News & Media

MSMS Board of Directors meet, discuss MOC, prior authorization, organizational remodeling

Wednesday, October 18, 2017

Earlier this week, the Michigan State Medical Society (MSMS) Board of Directors met to address the upcoming MSMS Foundation's 152nd Annual Scientific Meeting, organizational remodeling, maintenance of certification, prior authorization, and more. Below are some of the highlights:

  • MSMS Foundation's 152nd Annual Scientific Meeting: This year's annual conference will be held Tuesday through Saturday, October 24-28 at the Sheraton Detroit Novi. This year, ASM offers two options to meet the Board of Medicine's (BOM) CME requirement for Pain and Symptom Management, as well as offer two FREE plenary sessions that meet the BOM's Human Trafficking and Medical Ethics requirements. Registration and more information is available by visiting http://MSMS.org/ASM.
       
  • MSMS's Organizational Remodeling: The Board spent time on putting parameters on the various recommendations which came out of the 2017 House of Delegates meeting. At the July Board meeting, there were several recommendations identified to increase engagement and open up membership pathways for physicians within MSMS. During the October meeting, the Board of Directors began putting details together to begin collecting information to continue the dialogue at the House of Delegates meeting. This will help the HOD identify how that change will look, including the connectivity between the physicians and MSMS.
       
  • Maintenance of Certification:
    • Policy: Based on policy approved by the House of Delegates, MSMS supports Maintenance of Certification (MOC) only under all of the following circumstances:
      • MOC must be voluntary.
      • MOC must not be a condition of licensure, hospital privileges, or health plan participation.
      • MOC should not be the monopoly of any single entity.
    • Payer Advocacy: MSMS has advocated for a review of Blue Cross Blue Shield of Michigan’s policy through Tri-Staff and directly to the chair of the Credentialing Committee.
    • Legislation: State Representative Edward J. Canfield, DO (R-Sebewaing), has introduced two bills (HB 4134-4135) that would address mandatory MOC. Physicians may write their lawmakers by visiting http://Right2Care.org. MSMS was instrumental in getting a Hearing on both bills on May 24, 2017, and organized several physicians to attend and testify. A second Hearing has yet to be scheduled because of the professional divide among physicians.
      • The physician community is currently not unified in this fight; and, legislators are not motivated to push bills with a professional divide. Opposing physician groups include:
        • Michigan Board of Emergency Medicine
        • Michigan Section of the American Congress of Obstetricians and Gynecologists
        • Michigan Orthopaedic Society
        • Michigan College of Emergency Physicians
                
  • Prior Authorization:
    • Policy: The Michigan State Medical Society (MSMS) believes that prior authorization is overused and that existing processes are an administrative burden. MSMS believes that prior authorization is a hassle that needs to be addressed through a multifaceted approach to expedite patient care and reduce burdens on physicians.
    • MSMS Survey Data: A 12-question, web-based survey was administered by MSMS in July 2017. A sample of more than 600 Michigan physicians responded. It was refined to ensure that all participating physicians are currently in active practice in Michigan. Of those responding physicians, 29 percent were in primary care and 70 percent were specialists. The survey headlines are:
      • Prior Authorization is an extreme burden.
      • Prior Authorization delays care.
      • Prior Authorization causes physicians to be away from seeing patients.
    • Next Steps: MSMS is currently developing a plan to address prior authorization. If you have interest in the viability and scope of this initiative, please send an email to MSMS@MSMS.org.
         
  • Health Care Delivery and Education Committee:
    • Thomas L. Simmer, MD, Vice President and Chief Medical Director for Blue Cross Blue Shield of Michigan presented his annual updated:
      • Through some staff reorganization, there are some expected directional changes that will impact physicians, which includes a greater emphasis on prior authorization, and greater focus of PGIP and VBR payments on cost outcomes.
      • BCBSM will focus more on a value-based reimbursement approach that spans all provider types including primary care, specialists, POs, OSCs, and hospitals. Financial rewards and/or penalties are intended to drive quality outcomes and deliver value to customers. 
    • EHR/MAPS Integration Grant Opportunity: An updated and more user-friendly Michigan Automated Prescription System (MAPS) went live in April. All prescribers are asked to register and use MAPS in their practice. Through a combination of state and federal funding the state will cover Appriss Health's costs to integrate the newly-upgraded MAPS directly into physician practices' electronic medical records and pharmacy dispensing systems across Michigan, allowing instant access for prescribers and pharmacists. Learn more and apply today >>
    • MSMS Receives Year Two Grant for Diabetes Prevention: MSMS secured a second year of grant funding to continue its work on Diabetes Prevention. The grant of $30,000 will fund work with physician organizations, an educational session at the upcoming Annual Scientific Meeting, and continued work with the Michigan Department of Health and Human Services on the State Diabetes Action Plan.