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, January 20, 2017
TPA seeks physician input for telehealth services

Blue Cross Blue Shield of Michigan is considering expansion of opportunities for physicians to engage their patients through the use of telehealth services. The Physician Alliance is participating in the development of the new TeleHealth Initiative to be launched in early to mid-2017. TPA is seeking primary care physicians interested in adopting telehealth services and who are available to participate in development meetings with TPA staff to launch the initiative. Participating primary care physicians must be participating in BCBSM's Physician Group Incentive Program (PGIP) through TPA.
Most of the work will center around the concept of real-time visits between physician and patient, however future development will include other areas such as how this impacts the Patient-Centered Medical Home care model and any other opportunities linked with telehealth services. TPA anticipates variation in expected use as some providers may prefer to outsource these services and others may prefer to offer it directly.

Whether you prefer providing telehealth services directly or offering the service through a third party, TPA wants to hear from you! If you are interested in participating in the development of these services please contact to indicate your interest and availability. 
CMS pays for voluntary Advance Care Planning
The Centers for Medicare & Medicaid Services (CMS) began paying for voluntary Advance Care Planning (ACP) in 2016 under the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (OPPS). ACP helps patients make decisions that give them control over the type of care they receive.  Get tips for the billing and coding related to this important patient plan.  
Provider Delivered Care Management materials updated
Engrained in the Blue Cross Blue Shield of Michigan (BCBSM) Patient Centered Medical Home (PCMH) program, Provider Delivered Care Management (PDCM) is a model where care management is provided within the primary care physicians' practice by trained care managers. Blue Cross Blue Shield of Michigan (BCBSM) expanded its Provider Delivered Care Management (PDCM) participation to all Patient Centered Medical Home (PCMH) designated practices. PDCM is the mechanism used by BCBSM to reimburse for care management and care coordination activities for BCBSM members through the billing of care management codes.

The Physician Alliance aims to provide the necessary support to practices to ensure success in the integration of care managers into primary care practices, billing of the 13 PDCM codes, and building additional program criteria to increase revenue growth and improving the quality of care and patient satisfaction.

To view the updated information, presentation and training materials, visit the PDCM section on TPA's website.
Teleconference hosted on Provider Delivered Care Management updates
What:  2017 BCBSM PDCM Updates Teleconference

When: Tuesday, January 24, 2017, 8-9 am 
Who:  Practices participating in CPC+, SIM and/or PDCM initiatives or practices looking for more information about those initiatives; physicians, office managers, care managers, billers, care coordinators
Where: Teleconference (access information will be emailed to those who register.)
Why: There are quite a few changes to the BCBSM PDCM initiative for 2017. To maximize earning potential for 2017 and 2018, valuable information will be presented to help meet targets. Highlights of changes to the program will be addressed and practices will have opportunities to ask questions and obtain clarification. Fran Burley from The Physician Alliance has sent handouts about the changes in an email to eligible practice staff so this teleconference addresses these and more.

Register: Contact Fran Burley at - you will then receive access information for the teleconference.

Contact Fran with questions or if you need additional information.  
Tips to protect your practice from a HIPAA breach

Breaches, hacking, ransomware and more were rampant in 2016. Healthcare data continued to be a valuable asset on the black market.

Here are some quick tips to help protect your practice from HIPAA breaches and more:
  1. Backup everything! Make sure to have easily accessible backups in case your practice faces ransomware or any type of breach.
  2. Perform your HIPAA risk assessment - and make sure your staff is trained and able to act if a breach occurs. Make sure your policies and procedures are updated and appropriate for your practice.
  3. Staff is your first protection - or weakness - when it comes to cybercrime. Make sure your staff is aware of potential risks and takes cybersecurity very seriously. Conduct regular trainings to prevent staff related incidences.
  4. Update software and protections against attacks. Outdated software can be an easy target for hackers.
  5. Make sure that your business associate agreements (BAAs) are in place and up to date - many breaches in 2016 hit vendors. BAAs are a great way to make sure your practice is protected when a vendor is breached.
Continue to stay alert in 2017. Patient information is extremely valuable and awareness is essential. Staff should also be on high alert for any oddities that could potentially be a scam.

Source: Rickard & Associates is a partner in TPA's Physician Discount program, providing legal services in a variety of areas, including HIPAA compliance, risk assessments, employee issues, contract negotiations and more.
Seminar focuses on diagnosis / management of osteoporosis
St. John Providence Orthopedic Center of Excellence is hosting a seminar on Thursday, Jan. 26 at 6:30pm in Warren focusing on problems that exist with diagnosis and management of osteoporosis. The program will also discuss solutions such as implementation of a Fracture Liaison Service (FLS) - a coordinated preventive and post-fracture care model that operates under the supervision of bone health specialists and fosters collaboration with the patient's primary care physician.

For more information, including registration details, download the flyer  
LoVasco Consulting Group helps practices with insurance, employee benefits, and retirement planning solutions. TPA members receive access to proprietary insurance products and a complimentary financial evaluation of their employee group health benefits program .

  Learn more about these services.
The Physician Alliance | 20952 Twelve Mile, Suite 130, St. Clair Shores MI 48081 | 586-498-3555 |