The EVP Crystal Ball: The Top Ten Things to Watch in 2016


PAMED’s Executive Vice President Mike Fraser, PhD, CAE, FCPP, shares his list of “Top Ten Things to Watch in 2016.”

The end of the year always brings out the “lists,” so here is my list of those things I foresee as top 10 Pennsylvania Medical Society (PAMED) issues and priorities in 2016. While there are certainly many other issues than the ones listed below, if 2015 is any indication of where we may go in 2016, these 10 (and a few others I’m sure) are certainly going to involve significant investments of time and energy by PAMED members and staff. Stay tuned!

1. CRNP Independent Licensure

The recent decision by the Hospital and Healthsystem Association of Pennsylvania (HAP) to support CRNP independent licensure after a certain numbers of hours of collaborative practice is disappointing given PAMED’s continued support for physician-led, team-based care. Despite HAP’s decision, PAMED will continue to oppose legislation that eliminates collaborative agreements between physicians and CRNPs. PAMED believes that team-based care is the most cost effective and clinically appropriate way to deliver patient care.

The PAMED Board will be discussing this development at its February Board meeting and developing a response to HAP’s position based on Board discussion. Look for more activity on this issue early in 2016.

2. More on Drugs: Prescription Monitoring Database and Medical Marijuana

If all goes according to plan, the state’s ABC-MAP Prescription Monitoring Program should be launched sometime in late 2016. This long awaited tool to address opioid abuse in the Commonwealth is something PAMED has been advocating for as part of our “Pills for Ills, Not Thrills” program.

Once the database is established, PAMED is planning to work with partner groups across the state to develop physician-specific training on how to use the database, address some unresolved issues related to privacy concerns, and address some of the process and system changes that these systems entail.

The legalization of marijuana for medical use could see legislative action in the House of Representatives before the end of the year (the State Senate has already approved a legalization measure). PAMED has been consistent in its call for FDA approved clinical trials and other patient safety concerns before the legislature moves forward on legalizing the drug. If the legislature moves in this direction, what will the final legislation regulating marijuana look like? We could find out in the coming year.

3. Volume to Value, MIPS, Meaningful Use

The move toward reimbursing for “value” and not “volume” continues. PAMED will be tracking the implications of these initiatives on Pennsylvania physicians. Look for continued educational sessions, research briefs, and physician advocacy to make these new programs less onerous to physician practice.

PAMED will also be coordinating more closely with the American Medical Association (AMA) through our federal affairs consultant and share Pennsylvania-specific feedback on these programs with our Congressional Delegation and related federal agencies. Look to PAMED for resources and information on the alphabet soup of federal initiatives and programs and calls to action to help make these programs less onerous for physicians.

4. Hospital and Health System Consolidations and Impact on Physicians

The trend toward consolidation of health systems continues and PAMED will be tracking the impact of mergers and affiliations on patient access and physician practice. With the FTC’s decision to reject the Pinnacle-Penn State Hershey affiliation here in Central Pennsylvania, we know that 2016 will come with continued efforts to merge systems and address federal and state concerns over market share and access to care.

5. Primary Care Workforce and Physician Supply Issues

PAMED will be taking an aggressive stance on ways the physician community can help address physician distribution across the state and program and policy decisions to encourage physicians to practice in underserved areas. We will be forming a new Member Advisory Panel on the issue to help inform PAMED Board policy and ways that PAMED and its members can collaborate with other state and national efforts to increase the physician supply and address the shortage of primary care and medical specialists in some parts of the state.

6. Focus on Employed Physicians and Academic Affairs

PAMED starts the year welcoming two new staff members to our Physician Leadership, Engagement, and Outreach team who will be working early in 2016 to better understand the ways that PAMED membership can add value to several specific segments of our membership.

Look for new program development in the areas of physician employment by hospitals, health systems, and large physician groups as well as medical students, residents, academic affiliated physicians, including residency program directors, and early career physicians. We will also be reformulating our Employed Physician Task Force and looking for ways to address issues raised by PAMED members who are employed by hospitals, health systems, and large physician groups.

7. Task Force on Regional Medical Societies

An outcome of the 2015 House of Delegates was the formation of a PAMED Task Force to look at developing multi-county, regional medical societies. A member task force to discuss the pros and cons of forming regional societies will be appointed in early 2016 and hopes to have a report back to the House in 2016.

8. Addressing Administrative Barriers to Patient Care

PAMED continues to move forward in seeking legislative reforms to several health insurance practices that create barriers to effective patient care. Our physician credentialing legislation was introduced by Rep. Matt Baker late last fall and is expected to be considered by the House Health Committee early in 2016.

PAMED will also continue our work with the state’s Department of Human Services to improve the physician credentialing process used by the Medical Assistance program. A task force has been formed to work with the state to better understand the barriers to Medical Assistance credentialing and develop efficiencies and improvements.

Rep. Marguerite Quinn is poised to introduce legislation on PAMED’s behalf that will address health insurers’ prior authorization processes.

PAMED is actively working to more efficiently engage physicians on these two very important pro-patient issues.

9.  Support for Physician Innovation

The sale of PAMED’s KePRO subsidiary helped PAMED create an “Innovation Fund” to support new, emerging and priority projects across the state. PAMED will be forming a work group to help develop review criteria and determine support for various project requests and initiatives, including eligible applicants and levels of support. Look for those opportunities as we move into 2016 – we are just getting started now and there is a lot to do before we are ready to fund projects, but the opportunity is an amazing one to support physician innovation and membership development in 2016 and beyond.

10. PAMED Technology Upgrades

A new app and website are coming soon. We will be refining and enhancing the app in the months to come, but we are excited to share this great resource for members and look forward to your feedback on how to make it even better.

A new, customizable website will make it easier to tailor the information and resources you need to thrive in the business, practice, and life of medicine. Visitors to the new site will be able to take advantage of the ability to track favorites, tag articles, and more.

These 10 are just some of things I anticipate in 2016. Clearly there are many more policy and advocacy priorities as well as new programming that we are developing. And I didn’t even mention some of our ongoing priorities such as Mcare refunds, working to make Maintenance of Certification (MOC) work better for PA physicians, or predictions on the 2016 elections!

So, stay tuned for more and let me know which of these priorities excite you – and where else we should be getting engaged in the future. Happy New Year!