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, November 9, 2018
Improving communication in high-risk diabetic patient care  

With an alarming number of Americans diagnosed with diabetes each year, The Physician Alliance launched several projects to improve the care of these patients.  
One such project is the High-Risk Diabetic Pilot Program, designed to increase the care management touch -rate in this population to improve patient engagement, increase self-management activities and reduce emergency department utilization. The pilot includes six primary care practices with care managers. Improving metrics in this population also allow s for additional funding to TPA, which helps keep dues low and assures continued infrastructure support.
Bi-directional communication between primary care and specialty physicians is vital to the management of high-risk diabetic patients. Here are some tips to improve care of this population:
  • Many TPA practices have embedded care managers. Specialists can improve communications with their primary care referral base by asking staff to contact care managers affiliated with the primary care practices.
  • Communicate relevant patient information to other physicians on the care team, whether referring a patient or sharing treatment recommendations.
  • Continue to engage patients in completing their diabetic HEDIS measures that include retinal exams, HbA1c and blood pressure control, attention for nephropathy and other HEDIS preventative testing.
In addition, please feel free to share your suggestions on ways to improve bidirectional communication between PCP and endocrinology practices to improve patient care. Contact Francine Burley, MSN, RN, CPHQ at or (586) 498-3588   to obtain information on care manager contacts or for more information.
A variety of diabetes-related patient education materials are available on TPA's website (under the Learning Center tab). Read more about the diabetic clinical projects featured in the last quarterly newsletter.
New patient materials reinforce non-antibiotic use  
In an ongoing effort to help physicians engage in communication with patients, improve quality metrics and decrease healthcare costs, The Physician Alliance created a variety of patient education materials. These resources align with key health and HEDIS measures.

The newest poster provides "6 tips for managing bronchitis," and ties into the Resource Stewardship Initiative that TPA participates in to decrease unnecessary antibiotics and diagnostic tests. Other materials related to this RSI measure focus on managing a viral infection (without antibiotics).

To view all of the education materials available complimentary to members, visit TPA's website.
CMS announces updates, delays new E&M codes 
This past summer, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the 2019 Physician Fee Schedule and the Quality Payment Program (QPP) rule that would address provider burnout and provide clinicians immediate relief from excessive paperwork tied to outdated billing practices.CMS accepted comments on the proposed changes, resulting in thousands of entries from healthcare providers.
 The Physician Alliance also submitted a comment on behalf of physician members.    
CMS announced new Evaluation/Management documentation, effective Jan. 1, 2019. These will:  
  • No longer require physicians to re-document information that's already been documented by the practice staff or patient.
  • Only require physicians to document the patient's history since the previous visit.
The new CMS rule also provides access to "virtual" care for Medicare recipients. According to CMS, Medicare will "pay providers for new communication technology-based services, such as brief check-ins between patients and practitioners and pay separately for evaluation of remote pre-recorded images and/or video." CMS will continue to expand the list of Medicare-covered telehealth services. Also, effective Jan. 1, 2019,  payments for new drugs under Part B will be reduced, decreasing out-of-pocket costs for seniors.
CMS decided not to reduce payment for office visits when they are performed on the same day as another service. In response to public concerns and suggestions, CMS announced
implementation delays of E/M coding reforms until 2021. Click here to read the full final rule. 
Michigan launches new website to fight opioid epidemic 
In the past five years, more than 7.5 million Michigan residents have received more than 1.3 million prescriptions, resulting in 5,261 overdose deaths, according to the Michigan Department of Licensing and Regulatory Affairs.

In continuing efforts to combat the growing opioid epidemic in the state, Michigan recently launched a new website bringing together information on opioid addiction and treatment from various state departments and community organizations. Resources are targeted toward the public (addicts, families, etc.), prescribers and pharmacists.

Treatment centers, medication take back locations, hotlines, and other resources are included on the site. It also provides information on the Michigan Automated Prescription System (MAPS), the state's prescription drug monitoring program. As a reminder, prescribers are required to register with MAPS before prescribing a Schedule 2-5 controlled substance or exceeding a three-day supply.
News you can use

Michigan launches opioids website, Crain's Detroit   
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The Physician Alliance | 20952 Twelve Mile, Suite 130, St. Clair Shores MI 48081 | 586-498-3555 |