The Pulse is the bi-weekly e-newsletter from The Physician Alliance, one of Michigan's largest physician organizations serving more than 2,200 primary care and specialty physicians.
The Pulse of The Physician Alliance
Friday, Oct. 14, 2016
Patient education posters available for free download

The Physician Alliance created a variety of health-related education posters that are available free of charge to practices. These posters are meant to stimulate conversations with patients regarding important preventive screenings, decreasing utilization of tests and more. Practices are encouraged to download and print these materials to display in waiting areas and exam rooms, and share with patients. 

Examples of poster topics include tips for managing low back pain, using antibiotics for bronchitis in adults, wellness exam reminders checklist, colorectal cancer screening facts and more.

Download posters from The Physician Alliance's website
Use caution when sending patient information via email
Guidelines for complying with HIPAA privacy and security rules
Contrary to common assumptions, Health Insurance Portability and Accountability Act (HIPAA) technically does not require the use of encryption to secure your patients' private medical data (aka, electronic Protected Health Information or ePHI).


If you determine that encryption is not reasonable and appropriate, then you must document your rationale for that decision and implement an equivalent alternative to encryption that "is reasonable and appropriate." Although encryption is not a requirement under the HIPAA Security Rule, ePHI transmitted via email should be encrypted.

Sending unencrypted email is like sending a postcard. The email (postcard) has no envelope and anyone that touches it can read the contents. It's even worse for the digital world because it's accessible by anyone connected to the Internet. Encrypting email content is like putting it in a sealed envelope that only the recipient can read.

Not using encryption is too risky for your patients' ePHI. It is even riskier for your business because according to the breach notification rule under Health Information Technology for Economic and Clinical Health (HITECH) Act every incident of unencrypted ePHI requires you to provide time-bound notifications to: (1) affected patients; (2) the Secretary of HHS (i.e., the federal government); and/or (3) prominent local/state media outlets.

What about using Yahoo, AOL or free Gmail to send ePHI? The HIPAA Omnibus Rule expands the definition of HIPAA Business Associates to cloud providers. Some of the cloud providers include Google, Yahoo, AOL, Amazon, Microsoft, and Dropbox. As HIPAA Business Associates, cloud providers are required to sign Business Associate Agreements (BAA) with Covered Entities. Unfortunately, Yahoo and AOL will not sign a BAA. Google, Microsoft and Dropbox will sign a BAA if you use the paid apps service. It is a HIPAA violation if practices are using free email services via Gmail, Yahoo and AOL and there is ePHI stored in emails.

The best way to protect your patients is to use a solution from a HIPAA compliant vendor and use secure email by one of your partners, such as, or signing for Direct Messaging provided by your EMR/population health registry vendor, Wellcentive.

If you have any question or need TPA assistance in setting up secure email process, please contact us at
TPA members receive resources for patients at fairs

The Physician Alliance hosted three community resource fairs to share valuable information from nonprofits and community organizations that serve patients in the metro Detroit area. More than 170 physicians and practice staff attended the fairs, and 15 organizations hosted information tables to distribute information. Attendance at the fairs satisfied a practice's 'linkage to community services' Physician Group Incentive Program capabilities. Thank you to everyone who attended these events! 
Another path to payment in CMS' MACRA program

This is the 3rd article in our series regarding the Medicare Accountability and CHIP Reauthorization Act (MACRA) program. MACRA shifts reimbursements away from the current fee-for-service to a pay-for-value payment system.

The first path to payment discussed was MIPS (read that article). The 2nd path to payment reform by Medicare is the enrollment in an Alternative Payment Model (APM). APMs are new approaches to pay health care providers for medical care given that incentivizes for quality and value. These approaches include criteria developed to allow primary care physicians opportunities to participate in Advanced APMs through medical home models. The following models are qualified APMs:


1. Medical Shared Savings Program Accountable Care Organization

2. CMS Innovation Center Model (other than a health care innovation award recipient)

3. Medicare Health Care Quality Demonstration Program

4. A demonstration program required by federal law


The proposed rule outlines specific criteria for determining what would qualify as an Advanced APM. E ligible Professionals (EPs) must accept financial risk for their patients as part of the criteria for participation in an Advanced APM.

In order for clinicians to qualify for incentive payments from Medicare, they would need to receive enough of their payments through Advanced APMs (or see enough of their patients through Advanced APMs).

EPs must meet three requirements to be included in the proposed Advanced APMs:
1. Use of certified electronic health records technology (CEHRT)
2. Use of quality measures comparable to MIPS quality measures
3. Requires entities to bear more risk than nominal financial risk. Financial risk standards are one of the following ways:
A. Direct payment from APM entity 
B. Reduction in payment rates to APM 
C. Withhold of payment to APM entity or EPs

Examples of Advanced APMs are Comprehensive Primary Care Plus, Comprehensive End Stage Renal Disease Care Model, Next Generation ACO Model, Medicare Shared Savings Program -Track 2 and Track 3, and the Oncology Care Model.

With the creation of MACRA, CMS will be rewarding clinicians to provide higher quality care to Medicare beneficiaries through MIPS and APMs payment models. Under this proposed rule, CMS would annually update the payment models that qualify for Advanced APMs.

For more information visit CMS' MACRA overview.  
News you can use
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