Perspectives with the AMA

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Sandy Marks Guest: Kim Horvath, JD Guest: Kyle Thomson, JD With telehealth services expanding during the COVID-19 pandemic, has our access to them changed? To better understand this, Dr. Charles Turck meets with Sandy Marks, Kim Horvath, and Kyle Thomson from the AMA to explore what's been done to provide Medicare coverage during a public health emergency and what's on the horizon for telehealth access.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Emily Carroll, JD, MSW The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what's the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

Host: Jennifer Caudle, DO Guest: Jennifer Brown, JD The risks associated with pregnancy are disproportionately higher for some patient populations, but several organizations are taking action to change that. Dr. Jennifer Caudle joins Jennifer Brown, senior legislative and regulatory attorney at the American Medical Association, to discuss the AMA's efforts to improve maternal health.

Host: John J. Russell, MD Guest: Bobby Mukkamala, MD Chair of the AMA Substance Use and Pain Care Task Force, Dr. Bobby Mukkamala, joins Dr. John Russell to discuss the nation's worsening drug overdose epidemic and the AMA's recommendations to help patients.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Emily Carroll, JD, MSW Guest: Heather McComas, PharmD Guest: Chris Sherin The prior authorization cost control process can be a burden on clinicians and lead to delayed treatment for patients. But the AMA's recent advocacy efforts may help reform the process. Dr. Charles Turck meets with Emily Carroll, Heather McComas, and Chris Sherin to dive into these reforms and their impact at the state and federal levels.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Mira Irons, MD Guest: Shannon Curtis Following the approval of the first COVID-19 vaccine, mass-vaccination has made approving a vaccine difficult. How are the Food and Drug Administration and the Centers for Disease Control deciding on which vaccinations to authorize? Dr. Mira Irons and Shannon Curtis of the American Medical Association join Dr. Charles Turck to discuss authorization processes and recommendations for COVID-19 vaccines.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Patrice Harris, MD The U.S. Centers for Disease Control and Prevention estimate that more than 80,000 Americans died from May 2019 to May 2020 due to a drug-related overdose. CDC data indicates that the drug overdose epidemic is being fueled by a staggering rise in deaths involving illicitly manufactured Fentanyl methamphetamine, cocaine and heroin. In response to the far-reaching drug overdose epidemic, organizations like the American Medical Association and Manatt Health have come together to help end this epidemic. Here to recap the process that's been made and what the 2020 national policy roadmap recommends moving towards is Dr. Patrice Harris a psychiatrist and chair of the AMA Opioid Task Force.

Host: Jennifer Caudle, DO Guest: Kathleen Blake, MD, MPH With E&M coding changes taking effect January 1, 2021, the AMA offers tools and resources for physician implementation. Dr. Kathleen Blake, Vice President of Healthcare Quality at the American Medical Association, joins Dr. Jennifer Caudle to share what we can expect.

Host: Matt Birnholz, MD Guest: Susan R. Bailey, MD The COVID-19 pandemic has impacted the healthcare field through reductions in patient volume and higher practice costs. How will these economic challenges change health policy and alter the future of healthcare? President of the American Medical Association Dr. Susan R. Bailey joins Dr. Matt Birnholz to discuss their recent survey.

Host: Jennifer Caudle, DO Guest: Carol Vargo, MHS Physicians across the country have been working hard to keep their practices operational and their patients, as well as themselves, safe amid the COVID-19 pandemic. Carol Vargo returns to share some tips and resources to help keep healthcare practices open with Dr. Jennifer Caudle.

Host: Matt Birnholz, MD Guest: Kim Horvath, JD Guest: Sandy Marks Guest: Meg Barron, MBA With no signs of the adoption of telehealth slowing down, Dr. Matt Birnholz sits down with Sandy Marks, Kim Horvath, and Meg Barron of the AMA to explore how—and to what extent—telehealth is changing practice norms and what policies are being implemented to maintain high quality care for our patients.

Host: Jennifer Caudle, DO Guest: Kathleen Blake, MD, MPH Guest: Peggy Chen, MD Behavioral health integration has proven to be an effective solution to improving access to treatment for many mental health conditions… So why is it not more prevalent in the medical community? Joining Dr. Jennifer Caudle to dive into the findings and implications of the joint AMA-RAND Corporation study recently published in the Annals of Internal Medicine are Dr. Kathleen Blake with the AMA and Dr. Peggy Chen from the RAND Corporation. And, click here to listen to a conversation regarding Behavioral Health Integration and its effect on clinical practice.

Host: Matt Birnholz, MD Guest: Carol Vargo, MHS Guest: Sheryl Hirsch, MD, FAAP Guest: Thomas Eppes, MD The American Medical Association is one of the leading medical organizations across the country that have been working to provide physicians with the tools and resources they need to continue caring for patients and to keep their practices financially afloat amid the COVID-19 pandemic. Joining Dr. Matt Birnholz to review the AMA's guidance for reopening practices during the pandemic and how some practices have begun to reopen are Carol Vargo from the AMA, pediatrician Dr. Sheryl Hirsch, and family physician Dr. Thomas Eppes.

Host: Jennifer Caudle, DO Guest: Todd Askew What's being done to address the range of issues like the PPE shortage, lack of testing, and financial shortfalls encountered during the COVID-19 pandemic? Here to share his team's advocacy efforts to help tackle these and other challenges is Todd Askew, the American Medical Association's Senior Vice President of Advocacy.

Guest: David Ring, MD, PhD Guest: Ameet Nagpal, MD Guest: Steven P. Stanos, Jr., DO Individualized healthcare is extremely important for patients with pain, but physicians and patients face barriers for such care. Drs. David Ring, Ameet Nagpal, and Steven Stanos sat down with us to provide insight on how the 2019 AMA Opioid Task Force is working to support individualized care for patients with pain.

Guest: Patrice Harris, MD Guest: Frank Dowling, MD Guest: Elizabeth Salisbury-Afshar, MD Guest: Sharon Levy, MD, MPH Guest: John Renner, MD As the nation's opioid epidemic has now become a deadlier drug overdose epidemic, the AMA Opioid Task Force urges individualized and evidence-based patient care for those with a substance use disorder. Offering their unique perspectives on how to help patients, physician members of the AMA Opioid Task Force shared their perspectives on helping patients with a substance use disorder. Drs. Patrice Harris, Frank Dowling, Elizabeth Salisbury-Afshar, Sharon Levy, and John Renner.

Host: Matt Birnholz, MD Guest: Donald Meyer, MD Guest: Travis Mickelson, MD With physical and behavioral health practices often operating in silos, many healthcare providers are left wondering whether their patients' holistic needs are being adequately addressed. To help bridge this gap in care, Drs. Donald Meyer and Travis Mickelson helped lead the implementation of a more integrative approach to behavioral health services within their organizations and are now sharing the benefits and challenges that came along with it.

Host: Jennifer Caudle, DO Guest: Griffin Myers, MD, MBA, FACEP Guest: Barbara Spivak, MD Despite increasing levels of burden, physicians remain supportive of efforts that improve patient care. At least for now. As the move to value intensifies, it will be even more important for physicians to have access to avenues that encourage changes they consider valuable. This episode featuring Dr. Griffin Myers of Oak Street Health, a network of primary care practices for adults on Medicare, and Dr. Spivak from the Mount Auburn Cambridge Independent Practice Association (MACIPA), a physician membership organization, explore their experience working in the Medicare Advantage (MA) space. Topics of discussion include if and how MA has altered physician practices, the challenges clinicians have encountered, and its impact on patient outcomes and practice sustainability.

Host: Matt Birnholz, MD Guest: Kathleen Blake, MD, MPH Guest: Mandy Cohen, MD, MPH Guest: Sheila Savageau Guest: Michael Seres How do you define value-based care? That's the question being asked of some of the most influential stakeholders in healthcare, and to find out their answer, Dr. Matt Birnholz sits down with a few of them, including the AMA's Vice President of Healthcare Quality Dr. Kathleen Blake, General Motors' U.S. Health Leader Sheila Savageau, North Carolina Secretary of Health and Human Services Dr. Mandy Cohen, and Michael Seres, the CEO of 11Health.

Host: Matt Birnholz, MD Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD In response to physicians' feedback, the Centers for Medicare and Medicaid Services proposed some big changes to the documentation guidelines for office visits. But is there still room for improvement? Co-chairs of the American Medical Association's CPT/RUC Workgroup on Evaluation and Management Services Dr. Peter Hollmann and Dr. Barbara Levy join Dr. Matt Birnholz to discuss the Workgroup's effort to further simplify the work of the healthcare provider and improve the health of patients nationwide.

Host: Matt Birnholz, MD Guest: Barbara A. McAneny, MD There were a lot of changes made to the 2019 Medicare payment policies. Here to review what these updates mean—and what's being done in response to them—is Dr. Barbara McAneny, President of the AMA.

Host: Jennifer Caudle, DO Guest: Mark Friedberg, MD With the use of alternative payment models (APMs) on the rise, the American Medical Association and the RAND Corporation joined forces to investigate the impact of APMs on physicians across the country. So what exactly did the study uncover? Diving into the study's findings with Dr. Jennifer Caudle is Dr. Mark Friedberg, senior physician policy researcher at RAND and director of its Boston office.

Host: Matt Birnholz, MD Guest: Koryn Rubin Some big changes are taking effect in one of the performance categories under MIPS. The cost category is now affecting your MIPS score differently, and here to make sure you don't fall behind is Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association.

Host: Matt Birnholz, MD Guest: Carol Vargo, MHS Amid all the changes to quality reporting under MIPS, many hospital-based physicians are unsure about what effects, if any, there will be to their employment and compensation. Luckily, there are experts to help break down everything from performance-based changes to compensation accuracy, and providing a how-to guide for navigating the Quality Payment Program in the hospital setting is Carol Vargo, Director of Physician Practice Sustainability at the AMA.

Host: Matt Birnholz, MD Even though more and more physicians are becoming aware of the option to participate in the Quality Payment Program as a virtual group, many still may not have all the details needed to decide whether this is right for them—or how they can even go about joining one. To help clarify the confusion, Dr. Matt Birnholz is joined by Ashley McGlone, Washington Counsel for the AMA.

Host: Matt Birnholz, MD Alternative Payment Models, or APMs, were introduced as a way to reduce costs and improve patient care, but physicians have been slow to adopt this model. To address this issue, Dr. Matt Birnholz connects with Harold Miller, President and CEO of the Center for Healthcare Quality and Payment Reform, who provides the details that physicians need to know regarding APMs and why Physician-Focused Payment Models could be the solution.

Host: Shira Johnson, MD Guest: Laura Hoffman Guest: Matt Reid If you're planning on participating in the Quality Payment Program in 2019, you may be wondering what you can—and should—be doing now to prepare for upgrading your electronic health records, or how this update could affect your computers and networks. If so, you're not alone. To help guide you through this process, Dr. Shira Johnson is joined by two AMA staff—Senior Health IT Consultant Matt Reid and Assistant Director of Federal Affairs Laura Hoffman—who answer these and other FAQs.

Host: Randall Wong, MD Host: Russell Faust, MD Gone are the days when asking for reviews seemed desperate or unprofessional. Now it is much more acceptable, and in fact, patients expect it! Join Drs. Russ Faust and Randy Wong as they explain the importance of getting past the embarrassment and asking patients for reviews.

Host: Matt Birnholz, MD Guest: Koryn Rubin With more and more physicians wondering what the new individual and group reporting measures mean for them and their practice, Dr. Matt Birnholz sat down with Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association, to break down these options.

Host: Matt Birnholz, MD New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition. Host Dr. Matt Birnholz talks with Dr. Edward Sobel and Ms. Temaka Williams about what technical assistance is available to physicians navigating the quality payment program. Dr. Sobel is the Medical Director at Quality Insights,which is based in Charleston, WV, while Miss Williams is a Health Information Technology Advisor at Telligen Oak Brook, Illinois.

Host: Matt Birnholz, MD Guest: Richard Deem With the advent of the Medicare Quality Payment Program, there are notable practice changes for clinicians. What do these changes mean for you and your practice? To examine the issues and opportunities, host Dr. Matt Birnholz welcomes Richard Deem who is the Senior Vice President of Advocacy at AMA. Mr. Deem will explain how these changes affect small practices in particular, and what physicians in these practices need to know in order to succeed.

Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG's Center for Healthcare Regulatory Insight, and Carol Vargo, Director of Physician Practice Sustainability in the AMA Physician Satisfaction and Practice Sustainability Strategic Initiative Group about the results of this survey.

Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also serves as CMS's Chief Medical Officer.

Host: Matt Birnholz, MD MACRA' is one of the hottest buzzwords in clinical medicine and health policy today. But in a fast-changing legislative landscape, questions arise on the current and future directions for MACRA, as well as best practices for all of us going forward. Host Dr. Matt Birnholz talks with AMA Washington Counsel, Ashley McGlone and Laura Hoffman, Assistant Director of Federal Affairs, about the top questions on MACRA that everyone wants to know.

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we'll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Host: Matt Birnholz, MD Qualified Clinical Data Registries, or QCDRs, are keys to Medicare's new payment system in that they collect clinical data for the purpose of patient and disease tracking. But what do we need to know about QCDRs, where to find them, the requirements for successful reporting and why they are so important for clinical practices? Host Dr. Matt Birnholz welcomes a panel of QCDR experts from the AMA. Dr. Kathleen Blake, Vice-President, and Lance Mueller, Manager, both serve as part of the AMA group that works on payment reform and healthcare quality. Koryn Rubin serves as Assistant Director of Federal Affairs at the AMA.

Under MACRA, most physicians will participate in a value-based payment program known as MIPS, which stands for Merit-based Incentive Payment System. Beginning with the 2019 physician fee schedule, MIPS will replace the Physician Quality Reporting System, Value-Based Modifier, and Meaningful Use of electronic health records programs. Ms. Laura Hoffman, Assistant Director in the Department of Federal Affairs at AMA, provides an overview of the Clinical Practice Improvement Activities, or CPIA, category, including how the activities may be reported and scored by CMS. Please click here for a full list of CMS' proposed CPIAs Update as of September 2017: CMS shortened the category name to “improvement activities”. The content provided here is otherwise still accurate and up-to-date.

EHRs have made a significant impact in the practice of medicine across the country. While many improvements in the usability, flexibility, and interoperability of EHRs are needed, the use of an EHR can still be beneficial for many physicians. Matt Reid, MS provides you with information about the importance of electronic health records (EHRs) to participation in MACRA. Mr. Reid is a Senior Health Care IT Consultant at the AMA. You can find more information about certified EHRs at the Office of the National Coordinator's Certified Health IT Product List.

Ms. Koryn Rubin provides an overview of the reporting options under the Merit-Based Incentive Payment System (MIPS), specifically related to the quality performance category. After listening to this podcast, physicians should obtain a basic understanding between reporting as an individual or reporting as a group practice under MIPS. Ms. Rubin is Assistant Director of Federal Affairs at AMA. Program requirements are subject to change. The links below are intended to assist with MIPS preparation and are informational only.

Host: Matt Birnholz, MD Guest: Robin Zon, MD, FACP Value-based, patient-centered care has become the destination for all branches of medicine, and is the philosophy driving modern payment reform initiatives like MACRA. But the unique care delivery needs in each specialty challenge the notion that one payment model can serve everyone. And nowhere has this become more relevant than in the field of oncology. Dr. Matt Birnholz joins Dr. Robin Zon, practicing oncologist and vice president and senior partner at Michiana Hematology-Oncology in South Bend, Indiana. Dr. Zon serves as Chair-Elect of ASCO's Government Relations Committee was Past Chair of the Clinical Practice Committee, which alongside other stakeholders at ASCO developed a Patient-Centered Oncology Payment (PCOP) model. Recently, Dr. Zon presented this information at the recent AMA House of Delegates meeting in June. She speaks to the phases of this model, how it can function as a defined APM under MACRA, and its demonstrated positive impacts on oncology care pathways.

Host: Matt Birnholz, MD Guest: Lawrence Kosinski, MD The advancement of the Medicare Access and CHIP Reauthorization Act (MACRA) has catapulted Alternative Payment Models into the spotlight for identifying new value-based approaches to care. But questions persist as to the roles that specialists can and should play in the design and implementation of APMs, how these models will cut healthcare costs, and which administrative partnerships are needed to make them successful. Dr. Lawrence Kosinski, a practicing gastroenterologist with The Illinois Gastroenterology Group, is pioneering one such APM that applies an innovative method for tracking patients between clinic visits. The model, called SonarMD, for which Dr. Kosinski is founder and Chief Medical Officer, provides a web-based platform that pings patients beyond practice settings to help get ahead of issues before they become emergencies.