ACPA has experienced unprecedented growth and interest since its inception under the guidance and vision of founding President Ronald Rejzer, MD, CHCQM-PHYADV. ACPA is proud of the value that we provide to our membership – which would not have been possible without his tremendous efforts. In recognition of his accomplishments, Dr. Rejzer was awarded the 2nd annual ACPA Lifetime Achievement Award this past April at the 5th annual SEPAS conference. Not one to rest on his laurels, Dr. Rejzer has agreed to continue his support for organization by serving as the ‘immediate past president of ACPA.
I am honored and privileged to have been chosen by the ACPA Board of Directors to serve as the second President of ACPA, effective May 1, 2016. I look forward to building upon and expanding the efforts of the organization, while channeling the interests and tremendous expertise already present throughout our membership. Our mission and vision will continue to guide our efforts in providing value to our membership and promoting the role of the Physician Advisor.
As new members are joining ACPA every week, let me highlight some of the current offerings on our website. ACPA members have unrestricted access to all of the educational materials and references posted on the website. Our 2 Midnight Rule page includes essentially every important educational offering that CMS has published since the inception of the rule on October 1, 2013. For new physician advisors, you can review the original 2 MN rule, follow CMS’ subsequent comments and explanations, and read the recent modifications to the rule - such as the unanticipated mechanical ventilation exception and the new “less than 2 MN expectation” regulation. This comprehensive review helps physician advisors become 2 MN content-experts in their respective organizations. With regard to Medicare status, the CMS Inpatient Only list is a frequent source of consternation for physician advisors, as CMS requires an inpatient stay to reimburse an inpatient only procedure. A frequent challenge for the physician advisor is trying to determine whether a procedure should be billed as inpatient. Referring to our ‘Inpatient Only’ lists posted by specialty will certainly assist Physician Advisors and Case Managers in ascertaining the correct status.
Ronald Hirsch, MD, CHCQM and ACPA Advisory Board Member, is a frequent contributor to our website. His informative and typically hilarious animated videos are tremendously effective in describing and explaining many CMS regulatory concepts. Jessica Gustafson, Esq. and Abby Pendleton, Esq. (The Health Law Partners) have posted dozens of articles that they have authored explaining CMS regulatory concepts which can be found in the education section under ‘archives’. Check out updates on a wide variety of topics relevant to physician advisors in the ACPA Blog - organized and managed by our ‘Blogmaster’, Dr. Steven Meyerson, ACPA Board of Directors. The Blog postings are actively reviewed and discussed by ACPA members. If you haven’t checked it out recently, take a look and peruse our library of previous postings. You are certain to find contemporaneous topics that will spark your interest. In addition, the website boasts the only dedicated physician advisor salary survey, as well as our physician advisor job posting section.
ACPA members enjoy discounts to live conferences including SEPAS and the RAC Boot Camp. ACPA has also partnered with our friends at ABQAURP to offer discounts on the ACPA endorsed and newly created Physician Advisor certification (CHCQM-PHYADV), as well as the online course - “The Expanding Role of the Physician Advisor in HCQM”, written by ACPA Board and Advisory Board members. Additionally, ACPA members Dr. Pooja Nagpal and Dr. Ven Mothkur have co-authored the newly published 1st edition of Physician Advisor Handbook. This and other publications authored by our Board and Advisory Board are available through our online bookstore.
What about the future direction of ACPA? I believe our future is bright, having been well positioned by our successes and collaborations over the past two years. Our most important responsibility is to continue to serve our members. As a nonprofit organization, we are beholden only to you to deliver the value and resources that you desire and deserve. Our Educational Committee is currently at work developing teaching materials that will help keep ACPA members abreast of old and new regulatory developments. Also under active development is the physician advisor ‘core curriculum’ with plans in the near future to begin offering CME credit in the core competencies. Finally, our Government Advisory Committee will keep you updated on Congressional changes and assist those that may wish to initiate grassroots advocacy in his/her own area.
Physician advisors need to keep abreast of inexorable and inevitable changes in healthcare regulations. As an example, with the advent of the 2 MN Rule, we have had to deal with different status rules for different payers. However, status (inpatient, outpatient, or outpatient with observation) has always been simply a billing distinction- one that may or may not be relevant a few years from now. Although fee-for-service is changing to fee-for-value, the even broader changes that are occurring will involve managing the health of populations along the entire care continuum. These innovations will require the physician advisor to become comfortable with Alternate Payment Models (APMs), Clinical Documentation Integrity (CDI), Continuous Quality Improvement (CQI), and efficiency of care (e.g., length of stay management and appropriate use criteria).
Count on ACPA to be your enduring resource to help navigate these complex and changing times in health care. With that introduction, I humbly accept the opportunity to serve as your President on our important journey together!
Edward Hu, MD, CHCQM-PHYADV