PO’s Adoption of BCBSM’s Blueprint for Affordability Reflects Value Of Trusted Partnerships

By EWA MATUSZWEWSKI
Amid the flurry of pandemic responses and mitigation initiatives that physician organizations added to their plates in 2020 was a separate event that had been under consideration since just before the pandemic. I’m referring to Blue Cross Blue Shield of Michigan’s Blueprint for Affordability program, which was launched in January 2020.

Designed to hold the line on healthcare costs as it enables improved care quality, coordination of care, and outcomes for patients, Blueprint for Affordability is a value-based compensation model where each physician organization partner has annual cost-of-care targets and clinical quality benchmarks to meet. The targets are [Read More]

CMS Releases New Measures to Address Social Determinants of Health

By KAITLIN A. NUCCI
On January 7, 2020, CMS published a State Health Official letter to provide guidance in the adoption of policies to address social determinants of health in both Medicaid and Children’s Health Insurance Program (CHIP). The reasoning behind such strategy stems from the fact that even though the United States spends more money than almost any other country in the world on healthcare, the United States is often is outperformed on key health indicators such as life expectancy, reducing chronic heart disease, and maternal and infant mortality rates. This is due to a range of social, environmental and [Read More]

Baraga County Tells Whitmer: We’re Done
Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

The sum of Baraga County government passed a resolution telling Gov. Gretchen Whitmer it will no longer be participating in any more shutdown orders designed to protect the population from COVID-19.

All five county commissioners signed a resolution Jan. 11 along with the county’s sheriff, prosecutor, clerk, and treasurer that “we have no intention of participating in the unconstitutional destruction of our citizen’s economic security and liberty.”

The county officials also said they will “take no action whatsoever in furtherance of this terribly misguided agenda.”

County Commission Chair Bill Rolof said the people in his [Read More]

Employers Can Mandate Employees Have the COVID-19 Vaccine…With Restrictions

By SARA H. JODKA
On December 16, 2020, the Equal Opportunity Employment Commission’s (EEOC) issued “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws” (the Guidance). The Guidance does not even specially address the question as to whether employers can mandate employees have the vaccine, rather, the Guidance jumps right in assuming employers already knew they could have mandatory vaccine policies and goes into the limited restrictions as to when an employer may have to pause and engage the employee in interactive discussion regarding the employee’s medical, religious or other reasons for not wanting the [Read More]

By ELISABETH ROSENTHAL
I still remember exactly where I was sitting decades ago, during the short film shown in class: For a few painful minutes, we watched a woman talking mechanically, raspily through a hole in her throat, pausing occasionally to gasp for air.

The public service message: This is what can happen if you smoke.

I had nightmares about that ad, which today would most likely be tagged with a trigger warning or deemed unsuitable for children. But it was supremely effective: I never started smoking and doubt that few if any of my horrified classmates did either.

When the government required television and radio stations to give $75 million in free airtime [Read More]

More than 10,000 people have died of COVID-19 in Michigan as of Dec. 8.

The 191 deaths added to the state’s toll brought Michigan to 10,138. Another 5,909 cases brought that number to 410,295. The current fatality rate to COVID-19 is 2.47 percent.

On a nationwide scale, Michigan ranks ninth among the states by total deaths, according to The New York Times, although The Times has Michigan at 10,415 deaths as of today. On a per-capita basis, Michigan is 11th at 104 deaths per 100,000 people.

As a result, Gov. Gretchen Whitmer ordered U.S. and Michigan flags within the Capitol Complex and upon all public buildings and grounds across Michigan to be lowered [Read More]

By EWA MATUSZEWSKI
The move to virtual office visits has been swift and far-reaching. But are we perhaps going too far? I know of at least two physician practices that aimed to be completely virtual (with some exceptions) from the onset of the virus until January 2021. Why? As of this writing, the case count is far higher than it was when the initial switch to virtual visits occurred in April. Even with the promise of multiple vaccines, we are likely at least a year away from getting out of pandemic mode in terms of how we work, socialize, educate and entertain. We must commit to a new era of healthcare [Read More]

By DUSTIN WACHLER
Effective November 22, 2020, the Centers for Medicare & Medicaid Services’ (CMS) final rule “Modernizing and Clarifying the Physician-Self Referral Regulations” aims to reduce the regulatory burdens of compliance with the federal self-referral prohibition most commonly known as the Stark law. The final rule eliminates unnecessary requirements within the Stark law that imposed undue regulatory burdens and increased administrative costs on healthcare providers. The final rule also eliminates regulatory barriers to value-based, coordinated healthcare delivery and payments systems at the foundation of integrated care models, alternative payment systems, and other arrangements that improve patient care while reducing costs to governmental healthcare programs. ,

The final rule reflects the [Read More]

Opinions expressed in the article below are those of the author and do not necessarily reflect those of Healthcare Michigan, its publisher or staff.

By ALLAN DOBZYNIAK, MD
The motives driving the battle to control healthcare are suspect. Many physicians—likely the majority—do not buy into the public deception that has been attributed to them. In fact, a small contingent of progressive, “woke” physicians amplify this deception.

Most doctors are too busy with their own lives, families and professions to get involved with politics and leftist, “politically correct” healthcare thinking. They have become disinterested in the deteriorating professional organizations charged with guiding them through healthcare’s questionable evolution.

Physicians who try to participate in hospital decision-making—with [Read More]

By KIMBERLY RUPPEL
New and modified safe harbors to the Stark Law and Anti-Kickback statue allow healthcare providers and entities more flexibility to create and expand telehealth platforms in compliant fashion.

On Nov. 20, 2020, the Centers for Medicare & Medicaid Services and the Office of the Inspector General (OIG) finalized the rules modifying the safe harbors under the Anti-Kickback Statute and exceptions under the Stark Law, creating seven new safe harbors for value-based arrangements, modifying four already in place and codifying one new exception.

These changes offer opportunities for healthcare providers and entities to make better use of telehealth options in a “value-based enterprise” as opposed to the former regulatory framework [Read More]