The Value of VACEP

As we close out another year of supporting emergency medicine in Virginia, we wanted to take a moment to share with our membership the value of the Virginia College of Emergency Physicians. We seek to operate a sustainable chapter office, spending only where necessary to create an efficient organization that allows us to focus our dollars on advocating for the emergency medicine specialty and your future an emergency physician.

Each year, we ask you to renew, and we recruit new members to join. In addition, we also often ask for contributions to our Emergency Medicine PAC and new advocacy fund, STAT. It is important, then, that we show you all you receive as part of your support.

We took a survey of our 15-member Board, four officers, 10 councillors, and 10 fellows, and we estimate – conservatively – more than 3,200 hours of donated time this year just from those members. We equate that figure to approximately $680,000 worth of donated time advocating for emergency medicine interests.

Finances

We always have our eye on the bottom line.

  • We grew net profit in 2018 to $21,122 vs. a budgeted net of $2,530.
  • We saw a 15.25% increase to $394,494 in our financial position (revenue/gross income).

STAT Fund

Since it launched earlier this year, our STAT Fund has generated $48,300 for advocacy efforts. Unlike Political Action Committees (PACs), STAT (Statewide Action Trust) focuses on regulatory and legal actions and does not support political candidates. Contributions made by Virginia emergency medicine groups are used to help implement regulatory changes and challenge rules or policies that are inappropriately developed.

To join STAT, we ask for group contributions of $0.5 cents per chart based on the previous year’s visit numbers. For example, if your group saw 20,000 patients last year, it would donate $1,000. Our annual goal is $100,000 per year in contributions, given the potentially costly expenses to get our messages out to the legislators, regulators, and others impacted by emergency department visits.

Founding STAT members include:

Lobbying and PR

We use your funds to retain a government affairs guru and public relations professional. Our lobbyist works year-round to ensure emergency medicine is “at the table” on all legislative issues involving emergency care. Our PR team is also constantly on the hunt for new stories and ensuring VACEP remains a voice in statewide news coverage.

Issues of importance

In 2018, we focused on several key issues that have impacted your career.

Billing and reimbursement is a top issue legislators will address during the 2019 General Assembly. Predictably, health insurers want to enact laws that would dramatically decrease your reimbursement – and subsequently, salaries – even threatening the existence of many smaller groups. Our forward-thinking fair pay model has allowed us to be proactive in this fight, rather than reactive, giving us a better chance of a favorable outcome.

In 2019, VACEP will lead the way to ensure fair payment for physicians, prohibit balance billing the patient, ensure care is covered by insurance companies, and remove patients from the billing process.

Also, as health insurers deny patient reimbursement based on final diagnosis in many states, we are fighting to protect prudent layperson. We have not found evidence of this practice in Virginia, but we believe it is not a matter of if, but when.

New psychiatric guidelines

Over the past two years, VACEP and our partners have developed standardized, cost-effective, and safe guidelines for medical assessment of psychiatric patients. These guidelines went into effect on Nov. 5 for both adult and pediatric patients. This collaborative guideline helps streamline the medical assessment, as well as reduce costs and time needed to help take care of patients presenting with psychiatric emergencies. These guidelines were established with the welfare of patients foremost in mind.

While the implementation of these new psychiatric medical assessment guidelines have, as can be expected, seen a few bumps, we want to know about any cases where the process has not gone well. Specifically, we want to know:
  1.   name of psychiatric facility
  2.   name of psychiatrist (if a request to a doctor-to-doctor call failed)
  3.   specific issue related to the medical assessment
If you’ve seen any issues, please report them to us via email. We’ll get back to you.

Independent practice

This year, Virginia passed the most stringent nurse practitioner “transition to practice” model in the country, requiring not only five years of post-graduate training for NPs, but also that the training be with a physician serving the same patient population as the nurse practitioner. Gov. Ralph Northam signed House Bill 793 into law. The effort to create a transition to practice model for NP practice is thanks to the political advocacy efforts of the physician community, VACEP, MSV, and other specialty groups.

EDie

Working with the Virginia Department of Health and in partnership with VACEP, Utah-based Collective Medical implemented EDie across emergency departments in health systems statewide. EDie plugs directly into the existing EMR and alerts emergency physicians of high-utilizer patients, prescription “shoppers,” and those with complex needs. If there have been previous security events or there is presence of a patient care plan, the EDie will tell the provider. Physicians are regularly sharing stories of reduced costs, bypassed tests, and saved lives thanks to a system that Gov. Ralph Northam, himself a M.D., calls a “game changer.”

As we move into 2019, we thank you for your continued support of VACEP. We will continue to work behind the scenes to ensure patients have access to the highest quality emergency care – and that you are set up for success in your career as an emergency physician.

Thank you for all you do for emergency medicine in Virginia.

The VACEP Board