|ACPM Headlines 1/11/13|
In this Issue
Policy and Practice
Research and Reports
1. ABPM ANNOUNCES FIRST CLINICAL INFORMATICS SUBSPECIATY CERTIFICATION EXAM
The American Board of Preventive Medicine has announced that the first examination for certification in the subspecialty of Clinical Informatics will be offered from October 7-18, 2013. A one-day, multiple choice exam will be administered at Pearson VUE Professional Centers throughout the United States and several International sites. Current certification by at least one of the Member Boards of ABMS, along with additional qualifications, is required to sit for the exam.
The online application will
be available from March 1 through June 1, 2013, on the ABPM web site. Visit www.theabpm.org for additional
information and to download the online application.
2. PREVENTIVE MEDICINE TRAINING PROFILED AT IOM GME COMMITTEE MEETING
The Institute of Medicine (IOM) Committee on Governance and Financing of Graduate Medical Education invited and heard testimony from the preventive medicine perspective at its first meeting in December. Raul Mirza, DO, MPH, vice president of the ACPM Resident Physician Section (RPS) testified on the importance of securing strong support for preventive medicine residency training programs under a reformed graduate medical education (GME) payment methodology.
The IOM Committee has been charged with developing recommendations for policies to improve GME that "consider the current financing and governance structures of GME, the residency pipeline, the geographic distribution of generalist and specialist clinicians; types of training sites; relevant federal statutes and regulations; and the respective roles of safety net providers, community health/teaching health centers, and academic health centers.”
Dr. Mirza noted in his comments that, "as it currently stands, GME financing does not support emerging population-focused training models. Unfortunately, the shortcomings of Medicare’s GME payment methodology has placed PMR training programs at a financial disadvantage compared to all other residency training disciplines…The single, most-often cited reason by program directors for their inability to train at full capacity is lack of a stable, federal funding source to support residency training costs.”
Previously, following the initial organization of the IOM Committee, ACPM president Miriam Alexander, MD, MPH, FACPM sent a letter informing committee members of the unique pressures that adversely impact the preventive medicine training pipeline.
For more information about the IOM Committee visit http://bit.ly/HMpyZf.
A systematic review published in the January 2013 issue of JAMA found that being classified as "overweight” on the BMI scale was associated with significantly lower all-cause mortality, although "obesity” was associated with significantly higher all-cause mortality, when compared to normal weight. More specifically, the study found grade 1 obesity was not associated with higher all-cause mortality, and grades 2 and 3 obesity were associated with significantly higher all-cause mortality.
The researchers noted the study’s limitations, such as addressing only all-cause mortality and not morbidity, and the limitations of using the BMI scale versus other methodologies to measure body composition. These and other limitations of the controversial study are further expanded upon in a review by David L. Katz, MD, MPH, FACPM, who notes that individuals are living longer—but sicker—and that this study does not undo what we know about weight management and health.
4. ACPM WELCOMES TWO NEW CORPORATE ROUNDTABLE MEMBERS
ACPM is pleased to welcome UnitedHealth Group and RediClinic to ACPM’s Corporate Roundtable. UnitedHealth Group, a leading health care company, serves more than 75 million people worldwide. RediClinic provides high-quality, convenient care clinics located inside retail chains, offering pharmacy services and an innovative weight-loss program.
As a leader in the health benefits and services industry, UnitedHealth Group’s six businesses — UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement, UnitedHealthcare Community & State, OptumHealth, OptumInsight, and OptumRx — offer services, broad capabilities and enduring value in creating a modern health care system. UnitedHealth Group’s products and services are designed to empower individuals, expand consumer choice and strengthen patient-provider relationships across the health care spectrum.
RediClinic, in addition to the battery of preventive and therapeutic services to treat common conditions, has developed the Weigh Forward weight management program. It is a 10-week program that includes an initial medical evaluation and regular biometric testing to ensure patients are improving their health while losing weight. It is a physician-driven, family-oriented program in which participants also receive comprehensive information and counseling on diet/nutrition, physical activity and behavior modification.
ACPM’s Corporate Roundtable is a group of private sector stakeholders that share a commitment to ACPM and its multiple population-based and clinical approaches to health care.
The ACPM Graduate Medical Education (GME) committee is recruiting new members to advance its priorities under the ACPM Strategic Plan. These priorities, which in some cases will be carried out in collaboration with other ACPM committees, are to:
1) Help Preventive Medicine specialists obtain competencies and improve practice performance across the entire career continuum.
2) Promote and advance full, unrestricted licensure for Preventive Medicine physicians
3) Increase representation of Preventive Medicine physicians in national medical organizations.
4) Create and distribute multi-media-supported educational information about the specialty for medical students and other medical professionals/associations.
5) Develop and post medical student elective curriculum options on the ACPM web site.
GME Committee also will continue its long-standing work in support of the
annual Residency Directors Workshop, traditionally held the first day of the Preventive
Medicine conference. If you are interested in joining the committee,
please email Andrea Lowe, ACPM policy and practice manager, at firstname.lastname@example.org,
current CV and statement of interest in joining the committee.
6. THERE’S STILL TIME TO RENEW YOUR ACPM MEMBERSHIP
If you have renewed your membership in ACPM for 2013, the College sincerely thanks you for your ongoing commitment to and support of the organization and the specialty. If you have not, you are encouraged to do so before your membership lapses. ACPM members enjoy numerous benefits including discounts on CME/MOC credits (non-members pay $10 per credit), meeting registration discounts, savings on publications, and much more!
Membership in ACPM is on an annual billing schedule of January 1-December 31. If you have not submitted payment of membership dues for 2013, your membership expired on December 31, 2012. However, ACPM is allowing expired members additional time to renew online without penalty, but that option will soon expire. You may renew online at www.acpm.org using a major credit card or electronic check. Simply visit our web site, and log into the "members-only” section with your username and password. If you do not remember your password, you may reset it online, provided you are using the same email address as when you first registered. If you are unable to reset your password, please contact the membership department for assistance.
Attending Preventive Medicine 2013, February 20-23 in Phoenix-Scottsdale, AZ? We hope so! And if you do, be sure to visit the Expo Hall to check out innovative products and services in preventive medicine, and visit the ACPM booth (#6), located next to the ABPM booth, for career center postings, membership information, resources and giveaways. Drop off your business card and enter to win our grand prize (to be announced). We look forward to seeing you at PM2013!
Preventive Medicine 2013 attendees, hotel reservations at the Pointe Hilton Tapatio Cliffs Resort must be made on or before Sunday, January 20 in order to receive the special ACPM group rate of $169 per night. Please be sure to mention "ACPM” when making your reservation to receive the discounted rate.
Don’t miss the latest ACPM Perspectives in Prevention columns written by ACPM members and published on Medscape.
In the first article, "The Community as Patient: Ethical Principles for the Practice of Population Medicine," ACPM President-elect Halley S. Faust, MD, MPH, MA, FACPM, addresses the realities faced by preventive medicine physicians who are in the unique position of straddling the world of dyadic, patient-physician medicine with the more broadly based practices of health policy, epidemiology, economics, insurance, management, environmental, and other population-oriented approaches to health care. It explores the inherent conflicts and dilemmas for physicians who struggle to balance what is good for the individual with what is good for the community in the context of ACPM’s Code of Ethics and twelve key principles for practice. CME credit is available.
The second, "Public Health in the Smartphone Era,” was written by ACPM member Sheryl A. Bedno, MD, MPH, MS and Chief Information Officer at William Beaumont Army Medical Center, Darrin M. Vicsik, MBA, MHA. This timely column explores the rapidly changing environment where medical and healthcare apps are multiplying at an exponential rate. The column highlights advantages such as enhanced clinical decision making and the ability for broad dissemination of information. These benefits are weighed against what many see as clear challenges – the lack of adherence to evidence-based literature, varying levels of acceptability and usability among patients, and an array of security concerns. A CME version of this column will be made available soon; please check back.
These, and all Perspectives in Prevention columns, can both be accessed through ACPM’s website at http://www.acpm.org/?PerspectivesPrevent.
10. ACPM JOINS LETTER ON ESSENTIAL HEALTH BENEFITS RULE’S IMPACT ON TOBACCO CESSATION
ACPM joined several of its public health and medicine partner organizations on a sign-on letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius regarding the impact of proposed regulations that define Essential Health Benefits (EHB) on coverage of tobacco cessation.
The letter, signed by 15 national organizations, notes that "We strongly urge HHS to clearly define which tobacco cessation treatments are required coverage as a preventive service under EHB. This definition should include—and require—all tobacco cessation medications approved by the FDA and individual, group and phone counseling. It should be based on and reference the most recent version of Treating Tobacco Use and Dependence, to ensure that if the guideline is updated, the benefit will be too.”
ACPM will continue to advocate for full coverage of tobacco cessation programs as implementation of the Affordable Care Act moves forward.
To view a copy of the letter, visit http://bit.ly/UMhws4.
Just prior to the start of the New Year, ACPM joined its colleagues in the AMA Federation on a sign-on letter to Congress urging quick action to avoid the impact of the roughly 8 percent across-the-board cuts to all government programs that would have been required to implement the January 1 sequester. With mounting public pressure to avoid the sequester, Congress acted at the 11th hour and passed legislation that delays the sequester by two months, providing additional time for Congress and the president to negotiate a broad deficit reduction package.
The AMA letter stated that Congress should act to "maintain funding levels for key research, public health, and prevention programs administered by such agencies as the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, and the Food and Drug Administration. Investment in public health and prevention programs promotes wellness, prevents disease, and protects against public health emergencies, as well as generates long-term benefits that promise to lower future health care spending. The long-term benefits in improved health status, including greater productivity, should not be sacrificed to meet short-term budget objectives.”
The Agency for Healthcare Research and Quality’s Health Care Innovations Exchange now provides tools for Using Information Systems to Promote Prevention. The AHRQ tools focus on the many innovations in information technology and quality improvement that have emerged to promote prevention. These innovations are used to enhance preventive services by, for example, improving electronic health records to prompt and remind providers of recommended services, smart phone apps, and other interactive, electronic interfaces to promote preventive health services. For more information visit the Innovation and Quality Tools webpage.
13. AMA RELEASES GUIDE ON PREVENTIVE CARE AND CODING DOCUMENTATION
The American Medical Association (AMA) has created a pocket guide for preventive services and an online training module to help physicians correctly code and document for preventive services that health plans must cover without cost-sharing under new requirements of the Affordable Care Act. These tools identify services recommended by the U.S. Preventive Services Task Force (USPSTF) and help providers better understand when to use CPT modifier 33 in conjunction with delivery of clinical preventive services.
The Affordable Care Act now requires coverage of clinical preventive services that have received a "Grade A” or "Grade B” recommendation from the USPSTF and removed the copayment or co-insurance barriers for patients.
The Trust for America’s Health (TFAH) has issued its 2012 report, Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism, providing an independent analysis of the nation’s public health preparedness. The report found that although there has been significant progress toward improving public health preparedness over the past 10 years, particularly in core capabilities, there continue to be persistent gaps in the country's ability to respond to health emergencies, ranging from bioterrorist threats to serious disease outbreaks to extreme weather events.
The report focuses on the states’ level of preparedness, evaluates the federal government’s role and performance, and provides recommendations to improve emergency preparedness. The 2012 edition specifically reviews state and federal public health emergency preparedness, providing a snap shot of where our nation stands in its ability to respond to health disasters resulting from natural disasters, bioterrorist threats and disease outbreaks.
Fewer than one in five consumers in California who had a consumer-directed health plan were aware or understood that their plans provided first-dollar coverage of preventive services, according to an article published in the December 10 edition of Health Affairs. Consumer-directed health plans are plans with high deductibles that typically require patients to bear little or no out-of-pocket costs for preventive care, such as annual physicals or screening tests, in order to ease financial barriers and encourage patients to seek such care.
The study also found that roughly one in five respondents said that they had delayed or avoided a preventive office visit, test, or screening because of cost. Those who were confused about the exemption were significantly more likely to report avoiding preventive visits because of cost concerns. The study, conducted by researchers from Kaiser Permanente Northern California Division of Research, the Mid-Atlantic Permanente Research Institute, and Harvard University, surveyed a random sample of adult (ages 18–65) Kaiser Permanente Northern California primary subscribers who were enrolled in a health savings account–eligible, high-deductible plan through their small-group employer (fewer than fifty employees) throughout 2007.
The authors recommend that special efforts to educate consumers about preventive care cost-sharing exemptions may be necessary as more health plans, including Medicare, adopt this model.
16. APTR TO HOST TEACHING PREVENTION 2013 IN MARCH
The Association for Prevention Teaching and Research (APTR) will be hosting its annual Teaching Prevention meeting, March 11-12, 2013, in Washington, DC. This year’s meeting, "Developing Educational Experiences for an Evolving Health System,” will focus on opportunities and challenges in advancing prevention through health reform, promotion of public health and primary care integration, and innovative approaches in curriculum design, new technologies, and academic scholarship. For more information or to register, please visit the APTR website.
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The publication is edited by Ingrid Kohlstadt, MD, MPH, FACPM. This authoritative reference equips clinicians with the information they need to fully utilize nutritional medicine in their practice. Visit www.crcpress.com to obtain more information and place your order.