ACOG 2016 in Real Time. What Benefit ACOG brings to my Practice?

Transcription

1 ACOG 2016 in Real Time What Benefit ACOG brings to my Practice?

2 Disclosure Fellow in ACOG District IV Chair ACOG Member of Executive Board Employee Palmetto Health-Tuomey No financial conflicts

3 Objectives: Detailed Description of the Benefits of ACOG Membership. Describe ACOG; it's new structure, its goals, its emerging new role Discuss ACOG membership; its Member s Demographics National, District IV and Puerto Rico Population Demographics-How it will change out specialty Discuss Advocacy and the PAC A Necessity Its Recent Successes MARCA and MIPS Data Registry Initiative.

4 ACOG Goals Education--To provide evidence-based knowledge in women s health to our membership and to the women we serve. Practice--To promote quality, safety, efficiency and stability for the delivery of women s health care services. Membership and Organizational Structure--To continuously improve and maintain an organizational structure that will support and sustain our membership and fulfill our organizational mission and vision. Research Support: Lobbying for research dollars to NICHD. Independent support of research.

5 Objectives: Detailed Description of the Benefits of ACOG Membership. Describe ACOG; it's new structure, its goals, its emerging new role Discuss ACOG membership; its Member s Demographics National, District IV and Puerto Rico Population Demographics-How it will change out specialty Discuss Advocacy and the PAC A Necessity Its Recent Successes MARCA and MIPS Data Registry Initiative.

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8 Benefits: Practice Based ACOG Website: Markedly Improved, Easy to Use, Easy to Navigate. ACOG App: EDD, Practice Bulletins, Committee Opinions Mentorship: Become a Mentor. Executive Board just approved the purchase of software to assist in this District VI initiative and expand it to all members. Patient Education Materials: Who hasn t used or suggested online access to patients and many are in Spanish. Coding Department: We now send new physicians to our practice to the coding course with an employee. Attend early in your career. Probably best department on this topic in the medical industry.

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12 ACOG Benefits: Educationally based

13 Education Education--To provide evidencebased knowledge in women s health to our membership and to the women we serve. This what we do best. First to our membership to better care for the women we serve

14 Single Subject Detailed analysis of current knowledge on subject Generated by committee and extensively researched Full description but only what can be agreed upon Generally 6 to 8 per year. 10 to 16 pages long.

15 Practice Bulletin - Format Title, date, number and often describes what it replaces. A short general summary usually with a stated purpose. Background information Clinical considerations and recommendations Contains specifics in question format. Summary and Conclusions Proposed performance measures Generally for MOC References Often with a link. If that link is to the Green Journal then it will take you to the article.

16 Sometimes as many as 45 per year. Shorter and addresses emerging clinical and scientific advances. Usually 2-6 pages with references. Often created because of a change in practice or when new technology arrives. Example is 9-valent HPV vaccine; Is revaccination necessary when quad or bivalent vaccine completed--no Any available vaccine product can be used to continue vaccination. Still get it if HPV DNA testing is + If pregnant no problem but suspend until delivered Lactation does not prevent vaccination. Discusses of label use. Reminder to recommend to patients. Often CO directs you to additional resources.

17 Other ACOG Tools available Lists ACOG Department of Professional Liability Clinical Review Online Copy ACOG District and Section Activity ACOG Education Department ACOG Office of Communications ACOG Department of Health Economics & Practice Management ACOG Practice Activities ACOG Department of Continuing Professional Development

18 ACOG Office of Communications Generally, this keeps you aware of what is in the news. So you are not surprised by a patient s comments.

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20 Green Journal Subscription to Obstetrics and Gynecology Included in Dues Direct link between ACOG Website and Journal. The Green Journal App. All Volumes, Supplements available. Video also. View/Export Slideshow to PowerPoint Website: Listing of MOC Part II Articles All Practice Bulletins, Committee Opinions in the Green Journal but

21 Forest plot illustra... All-Cause and Cause-Specific Mortality After Hypertensive Disease of Pregnancy Theilen, Lauren H.; Fraser, Alison; Hollingshaus, Michael S.; Schliep, Karen C.; Varner, Michael W.; Smith, Ken R.; Esplin, M. Sean Obstetrics & Gynecology. 128(2): , August doi: /AOG Forest plot illustrating risks of general causes of mortality for women with each category of hypertensive disease of pregnancy compared with matched women without hypertensive disease of pregnancy. Created by Jennifer West.Fig. 1. Theilen. Pregnancy-Related Hypertension and Mortality. Obstet Gynecol Copyright 2016 Obstetrics & Gynecology. Published by Lippincott Williams & Wilkins. 21

22 Running out of Journal room to publish in ACOG publications in the Green Journal Therefore 1-2 page summary of Practice Bulletins, Committee Opinions, other publications. Full online version at ACOG.org or Green Journal Websites. Started September, 2015.

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24 Task Force and Work Group Reports 2016 Collaboration in Practice: Implementing Team-Based Care Additional resources related to team-based care identified by the Task Force are also available. Read the Executive Summary Well-Woman Task Force: Components of the Well-Woman Visit Power Morcellation and Occult Malignancy in Gynecologic Surgery Neonatal Brachial Plexus Palsy (Members Only) Neonatal Encephalopathy and Neurologic Outcome, Second Edition (Members Only) 2013 Hypertension in Pregnancy 2010 Report of the Presidential Task Force on Patient Safety in the Office Setting (2010) (Members Only) 2009 Management of Depression During Pregnancy: a Report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists (2009) (Reaffirmed 2014) (Members Only)

25 Education feedback from Survey 2015 at the ACM Meetings: Harder to get to. Many practices limit travel expenditures. Difficult Timing missing work. Considering After-Work Courses. Webinars, etc.

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27 Tools for Patient Education Valued highly by ACOG members but Need more and varied content Need Electronic Need link to EMR Not the only choice Other choices considered acceptable

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29 Objectives: Detailed Description of the Benefits of ACOG Membership. Describe ACOG; it's structure (old and new), its role, and its future Discuss ACOG membership; its Member s Demographics National, District IV and Puerto Rico Population Demographics-How it will change out specialty Discuss Advocacy and the PAC A Necessity Its Recent Successes Activity in an election year. MARCA and MIPS Data Registry Initiative.

30 ACOG Headquarters in Washington, DC

31 ACOG Location in DC

32 Headquarters th Street S Washington, DC Mailing Address: PO Box 70620, Washington, DC (800) ; (202)

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34 Mission/Vision Statements MISSION STATEMENT The American Congress [College] of Obstetricians and Gynecologists is a membership organization dedicated to the advancement of women s health care through continuing medical education, practice and research. The ACOG Continuing Medical Education program supports the mission of the College to advance women s health through life-long education of its members. VISION STATEMENT The College, as the premier organization for women s health care, will provide the highest quality education worldwide, continuously improve health care for women through practice and research, and provide excellent organizational support and services for our members.

35 Mission/Vision Statements MISSION STATEMENT The American Congress [College] of Obstetricians and Gynecologists is a membership organization dedicated to the advancement of women s health care through continuing medical education, practice and research. The ACOG Continuing Medical Education program supports the mission of the College to advance women s health through life-long education of its members. VISION STATEMENT The College, as the premier organization for women s health care, will provide the highest quality education worldwide, continuously improve health care for women through practice and research, and provide excellent organizational support and services for our members.

36 Still I learn Francisco de Goya

37 Structure Governance & Involvement Administration: CEO, new COO and Vice-Presidents hired to run organization. Elected Officers ON Executive Board President, President Elect, Past President - 1 year Secretary, Treasurer & Assistant Secretary 2 year Members-at-large(2)/Young Physician-at-large(2): 2 years terms. District Officers (12) - 2 year terms Public Member 3 year term with optional repeat x1 Junior Fellow Chair and now Vice Chair - 1 year each. Sub-specialty Reps 2 years each. REI, MFM, SGO, AUGS District Advisory Level: Section Officers - 2 year terms, Vice Chair, Secretary, Treasurer,? Scientific Program Chair.

38 Administration Individuals hired by the membership to run the organizations. Hal Lawrence - Executive Vice President and CEO. Sandra Carson-Education Barbara Levy - Advocacy Chris Zahn Practice Activity Rick Robinson- COO Penny Rutledge (Legal Counsel) Warren Cook CFO.

39 Executive Board Members (29) Elected officers President President Elect Immediate Past President Secretary, Treasurer, Assist. Secretary JFCAC Chair & Vice Chair Fellows-at-Large -- 2 Young Physicians-at-Large - 2 District Chairs - 12 Public Member - 1 Subspecialty Representatives - 4 AUGS SGO SMFM SREI

40 Goals: Membership and Organizational Structure Describe the College[Congress] governance structure. Maintain high qualifications for ACOG membership. Promote involvement of our membership at all levels of the organization.

41 ACOG Started from prior organizations joined. June 13, 1951 at the Homestead in Virginia Started with 500 members. Current membership 58,084 (all categories) 6,500 Medical students. 9,800 Junior Fellows (training + practice) 81% Female 30,000 Fellows 54% Female

42 Committees/Sub-Committees Executive Board Executive Cmt of the Executive Board Council of District Chairs Junior Fellow College Advisory Council AAFP-ACOG Liaison ACOG-SMFM Joint Editorial Committee Adolescent Health Care Ambulatory Practice Operations American Indian Affairs Appeals Panel Committee Audit Committee Clinical Document Review Panel- Gynecology Clinical Document Review Panel- Obstetrics Coding and Nomenclature Compensation Continuing Medical Education Credentials CREOG Ed Bd for Clinical Updates in Women s Health Care Ed Cmt Guidelines for Women s Health Care Ethics Finance Genetics Government Relations & Outreach Grievance Committee Gynecologic Practice Subcommittee on Gynecologic Oncology Subcommittee on REI Subcommittee on Urogyn Health Care for Underserved Women Honors & Recognitions Industrial Exhibits International Affairs Nominations Obstetric Practice Patient Education Editorial Board Patient Safety and Quality Improvement VRQC Steering Committee Practice Bulletins-Gynecology Practice Bulletins-Obstetrics PRECIS Advisory Committee Professional Liability PROLOG Advisory Committees PROLOG Task Force on Gyn/Surgery, 6th Ed. PROLOG Task Force on REI, 6 th Ed. Scientific Program Districts and Sections

43 Objectives: Detailed Description of the Benefits of ACOG Membership. Describe ACOG; it's structure (old and new), its role, and its future Discuss ACOG membership; its Member s Demographics National, District IV and Puerto Rico Population Demographics-How it will change out specialty Discuss Advocacy and the PAC A Necessity Its Recent Successes Activity in an election year. MARCA and MIPS Data Registry Initiative.

44 Membership Demographics ACOG Stats July, 2016 Total Membership 58,949 Male/Female % Total Females for all categories 32, % Total Males for all categories 26, % Total Females for Junior Fellow categories 8, % Total Males for Junior Fellow categories 1, % Average Ages: Averages All Fellows 52 Male Fellows 60 Female Fellows 42

45 ACOG Stats as of July 7, 2016 District IV Stats Total Female Male Fellow FSS JFT-R JFT-P Argentina District of Columbia Georgia Virgin Isl Maryland North Carolina Puerto Rico South Carolina Virginia Virgin Isl West Virginia Totals

46 Membership Demographics It is predicted that by 2020 there will be 6,000 8,000 fewer ob-gyns [compared with 2014]. By 2025 the number of ObGyns leaving the workforce will exceed the number of graduating residents entering the workforce by 20%. Residents graduating with less operative surgical experience are avoiding challenging vaginal surgery and more difficult laparoscopic procedures. Others are choosing an obstetric practice as a laborist or an office-based practice. One third are choosing to subspecialize.

47 Total Male Female 152,274,000 75,851,000 76,423,000 Female

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58 Total(1950) 152,274,000 Total(2002) 280,562,489 Male 75,851,000 Male 137,256,424 Female 76,423,000 Female 143,306,065

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61 Total(1950) Male Female 152,274,000 75,851,000 76,423,000 Total Male Female 321,418, ,229, ,189,523

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68 Total Male Female 403,943, ,267, ,675,464

69 Total Male Female 152,274,000 75,851,000 76,423,000

70 Total(1950) Male Female Total(2002) Male Female Total(2015) Male Female Total(2050) Male Female 152,274,000 75,851,000 76,423, ,562, ,256, ,306, ,418, ,229, ,189, ,943, ,267, ,675,464

71 Life Expectancy and Age of Menopause Age(Years) Date

72 Life Expectancy Year All Races White Black Both Sexes Male Female Both Sexes Male Female Both Sexes Male Female

73 Presidential Initiatives 2016: Global Health All In For Advocacy We have made great strides in the last 5 years. Really since the 501-c-6 organization. New Resident Education Models: What we train our residents for depends on supply and demand.

74 How do we prepare for the future? American Board of Obstetrics and Gynecology, the Council on Resident Education in Obstetrics and Gynecology, the Residency Review Committee, and the American College of Obstetricians and Gynecologists have completed their new draft of the Educational Objectives for Residents. We will use these to research, study, and develop alternative training and education models to address the needs of the future based on what the ob-gyn actually does.

75 Other Things: Practice oriented Mentoring Safety Initiative Data Registry and development of Quality Measures. Commitment from the Executive Board.

76 To support our membership Mentoring: Project of District VI initially. Expanded to National Purchasing software to assist in mentor-mentee assignment So relationships can more easily extend across districts

77 Practice To promote quality, safety, efficiency and stability for the delivery of women s health care services AIM--ACOG is a core partner in The Alliance for Innovation on Maternal Health (AIM) program under the auspices of the Council for Patient Safety in Women s Health Care Alliance includes: American College of Nurse Midwives (ACNM), Association of Maternal and Child Health Programs (AMCHP), Association of State and Territorial Health Officials (ASTHO), Association of Women s Health, Obstetric, and Neonatal Nurses (AWHONN), California Maternal Quality Care Collaborative (CMQCC), Society of Maternal-Fetal Medicine (SMFM), The Health Resources and Services Administration Maternal and Child Health Bureau (HRSA- MCHB)

78 Practice Women's Health Registry Alliance Established in June 2011, the Women s Health Registry Alliance serves to provide a central, collaborative home for registries that seek to improve women s health outcomes. Example: revitalize Campaign. To develop a registry A cost effective and user friendly database development for sharing across multiple registries. Once you have the database, Identify effective patterns of care Track benefits, risks, complications, outcomes (short and long term) Once developed, then it can be used: To answer key questions in women s health. To develop meaningful measures. To assure common definitions (why they started with revitalize ) To Assure Common and detailed coding mechanisms to support credible and interchangeable data. (sounds like ICD10). To evolve as needed and provide data to help Fellows fair better in a Pay-for-performance world.

79 Advocacy and the PAC Past Successes SGR-Fixed RUV increases 2012

80 Top ACOG Wins -- SGR Replaced Reliable Payment Increases for the First Five Years: Ensures a period of stability with modest Medicare payment. Protection for Low Medicare Volume Physician Practices: Ob-gyns and other physicians with a small Medicare patient population are exempt from many program requirements. Physician Liability Protections: Ensures that federal quality measurements cannot be used to imply medical negligence and generate lawsuits. Protected Ultrasound: No cuts to ultrasound reimbursement. Penalties Ended: Penalties related to Electronic Health Records (EHR) Meaningful Use, Physician Quality Reporting System, and use of the Value-Based Modifier end in Alternative Payment Model (APM) Bonus Payments: Bonus-eligibility for APM participation is based on patient volume, not just revenue, to make it easier for ob-gyns to qualify. Children s Health Insurance Program (CHIP): Includes a 2-year extension of program. Quality Measure Development: Helps professional organizations, like ACOG, develop quality measures for the Merit-Based Incentive Payment System (MIPS),. Stops CMS Policy on Global Surgical Codes: Halts implementation of Center for Medicare and Medicaid Services plan to unbundle all 10- and 90-day global codes. Extension of Key Programs of Importance to Ob-gyn: Funding extensions to Medicaid/CHIP Pediatric Quality Measures Program, Community Health Centers, National Health Service Corps, and Teaching Health Center Graduate Medical Education Payment Program.

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82 Expansion of Primary Care Bump

83 MACRA-Medicare Access and CHIP Reauthorization Act Quality Payment Program Better than SGR. But it s far from perfect. Moving from the number of procedures we perform to the quality of care we provide. Rules: all 962-page proposed rule the agency put out on April 27, Explains why we need Data Registry Learning about the New Payment System ACOG explores the ins and outs of MACRA at Send your MACRA questions to practicemanagment@acog.org New tools and resources to help you succeed with MACRA and MIPS(Merit-based Incentive Payment System) are being developed.

84 Questions Addressed What does ACOG look like now? Most Offices will be 2 years New COO. New effort on Data Registry formation and development of appropriate Quality Measures What does ACOG do for us? Education-The thing we do best and a good way to care for Women s Health in the US and Internationally Practice Support-best at Coding Education. How can we prepare our Members for Future Health Care changes? New Payment Models requiring Data Collect-Registry Development of quality measures. Changes in Resident Education Understanding the changes in population and membership demographics will help us prepare for the future.