|ACPM Headlines 4/24/15|
April 24, 2015
In this Issue
Policy and Practice
Research and Reports
1. ACPM, ACLM MOVE CLOSER TO MERGER AGREEMENT
I am pleased to report that after a year of discussions and negotiations ACPM is moving closer to finalizing an agreement to acquire the American College of Lifestyle Medicine (ACLM) as a wholly-owned subsidiary. The merger has the potential to capitalize on the complementarity of the two organizations: ACPM is the larger and more established of the two and represents a specialty recognized by the American Board of Medical Specialties; ACLM is the faster-growing, with a membership that has risen to over 500 (about two-thirds physicians) in just a few years. Merging the two organizations will help to create a unified voice and home for the field and practitioners of lifestyle medicine, reduce the fragmentation of organized public health and preventive medicine, reduce or eliminate competition for donors and sponsors, and concentrate ownership of the Lifestyle Medicine "brand” under one umbrella.
Lifestyle medicine is defined by ACLM as "the use of lifestyle interventions in the treatment and management of disease.”Its focus is nutrition, exercise, stress management, smoking cessation, and other non-drug modalities. It is currently an independent 501(c)(6) membership organization with its own board of directors, corporate office in Chesterfield MO, and annual meeting. Although the terms of the merger agreement are not final,the merger would incrementally integrate key governance, policy, finance, and programmatic functions while preserving ACLM’s unique identity and culture. For example, ACPM would appoint two members to the ACLM board; policy statements and practice guidelines would be issued by a Joint Policy Committee; and both organizations would co-sponsor each other’s annual conferences. ACLM would otherwise maintain its autonomy for two years, after which its assets would be more completely merged into ACPM (unless either organization opts out) and it would operate similar to an ACPM section with its own officers and advisory board.
While many of ACLM's members are non-physicians –ranging from PhDs in psychology to naturopaths –these individuals would not be eligible for membership in ACPM until such time as ACPM adopts a category of membership for non-physicians. Physician members of ACLM would be invited to join ACPM (there is already a small amount of overlap), with reduced dues for joint membership during the first year of the merger.
am looking forward to working more closely with our
colleagues in ACLM.
2. ACPM TO HOST REGIONAL SUMMITS ON HEALTH SYSTEMS TRANSFORMATION
ACPM is pleased to host three upcoming regional workshops to allow members and partners to engage in Health Systems Transformation (HST) activities. Regional Summits on HST will occur in California, Tennessee, and New York in May and June, 2015. Attendees will be able to identify innovative health systems transformation activities occurring in the surrounding region, discuss the role of population health in health systems transformation, and define the roles of public and private sector entities in health.
These regional meetings represent one of several projects developed through a cooperative agreement with the U.S. Centers for Disease Control and Prevention to educate, connect, and promote health systems transformation to the preventive medicine and public health communities.
Registration is NOW OPEN for these events and is only $30 per attendee. CME/MOC credits will be offered at each meeting. Space is limited.
Congress ended over a decade of repeated annual "doc fixes” that temporarily suspended scheduled Medicare provider reimbursement cuts by passing the "Medicare Access and CHIP Reauthorization Act.” The legislation permanently ends the Centers for Medicare and Medicaid Services (CMS) use of the flawed physician payment formula known as the "Sustainable Growth Rate” ("SGR”), which was projected to reduce Medicare reimbursement rates by 21 percent starting April 15, 2015.
ACPM executive director Mike Barry attended a Rose Garden reception at the White House, where the President thanked medical specialty organizations for their support of legislation to repeal the SGR.
4. DONALD GEMSON RESIDENT AWARD: SHELLY CHOO, MD, MPH
The 2015 Donald Gemson Resident Award was presented to John Hopkins General Preventive Medicine Resident Shelly Choo, MD, MPH. Dr. Choo has been part of a strong team of residents working to invigorate the Resident Physician Section of ACPM. She also works part time as a wedding filmmaker, and lent her information technology and communications skills to ACPM by producing, directing and filming a video on the importance of preventive medicine, which currently is being hosted on the ACPM home page. Congratulations and thanks to Dr. Choo!
The Donald Gemson Resident Award honors a resident member of ACPM, in any year of training including the practice year, for outstanding achievement in community service, scholarship, research, teaching and overall leadership. To nominate or learn more about ACPM’s Awards, visit: http://www.acpm.org/awards.
5. ACPM SUPPORTS BILL TO BOLSTER PUBLIC HEALTH SYSTEM’S CAPACITY TO RESPOND TO CLIMATE CHANGE
ACPM joined partner organizations in medicine and public health on a sign-on letter to Rep. Lois Capps (D-CA) expressing support for her bill, the "Climate Change Health Protection and Promotion Act.” The letter states that, "while there is an increased awareness of the public health impacts of climate change by the public health community, according to surveys conducted by the National Association of County and City Health Officials and the Association of State and Territorial Health Officials, many of the nation’s health departments surveyed continue to state they lacked the expertise or resources to address climate-related health threats…By prioritizing the public health response to climate change, your bill would bolster the capacity of our public health system and help to avoid many preventable illnesses and deaths.”
6. ACPM SIGNS LETTER URGING SMOKE-FREE POLICIES IN ALL GOVERNMENT HOUSING
ACPM joined partner organizations in medicine and public health on a sign-on letter to U.S. Housing and Urban Development secretary Julian Castro urging enactment of smoke-free policies in all government housing. The letter points to a February 2015 Centers for Disease Control and Prevention (CDC) study that found "that while there has been a significant reduction in exposure to secondhand smoke among people who rent their homes, renters are still almost twice as likely to be exposed to secondhand smoke compared to those who own their homes. Implementing smoke-free regulations in all government-subsidized housing would decrease these rates of exposure to secondhand smoke and promote the health of residents.”
7. ACPM SIGNS LETTER URGING FULL FUNDING OF FY 2016 LABOR/HHS/ED APPROPRIATIONS BILL
ACPM joined partner organizations on a sign-on letter to the House and Senate Appropriations Committees requesting an increase of 18 percent in FY ‘16 funding for the Health Resources and Services Administration (HRSA). HRSA is the administrative home of the health professions programs, which provide support to preventive medicine residency (PMR) training programs. The additional funding request will provide room for HRSA to continue to expand the preventive medicine training pipeline. HRSA FY ’15 funding for PMR programs increased 70 percent over FY ’14.
8. FIVE STATES ENACT MEDICAL LICENSURE COMPACT
Five states—Idaho, South Dakota, Utah, West Virginia and Wyoming—have signed the Interstate Medical Licensure Compact into law. The compact, an initiative of the Federation of State Medical Boards (FSMB), establishes a voluntary, expedited pathway for physicians seeking medical licensure in multiple states, while ensuring state boards retain regulatory oversight necessary to protect patients.
The compact is expected to facilitate expanded use of telemedicine, especially in rural areas. Legislation to enact the compact is currently pending in 12 additional states, including Montana, where the bill has been transmitted to the governor. FSMB has created an interactive map that highlights the status of legislation to support the compact in state legislatures.
The United States Preventive Services Task Force (USPSTF) has published a draft recommendation statement and three draft evidence reviews related to breast cancer screening.
In the draft recommendation statement, "Breast Cancer: Screening,” USPSTF provides a B recommendation in support of biennial mammography screening for women aged 50 to 74 years and a C recommendation for clinicians to consider the individual breast cancer risks of women aged 40-49 years before starting screening mammography. USPSTF provides I statements, asserting current evidence is insufficient to assess the balance of benefits and harms, for screening among all women, women aged 75 years and older, or women with dense breasts.
USPSTF also is seeking public comment on its draft evidence reviews of Screening for Breast Cancer, Screening for Breast Cancer with Digital Breast Tomosynthesis, and Adjunctive Screening for Breast Cancer in Women with Dense Breasts.
Public comments on the draft recommendation statements and evidence reviews are due by May 18th at 8:00 pm EST.
The Food and Drug Administration (FDA) has released final guidance on use of abuse-deterrent technology to help manufacturers of opioid painkillers design and conduct studies so that they can prove their products have abuse-deterrent properties — such as being difficult to crush, break or dissolve — and can label them as such. The agency has already approved four opioids as abuse-deterrent.
FDA officials said the guidance maintains the balance between addressing the opioid abuse epidemic and serving patients suffering from chronic pain. They plan to monitor the market for problems with access to ensure that the needs of all patients, including those in hospice care who might require opioids in a crushable form, are being met.
The ACPM Board of Regents recently adopted a policy resolution noting ACPM’s support for use of abuse-deterrent technology by manufacturers of painkiller medications.
11. E-CIGARETTE USE INCREASES 3-FOLD AMONG HIGH SCHOOL STUDENTS IN ONE YEAR
E-cigarettes became the most commonly used tobacco product by middle and high school students in 2014, according to a study by the U.S. Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) published in Morbidity and Mortality Weekly Report(MMWR). Tobacco Use Among Middle and High School Students—United States, 2011-2014found that 13.4% of middle and high school students currently using tobacco were using e-cigarettes, tripling the number of e-cigarette users in 2013, based on data from the National Youth Tobacco Survey. Statistically significant increases in hookah use were also seen between 2011 and 2014, alongside decreased use of more ‘traditional’ products such as cigarettes and cigars.
The number of hypertension-related deaths have increased by 66% over the past decade, according to new data from the Centers for Disease Control and Prevention (CDC). Total deaths related to all other causes only increased 3.5% during the same time period. The rate of hypertension-related deaths also grew precipitously—23.1% from 2000 to 2013—compared to deaths from all other causes, which actually decreased by about the same percentage over the same period.
A study published in BMJ Open estimates that less than 0.5% of the population in the United States, United Kingdom, France, and Mexico are complying with World Health Organization (WHO) guidelines for sodium and potassium intake. In The Feasibility of Meeting the WHO Guidelines for Sodium and Potassium, study authors note that "the numbers being proposed by WHO and other health agencies are completely unfeasible. The chances that a majority of the population would achieve these goals is near zero.”
Current WHO guidance recommends an intake of less than 2,000 mg of sodium and a minimum of 3,510 mg potassium per day. Based on their research, the authors recommend further studies on the feasibility of public policy decisions, counsel guidelines developers to consider recommendations that will not increase diet cost, and recommend better harmonization of dietary guidance across various countries.
A study led by researchers at the University of Michigan have found that fee-for-value—a physician-reimbursement model that maintains traditional fees for service but includes quality and spending incentives—can reduce spending and improve quality in primary care. The study, appearing in the April issue of Health Affairs, examined Blue Cross Blue Shield of Michigan’s Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians.
Among the incentives offered by the Physician Group Incentive Program were 25 initiatives to improve process and outcomes of care, such as the creation of process-improvement teams, use of generic drugs, and increased patient-centered medical home capacity. Incentive payments were made to qualifying physicians twice a year.
The average amount spent per month per adult patient by a provider in the incentive program was $3.53 less than that spent by nonparticipants, a savings of just over 1 percent. Participating providers spent $5.44 less than nonparticipants for pediatric patients, a savings of 5.1 percent. Participants also demonstrated the same or improved performance on 11 of 14 quality measures over time, in areas such as childhood immunizations, well-child checkups, and diabetes prevention and management measures.
15. NHLBI NEEDS YOUR INPUT IN STRATEGIC VISIONING PROCESS
The National Heart, Lung, Blood Institute (NHLBI) has recently launched its strategic visioning process and is gathering ideas for the most compelling scientific priorities to address over the next decade. NHLBI is encouraging participation from a variety of organizations and individuals and requesting input from ACPM members.
To participate, submit your compelling questions and critical challenges to the Strategic Visioning Forum between now and May 15, 2015, at http://nhlbistrategicvisioning.ideascale.com/.
More information can be found on the NHLBI’s strategic visioning website: https://strategicvisioning.nhlbi.nih.gov/.