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American Society of Interventional Pain Physicians News | November 30, 2016
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 Might Healthcare Undergo a 'Trump Revolution?'
 The election result shook the world. As the vote counts started to come in, most of the country descended into a state of collective shock and disbelief -- even Mr. Trump's own supporters. Nobody seemed more surprised than the political pundits on all the cable news channels, who had for months incorrectly predicted the opposite result.
But in the days after Hillary Clinton's defeat, like millions of people across the country, I reflected on what had happened and tried to understand how everything had gone so unexpectedly wrong. Then I began thinking more about some of his talk about a "privileged and disconnected elite" (although some may say he was part of that), "power of big business interests," and "too much regulation."
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President-Elect Trump Makes Bold Healthcare Appointments
 President-elect Donald Trump has selected Georgia Rep.Tom Price, a leading critic of President Barack Obama's sweeping health care law, to head the Department of Health and Human Services.
Price is expected to be confirmed by the Senate, and would play a central role in Republican efforts to repeal and replace the current healthcare law.
ASIPP has worked with Rep. Price closely and he is friends with many of ASIPP's Georgia members and members of the Georgia Society.
Also, Seema Verma was picked to become administrator of the Centers for Medicare and Medicaid Services. Verma is well-known to Indiana's members.
 She is currently the President, CEO and founder of SVS, Inc, a national health policy consulting company. She has played a major role in developing many of the recent Medicaid reform programs, including Indiana's Medicaid program.
Indiana
is among a handful of states that took federal aid through the Affordable Care Act to expand Medicaid eligibility. But unlike most traditional Medicaid expansions, Indiana set up a system that requires many low-income residents on the program to pay small monthly contributions for their health coverage.
Both of President-elect Trump's appointments are crucial for interventional pain management and ASIPP.
Related Articles:
Trump Signals Big Health Policy Changes Are Coming
WASHINGTON
-In tapping Rep. Tom Price and Medicaid consultantSeema Verma Tuesday for top health positions, President-electDonald Trump has signaled that he intends to put conservative health-policy goals at the forefront of his administration.
Wall Street Journal
Access to this article may be limited.
Trump Picks 'Godmother' of Medicaid Reform to Run CMS
President-elect Donald Trump's selection of healthcare consultant
Seema Verma, MPH, to run the Centers for Medicare & Medicaid Services (CMS) is a sign that the focus of CMS for the next few years will be largely on Medicaid, according to one healthcare expert.
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| No More Interventional Techniques in Oregon - Soon It May Be Coming to the Rest of the Country
The Oregon Health Evidence Review Commission, without fanfare and without even looking at the literature appropriately, is eliminating coverage for what appears to be ALL spinal interventional techniques, now or in the next few months. They have issued draft coverage guidance strongly recommending against coverage for epidural, facet joint, medial branch, and sacroiliac joint injections for low back pain, regardless of etiology.
It is time to mobilize our forces across the nation. As you all know, this is based on the inappropriate evidence synthesis that was performed with intellectual bias by Chou et al from an organization which is facing extinction in its own - the Agency for Healthcare Research and Quality (AHRQ).
Please see the letter we have drafted for presentation to the Oregon Health Authority. The comment period ends on December 9, 2016. We encourage you and every provider in your practice to submit all your signatures including your name, title, city and state, as soon as possible, no later than December 6, to Savannah Gold at [email protected].
We will be enclosing an extensive citations list apart from this letter.
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ASIPP Qualified Clinical Data Registry (QCDR) for Interventional Pain Management is Progressing
So far over 110 practitioners have expressed interest to join this historic registry to meet criteria of Merit-Based Incentive Payment System to avoid penalties and reap bonuses and also provide an outcome registry to show how interventional pain management is effective.
As we have seen over the past several months, Merit-Based Incentive Payment System (MIPS) has taken many turns. We have written a comment letter with 4,534 signatures and also went to Washington. We made great strides.
While MIPS requirements have been substantially relaxed in reference to penalties, we need to focus on making bonuses and also putting ourselves into exceptional categories which may yield bonuses of over 20% in the beginning.
To achieve this, the major tool is to publish measures excessively than required and follow through Qualified Clinical Data Registry (QCDR) registry.
The advantage of QCDR registry will be not only that we will use many of the existing measures, but also we have to incorporate multiple interventional pain management specific measures to show the outcomes. Thus, this registry will not only meet the criteria for MIPS, but will also provide us with outcome measures across the nation.
Consequently, the American Society of Interventional Pain Physicians (ASIPP) is developing a Qualified Clinical Data Registry (QCDR) alongside our technology and analytics partner ArborMetrix. Our goal is for ASIPP to be a QCDR for the Centers for Medicare and Medicaid Services' Merit-Based Incentive Payment System (MIPS) for 2017 and beyond, as the Physician Quality Reporting System (PQRS) transitions to MIPS.
Why is ASIPP developing a QCDR?
As ASIPP has communicated over the past several months, the existing measures and reporting options available through CMS are not adequate for our specialty. They do not reflect the procedures and nuances of interventional pain management. The QCDR we are developing will provide ASIPP members the ability to meet CMS quality reporting requirements through MIPS while utilizing measures specific to the specialty.
Why do I need to participate in a QCDR?
Participating in a QCDR is one way to meet requirements mandated to you by CMS under MIPS. In 2017, if you are a solo practitioner, in a group practice, or work as a consultant, and you bill Medicare Part B, you are required to report through MIPS. Doing so will allow you not only to avoid negative payment adjustments but also potentially to receive gains in 2019 for reporting in 2017.
What are the benefits of participating in the ASIPP QCDR?
- You will be able to report on the specialty-specific measures ASIPP is developing. These measures will be more relevant, clinically appropriate, outcomes oriented, and meaningful to interventional pain physicians than general measures defined through MIPS. They will also help drive meaningful quality improvement in the specialty.
- You will meet CMS requirements for reporting in 2017 to avoid penalties of up to 4% of your Medicare reimbursements and the specialty-specific measures will give you a better chance to optimize incentives (even leading to exceptional performer) and avoid penalties under MIPS.
- You will be better prepared for CMS quality reporting in future years when penalties and incentives get even larger. By 2022, the impact on your CMS payments will range from a penalty of 9% to incentives of upwards of 9% (may be as high as 21 - 30%), depending on your reporting performance.
How do I enroll in the ASIPP QCDR?
The first step is to let us know you are interested by replying to this email. Once we have garnered enough interest, we will be in contact with details of the enrollment process. Participating in the ASIPP QCDR will be $500 per year for physician for ASIPP members, $750 for non-members. For physician assistants and nurse practitioners the cost is 20% less (i.e., $400 for members or $600 for non-members).
What is the timeline for participation?
ASIPP must enroll at least 200 physicians in our QCDR by November 30, 2016 to meet this initial milestone.
Where can I find additional information about QCDR participation?
The CMS website has information on QCDR. We will be making more ASIPP-specific information available soon.
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 LIMITED TO 20 REGISTRANTS
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Click HERE for more information and to register.
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| Listen to November Podcast!
 On the November 2016 edition of the ASIPP Podcast we'll list the didactic courses ASIPP has scheduled for next year; we'll meet ASIPP's new director of operations; in the news segment we'll find out if pain is contagious, the latest medical marijuana news, some pediatric pain news, and much more; and we'll wrap things up with a study about whether rats are ticklish.
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Will administer in June
The American Board of Interventional Pain Physicians (ABIPP) has developed certification programs that recognize accepted levels of knowledge and expertise in the interventional pain management profession, with the goal of improved patient care. Hundreds of qualified physicians have made the commitment to become ABIPP certified. ABIPP is recognized in 11 states. Ten states have no statutes governing specialty boards. Approval is pending in remaining states.
ABIPP is a Specialty Board providing certifications in the following areas:
Board Certification in Interventional Pain Management
Either with ABMS pain medicine board certification or ABMS primary certification only
Competency Certification in:
- Interventional Pain Management
- Regenerative Medicine
- Controlled Substance Management
- Coding, Compliance, and Practice Management
- Fluoroscopic Interpretation and Radiological Safety
- Endoscopic Spinal Decompression
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Opinion: Lame duck Congress looks for swift approval of massive medical innovation bill
While most Americans were more focused on family gatherings, turkey dinners, football and Black Friday shopping trips, Republicans in the Congress quietly unveiled a massive health policy initiative over the Thanksgiving break - what seems to be a legislative Christmas tree on health policy - that lawmakers hope to speed through the House and Senate before wrapping up work for the year.
Known as the "21st Century Cures Act," the $6.3 billion plan is designed to spur new medical innovation and research by the federal government - but at almost 1,000 pages of legislative text - it's also rapidly become a magnet for action on other varied health-related issues in the Congress.
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Paul Ryan is determined to kill Medicare. This time he might succeed
Bu
rsting with the policymaking power that control of both houses of Congress and the White House gives Republicans, House Speaker Paul D. Ryan (R-Wis.) has lost no time in teeing up a favorite goal: gutting Medicare.
In an interview with Fox News Channel only days after the election, Ryan said: "Obamacare rewrote Medicare ... so if you're going to repeal and replace Obamacare, you have to address those issues as well. ... What people don't realize is that Medicare is going broke, that Medicare is going to have price controls. ... So you have to deal with those issues if you're going to repeal and replace Obamacare. Medicare has got some serious problems because of Obamacare. Those things are part of our plan to replace Obamacare."
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Opioid Epidemic
'Dreamland' Author Takes an Opioid Epidemic Trip Investigative journalist Sam Quinones talks about the crisis
The U.S. opioid epidemic left roughly 30,000 people dead in 2014 -- with overdose deaths outnumbering fatalities from car accidents in 16 states.
In his book, "Dreamland: The True Tale of America's Opiate Epidemic," Sam Quinones, a former reporter for the
Los Angeles Times
, traces the history of this epidemic, and the forces that fueled the crisis to grow, unnoticed and unabated for years.
The story begins in the "ranchos" of one small Mexican community, continues at paid speaker training seminars in Boca Raton, Fla., and slowly unravels in places like Portsmouth, Ohio; Huntington, W.Va.; and Denver.
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Fentanyl & Heroin Changing U.S. Opioid Epidemic
A prominent Alabama physician says the U.S. opioid epidemic has changed so profoundly in the last 3 years that a serious reconsideration of government policy is needed.
Stefan Kertesz, MD, an associate professor at the University of Alabama at Birmingham School of Medicine, says heroin and illicit fentanyl are now the driving forces behind the opioid epidemic - not prescription pain medication.
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Start Planning NOW!
ASIPP® Abstracts Submission for 2017 Annual Meeting OPEN
 Registration will be open for Abstract Submissions is now available.
The American Society of Interventional Pain Physicians will hold its 19th Annual Meeting April 20-22 in Las Vegas at Caesar's Palace.
This year, we will be making significant changes to the Abstract and Poster Sessions. Submissions will be in two categories: Resident/Fellow and Physician. Selected posters will be on display forall meeting participants during all breaks and meal times.
The Abstract Committee will select the top 25 for publication in Pain Physician and of those 10 will be selected for Abstract presentation and judging during the Annual Meeting. The top 3 will receive cash prizes.
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JNIS Editor's Choice Article:
Analysis of vertebral augmentation practice patterns: a 2016 update
Abstract
Objective
To evaluate procedure utilization patterns for vertebroplasty and kyphoplasty in the US Medicare population from 2004 to 2014.
Methods
The analysis was performed using the Centers for Medicare and Medicaid Services database of specialty utilization files for the fee for service (FFS) Medicare population.
Results
The FFS Medicare population increased by 28% with an annual increase of 2.5% from 2004 to 2014. Utilization of vertebroplasty procedures decreased by 63% with an average annual decrease of 9.5% from 2004 to 2014 per 100,000 FFS Medicare beneficiaries. During the same time period, kyphoplasty procedures decreased by a total of 10%, with an average annual decrease of 1.3%. For augmentation generally (combined vertebroplasty/kyphoplasty data) there was thus an overall decrease in the rate per 100,000 Medicare population of 32% from 2004 to 2014, with an average annual decrease of 4.8%. The majority of vertebroplasty procedures were performed by radiologists whereas the majority of kyphoplasties were performed by orthopedic surgeons and neurosurgeons.
Conclusions
There has been a significant decline in vertebroplasty and kyphoplasty procedures in the FFS Medicare population between 2004 and 2014.
Click
HERE to read full article
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On the Need to Update the Definition of Pain
Pain, in particular chronic pain, is a private and subjective experience. While many studies have elucidated some of the intricacies of the chronic pain experience, the definition of pain has not adapted to current knowledge.
1,2
In fact, the precise definition of pain varies depending on literature source. Indeed, individual levels of pain tolerance, and varying descriptorsused to express pain, illustrate the challenge of a unifying definition that address the spectrum of pain experience.
The challenges, when attempting to define pain were highlighted by Joanna Bourke, PhD, professor of History, at Birkbeck, University of London: while acknowledging that pain is difficult to both describe and define, she argues that the sensation of pain refers to the experience, not what is experienced.
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State Society News
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Physicians Wanted To view or post a job, please go to: http://jobs.asipp.org/home To receive a member discount for posting a job, use member code: 20Member |
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