AMA: Regulate network adequacy to stop surprise medical bills

Policies aimed at addressing unanticipated out-of-network care—often called surprise billing—should not put patients in the middle of payment negotiations or reward payers whose inadequate, narrow provider networks are a primary driver of the problem.

That was the key message from AMA Trustee S. Bobby Mukkamala, MD, at today’s House Ways and Means Health Subcommittee hearing on surprise medical bills.

“The AMA has long been concerned about gaps in out-of-network coverage and is committed to working on solutions to protect patients from the financial impact of ‘surprise’ coverage gaps,” said Dr. Mukkamala, a board-certified otolaryngologist—head-and-neck surgeon who practices in Flint, Michigan.

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3 big questions for the AMA’s new chief health equity officer

Pediatrician, preventive medicine and public health physician Aletha Maybank MD, MPH, has taken on the task of leading the AMA’s new Center for Health Equity, which the AMA House of Delegates directed the Association to create as part of sweeping policy on health equity adopted at the 2018 AMA Annual Meeting.

Dr. Maybank comes well-prepared for her new position. She was founding director of the New York City health department’s Center for Health Equity. In that role, she led changes in the culture and public health practice of the health department by building the capacity of staff to better understand how their work advances or exacerbates health equity.

She also oversaw the rebranding of local district public health offices as Neighborhood Health Action Centers, renewing the agency’s commitment to neighborhood-based work and enhancing coordination of these efforts. In addition, she oversaw one of the first place-based community health worker efforts in New York City public housing.

Dr. Maybank took some time to answer three big questions about her role—and the AMA’s—in the struggle to ensure that all Americans have access to high-quality, affordable health care.

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Wearables improve post-op recovery when every step counts

It’s the surgeon’s standard advice to patients as soon as they awaken from the procedure: start walking. Walk with help. Walk to the chair in your room. Walk as much as you can. But how many steps should patients actually aim for? One patient’s understanding of the instruction can differ from another’s, with a related impact on their recovery.

Researchers at Cedars-Sinai Medical Center are looking to put a finer point on the matter with the help of wearable activity trackers. For a study whose results were published in JAMA Network Open, they outfitted 100 patients with digital step-counters and found that those who took 1,000 steps on day one post-surgery had 63% lower odds of a prolonged length of stay related to their operation.

The lede for my  latest at the AMA. The whole shebang.

How the CDC’s opioid prescribing guidance went astray

What’s the news: Three authors of the Centers for Disease Control and Prevention’s controversial 2016 guideline on opioid prescribing now say their advice has been misused in ways that can harm patients.

These misapplications “include inflexible application of recommended dosage and duration thresholds and policies that encourage hard limits and abrupt tapering of drug dosages, resulting in sudden opioid discontinuation or dismissal of patients from a physician’s practice,” wrote the CDC’s Deborah Dowell, MD, MPH, Tamara Haegerich, PhD, and Roger Chou, MD, in a New England Journal of Medicine essay, “No Shortcuts to Safer Opioid Prescribing.”

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Two physicians moving medicine

The AMA recently unveiled a digital magazine, Moving Medicine, that is exclusive to AMA members. Two physician profiles carry my byline in the inaugural issue. You can read them below.

Recognizing the patterns of truth
You may have seen the movie based the life of Bennet I. Omalu, MD, MBA, MPH. Find out the real story behind what he has discovered—in CTE and in letting science lead the way.

Digital designs for the age of evidence
JAMA Editor-in-Chief Howard Bauchner, MD, has worked relentlessly to devise ways for the AMA’s crown jewel of high-quality research to be available to physicians on command.

5 reasons why physicians should use social media professionally

As social media has moved from a toy of the technorati to a mainstream facet of American life, many physicians have learned how to get the most out of Facebook, Twitter and the like while avoiding some of the ethical pitfalls. But if you’re still trying to understand why smart use of social media could help your physician career, AMA member Tyeese L. Gaines, DO (@doctorty), has got the answers.

The board-certified emergency physician spent years as a health care journalist, has earned an MBA, recently launched her own urgent-care practice in New Jersey, and offers training to physicians on how to navigate the intersection of medicine and social media. So, if your social media use is restricted to checking in for pictures of friends’ children on Facebook, here is Dr. Gaines’ perspective on why you should consider engaging more deeply at a professional level.

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8 physician advocacy wins that set the stage for 2019

Given the turbulence in Washington, it’s easy to overlook the many policy wins scored on behalf of patients and physicians at the national and state levels. In her opening address to the AMA State Advocacy Summit, AMA President Barbara L. McAneny, MD, detailed how physician advocacy has made a difference on gun violence, regulatory relief, physician payment and more, while offering a look ahead to the Association’s ambitious 2019 policy goals.

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Digital health funding hits $8.1 billion. How to spend it wisely.

A recently released report details the record growth in funding in the digital health space that has experts wondering whether a market bubble is forming. This much is clear: No flood of cash can replace the unique insight that physicians offer health tech entrepreneurs to ensure that innovations are safe, effective, scalable and evidence-based.

The report—“2018 Year End Funding Report: Is digital health in a bubble?”—comes from San Francisco-based health tech funder Rock Health. Researchers tallied $8.1 billion in funding in digital health last year, up 42 percent from $5.7 billion in 2017.

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Liked, loved, shared: What got physicians talking this year

Gun violence. The fight for gender equity. Physician burnout. Heartbreak at the border. These are among the issues that got people talking and sharing on social media in 2018. In a timely way, the AMA set forth physicians’ views, tools and resources on these and other hot-button topics. Learn about the big moments that struck a chord with patients and physicians on social media.

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Talking firearms in the exam room: 3 cases where it matters

James, an Army veteran living with post-traumatic stress disorder, presents at your practice. Previously, he has revealed to you that he occasionally has suicidal thoughts. Knowing that firearms are among the most lethal suicide-attempt methods, should you bring up the potentially touchy topic of whether he has access to a gun?

If you’re like most American physicians, you haven’t had much training on how to effectively address firearm safety with a patient like James. His case is one of three high-risk scenarios in which physicians can help reduce their patients risk of firearm injury death that are highlighted in a CME module available in the AMA Ed Hub.

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Controversial ACA ruling: 4 things physicians should know

In the days since a federal judge’s ruling striking down the Affordable Care Act in its entirety, there has been a flood of punditry on the merits of the decision and its potential impact. While that makes fun reading for some, for others without law degrees it can be a bit overwhelming. So here are four key things that practicing physicians should understand and share with patients who ask.

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What your patients must know about direct-to-consumer lab tests

More than 12 million people have had their DNA analyzed with direct-to-consumer genetic genealogy tests, according to estimates from the industry, with use of tests from companies such as AncestryDNA doubling in 2017. These and other DTC laboratory tests—often conducted without the involvement of a physician, with results reported directly to the patient—may lead patients to potentially harmful misunderstandings.

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