jeff’s presence whenever we rise to speak to important issues that impact the practice of medicine. When we do, because of him, we will be less self-conscious, more passionate, and more determined to carry forward the work of the AMA.”

AMA Delegation Chair Dr. Jorge Alsip also remembered his friend and colleague. “Jeff was a fierce defender of the patient-physician relationship and a force to be reckoned with in the AMA House of Delegates. The sacrifices he made traveling  across the country to advocate for patients and physicians set an example that few can ever hope to emulate.”

In his remarks to the AMA House of Delegates Dr. William Terry recalled his father’s love for the AMA and the privilege of being a physician, and he concluded with the following challenge to the AMA House of Delegates: “Dad would tell us that if we sometimes find the practice of medicine to be a cold place, then make it your business to build fires.”

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Medical Association Joins AMA for Release of Opioid Education and Resource Toolbox

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Medical Association Joins AMA for Release of Opioid Education and Resource Toolbox

BIRMINGHAM – The Medical Association and the American Medical Association partnered in the development and release of a toolbox of data, education and other resources to aid physicians in their continued fight against Alabama’s epidemic of prescription drug misuse, overdose and death. The toolbox was released in a press conference during the Association’s November Opioid Prescribing Education conference in Birmingham.

This toolbox is part of the Medical Association’s continuing efforts – legislative and other – to reverse this epidemic, and Alabama is one of two states participating in this pilot program.

“Although Alabama is no longer the top prescriber of opioids in the country, we still have a very long way to go as far as educating our physicians and other prescribers how to properly handle the prescription of opioid pain medication and those patients that require that medication,” said Medical Association Executive Director Mark Jackson. “This toolbox will help physicians not only educate patients about pain, but also provide resources for overdose prevention and treatment.”

Jackson said he hopes Alabama’s physicians will find the toolbox useful and help strengthen their physician-patient relationships as they continue to discuss pain-related issues with their patients.

“This toolbox contains the types of data and resources that physicians can rely on to help improve their practices for their patients,” said Gerald Harmon, M.D., chair-elect of the American Medical Association Board of Trustees, who also spoke at the press conference. “We recognize that we have much more to accomplish, but physicians in Alabama and across the nation already have made important strides to reverse the nation’s opioid epidemic, and using these resources will help physicians continue that progress.”

Alabama, along with Rhode Island, are the only two states in this grant. These states were chosen due to many factors, including high rates of opioid-related harm as well as diverse demographic, socioeconomic, geographic and other characteristics. The characteristics offer excellent opportunities to study the implementation of the toolbox, refine it, and potentially use it as a model for other states that want to undertake similar efforts.

The toolbox can be viewed online at www.SmartAndSafeAL.org/physicians.

Funding for this initiative was made possible (in part) by Providers’ Clinical Support System for Opioid Therapies (grant no. 5H79TI025595) from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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Statement Opposing VA Proposed Rule on APRNs

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Statement Opposing VA Proposed Rule on APRNs

Alabama Delegation Supports AMA Resolution Opposing Proposed VA Rule

UPDATE June 16, 2016: This week at the AMA Meeting the Association’s AMA Delegation joined others in support of a resolution opposing the proposed Department of Veterans Affairs rule that would expand the role of all Advanced Practice Registered Nurses, including nurse anesthetists.

The AMA resolution in opposition to the VA proposal follows earlier statements in opposition to the rule, and is in line with the Association’s position, and reads that the policy in the rule is “antithetical to multiple established policies of our AMA and thus should not be implemented.” The resolution directs AMA staff to assess feasibility of pursuing federal legislation to prevent the rule, calls on Congress to disapprove the rule, and suggestion collaborations between the AMA and other medical professional organizations to oppose the final adoption of the rule.

Dr. Carolyn Clancy, the VA’s Assistant Deputy Under Secretary for Health Quality, Safety and Value, spoke before the AMA reference committee encouraging members to submit comments during the 60-day public comment period, which ends July 25. Comments may be submitted online at www.SafeVACare.org.

It is the opinion of the Medical Association that this proposed rule change would undermine the delivery of care within the VA system. Our country’s health care system relies on physician-led teams to improve care and reduce costs. Physicians receive more than 10,000 hours of education and training and bring a wealth of value to the health care team. To deny any patient access to qualified physician-led, team-based care is simply inadequate, and our nation’s veterans deserve more from our health care system. In 2014 the Medical Association spearheaded a registry of physicians willing to treat veterans outside the VA system hoping to shorten the amount of time our veterans face before getting appropriate medical care.

Protecting Veterans’ Access to Physician-Led Medical Care

UPDATE June 10, 2016: As previously reported, the Medical Association is joining various medical associations and societies in opposition to the Department of Veterans Affairs’ proposed amendment to its medical regulations to permit full practice authority of all VA advanced practice registered nurses (APRNs) when acting within the scope of their VA employment.

Now, there is a letter being circulated by U.S. Rep. Dan Benishek (R-MI) expressing his “deep concern about the potential impact of this change to the long-standing best practices on the veterans the VHA serves.” Rep. Benishek, who is Chair and Ranking Member of the House Veterans’ Affairs Subcommittee on Health, began circulating his letter of support to continue physician-led health care in the VA medical system in late May, wrote “a sudden change to the status of nurses and the abandonment of the care team model would be extremely disruptive, leaving many of us with inappropriate staffing ratios which would directly compromise patient safety and limit our ability to provide quality care to veterans.”

To date, Alabama Reps. Martha Roby and Mo Brooks have signed on in support of Rep. Benishek’s letter. The Medical Association will be calling on all of Alabama’s Congressional Delegation to do the same. While the Medical Association applauds the VA for addressing the challenges that face the patients inside the VA health care system, the Association is drafting comments to submit opposing the proposed rule because we believe a physician-led team is the best approach to improving quality care for our nation’s veterans.

UPDATE June 3, 2016: The Medical Association will be joining the American Medical Association and other state medical associations and societies in opposition to the Department of Veterans Affairs’ proposed amendment to its medical regulations to permit full practice authority of all VA advanced practice registered nurses (APRNs) when acting within the scope of their VA employment. While the Medical Association applauds the VA for addressing the challenges that face the patients inside the VA health care system, the Association is drafting comments to submit opposing the proposed rule because we believe a physician-led team is the best approach to improving quality care for our nation’s veterans.

This rule proposed by the Department of Veterans Affairs is intended to increase veterans’ access to VA health care by expanding the pool of health care professionals who are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision of physicians. The proposed rulemaking would establish additional professional qualifications an individual must possess to be appointed as an APRN within VA. The proposed rulemaking would subdivide APRNs into four separate categories including certified nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, and certified nurse-midwife. The proposed rulemaking would also provide the criteria under which VA may grant full practice authority to an APRN, and define the scope of full practice authority for each category of APRN.

It is the opinion of the Medical Association that this proposed rule change would undermine the delivery of care within the VA system. Our country’s health care system relies on physician-led teams to improve care and reduce costs. Physicians receive more than 10,000 hours of education and training and bring a wealth of value to the health care team. To deny any patient access to qualified physician-led, team-based care is simply inadequate, and our nation’s veterans deserve more from our health care system. In 2014 the Medical Association spearheaded a registry of physicians willing to treat veterans outside the VA system hoping to shorten the amount of time our veterans face before getting appropriate medical care.

Therefore, the Medical Association urges the Department of Veterans Affairs to maintain the integrity of the physician-led health care team model within the VA health system to ensure greater integration and coordination of care for our veterans and improve health outcomes.

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