Skin date: 5/5/2014
On Wednesday, May 1, I flew to Chicago to attend the Midwest Business Group on Health’s meeting for health care purchasers. Approximately 120 human resource staff (and some insurers) attended. Dr. Simon Yoo (Northwestern) and I conducted a skin cancer screening for three hours in the morning, and then I got to speak for 10 minutes. I spoke about the epidemic of skin cancer, what it was going to cost our country, and asked them to protect their workers from ultraviolet radiation (including tanning beds). I explained dermatology’s cost effectiveness — especially in-office treatment. It seemed well received.
Then, in the midst of very warm temperatures, I flew to Phoenix for the American College of Mohs Surgery meeting May 1–4. The discussion at this meeting included the impact of tightening physician networks on patient access. Most of the dermatologists had not yet been excluded from the Medicare Advantage plans, but were concerned about this impending threat. I explained how grossly inaccurate the physician rosters for these plans are. The bottom line is that if there are no doctors to see, the plans will have no medical bills to reimburse. I told them that the AADA is studying this, and I believe we are making progress. As a result, in part, of activities we support, UnitedHealthcare has stopped the roll out of these tight networks, although 10 states are still suffering.
I also explained that specialty medicine, and especially dermatology, is under attack. Our support of efforts to answer that attack is critical since significant change is underway. For example, we are continuously fighting the loss of our Stark exemptions, and payment decisions are being increasingly moved to CMS. A strong Academy in the face of these changes is essential to the vitality of our specialty.
There was also much discussion about the CMS physician payments data release. The ACMS is going to act proactively to educate the group about normal distributions and billing patterns before the next set of numbers are released.
It must be emphasized that the current data has not been confirmed as accurate by physicians and each practice is unique in its use of providers and provision of services. I believe that releasing this data, without a chance to correct or to give context of the individual practice and patient mix is most destructive. Physicians may be judged without ever having the opportunity to respond. I remind all of you that if you get a media request, ask about the nature of the interview (what does the reporter want to know?), request to revisit the conversation at a later time (set a time so the reporter knows when he/she can expect a response), and contact Melanie Tolley Hall and the AAD communications department for assistance at mediarelations@aad.org.
We have our AAD board meeting coming up (my first as president), and I am studying the material … running the meeting is about 100 times as hard as listening. We have many interesting topics that will require our full attention, including data registries — which are extremely valuable, but can be exceptionally expensive. Initiating this effort will be even more challenging since the recent dues increase proposal failed. Apparently, we need to have more meaningful conversation around the financial needs and benefits you as members would gain from an increase in investment into our specialty. I am sure we’ll be discussing this in the coming months.
Sincerely,
Brett Coldiron, MD
The American Academy of Dermatology 