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CareSource

Womens Telehealth

Tanya Mack and Jason Bearden

CareSource

Beginning, July 1 st , CareSource, an Ohio based Care Management Organization (CMO) will expand into the
Georgia market and begin serving a portion of Georgia’s 1 million Medicaid consumers and become the
state’s 4 th CMO. They will share an over $4B agreement over the next 6 years with GA’s other CMO
providers. The company is the second largest CMO in the US.

They are unique already as they are the only GA CMO that is non-profit, their top leader is a woman and they are poised to bring some innovative
programs to the Georgia market. Listen in as we welcome top Caresource leaders to Georgia and hear about their plans.

  

Dr. Tarik Shaheen and Iris Telehealth

 

Dr. Tarik Shaheen and Iris Telehealth

Attention Deficit Hyperactivity Disorder, or ADHD is now the most prevalent psychiatric illiness of young people in America, affecting approximately 11% of children between the ages of 4-17. This brain/mental health disorder is characterized by inattention, impulsivity and hyperactivity. The cause is unknown, but suspected to be a link between genetic and environmental factors.

ADHD affects males almost 3x more than females. Complicating this problem in our healthcare system is both a lack of access (especially in rural areas) and a shortage of child psychiatrists and counselors. Join our segment today as one of the top child psychiatrists discusses ADHD and his company’s unique approach to provide these services via telehealth.

www.iristelehealth.com

 

Does My Practice Still Need To Prepare For MACRA?

Medical Association of Georgia

Sydney Welch

Does My Practice Still Need To Prepare For MACRA?

Lawmakers changed the way Medicare physicians and other health care professionals are paid
when they passed the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015.
MACRA resulted in the Medicare Quality Payment Program (QPP), which is designed to move
physicians from a fee-for- service program to a value-based payment system.

The actions that physicians take in 2017 will determine what they get paid in 2019. The Centers for Medicare, Medicaid Services’ goal is to tie 90 percent of all Medicare fee-for- service payments to quality or value by the end of 2018. The QPP replaced the Medicare SGR, and it is a zero-sum gain
program – which means that there will be winners and losers. Physicians could see their pay
increase or decrease by as much as four percent in 2019, depending on what they do in 2017.

The QPP established two paths for physicians to take, including the Merit-based Incentive
Payment Program (MIPS), which is a modified fee-for- service system, and Advanced Alternative Payment Models (APMs), which is a track for physicians who are already participating in one of the eligible advanced alternative payment models. It is crucial for physicians to figure out how to fulfill their QPP reporting requirements to avoid any cuts in pay in 2019 – as well as determining whether they will go above and beyond the minimum requirements to position themselves for a pay increase in 2019.

Finally, it is highly unlikely that MACRA/MIPS will be revised or repealed in the foreseeable
future.

Sidney Welch is the chair of Health Care Innovation at Polsinelli PC. Sidney counsels physicians, physician practices, and health care technology clients in transactional, regulatory, administrative law, and litigation matters on a national basis. She serves in leadership roles for the ABA Health Law Section, the America Health Lawyers Association, and the American Society of Medical Association Counsel.

Sidney has a bachelor’s degree from Davidson College, a master’s degree in public health from the George Washington University School of Medicine and Health Sciences, and a law degree from Samford University. It is also worth noting that she has written a regular feature for MAG’s quarterly Journal since 2008.

Womens Health Week

Womens Telehealth

Dr. C. Anne Patterson

Womens Health Week

This week marks national “Women’s Health Week” in America! The goal is empower women to make their health a priority and to take time out to reflect on how we can improve our health. Women are never too busy to take care of their health! Dr. Anne Patterson, a board-certified OBGYN and past President of the GA OBGYN Society will be discussing steps women can take to improve and maintain their health throughout their lives and preventive screenings for women.

Talking About Bad Outcomes

Medical Association of Georgia

Dan Huff

Talking About Bad Outcomes

All medical malpractice cases involve bad outcomes that generally involve significant damages.
In addition to the patient and their family, bad outcomes often devastate the physician and other
care providers. Unfortunately, bad outcomes are unpreventable in many cases.

How a physician handles a bad outcome with the patient and their family is critical when it comes to avoiding litigation, and how a physician responds to a bad outcome can say more about them than the fact that the bad outcome occurred.  In the event of a bad outcome, the interest of the patient must be first and foremost.

A physician must put his or her pride aside and do what is best for the patient under the circumstances – and the patient’s needs and timeliness should always govern the decision-making process.  Good communications and documentation are also important factors when a bad outcome occurs.

All medical malpractice cases involve bad outcomes that generally involve significant damages.
In addition to the patient and their family, bad outcomes often devastate the physician and other
care providers. Unfortunately, bad outcomes are unpreventable in many cases.  How a physician handles a bad outcome with the patient and their family is critical when it comes to avoiding litigation, and how a physician responds to a bad outcome can say more about them
than the fact that the bad outcome occurred.

In the event of a bad outcome, the interest of the patient must be first and foremost. A physician
must put his or her pride aside and do what is best for the patient under the circumstances – and
the patient’s needs and timeliness should always govern the decision-making process.  Good communications and documentation are also important factors when a bad outcome occurs.

Genteel Device Takes Pain Out of Glucose Monitoring

Genteel Device Takes Pain Out of Glucose Monitoring

Genteel LLC manufactures and sells a lancing device for those with

diabetes who either avoid, or limit, their blood glucose checks because of the anxiety and pain of the

dreaded finger stick! Developed by Dr. Christopher Jacobs, biomedical engineer, Genteel is the only

stand-alone lancing device, 510K cleared by the FDA for both fingers and alternate site testing.

MAG’s Sponsored MEP 401k Plan

ACG Wealth

Kevin Rainwater

MAG’s Sponsored MEP 401k Plan

MAG member practices can reduce their fiduciary liability, lower plan expenses, and retain
their employees by participating in the MAG-sponsored 401(k) retirement plan that’s available
through ACG Wealth. The MAG 401(k) Plan is treated like one large plan from a government
Form 5500 reporting standpoint. In short, the MAG 401(k) Plan offers the advantages and
flexibility of a stand-alone plan while avoiding the expenses and administrative headaches
associated with sponsoring a stand-alone plan.

Member benefits include…

  • Cost savings on the investments
  • No individual Form 5500 reporting
  • Minimal plan maintenance
  • Flexible plan features, including safe harbor
  • Roth and profit sharing
  • Customizable 401(k) plan design options involving eligibility, matches, and vesting schedules
  • No audit at member level

By participating in the MAG 401(k) Plan, virtually all of the administrative tasks can be offloaded from the practice to ACG Wealth and MAG.

Kevin Rainwater is a managing partner with Atlanta Capital Group. He specializes in retirement planning.  Kevin began his career in the financial services industry more than 16 years ago. He has a passion for helping employees, executives and business owners reach their retirement goals. Kevin provides investment and plan advisory services to companies and individuals throughout the nation.

He relies on his extensive knowledge of qualified plan design and investment offerings to provide business owners and participants with the most competitive retirement plan option available.

AMCP Foundation Executive Director Paula Eichenbrenner

AMCP

Paula Eichenbrenner

AMCP Foundation Executive Director Paula Eichenbrenner

I sat down with Executive Director of the AMCP Foundation, Paula Eichenbrenner, to talk about some of the emerging research trends likely to have an impact on managed care pharmacy over the next few months and years.

AMCP CEO Susan Cantrell

AMCP

Susan Cantrell and CW Hall

AMCP CEO Susan Cantrell

I sat down with AMCP CEO Susan Cantrell at the spring conference in Denver.  She shared an update on a few of the issues leaders and pharmacy clinicians are dealing with this year.  Some top areas of focus include contracting with pharmaceutical companies.  Value-based reimbursement is emerging as a new trend that will likely gain traction over the coming year.

Jim Kenney, Manager of Specialty and Pharmacy Contracts at Harvard Pilgrim, lead a session titled “Approaches to Managed Care Contracting with Pharmaceutical Manufacturers.” This session discussed innovations in managed care pharmacy contracting, including indication-based contracts and price protection arrangements.

The Boston Globe recently reported on two Harvard Pilgrim pay-for-performance programs focused on rheumatoid arthritis and osteoporosis aligned with adherence and effectiveness measures. The strategy is designed to curb spending while giving patients access to costly treatments.

Healthcare Risk Management Review described the launch of an Enhanced Medication Therapy Management (MTM) program by Tabula Rasa HealthCare. This pilot program of the Part D Enhanced MTM Model involves seven states: Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming. The article shared requirements of the Centers for Medicare and Medicaid Innovation (CMMI), which oversees the model.

And of course, the AMCP conference featured speakers discussing the possibility of repeal/replacement of the ACA and the impacts such a change would have on the pharmacy landscape.