April 18, 2018
2018 FM Clinical Forum Was a Resounding Success
"The meeting exceeded my expectations and made me feel proud to be a family physician in California." - 2018 attendee
More than 250 members came together in Monterey last weekend to learn about a variety of important clinical topics, network with peers and celebrate family medicine! Highlights included the impactful keynote session with stories from family physicians directly involved in recent traumatic events such as natural disasters and mass shootings, Hobart Lee's popular Family Medicine Update, the launch of two new curricula, a celebration of CAFP's 70th birthday and 10,000th member, the incoming and outgoing presidential addresses of Lisa Ward and Michelle Quiogue, award presentations and a special event in honor of retiring CAFP EVP Susan Hogeland, at which CAFP and the CAFP-Foundation endowed a new student and resident health policy fellowship.
We will be finalizing the date and location of next year's meeting soon and hope to see you there!
CAFP Primary Care Spending Bill Passes Committee
CAFP’s sponsored bill, AB 2895 (Arambula and Bonta), overwhelmingly passed out of the Assembly Health Committee yesterday after testimony from CAFP Legislative Affairs Committee Chair Carla Kakutani, MD. AB 2895 requires health plans/insurers to report total primary care medical expenditures compared to overall medical expenditures and the methods plans/insurers use to financially support primary care. A compelling body of evidence clearly demonstrates that investment in primary care delivers greater value to patients and health systems, resulting in fewer hospitalizations and emergency department visits, higher patient satisfaction and lower mortality. A lack of transparency in spending prevents legislators, regulators, employers and consumers from knowing how much health plans/insurers dedicate to primary care. The increased transparency and support outlined in AB 2895 will make it possible to coordinate payer efforts to achieve a high-value health system. The bill now goes to the Assembly Appropriations Committee, where it will be heard in May.
Monterey CAFP Board Meeting Jam-Packed with Important Issues
The CAFP Board of Directors met over two days, prior to the opening of the Family Medicine Clinical Forum last weekend. Positions were taken on more than 50 bills pending before the State Legislature, including one introduced just days before the meeting’s start with far-reaching, potentially negative consequences for patients, AB 3087 (Kalra) – Health Care rates: Payment Board and limitations. The Board approved an Oppose position on this misguided bill. Many bills were related to controlled substances and are being opposed because they infringe on the practice of medicine (one proposed a three-day prescription limit on opioids). The Board also adopted expanded Academy policy on firearm violence prevention, including support of research into gun violence.
Goals for three priority areas for CAFP, payment reform, practice transformation and workforce, were reviewed and approved along with the final report on actions in each of these three areas from the 2016-18 CAFP strategic plan. The Board will provide input to the AAFP on health care reform issues and agreed to develop a new CAFP committee to address health equity and health of the public issues that intersect with the practice of family medicine.
The Board approved adoption or adoption as amended of five resolutions, three of which were submitted at the 2018 All Member Advocacy Meeting (AMAM) (the “A” resolutions) and two of which were submitted after the deadline (the “B” resolutions): Res. A-94-18 Removing REMS Categorization on Mifepristone; Res. A-07-18 Call for Physician Wellness as a Quality Indicator of Health Organizations; Res. A-08-18 Requiring an Evidence-Based Nutrition Curriculum for US Medical Schools; Res. B-12-18 Including Board Report F in Evidence-Based Academy Educational Programs; and Res. B-13-18 Open, Member-Driven Process for Policy Development for CAFP (the first Resolved was not approved, the second was amended, the third was adopted and the fourth was not adopted).
Seven other resolutions were referred to CAFP committees for review and recommendation back to the Board by its July meeting. A chart indicating action taken on all resolutions will be available on the CAFP website; resolutions received between meetings of the AMAM also will be posted on the website for member comment (as resolutions submitted to the Board at the AMAM already are). All authors will be notified of actions by the Board on their resolutions.
New Leaders Sworn In
AAFP President-elect John Cullen swore in CAFP’s new officers at the Saturday luncheon session of the Family Medicine Clinical Forum in Monterey: Lisa Ward, President, Walt Mills, President-elect, David Bazzo, Speaker, Shannon Connolly, Vice Speaker, Lauren Simon, Secretary-Treasurer; AAFP 2018-19 Delegate Carol Havens and AAFP 2018-19 Alternate Delegate Lee Ralph. Immediate Past President Michelle Quiogue received a standing ovation from attendees for the job she did as 2017-18 President. Other new additions to the CAFP Board include Alex Mroszczyk-McDonald, New Physician Director and Brent Sugimoto, Editor. Congratulations, welcome and thank you all!
Reproductive Health Initiative Launches
The CAFP's newest initiative, "Reproductive Health Care: Conversations for Family Physicians and Their Patients," kicked off this past weekend at the CAFP and West Virginia AFP chapter meetings. The three-year initiative includes a wide range of activities for family physicians and their practice teammates, including live and enduring CME, a performance improvement project that is approved for ABFM maintenance of certification Part IV credit, an online Learning Self Assessment module and a collection of tools and resources – all of which are free. For more information, visit www.familydocs.org/rhi.
Big Membership Renewal Outreach Happening NOW
If you haven’t renewed your CAFP/AAFP membership for 2018 yet, time is running out! AAFP mailed out final invoices to all unpaid members at the end of March. Members with unpaid dues and/or insufficient CME will be dropped from membership May 1! We obviously don’t want that to happen, so we’ll be engaging in an all-hands-on-deck outreach campaign throughout April. We love talking to our members, but renew now and we won’t bother you. You can renew online or by calling the AAFP Member Resource Center at (800) 274-2237, Monday through Friday between 6:00 am and 3:30 pm. Thank you for your membership.
Call for Applications: Student and Resident Council
Are you interested in a leadership opportunity with CAFP? We are seeking members to serve on the Student and Resident Councils for the 2018-2019 term. Council members help coordinate statewide student-resident activities and promote the exchange of ideas and strategies to advocate for family medicine in California. The councils exist to facilitate communication across the state, increase teamwork among all programs and establish lasting relationships between family medicine leaders. Please complete the following application if you are interested in becoming a member of the CAFP Student-Resident Council. Applications are due Tuesday, May 15, 2018.
CAFP Scholarship Opportunity to AAFP National Conference
The CAFP-Foundation provides a limited number of scholarships to support students and residents interested in attending the AAFP National Conference for Family Medicine Residents and Medical Students. This year's conference will be held in Kansas City, August 2-4, 2018. We are offering 12 scholarships in the amount of $750 each. If you are interested in this opportunity, please check out the scholarship details. Applications are due Tuesday, May 15, 2018.
California Public Health Care Program Roundup
Significant updates to numerous state-run health care programs are taking place. Here are some recent changes that may affect your patients and practice.
Medication Assisted Treatment (MAT) Expansion Project Update
California’s MAT Expansion Project strategically focuses on populations with limited access to MAT for treating opioid abuse, including rural areas and American Indian and Native Alaskan communities, and increases statewide access to buprenorphine. The California Hub and Spoke System (CA H&SS) has expanded the network of contracted spokes to more than 100 across more than 32 counties. Department of Health Care Services (DHCS) expects to initiate MAT bridge services this month at 12 participating emergency departments (EDs) across a minimum of six counties, which will induct patients into treatment in the ED and subsequently connect them with outpatient treatment centers for maintenance MAT. The Tribal MAT Project launched several services last month. This includes such programs as UCLA’s Project ECHO; Tele-MAT with academic detailing; and the MAT Champions, who will expand the existing network of local opioid coalitions, develop culturally-adapted MAT education materials and serve as MAT liaisons with tribal and urban American Indian partners. More information about the MAT Expansion Project is available on the DHCS website.
Trauma Screening Advisory Workgroup Holds First Meeting
Last year, Governor Brown signed CAFP-supported AB 340, which requires screening services under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program to include screening for trauma. The goal is to identify those children who suffered trauma early in life and provide them with preventative services. On April 20, 2018, DHCS will host the first meeting of the Trauma Screening Advisory Workgroup in Sacramento. The agenda and any meeting materials will be posted on the AB 340 webpage prior to the meeting.
Restoration of Adult Dental Services
After years of advocacy, full-scope dental coverage was restored starting January 1, 2018 for Medi-Cal adult enrollees ages 21 and older. Restored benefits include laboratory-processed crowns, posterior root canal therapy, periodontal services and partial dentures, including denture adjustments, repairs and relines. Visit the DHCS website to view a presentation on the adult dental benefit restoration that was given at the most recent Stakeholder Advisory Committee meeting.
Whole Person Care (WPC) Pilot Program
On April 30, 2018, DHCS will hold an in-person meeting with participating WPC pilot lead entities to discuss lessons learned and to share accomplishments. The overarching goal of the WPC pilot is the coordination of health, behavioral health and social services to improve beneficiary health and well-being for a particularly vulnerable group of Medi-Cal beneficiaries who have been identified as high users of multiple systems and continue to have poor health outcomes. The WPC pilots can be implemented by a county, city, health or hospital authority, or a consortium of these entities. The WPC pilot program just completed year two activities, which emphasized building service delivery and systemic infrastructure as well as implementing services. DHCS also began a new series of discussions aimed at addressing common barriers to care. The discussions covered such topics as re-entry (or hard-to-reach) populations, data sharing, care coordination best practices and successes, housing strategies and sustainability. For more information about the WPC pilot program, please visit the DHCS website.
Multipurpose Senior Services Program (MSSP) Renewal
DHCS is preparing for the renewal of the MSSP waiver program for an additional five-year term. The current MSSP waiver is set to expire June 30, 2019. The MSSP provides home- and community-based services to Medi-Cal-eligible individuals who are 65 years or older and wish to remain safely in their homes as an alternative to nursing facility placement. The California Department of Aging will engage stakeholders for recommendations on potential program changes to the MSSP waiver. Additional information on this stakeholder process will be available on the DHCS website. DHCS will undergo the same process for the Assisted Living Waiver (ALW) program, which expires February 28, 2019. The ALW program serves Medi-Cal-eligible individuals ages 21 and older and bridges the gap between independent living and nursing home care, offering an alternative to nursing facility placement and an opportunity for individuals to transition out of nursing facilities.
Cal MediConnect (CMC) Performance Dashboard
On March 15, 2018, DHCS released the quarterly CMC performance dashboard. The CMC program is a demonstration operated by DHCS, in partnership with the Centers for Medicare and Medicaid Services (CMS) and health plans, to provide better coordinated care for beneficiaries eligible for both Medicare and Medicaid services. The dashboard shows information and data measures on key aspects of the CMC program, including enrollment and demographics, care coordination, grievances and appeals, behavioral health services and long-term services and supports. The purpose of the dashboard is to highlight performance trends for program monitoring, quality improvement and data transparency.
MIPS Data Submission Period Closed and Preliminary Performance Feedback Data Now Available
The data submission period for the 2017 Merit-based Incentive Payment System (MIPS) closed on April 3, 2018. The Centers for Medicare and Medicaid Services (CMS) currently is in the process of reviewing all the data submitted. If you submitted data, you now are able to review your preliminary performance feedback data on the Quality Payment Program website. This is not your final score or feedback. Your final score and feedback will be available on July 1, 2018. Between now and June 30, 2018, your score could change. You will be able to access preliminary and final feedback with the same Enterprise Identity Management (EIDM) credentials that allowed you to submit and view your data during the submission period. Don’t have an EIDM account? Refer to the EIDM User Guide for instructions on how to create one. If you have questions about your MIPS performance feedback preliminary data, please contact the Quality Payment Program by phone: 1-866-288-8292/TTY: 1-877-715-6222 or email: QPP@cms.hhs.gov
Speak Out on the Future of Continuing Certification
The Vision Initiative, a collaborative effort created by the American Board of Medical Specialties, is conducting an important survey and needs your input to re-envision the future of continuing board certification and physician assessment.
The better data the Vision Initiative gathers, the clearer the answers will be regarding how the board certification process should evolve to truly serve the needs of physicians and their patients. Help construct the future of continuing board certification today.