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ACEP Leadership Report

Our monthly Leadership Report is the best way to stay apprised of how ACEP leaders are working on your behalf to advance emergency medicine. We know the challenges our members face, and we are continually taking steps to protect your interests and make it easier for you to provide the highest quality care for your patients. Keep reading for the latest updates from the national office.

August 2019

#ACEPNation Hits Membership Milestone
Back in August 2011, ACEP hit the 30,000 member mark. In August 2019, we reached 40,000 members for the first time in our history. We’re so proud to stand beside you. Here’s to the next 50 years!

Medicare Payment Rule Adjusts Value of EM Services
The Centers for Medicare & Medicaid Services (CMS), the agency responsible for running Medicare and Medicaid, recently issued its proposed Medicare physician fee schedule for 2020. CMS included a proposal to revalue the ED Evaluation and Management Codes, the most commonly billed services for EM physicians.

As the only EM organization represented on the AMA Relative Value Scale Update Committee that develops values for physician service codes, ACEP advocated strongly for this revaluation. The RUC accepted our recommendations, and CMS is proposing to accept the RUC’s recommended values. If finalized, this revaluation would increase Medicare reimbursement for ED visit codes by approximately $137 million in 2020, when the policy becomes effective. The increased values would become the new standard for each year after that. View EM-specific highlights of the rule.

ACEP Shares Opioid Resources with FDA
The FDA is interested in the development of resources to reduce the use of opioids where alternatives exist, so ACEP shared its extensive opioid resources. Our two opioid-related point of care tools, MAP (managing acute pain) and BUPE (buprenorphine) are now available on our new app, emPOC, available through the Apple Store and Google Play.

Update on Firearm Violence Initiatives
In response to the mass shootings in July, ACEP President Vidor Friedman, MD, FACEP, provided the ACEP membership with an update on ACEP’s firearm safety initiatives that span the last several years. Several key pieces will be discussed or debuted at ACEP19 in Denver:

  • A resolution has been submitted to the Council for consideration that will be discussed at the Council Meeting Oct. 25-26.
  • The results of our Council Survey about a variety of policy positions related to gun injury prevention will be available by the Council Meeting.
  • Until Help Arrives, our training program designed to help EM physicians provide basic first responder training in their communities, will officially launch at ACEP19.
  • ACEP will host a preconference course on assessing threat and identifying patients at risk for causing harm entitled “Care Under Fire: EDs, Gun Violence and Threat Asssessment.

View all of ACEP’s active shooter resources, including policy statements, podcasts and more.

Working to Decrease Your Documentation Burden
In August, ACEP sent official comments to CMS related to its call for suggestions for how to reduce administrative burden for health care providers. On August 12, ACEP responded to a CMS request for information (RFI) on additional ways to reduce administrative burden through the “Patients over Paperwork” Initiative. In summary, we asked CMS to take the following actions:

  • Postpone the Appropriate Use Criteria (AUC) Program. Although we got a clarification to the exemption for emergency medical conditions, we need more time to educate our members and hospitals about when the exemption for is applicable.
  • Make electronic health records easier to use and increase the ability to receive and exchange information about our patients.
  • Require hospitals to share clinical data with clinical data registries to fulfill MIPS reporting requirements.
  • Simplify MIPS requirements for hospital-based clinicians.
  • Revise existing criteria for adding new codes to the list of approved telehealth services to make it easier to add emergency telehealth codes to this list.
  • Implement emergency medicine-specific alternative payment models (APM) and specifically adopt ACEP’s APM, the Acute Unscheduled Care Model.

Learn more about ACEP's work to reduce your administrative burden.

ACEP Hosts Health Care IT Summit
In July 2019, ACEP hosted thought-leaders from health IT for a one-day collaborative summit designed to foster important discussions about the future of healthcare IT in the acute care setting. More than 100 outside-the-box thinkers discussed both aspirational and immediately actionable ways to make healthcare IT more intuitive and functional for EM physicians and your patients.

The HIT Summit included prominent EM informatics experts and representatives from the CDC,  the ONC, the VHA, Cerner, Epic, and more, brainstorming about the future of care delivery and data sciences. What’s the ideal future state of healthcare IT, and how do we get there?  How does data acquisition, AI, data transparency, population health, quality initiatives, policy, advocay, predictive modelingand data-driven networks factor into future plans?

The work product of this summit will be summarized to serve as a guidebook for ACEP’s future planning, policy and advocacy related to administrative burden and EHR.

Longevity & Tenure Awards
ACEP's Careers in EM section has announced its 2019 award winners. Longevity Awards went to Kenneth T. Larsen, Jr., MD, FACEP, who has been practicing EM for 46 years, and George Edward Malcom, Jr., MD, FACEP, who has been practicing for 44 years. The 2019 Tenure Award winner is Kashmir Singh, MD, FACEP, for 30 consecutive years in the ED. 

 

July 2019

June Board Meeting Addresses Key Issues
ACEP’s Board of Directors convened June 26-27, approving ACEP’s FY2019-20 budget and discussing several topics related to policy and practice. Among their decisions, they approved the following new or revised policy statements:

The Board also reaffirmed the Disaster Medical Response policy statement and the Point of Care Utrasonography by Pediatric Emergency Medicine Physicians policy statement and its associated technical report that was developed jointly with the American Academy of Pediatrics, SAEM, and the World Interactive Network Focused on Critical Ultrasound.
 
The following items were also approved during the June meeting:

  • New clinical policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the ED with Acute Headache
  • Governance Charter for the ED Pain and Addiction Management Accreditation Program
  • Revised criteria for the ED Pain and Addiction Management Accreditation Program
  • Taking no further action on Resolution 20(18) Verification of Training – the Emergency Medicine Practice Committee reviewed the resolution and staff compiled information on standardized methods for verification of training. A standardized form for verification of training was developed by the National Association of Medical Staff Services. This information will be posted on ACEP’s website.
  • 2019 Compendium of ACEP Policy ACEP Policy Statements on Ethical Issues.
  • Revised Procedures for Addressing Charges of Ethical Violations and Other Misconduct. The revised procedures must be approved by the Council. The Board approved cosponsoring a College Manual resolution that will be submitted to the 2019 Council for consideration.
  • Taking no further action on Referred Resolution 35(18) ACEP Policy Related to Immigration. The resolution is addressed by ACEP’s policy statement “Delivery of Care to Undocumented Persons.” In December 2018 ACEP sent a letter to the Department of Homeland Security expressing objection to the proposed rule that would change the definition of public charge. Policies already exist throughout the health care community to protect patient information, unless disclosure is required by law, and creating additional policy specific to providing information to immigration authorities would essentially be superfluous.
  • Taking no further action on Referred Resolution 42(18) Expert Witness Testimony for the Specialty of Emergency Medicine. The resolution requested that ACEP revise the “Expert Witness Guidelines for the Specialty of Emergency Medicine”’ policy statement to define an expert witness as a person actively engaged in the practice of medicine during the year prior to the initiation of litigation who has the same level or greater training in the same field as the subject of the tort for a majority of their professional time. Theone-year requirement would eliminate many qualified experts who recently retired from practice. The requirement would also apply to defense experts, which could have the unintended consequence of limiting the number of qualified experts available to defend emergency physicians.
  • Not seeking access to malpractice data from the National Practitioner Data Bank directly but review relevant aggregate NPDB data that may be made available. This information will be used to explore opportunities to develop educational materials that may reduce medical errors and improve patient safety.
  • 2018 Section Grant projects for funding (five grants awarded)
  • Formation of the Aerospace Medicine Section
  • Disseminating the MITIGATE Antimicrobial Stewardship Toolkit
  • Referred the revised policy statement “Firearm Safety and Injury Prevention” back to the Public Health & Injury Prevention Committee for additional revisions
  • Petitioning the Office of Coverage and Analysis Group at CMS to reconsider the addition of the ED as a place of service for Hepatitis C testing (in response to Referred Resolution 41(17) Reimbursement for Hepatitis C Virus Testing in the ED)
  • Expert Witness Testimony Model State Legislation
  • Endorsing the American College of Medical Toxicology’s “ACMT Position Statement Recommending Removing the Waiver Requirement for Prescribing Buprenorphine for Opioid Use Disorder”
  • Distributing a survey to the membership regarding The Joint Commission regulations
  • Further assessment of the Broselow Blue Code product for potential endorsement consideration
  • Revised Clinical Ultrasound Accreditation Program Governance Charter
  • Distributing a survey to the Council on firearms research, safety, and policy
  • Revised Geriatric ED Accreditation Program Criteria
  • Supporting the preliminary 2019-20 committee objectives
  • Completing the work already in process to review membership data and developing a report to the Board

ACEP Hosts Health Care IT Summit
ACEP recently hosted thought-leaders from health IT for a one-day collaborative summit designed to foster important discussions about the future of healthcare IT in the acute care setting. More than 100 outside-the-box thinkers discussed both aspirational and immediately actionable ways to make healthcare IT more intuitive and functional for EM physicians and your patients.

The HIT Summit included prominent EM informatics experts and representatives from the CDC,  the ONC, the VHA, Cerner, Epic, and more, brainstorming about the future of care delivery and data sciences. What’s the ideal future state of healthcare IT, and how do we get there?  How does data acquisition, AI, data transparency, population health, quality initiatives, policy, advocay, predictive modelingand data-driven networks factor into future plans?

The work product of this summit will be summarized to serve as a guidebook for ACEP’s future planning, policy and advocacy related to administrative burden and EHR.

Surprise Billing Toolkit Updated
Work continues on surprise billing, and our advocacy team has updated its Member Advocacy Toolkit in response to the changing environment. You must be logged in as an ACEP member to view this resource

Teaching Award Winners Announced
Congratulations to the winners of the 2019 teaching awards, who will be honored during ACEP19 in Denver!

 

June 2019

New POC App is Transforming Bedside Care
ACEP worked with top experts in the field to develop emPOC, our new point of care app that provides clinical content and tools for EM physicians. Get five bedside tools in one app: AFIB (atrial fibrillation & flutter), BUPE (Buprenorphine use in the ED), ADEPT (agitation in the elderly), MAP (management of acute pain) and iCar2e (suicide assessment). This app was designed by EM physicians, for EM physicians, to provide helpful clinical tools in a native app for those who don’t have wifi access in their emergency departments. If you’re an ACEP member, you can get this free app on iTunes and Google Play.

Surprise Billing: ACEP President Testifies to Congress, New Toolkit Available
On June 13, ACEP President Vidor Friedman, MD, FACEP, testified on behalf of EM physicians in front of the House Energy and Commerce Health Subcommittee.“In a medical emergency, getting treatment as soon as possible is the number one priority—not verifying which providers are in-network, figuring out how much your deductible is, or worrying how much treatment will cost,” Dr. Friedman said. He explained how EMTALA affects emergency physicians and discussed ACEP’s proposed framework for out-of-network billing solutions. His full testimony can be found in the ACEP newsroom

For nearly a year, ACEP has been doing everything it can to advocate on behalf of emergency physicians and our patients on this rapidly-changing situation. Now that administrative and congressional attention to the issue is intensifying, we need you to raise your voice and help us advocate for the field. Our new toolkit provides messaging guidance and other resources to help promote ACEP’s advocacy position. Thank you for all you to do to fight for the millions of emergency patients who count on us every day. View the toolkit – only available to ACEP members.

Use Your Voice: Submit Council Resolutions for ACEP19
Did you know you can influence the ACEP agenda? It only takes two members to submit a Council resolution as part of ACEP’s democratic decision-making process. Submit your resolution by July 27, and the Council will vote during its annual two-day meeting in conjunction with ACEP’s Scientific Assembly. The Board of Directors will also vote on the resolutions. Learn more about the process and submit your resolution.

Holliman Honored with Lifetime Achievement Award
Jim Holliman, MD, FACEP, was honored with the Guata Bodiwala Lifetime Achievement Award at the 2019 International Federation for Emergency Medicine conference in Seoul. This is IFEM’s highest honor, recognizing an individual who has demonstrated an extraordinary commitment to both IFEM and the specialty of emergency medicine in his/her home country.

Holliman has devoted his career to the international development of EM, including past service as IFEM’s president. In 1994, he founded the Center for International Medicine at Penn State University’s Hershey Medical Center, which operated a fellowship program to train future international leaders for EM. In 2008 he became a professor of military and emergency medicine with the Uniformed Services University of Health Sciences, where he was deployed to Iraq and Afghanistan to develop an emergency health care system and to train first responders.

New Blog Updates You on Federal Regulations Affecting EM
New resource alert! ACEP members can now get quick summaries of ACEP’s ongoing regulatory work through Regs & Eggs, a blog written by ACEP’s Director of Regulatory Affairs, Jeffrey Davis. Davis will provides a heads-up about new proposed or final regulations, demonstrations, grant opportunities, or other announcements from federal agencies, like CMS or the VA. As we fight against burdensome new requirements, we’ll be asking for member input to help us alleviate administrative burden for emergency physicians. Read the blog

 

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Whether your needs are big or small, your ACEP staff is here to help. Need our assistance? Contact our membership team.

August 2019 Highlights

Our Finance, IT and Quality departments worked together to solve invoice issues for CEDR customers, greatly reducing the timeframe for invoice generation, adding helpful invoice information and offering real time GP reports to improve CEDR customer service. 

Our Reimbursement team led the group of EM physicians and staff that convinced the AMA’s RUC to increase the values of ED/EM codes. If finalized, this revaluation would increase Medicare reimbursement for ED visit codes by approximately $137 million in 2020, when the policy becomes effective.

The IT department added the Mx. Prefix to ACEP user account creation to promote inclusivity, and he created a searchable council resolution archive.

Our Grants team developed clinical measure workflows for EMS Compass measures that will help end users query in the correct and logical order to properly calculate the measures. They also spearheaded a funding proposal to develop stroke and sepsis measures.

Our Quality department attended a CMS conference and was awarded a challenge coin on behalf ACEP for the success of the E-QUAL program.

The Regulatory and Reimbursement teams worked together to write EM-specific summaries of the Medicare Physician Fee Schedule proposed rule to make it easier for members to catch up on the latest developments and better understand how this rule affects them.

Our Geriatric Accreditation department started discussions with both the Institute for Healthcare Improvement (IHI,) and the American College of Surgeon’s new Geriatric Surgery Verification (GSV) program to begin building conceptual agreements for both GEDA/IHI and GEDA/GSV programs to work together to get the word out about increasing the standard of care in the ED for our nations seniors. Our goal is to make it easy for EDs and health systems/hospitals to access useful and relevant program information about serving older patients and families no matter which program they learn about first.

The Educational Products team is working on a new performance improvement (PI) pathway and educational module about opioids for our eCME platform. It’s a 20 question assessment of the user’s treatment of opioid use disorder so they can identify gaps between their treatment and current best practices.

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