The VALUE of VACEP: Summer 2020
As emergency physicians on the front line of the COVID-19 pandemic, we’ll be the first to say it: 2020 hasn’t gone as planned.
And yet, members have continued to split time between their ED shifts and advocating for the emergency medicine speciality. We have pushed back against private equity-led groups seeking to reduce benefits or cut salaries in the face of lower ER volumes, and have made our voice heard as the Commonwealth of Virginia looks to reduce Medicaid reimbursement claims for nearly 800 conditions, many of them common. More on all this below.
Thanks to your support as a member, and by giving to our Emergency Medicine Political Action Committee (EMPAC-VA) and our STAT fund, we are able to advocate for our specialty and your patients, expand our communications, score victories, and defeat legislation that would be harmful to emergency physicians.
Here’s our Top 10 Highlights from 2020 (so far):
1. FIXING SURPRISE BILLING
Our supported legislation to end Out-of-Network/Surprise bills and ensure fair reimbursement for physicians passed in March and goes into effect Jan 1, 2021.
As a reminder: the bill signed by Gov. Ralph Northam is a compromise based on similar successful legislation in Washington state, in which providers are paid a “commercially reasonable” rate. If necessary, negotiations or a structured arbitration process is available. Most importantly, this legislation protects all Virginians from surprise billing.
Success here is, in part, thanks to members sending more than 10,000 emails to Virginia legislators stressing the importance that an equitable solution is found this year. We are now collaborating on a state task force to determine the terms of arbitration and commercially reasonable payment dataset.
2. FIGHTING THE MEDICAID BUDGET AMENDMENT
(ED Overutilization Program)
In March, Governor Northam signed a budget with an amendment in which Medicaid reimbursements would be automatically reduced to a level 1 claims — $14.97 — if an ER visit code is on the “preventable” diagnosis list, which includes 789 level 2, 3 and 4 codes.
We believe:
the Prudent Layperson Standard obligates Medicaid programs and MCOs to reimburse doctors and hospitals for the delivery of emergency medical care based on presenting symptom; and,
payments cannot be solely determined using a diagnosis list
We have been advocating at state and national levels to reverse this decision. Most recently, we submitted a letter to CMS (in coordination with the Virginia Hospital & Healthcare Association, Medical Society of Virginia, and the Emergency Department Practice Management Association asking them to review this program for compliance with CMS guidance, which we believe it violates. We have heard from CMS that they are preparing a response and expect to hear soon.
3. RESPONDING TO COVID-19
As emergency physicians and healthcare teams have worked the frontlines of the pandemic, VACEP has been hard at work telling those stories and ensuring providers stay protected.
ON (VIDEO) CALL: VACEP members got facetime (well, technically, it was Zoom) with Gov. Northam in March.
Months of working on a public-facing PR campaign with patient-focused messages on Facebook and editorials and interviews with state and national media paid off. We’ve developed stronger relationships with lawmakers, agencies and other organizations through video conferences, phone calls, emails and task forces.
Our graphic, which speaks to patients to make them aware that ERs are open and safe, has been picked up and used by ACEP chapters nationwide.
When some equity-backed groups announced plans to cut benefits and salaries to physicians, VACEP took the lead nationally with a statement that was picked up by, among other places, ProPublica. Many groups later reversed their decisions.
The Richmond Times-Dispatch profiled the frontline work of emergency physicians, most all VACEP members, in a story in early April.
WTVR-CBS 6 also spoke to Richmond-area member Carlton Stadler, who pushed forward our message that patients should not delay treatment, and that ERs remain open, safe, and ready for anything that comes through the door.
In late April, Gov. Northam signed Executive Order Sixty, which reinforces certain existing liability protections for Virginia healthcare workers. Virginia’s code offers protections for healthcare workers and first responders in cases of emergency. The order clarifies that these statutes protect healthcare workers operating during the COVID-19 crisis.
VACEP specifically requested and received protections for a.) free-standing emergency departments, and b.) implementation or execution of triage protocols or scarce resource allocation policies necessitated by healthcare provider declaration of crisis standards of care.
Read on for more information on how VACEP continues to advocate for liability, workforce protections and PPE.
4. SUPPLYING VACEP-MADE PPE
Like many others, VACEP President Dr. Scott Hickey saw physicians around the country using a freely available online template to build their own intubation boxes and wanted to provide a way for physicians to obtain these boxes in Virginia and protect themselves against COVID-19.
Here, Dr. Hickey makes a contactless delivery in Crozet with Julie McElwee of the LewisGale Montgomery Emergency Department in Southwest Virginia.
In mid-April, VACEP completed shipping one free COVID-19 intubation box to every emergency department in Virginia. These boxes protect teams against aerosolized droplets when intubating a COVID-19 patient. These free boxes are possible thanks to the donations of generous individuals and organizations. We give special thanks to the Medical Society of Virginia Foundation and the Virginia Association of Health Plans, which contributed significantly to our cause. All our donors are listed on our website.
5. PREPARING FOR THE SPECIAL LEGISLATIVE SESSION
The Virginia legislature will hold a special session this summer. Topics are likely to include racial and health equity, the budget, and COVID-19. We plan to focus our efforts on reversing the Medicaid Budget Amendment and COVID-19 related issues of PPE, liability, scope of practice, telemedicine, and workforce protections.
6. PLANNING OUR NEXT ANNUAL CME CONFERENCE
We’re in the early planning phase for our Annual CME Conference scheduled for February 19-21, 2021 at the Omni Homestead. We’re carefully considering how to safely host education and networking opportunities as well as brainstorming changes to content with our leadership team to find new ways to provide value.
7. WELCOMING NEW LEADERS
In May, the leadership team completed virtual interviews with all seven ACEP leadership candidates. Early feedback from VACEP leadership is that we learned so much more about the candidates than we normally do during council. You can watch the interviews at www.vacep.org/acepboard
At our June meeting, The VACEP Board voted to welcome three new fellows to our Leadership & Advocacy Program. We’re excited to have Drs. Jason Bavarian, Aubrey Miner, and Jessica Nguyen join the team!
We have also been working with our new Medical Student Council chapter on ways to collaborate (including planning a virtual residency PD panel for M4’s in mid-August).
8. DEVELOPING A NEW MEMBER BENEFIT
The VACEP Board has voted to move forward with providing a providing a (duplicate) personal health plan at group rates to our members. This will allow VACEP members to access an excellent health insurance plan as individuals at a group rate. We will have more information this summer.
9. REFINING OUR COMMUNICATIONS
Back in February (a lifetime ago), we relaunched our monthly newsletter. With so much happening over the last few months, it’s been a great way to collect and share updates about our work each month. In May, we started a new email series to boil down all the news each week into ONE IMPORTANT THING in your inbox each Saturday. We’re also working on updates to our website to make it easy for you to get involved.
10. GROWING STRONGER THAN EVER
Our membership has reached an all-time high of 1,000 emergency medicine attending physicians, residents, and medical students. The majority of our members are up for renewal this summer. ACEP delayed reminders for several months during the pandemic so it’s important to log in and check your membership status.
VACEP and our emergency physician members are working hard every day to advocate for our speciality and we’ve been working harder than ever this year. We are committed to serving our membership of advanced practice providers, medical students, and residents. If you’re not already a part of our organization, please consider joining or re-joining VACEP and ACEP.
