Update from the Medical Association of Georgia

1. Update from the Medical Association of Georgia Fall Forum MGMA-Georgia November 11, 2016 Building a Better State of Health Since 1849

2. 2016 MAG Advocacy Highlights • MAG has been a leader in opposing the “mega health insurer mergers.” On July 21, the U.S Department of Justice and multiple state attorney generals – including Georgia’s Sam Olens – filed a lawsuit to block the mergers. More than 600 individual physicians made phone calls and sent emails to the Georgia Insurance Commission to explain why these deals would have such disastrous results both physicians and patients. • Key bills that passed during the state legislative session in 2016 included S.B. 158, a health insurance rental networks bill that will result in greater insurer disclosure and transparency and which will ensure that physicians get paid their contracted rate in the event their network is leased; S.B. 302, which will require health insurers to maintain more accurate provider directories; and, H.B. 900, which enhanced the state’s prescription drug monitoring program.  • More than 40 physicians and 40 lawmakers attended the Physicians’ Day at the Capitol event in January, while 50 physicians and 25 legislators addressed key issues like out-of-network billing, Georgia’s uninsured patient population, and the pending mergers at MAG’s Legislative Seminar in July.  • MAG served on a Georgia Chamber of Commerce work group that developed three options for expanding health insurance for the uninsured in the state. These plans would all result in a cost savings compared to the traditional approach to Medicaid expansion while still enabling the state to draw down its federal funds.    • MAG helped more than 300 practices resolve payment problems with health insurance companies in the last year – resulting in millions of dollars of savings.   Building a Better State of Health Since 1849

3. 2017 Legislative Priorities Out-of-Network Billing and Network Adequacy The Medical Association of Georgia will support reforms that require appropriate network adequacy standards for insurers. We will advocate for transparency for insurers entering into contracts with physicians’ practices and support legislation that will result in physician payment methodologies that are adequate and sustainable for out-of-network emergency care. Medicaid Payment Parity The Medical Association of Georgia will advocate for the General Assembly to continue funding for the Medicaid Parity Payment Program. We will advocate that the legislature continue to fund all areas of primary care. Maintenance of Certification (MOC) The Medical Association of Georgia will work to ensure that Maintenance of Certification is not a condition for licensure or hospital privileges. We will support efforts to alleviate the costly and burdensome aspects of MOC for physicians. Patient Safety Options The Medical Association of Georgia will advocate for measures that improve patient safety. Covering the Uninsured The Medical Association of Georgia will work with the legislature and state regulators on solutions for Georgia citizens who currently fall in the insurance coverage gap. Building a Better State of Health Since 1849

4. MAG -more than Legislative& TPP Advocacy Correctional Medicine Education Accreditation Top Docs Radio Building a Better State of Health Since 1849

5. Total MAG Membership1996-2015 Building a Better State of Health Since 1849

6. MAG - delivering additional value to its members. Building a Better State of Health Since 1849

7. MAG Foundation “Think About It” Campaign - promoting drug abuse prevention. Building a Better State of Health Since 1849

8. TOP Docs Talk Radio -providing convenient access to timely information on relevant issues. • Health Literacy • HealtheParadigm • Practice Transformation • Network Resources • Chronic Disease Strategies • Transition to MIPS • Compliance with • State/Federal Law • Opioid Abuse, MACRA • Why Manners Matter • Medicare Merit-based Incentive Payment System (MIPS) • Medicare Value-Based Pay • Diabetes Epidemic • Naloxone, 9-1-1 Medical Amnesty Law • Health Care Fraud and Abuse • And more! Building a Better State of Health Since 1849

9. MAG MRC- building medical society state and local response capacity, a first in the nation.

10. COMPASS Practice Transformation Network- providing tools, techniques and support to transform practices. • The Compass PTN, established by the Iowa Healthcare Collaborative, supports physicians and clinicians across six states in Georgia, Iowa, Kansas, Nebraska, Oklahoma and South Dakota. Quality advisors work with physicians and clinicians to achieve the five phases of transformation to prepare for the 2019 alternative payment models while improving and sustaining quality care practices: • Improved health outcomes for patients; • Improved care coordination through connectivity; • Better engaged patients and families in their care; • Improved patient, clinician and staff satisfaction; and • Reduced overall cost of care Building a Better State of Health Since 1849

11. connecting, analyzing, engaging and transforming. Building a Better State of Health Since 1849

12. Meet HealtheParadigm A physician-led electronic network that connects health care providers to improve health care quality, safety, care coordination and efficiency. A physician-ledsecure interoperable electronic system for real-time sharing of actionable clinical information among health care professionals. A physician-ledclinical data repository to support health care professionals in value based payment models. A physician-led suite of tools and services to deliver metrics required by payers to maximize reimbursement.

14. Fact 50%of polled non-pediatric physicians have never heard of MACRA.Source: 2016 MACRA survey by Deloitte

17. Timeline

18. Consider : MIPS Potential Impact on $250,000 Annual Medicare Reimbursement

19. Building a Better State of Health Since 1849

20. ……. MAG has and will continue to be Your relevant resource and trusted advocate! ?

21. Thank you. Questions?