The Area 7 Council , which is composed of representatives from the 13 District Branches (DBs)in the far west of the United States (excluding California) met in August. Several themes amongst the various DBs emerged from this meeting:
- Scope: psychologist prescribing passed in Iowa and Illinois, and was defeated in Hawaii.
- Member recruitment: several DB’s working on this including calling the drop list and providing a variety of events for members to interact with each other.
- Physician burn-out: several DB’s discussed how isolating it is to be in a busy / overwhelmed practice and the need for more support after an adverse event like a physician suicide. One DB is helping implement the American Medical Association burnout evaluation and prevention program (StepsForward) in their area. See: https://www.stepsforward.org/modules/physician-burnout
- Services for rural areas: one DB has noticed an increase in psychiatrists working in their underserved area after participating in a residency program located there. The group discussed more ways to help serve underserved areas including the use of telemedicine and a program called Project ECHO (Extension for Community Health Outcomes) which has been developed in New Mexico. See: http://echo.unm.edu/
Support for MACRA Changes Available from APA
The Medicare Access and CHIP Reauthorization Act (MACRA) transforms the payment and quality programs for Medicare Part B physician services by replacing the old sustainable growth rate (SGR) with a stable update system. Right now this is scheduled to go into effect as of January 2017. APA has developed a web page devoted to the implementation of MACRA which includes a webinar and more to come as this gets closer. See: https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/payment-reform
American Psychiatric Association to Fund a Registry
Changes to health care delivery as a result of the Affordable Care Act will require improvement in quality of care, while at the same time reducing costs. With an increasing national focus on quality and cost, the opportunity to leverage clinical registries to improve outcomes and appropriate utilization has never been greater. The AMA believes that the establishment of a registry will assist members in meeting these new requirements and is an investment for the future of the profession of psychiatry.
Establishing a registry will also help members comply with Physician Quality Reporting System (PQRS) & Merit-Based Incentive Payment System (MIPS) requirements and avoid penalties, which began in 2016 (2%) and will increase to 9% in 2022. A registry would also allow members to submit performance and practice data from the registry for Maintenance of Certification (MOC) Part IV credit. A registry will provide a national research data base with aggregate de-identified data to help improve patient outcomes, develop new diagnostics and therapeutics, develop practice guidelines, identify gaps in care and inform APA educational programs, and support advocacy initiatives. It will also allow the APA to develop new psychiatric quality measures (with funding from CMS until 2019).