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PHYSICIAN FORMERLY KNOWN AS the CLEVELAND PHYSICIAN Formerly Known As AMC/NOMA March/April 2009 | Volume 94 | No

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PHYSICIAN FORMERLY KNOWN AS the CLEVELAND PHYSICIAN Formerly Known As AMC/NOMA March/April 2009 | Volume 94 | No NORTHERN OHIO PHYSICIAN FORMERLY KNOWN AS THE CLEVELAND PHYSICIAN formerly known as AMC/NOMA March/April 2009 | Volume 94 | No. 2 THE VOICE OF PHYSICIANS IN NORTHERN OHIO www.amcnoma.org AMCNO Meets with State Medical Board Regarding Physician Ranking Legislation Recently, representatives from the AMCNO met with the Executive Director and other members of the legal staff from the Ohio State Medical Board (OSMB) to discuss the physician ranking legislation spearheaded by the AMCNO. The OSMB staff had questions regarding In follow-up, the AMCNO leadership and staff the intent of the legislation and how the met with the OSMB legislative committee. information collected by the insurance At that meeting, members of the Board felt companies would be utilized and published. strongly that physicians shouldn’t be ranked Dr. John Bastulli (right), Vice President of Legislative Affairs for the AMCNO spends a moment with the The AMCNO explained our position and the by the insurance industry due to the inherent Executive Director of the Ohio State Medical Board, reasons for introducing the physician ranking conflict of interests and concerns over the Mr. Rick Whitehouse. legislation pointing to other states that have methodology used; however, the AMCNO passed a similar law as well as the review of was able to provide information to the interested party in this process. The AMCNO this issue by the New York Attorney General. OSMB legislative committee that the best plans to work with the OSMB and other The AMCNO informed the OSMB staff that course may be to ensure that there is an medical groups as this legislation moves we plan to reintroduce the legislation in this evidence-based framework upon which this forward in the General Assembly. I General Assembly and we offered to provide will take place. Therefore, the consensus of additional information to the OSMB legislative the OSMB was to accept the recommendation committee or to their full board if necessary. of their legislative committee and remain an AY SIGN UP TOD NO/AMEF AMCNO Adopts Joint Principles of the OR THE AMC F LEGAL SPONSORED NAR – SEE Patient-Centered Medical Home ISSUES SEMI N FORM REGISTRATIO The Academy of Medicine of Cleveland & Northern Ohio (AMCNO) Board of Directors has ON PAGE 19. voted to adopt the “Joint Principles of the Patient-Centered Medical Home,” joining the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association in endorsing the principles. The principles include guidelines for the coordination of care to improve the patient-physician relationship, quality and safety, access to care, and the payment model for coordinated services. INSIDE THIS ISSUE The concept of the medical home has been diseases, and it includes attributes of the around for some time. The American “chronic care model” that encourages HB 125 Committee Academy of Pediatrics has advocated this greater collaboration among physicians, Submits Final report Page 4 model for decades for children with chronic (Continued on page 3) Ohio Department of Insurance Issues Toolkit Page 5 AMCNO 6100 Oak Tree Blvd. Ste. 440 AMCNO Legislative Update Page 8 Cleveland, OH 44131-0999 Physician Interaction with Pharmaceutical Companies Page 10 ADDRESS SERVICE REQUESTED 2 NORTHERN OHIO P HYSICIAN I March/April 2009 BOARD ACTIVITIES AMCNO Adopts Joint Principles of Joint Principles for a the Patient-Centered Medical Home Patient-Centered Medical Home : SAVE THE DATE (Continued from page 1) Care Coordination The Academy of Medicine hospitals and others for using cost-effective Each medical home patient has an ongoing of Cleveland and Northern approaches to meet patients’ overall needs. relationship with a personal physician trained to provide first-contact, continuous Ohio (AMCNO) invites As government and private payers use and comprehensive care, coordinated across you to attend our demonstration projects to test the medical all elements of the U.S. health system. home model for patients with multiple 2009 Annual Meeting chronic conditions, it’s important that Physician Pay incentives are provided to physicians who Medical home payments reflect the value Friday, April 24, 2009 use the medical home model in their of care-management work conducted by Ritz-Carlton Cleveland practices. Helping patients manage chronic physicians and staff beyond face-to-face 1515 West Third Street conditions more effectively and efficiently visits. Payment is available for use of health will go a long way toward improving our information technology as well as secure e-mail 6 p.m. Reception • 7 p.m. Dinner nation’s healthcare system. and telephone consultations. Doctors share Black Tie Optional in the savings from reduced hospitalizations. “The use of a patient-centered medical home Additional payments are available for medical INDUCTION OF THE model can enhance the ability of physicians homes that achieve measurable and 2009-2010 AMCNO P RESIDENT , and other healthcare workers to provide continuous quality improvements. Anthony E. Bacevice, Jr., MD coordinated care to their patients,” said AMCNO President Raymond J. Scheetz, Quality and Safety PRESENTATION OF 50 Y EAR AWARDEES Jr., MD. “The AMCNO has been involved in Medical homes seek optimal patient outcomes AND ACADEMY OF MEDICINE EDUCATION discussions regarding this concept at both defined by a care-planning partnership among FOUNDATION (AMEF) S CHOLARSHIPS TO the local and state levels and we will continue physicians, patients and their families. Doctors MEDICAL STUDENTS FROM CASE SCHOOL to evaluate the impact of the medical home follow evidence-based medicine and actively OF MEDICINE , C LEVELAND CLINIC concept as it develops in our region.” seek patient feedback. An appropriate non- LERNER COLLEGE OF MEDICINE AND government entity certifies practices seeking This patient-centered medical home (PCMH) to become medical homes. OHIO UNIVERSITY COLLEGE OF MEDICINE . model of care starts with a patient having a personal relationship with a primary care Access AMCNO 2009 H ONOREES physician, such as a family physician, where Enhanced patient access is available through Jeffrey L. Ponsky, MD the physician takes care of the patient and open scheduling, expanded hours and new JOHN . H. B UDD MD coordinates all aspects of their healthcare in communication options among patients, their a system built around primary care. personal physicians and medical home staff. DISTINGUISHED MEMBERSHIP AWARD The joint principles of the PCMH model To view the joint principles in their entirety Delos M. Cosgrove III, MD adopted by American Academy of Family go to: http://www.aafp.org/online/etc/ CHARLES L. H UDSON MD Physicians, American Academy of Pediatrics, medialib/aafp_org/documents/policy/fed/ DISTINGUISHED SERVICE AWARD American College of Physicians and American jointprinciplespcmh0207.Par.0001.File.tmp/ Osteopathic Association as well as by the 022107medicalhome.pdf . I Kevin T. Geraci, MD AMCNO are as follows: CLINICIAN OF THE YEAR Michael T. Gyves, MD PECIAL ONORS WARD NORTHERN OHIO Editorial Offices: AMCNO, 6100 Oak Tree Blvd., Suite S H A 440, Cleveland, Ohio 44131, phone (216) 520-1000. $36 PHYSICIAN per year. Circulation: 3,500. The Honorable George V. Voinovich Opinions expressed by authors are their own, and not SPECIAL RECOGNITION AWARD THE ACADEMY OF MEDICINE OF CLEVELAND & necessarily those of the Northern Ohio Physician or The NORTHERN OHIO Academy of Medicine of Clevelan d & Northern Ohio. 6100 Oak Tree Blvd., Suite 440 Northern Ohio Physician reserves the right to edit all Brian F. Keaton, MD Cleveland, Ohio 44131-2352 contributions for clarity and length, as well as to reject HONORARY MEMBERSHIP AWARD Phone: (216) 520-1000 • Fax: (216) 520-0999 any material submitted. STAFF Executive Editor, Elayne R. Biddlestone ADVERTISING: George H. Allen, Jr. (posthumous) THE NORTHERN OHIO PHYSICIAN (ISSN# 1935-6293) is Commemorative Publishing Company AMCNO P RESIDENTIAL CITATION AWARD published bi-monthly by the Academy of Medicine of c/o Mr. Chris Allen Cleveland & Northern Ohio (AMCNO), 6100 Oak Tree 2093 W. 11th Street, Cleveland, Ohio 44131 Blvd., Suite 440, Cleveland, Ohio 44131. Periodicals P: (216) 736-8601 • F: (216) 736-8602 Please join us in congratulating our postage paid at Cleveland, Ohio. POSTMASTER: Send © 2009 The Academy of Medicine of Cleveland & address changes to NORTHERN OHIO PHYSICIAN, 6100 medical scholarship recipients and Northern Ohio, all rights reserved. Oak Tree Blvd., Suite 440, Cleveland, Ohio 44131. awardees on April 24th. NORTHERN OHIO P HYSICIAN I March/April 2009 3 PHYSICIAN ADVOCACY ACTIVITIES • Payments made for services rendered to The HB 125 Advisory Committee on ineligible employees and dependents should not be permitted to be “taken Real-Time Adjudication and Eligibility back” after one year from the date of original payment, if the provider confirmed Releases Their Final Report eligibility electronically on the date of service and can demonstrate that eligibility In recent months, the AMCNO has been actively involved in an advisory committee set up by was verified at the time services were the Ohio Department of Insurance (ODI) under HB 125 to address the issue of standardizing rendered. (The AMCNO and other communications between doctors and insurance companies in Ohio. HB 125 of the 127th provider groups pressed hard to reduce Ohio General Assembly required the creation of an Advisory Committee on Eligibility and the “take back” provision from two Real-Time
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