Posts Tagged community

U.S. House Passes SUPPORT for Patients and Communities Act

U.S. House Passes SUPPORT for Patients and Communities Act

In a 396-14 vote, the U.S. House of Representatives passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, or H.R. 6 —bipartisan opioid legislation that aims to curb drug abuse.

Sponsored by Greg Walden, R-Oregon, the package of legislation contains more than 50 individually approved bills to address what Pres. Donald Trump has called a health emergency.

The SUPPORT bill is intended to fight the opioid crisis by advancing treatment and recovery programs, improving prevention efforts, providing resources to communities and fighting drugs like Fentanyl. The legislation also calls for a review of current opioid prescriptions, development and usage of non-addictive painkillers, making a patient’s addiction history as part of their medical records to prevent relapse and reducing the trafficking of Chinese fentanyl into the country. Additionally, the legislation will expand Medicare and Medicaid-related services to combat drug abuse.

Opposition votes came from 13 Republicans and a lone Democrat. Alabama’s Rep. Mo Brooks voted against the legislation, which is now headed to the Senate for review and passage.

In short, the bill makes several changes to state Medicaid programs to address opioid and substance use disorders. Specifically, the bill:

  • modifies provisions related to coverage for juvenile inmates and former foster care youth,
  • establishes a demonstration project to increase provider treatment capacity for substance use disorders,
  • requires the establishment of drug management programs for at-risk beneficiaries,
  • establishes drug review and utilization requirements,
  • extends the enhanced federal matching rate for expenditures regarding substance use disorder health home services, and
  • temporarily requires coverage of medication-assisted treatment.

The bill also alters Medicare requirements to address opioid use. Specifically, the bill:

  • exempts substance use disorder telehealth services from specified requirements,
  • requires the initial examination for new enrollees to include an opioid use disorder screening,
  • modifies provisions regarding electronic prescriptions and post-surgical pain management,
  • requires prescription drug plan sponsors to establish drug management programs for at-risk beneficiaries, and
  • requires coverage for services provided by certified opioid treatment programs.

The bill also addresses other opioid-related issues. Specifically, the bill:

  • establishes and expands programs to support increased detection and monitoring of fentanyl and other synthetic opioids, and
  • increases the maximum number of patients that health care practitioners may initially treat with medication-assisted treatment (i.e., under a buprenorphine waiver).

Additionally, the bill temporarily eliminates the enhanced federal matching rate for Medicaid expenditures regarding specified medical services provided by certain managed care organizations.

The Medical Association is closely monitoring the status of this legislation, but we encourage you to read more about the legislation here.

Posted in: Advocacy

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“Physician Leadership” Must Never be an Oxymoron

“Physician Leadership” Must Never be an Oxymoron

If there has ever been a time in the practice of medicine when leadership was needed, it is certainly now. Just a few of the challenges facing practices include:

  • Payer encroachment on medical decision making is increasing;
  • Payments for health care services are declining;
  • Utilization review processes question the extent of treatment provided;
  • Aging physicians in the U.S. want a lighter work schedule;
  • Medical staff are more inclined to frequently change jobs;
  • Patients take an increasingly unappreciative attitude toward the medical profession; and
  • The payment architecture for health care services changes often enough to make it nearly incomprehensive.

While there are many elements needed for navigating this maze, physician leadership is the most essential.

In future issues, we want to address the role of leading your physician partners, the leadership of your employee team, leadership in your medical community, your impact on your patient population, and leadership outside of your profession. However, leadership in all areas begins with effective leadership of yourself.

Because the Healthcare Division of our Firm is singularly devoted to the provision of services to physicians and their practices, we have the opportunity to regularly observe hundreds of physicians in their roles within their practice. Some are natural leaders, while others have made themselves into the leaders needed by their group and some have assumed leadership but are not truly ready for the role. To be a leader, you must have the right perspective, clear personal goals and an abundance of wisdom.

The foundation for leadership readiness is found in a perspective that your purpose is to serve those you lead. In the opening words of Rick Warren’s book, A Purpose Driven Life, the author begins with a reminder that “it is not about you.” If you believe that your environment exists to serve you, your decisions will be selfish, your judgments self-serving, and your appetites insatiable. This belief cannot be concealed, and it is very distasteful when observed by your partners, staff and others. However, when a physician of supreme abilities, abundant blessings and high regard behaves selflessly, the esteem in which they are held is increased, and a resulting willingness to follow their lead is instilled. This means they know the needs of those around them and possess a healthy empathy toward their fellow physicians, employees and others.

Those who have a magnetic leadership ability also have a clear vision of what they want to achieve. Their roles as a spouse, parent, grandparent, child of their parents and sibling are marked by intentional goals and plans to achieve those goals. They have fitness and health aims, personal hobbies and recreational goals, and faith-based priorities as well as their medical practice plans. Rather than having to insist on followers, those around them follow by admiration of their balanced lives, clearness of direction, and discipline to stay on task in their pursuits.

This leadership by respect rather than by position is discussed in The 360 Degree Leader by John Maxwell. This pursuit of goals must be balanced. For example, the young physician who is so committed to parenting that he or she wants to coach their child’s soccer team is appreciated for their success in all realms of life if they are also the top producer at the clinic, have expanded their hours to see patients before normal office hours and are working on their afternoon off to make up for lost production.

Given the same scenario, the doctor/coach who is the lowest producer and does nothing to supplant the production lost to extra time away from work will never receive respect for their one-dimensional enthusiasm. If they also complain about the unfair allocation of patients, errors in the practice revenue cycle and the need for greater compensation, they are assured of disrespect from their staff and peers.

The servant leader must have a “healthy empathy,” and the goals of a driven physician must be “balanced.” These qualities can only be found in an abundance of wisdom built over the years. Wisdom enables you to pick the battles you should fight selectively. Patiently wait for the opportune time to engage on the issues, and calculatingly arrange the desired audience to be present as you deal with a matter. Wise actions are deliberate, not impulsive. Some wisdom comes from past mistakes, so always review your own handling of tough situations for ways in which you could have improved. Wisdom is also found in seeking the counsel of others, especially those outside your practice.

Future leadership articles will speak to the various areas calling for physician leadership, but self-leadership must be at the core.

Article contributed by James A Stroud, CPA, D. Maddox Casey, CPA, and Sae Evans, CPA, with Warren Averett CPAs and Advisors. Warren Averett CPAs and Advisors is an official Gold Partner with the Medical Association.

Posted in: Leadership

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