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CSNS Update

CSNS Update. Fall 2012. www.csnsonline.org Prepared by Hooman Azmi MD, Julie Pilitsis MD,PhD. CSNS mission:

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CSNS Update

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  1. CSNS Update Fall 2012 www.csnsonline.org Prepared by Hooman Azmi MD, Julie Pilitsis MD,PhD

  2. CSNS mission: to provide a national forum for the State Neurosurgical Societies of the United States, for the discussion, consideration, and proposals of action regarding socioeconomic issues concerning Neurological Surgery.

  3. Passed Fall 2012 ResolutionsRe: Healthcare economics • RES II: THE PATIENT PROTECTION AND AFFORDABLE CARE ACT: • The Washington Committee will report salient features of the PPACA which effect neurosurgeons • RES XII: UNDERSTANDING COST EFFECTIVENESS IN NEUROSURGERY: • This resolution seeks insight into and education on the cost effectiveness discourse in neurosurgery. • RES IX: MA HEALTH CARE LAW 2.0 IMPACT ON NEUROSURGICAL CARE: • This resolution calls for an evaluation of a new Massachusetts Law that will tie restriction of health care costs to the Gross State Product.

  4. Passed Fall 2012 ResolutionsRe: Outcomes • RES VII: NEUROSURGERY STRUCTURAL HEAD INJURY IN SPORTS REGISTRY: • The call for the establishment of a registry for such patients will be evaluated by appropriate CSNS committees. • RES X: ADMINISTRATIVE METRICS IN NEUROSURGICAL PATIENT OUTCOMES: • This resolution calls for an evaluation of metrics employed by health care systems and the government to measure outcomes and quality of care. • RES XI: UNDERSTANDING COVERAGE OF NEUROLOGIC EMERGENCIES: • This resolution, referred to committee, seeks to look at emergency neurosurgery coverage issues-particularly the role and involvement of non-academic and community neurosurgeons in its delivery

  5. Passed Fall 2012 Resolutions: re: CSNS • RESI: FORMATION OF A CSNS PUBLIC RELATIONS COMMITTEE: • for better integration of PR efforts in related Neurosurgical organizations, including the AANS, CNS, and Washington Committee. • RES VITI: THE RANDALL W. SMITH AWARD FOR MERITORIOUS SERVICE TO CSNS: • This resolution recognizes the life-long contributions to the CSNS first of Dr. Smith, and then those of other highly dedicated members.

  6. 2012 Meeting Highlights: • “Doctor Envy: The Curious Co-Evolution of Medical and Legal Education” • Mr. Gregory Mark, Dean of Depaul University College of Law • “Accountable Care Organization, How ACO’s Change Neurosurgical Practice” • Patrick Elwood, MD. Prof Emeritus of Neurological Surgery, University of Illinois, Peoria; CEO OSF Neuroscience clinical service line

  7. 2012 Meeting Highlights: • “Geisinger’s Approach to Sustainable Facility Operations” • Robert Davies, CSO Geisinger Health System • “Green and Lean Healthcare Architecture” • Robert Pratt, CEO Pratt Design Studio

  8. 2012 Meeting Highlights: • First Randall Smith Distinguished Service Award • Recipient Dr. Randall Smith, Presented by Dr. Benzil and Kusske

  9. Coding and Reimbursement:Ed Vates MD BAD NEWS: • as much as an 85% decrease in Medicare reimbursements over the next few years could take place. • CPT code 63047 (lumbar laminectomy) will get re-evaluated and a negative re-evaluation may have an impact on other spine codes GOOD NEWS: • Several CPT codes were deferred in revaluation thus maintaining their current valuation because of efforts of members of the CSNS • Dr. Joe Cheng and his rapid response team were successfully in protecting the approval and valuation of multiple neurosurgical procedures.

  10. Social Media to expand our mission Health reform Neurosurgery Blog: More Than Just Brain Surgery – (www.neurosurgeryblog.org) Neurosurgery’s Twitter Feed: @Neurosurgery – (https://twitter.com/neurosurgery) Neurosurgery’s Facebook Page – (http://bit.Iy/NeuroFacebook) Neurosurgery’s LinkedIn Group (http://bit.Iy/NeuroLinkedIn)

  11. CSNS and Education • Despite the identified need for more socioeconomic and medicolegal courses, attendance of these courses at the CNS and AANS has left room for improvement. • To address this, CSNS has designed specialty specific courses and has offered it directly at the specialty sections: Vascular and Spine and Peripheral Nerve. • CSNS is planning courses for the Pediatric, Tumor and Functional sections.

  12. Washington Committee Highlights:Alex Valadka, MD and Katie Orrico • Patient Protection and Affordability HealthCare Act • Upheld by Supreme Court on 6/28/2012, expansion of Medicaid coverage by states was struck down. • ACA Medical Device Tax • HR436 passed by House repealing the medical device tax, bill has moved to the Senate. • SGR • Neurosurgeons face a 27% cut in reimbursement. Several alternatives fixes to the SGR pit specialists versus primary care providers for an ever decreasing pot of funds. • PQRS • 0.5% bonus pay to participants in 2012-2014. Under PPACA bonus will be phased out and a progressive 2% penalty will be assessed for 2016 and beyond.

  13. Washington Committee Highlights:Alex Valadka, MD and Katie Orrico • Electronic Health Records • Beginning in 2015 non users of EHRs will begin facing penalties. “Up to 5% in later years.” • CMS proposed rule • Overall neurosurgical reimbursement is expected to drop by 1%, as PCP payments are increased for care coordination. • CPT coding issues • Code 37201 non coronary thrombolysis code used by endovascular neurosurgeons for stroke was eliminated by bundling with a renal angio code and the neurosurgical use was overlooked. For 2013 an unlisted code will be used. Dr. Henry Woo has drafted a proposal change submitted to CPT.

  14. Washington Committee Highlights: Dr. Alex Valadka and Katie Orrico • Graduate Medical Education • Congress asked IOM to aid in modification of the GME to “produce the 21st century physician workforce.” • CRNAs and pain management • AANS and CNS opposed a new proposal allowing CRNAs to provide chronic pain management services without the supervision of a physician. • Emergency Medical Services and other Appropriations • Trauma EMS was provided no funding in Congressional appropriations for FY 2013. CDC saw an increase of $55 million

  15. Member Activities: • Resident fellows • 13 fellows were selected from 47 well qualified applicants. Applications for the fellowships are available at csnsonline.org. • Douglas Brinkley in the Big Easy • Douglas Brinkley a noted author and historian will be the Luncheon Speaker for the Spring 2013 meeting. • Medical Student Handbook for Neurosurgery • An online tool now available to medical students on the CSNS website for forming and maintaining neurosurgical interest groups in medical schools.

  16. Updates on Prior Resolutions: • Resolution X-11F Hospital Employment • Survey of 221 hospital employed neurosurgeons by Colen et al detailed in the Fall 2012 newsletter • Resolution VI-2012S Burning the Candle at both ends • Klimo et al examining burnout in neurosurgeons with pilot survey being shortened and prepared for national distribution. • Resolution I-10F meeting duration • Based on Jenkins et al, CSNS has a later starting time to allow for travel.

  17. Update on the Resolutions: • Resolution III 20102S • Regarding the stewardship of the CSNS resolutions is being incorporated into the SOP committee. • Resolution X 2012S • Being incorporated into a larger project regarding the effect of closed ICUs on neurosurgical residency training. • Letters sent to AANS/CNS • For Resolution I 2012S (importance of patient comprehension of online spinal cord injury education material). • For Resolution XIII 2012S (impact of global cost of spine care). • For Resolution XIV 2012S (promoting international health opportunities in neurosurgery). • For Resolution XVIII 2012S (response to intraoperative monitoring guidelines from the American Society of Neurophysiological Monitoring). • Resolution IX 2012S (improve recognition of and participation in the N2QOD project).

  18. Upcoming Meetings

  19. Leibrock State Leadership Award • The state with the highest total contributions and percentage of donations to the Neurosurgery Political Action Committee will win the annual Leibrock State Leadership award. https://www.aans.org/Legislative%20Activities/NeurosurgeryPAC.aspx Or call the Washington Office at 202-628-2072

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