American Academy of Ophthalmology Web Site: www.aao.org
“Pay for Performance” May Become an Important Component of SGR Fix
In January the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare payment issues, recommended adoption of a quality incentive payment policy for physicians and other providers. And lawmakers appear to be listening.
In February, the chairman of the House Ways and Means Subcommittee on Health indicated that efforts to replace Medicare’s sustainable growth rate system may include a quality component. The idea appears to have bipartisan support.
The sustainable growth rate—a flawed formula. The SGR is a formula that helps determine physician pay, and it is largely responsible for the looming 5 percent cut for 2006 and similarly sized reductions for the following six years. For months, congressional aides have said that fixing the SGR payment system—which lawmakers on both sides of the aisle say is flawed and outdated—likely will include a mechanism that moves physicians toward performance-based payment.
“Pay for Performance.” Under MedPAC’s proposal, 1 percent to 2 percent of all Medicare physician payments would be set aside to make higher payments to physicians who participate in quality reporting programs. While legislators view the proposal as budget neutral, it could have a not-so-neutral impact on physicians, especially those who can’t or choose not to participate.
Ophthalmology coordinates strategy. In response, the Academy is ready to fight to ensure that ophthalmologists can compete for the differential pay. In January, the Academy met with key leadership from ophthalmic subspecialty societies to present its strategy. The AMA has so far taken no formal position on Medicare “Pay for Performance,” but the AMA’s House of Delegates is expected to take up the issue at a meeting in June.
Demonstration programs are under way. The Centers for Medicare and Medicaid Services is testing the concept in several demonstration programs launched this year. The quality measures used in the demonstrations mostly relate to primary care physicians and chronic disease management, but some include provider adoption of health information technology measures. If these programs are implemented more broadly before results of the demonstrations are known (perhaps within the next two years), the emphasis will be on participation in reporting rather than on performance and outcomes.
An insider’s perspective. “For ophthalmologists to become involved, the Academy will need to submit evidence-based performance measures and concurrently develop Category II codes that can identify when the service has been performed,” said William L. Rich III, MD, former Academy secretary for Federal Affairs and chairman of the RVS Update Committee.
Historically, the Academy has been a leader in quality of care issues, said Dr. Rich. The Academy began looking at performance measures in the early 1980s, which resulted in publication of the Preferred Practice Patterns. In the late 1990s, the Academy developed a software program for cataract surgical outcomes.
“But there was no reward for doctors who looked at outcomes or assiduously followed our PPPs,” he explained. “Many thought the Academy was way ahead of the curve. Well, the rest of medicine and the payers have caught up.”
Finishing a Residency or a Fellowship?
If you are completing a training program this year, you should expect to see a Member Status and Training Update form in the mail in the coming weeks. Please take the time to fill out and return this form by June 15.
To keep your membership status up to date, the Academy must know whether you will be completing or continuing your training in 2006.
If you have questions, contact Member Services by phone, 888-393-3671 (toll-free) or 415-561-8581, or by e-mail, email@example.com.
Help Identify Your Profession’s Priorities
In late April, the Academy will mail a questionnaire to a representative sample of approximately 4,000 members worldwide. The data from this questionnaire will help the Academy identify trends that are likely to affect ophthalmologists.
If you receive a questionnaire, your response will help the Academy to fulfill its mission of serving the professional needs of its members.
Boost Your Collections: Set Aside One Hour to Find Out How
The next AAOE-sponsored audioconference, Collecting What You’re Owed: Do’s and Don’ts of Accounts Receivable Management, will cover tips and techniques to improve collections, provide an update on relevant legal issues and discuss real-life case studies.
The audioconference will take place on Tuesday, May 10, from 11 a.m. to noon PDT. The fee is $115 for members ($150 for nonmembers) and your practice pays only once, regardless of the number of people listening.
Audiotapes or CDs (including handouts) can be purchased after the audioconference. If you missed the last audioconference—Conquer Patient Flow Problems in Your Office—you can visit www.aao.org/store to purchase an audiotape or CD of the proceedings (Product #012706V).
For more information on next month’s audioconference, visit www.aao.org/aaoe.
Check Your E-mail for Academy Newsletters
If the Academy has your correct e-mail address, you should be receiving two e-newsletters.
Academy Express highlights important study results, coding alerts and professional news. It is e-mailed to Academy members every Wednesday evening.
Washington Report Express, which was launched in February, provides e-mailed updates on legislative and regulatory issues. This supplements the Washington Report newsletter, which is faxed to Academy members throughout the year.
If you haven’t been receiving these e-mails or faxes, the Academy may not have your current contact information. To check and, if necessary, correct your Academy listing, go to www.aao.org, click on “Member Services” and then select “Update Your Membership Listing.”
If you have further questions, contact Georgia Alward at firstname.lastname@example.org.
Order a Selection of Titles From Medical Publishers Worldwide
The Academy Bookshelf acts as a “one-stop shop” for ophthalmic titles from Elsevier, Lippincott and other respected publishers worldwide.
It was recently expanded to more than 20 titles, including such classics as Yanoff’s Ophthalmology 2nd ed., Spaeth’s Ophthalmic Surgery 3rd ed., and Walsh & Hoyt’s Clinical Neuro-Ophthalmology 6th ed., all published within the past 12 months.
In addition to books, the Academy Bookshelf includes PDA software packages for the newest editions of The Massachusetts Eye and Ear Manual and The Wills Eye Manual of Ophthalmology, as well as the online edition of Ophthalmology.
Note These Dates for Chicago 2005
Don’t forget to mark your calendar for the Academy’s 109th Annual Meeting. Circle the following dates:
For meeting updates, visit www.aao.org/annual_meeting.
The Orbital Gala: An Evening of Celebration
The Academy Foundation invites you to celebrate its 25th Anniversary at this year’s Orbital Gala, Sunday, Oct. 16. It takes place at the InterContinental Chicago, which is on Chicago’s “Miracle Mile.”
Join Academy leaders, industry executives and other individuals committed to the educational and public service mission of the Academy Foundation to commemorate this significant milestone.
Advance tickets are now available online. Space is limited and tickets are sold on a first-come, first-served basis.
To purchase your ticket, visit www.faao.org.
Washington Report: Go Online for Advocacy News and Resources
Visit the Academy’s Web site for news of urgent developments and for help in getting involved in the legislative process both in your home state and at the federal level.
Get the latest news. Visit www.aao.org/advocacy and select “State Issues” to read up on what’s happening around the nation. Or select “Federal Issues” to learn about matters that will be decided by the U.S. Congress.
Contact your legislator. Visit www.aao.org/advocacy and select “Action Center” or “Advocate Resources” to get involved in the policy process. Here, you will find the latest calls to action on important policy issues and online tools that will connect you with your federal and state legislators.
Put these advocate resources to use by participating in the Congressional Advocates Program—the Academy is always looking for members willing to meet one-on-one with their members of Congress to discuss our key issues.
Support the Surgical Scope Fund. Visit www.aao.org/advocacy and select “Surgical Scope Fund” to learn about one of ophthalmology’s most powerful weapons against optometry’s bid for surgical privileges. The fund provides grants to state ophthalmological societies to support legislative and public education efforts on safe eye surgery. The fund is not subject to the Federal Election Commission’s reporting requirements, which means that your contributions are confidential. You may contribute online or download a printable form to fill out and send via fax or mail.
For additional information, contact the Academy’s advocacy staff in Washington at 202-737-6662.
Colorado Eye M.D.s Fine Tune Their Work/Life Balance
How do you juggle the demands of work with the needs of your personal life? Leaders of the Colorado Society of Eye Physicians and Surgeons have put the concept of work/life balance into practice by combining their passion for medicine with a love of music. And this approach seemed to strike a chord with CSEPS members at the society’s annual meeting in Breckenbridge, Colo., Jan 28 to 30.
By day, attendees learned about Ethics Case Studies in Ophthalmology, Treating Presbyopia and more from a line-up of speakers that included Kuldev Singh, MD, Nancy M. Holekamp, MD, and Stephen V. Scoper, MD.
By night, attendees, presenters and passersby were entertained at an after-hours jam session by the Toasterheads: Gary A. Jamell, MD, (lead guitar, vocals and CSEPS president), David W. Johnson, MD, (lead guitar, vocals, CSEPS councilor and the meeting’s program chairman), Jack D. Zilis, MD, (drums, percussion and CSEPS member) and John G. Petty, MD, (tenor saxophone and CSEPS member).
A fifth band member, Doug Kenney, PhD (bass), usually joins them for their frequent gigs in Denver. Entertaining the public at venues such as the Bluebird Theater, enables the Toasterheads to polish their act so they’ll be in top form when asked to perform at local Eye M.D. functions. Last year, for instance, the Toasterheads had Academy executive vice president H. Dunbar Hoskins Jr., MD, and 2004 Academy president Allan D. Jensen, MD, on their feet dancing (not together!) at the 2004 Rocky Mountain Regional Roundup, a meeting sponsored by 10 state ophthalmological societies.