MSSNY eNews: September 16, 2020 – Top 10 Physician Specialties Using Telemedicine

Gov. Cuomo’s Press Briefing

COVID:

– Day 200
– 75,000 tests conducted yesterday
– 0.87% infection rate
– 4 lives lost yesterday
– 483 hospitalizations
– 138 ICU patients
– LI infection rate at 1.3%

REOPENING:

– Gov. stressed importance of continuing measured reopening
– Important that infection rate is not over 1% for extended period of time
– Gov. discussed federal response, “dangerous” denial of virus
– Gov. stated state is “doing as much as we can” to reopen businesses and keeping infection rate down
– Gov. discussed “trauma” from COVID, said cases of PTSD will likely increase as a result


Top 10 Physician Specialties Using Telemedicine
Endocrinology is the physician specialty with the highest rate of telemedicine adoption, according to Doximity’s 2020 State of Telemedicine report.

For the report, Doximity analyzed data on telemedicine adoption among U.S. physicians who use its virtual care network. The number of physicians reporting telemedicine as a skill increased by 38 percent from 2019-20, nearly doubling the 20 percent annual growth rate recorded over the past five years.

Here are the top 10 specialties using telemedicine:

  1. Endocrinology
  2. Rheumatology
  3. Gastroenterology
  4. Nephrology
  5. Cardiology
  6. Urology
  7. Neurology
  8. Geriatrics
  9. Hematology/oncology
  10. Pulmonology

Click here to view the report. (Sept. 16, Beckers Hospital Report)


Urge Congress to Waive “Budget Neutrality” to Prevent Steep 2021 Medicare Cuts
The 2021 Medicare Physician payment rule advanced by CMS contains a number of important changes, including reduced documentation for E&M codes and long overdue increases for office visits.

However, of great concern it also sets forth an 11% cut to the Medicare conversion factor, greatly limiting the benefit of these other increases and potentially causing great harm to many practices.  The conversion factor cut is required due to statutory “budget neutrality” requirements that prohibit increases without corresponding decreases.  MSSNY and many other groups are urging Congress to pass legislation to waive these “budget neutrality” requirements to prevent devasting cuts and permit needed changes to go forward.

You can send a letter to supplement these efforts here.

Recently, the AMA prepared a comprehensive summary of the proposed payment rule.  A few key points from the summary:

  • Of significant concern, the proposed CY 2021 Medicare Physician Fee Schedule (PFS) conversion factor is $32.26, which represents an almost 11% reduction from the CY 2020 conversion factor of $36.09. This is the result of positive adjustments in other parts of the rule.  As a result, AMA and MSSNY and many other societies are pushing for Congress to waive these problematic budget neutrality requirements.
  • Similarly, the proposed CY 2021 anesthesia conversion factor is $19.96, down 10% from the CY 2020 anesthesia conversion factor of $22.20.
  • The AMA/Specialty Society RVS Update Committee (RUC)’s recommendations account for only half of the reduction. The remaining spending increases and resulting conversion factor reduction is attributed to various CMS proposals to increase valuation for specific services.
  • CMS proposed to accept approximately 75% of the RUC recommendations for Physician Work RVU Updates. Updates to the direct practice expense inputs are proposed for individual codes based on RUC recommendations. The proposed rule does not include the 1.0 work geographic practice cost index (GPCI) floor.
  • CMS proposes to implement finalized CPT descriptors, guidelines and payment rates effective on January 1, 2021, which will be a significant modification to the coding, documentation, and payment of evaluation and management (E/M) services for office and outpatient visits: retain 5 levels of coding for established patients, reduce to 4 levels for new patients, and revise code definitions. CMS revalues services analogous to office outpatient E/M visits.
  • CMS proposes to allow the three G-codes used to report opioid use disorder (OUD) to also be used for monthly treatment reporting for patients with substance use disorder (SUD) as well. So that they could be used to report monthly treatment of patients with any SUD, not just OUD.
  • CMS has proposed to permanently keep several codes that were temporarily added to the Medicare telehealth list, including the prolonged office or outpatient E/M visit code and certain home visit services. CMS also proposes to keep additional services, including certain emergency department visits, on the Medicare telehealth list until the end of the calendar year in which the PHE ends to allow more time to study the benefit of providing these services using telecommunications technology outside the context of a pandemic.

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Please Urge Governor Cuomo to Veto Mandatory OPMC Signage Legislation
All physicians are urged to contact Governor Cuomo to request that he veto legislation (S.6678-A/A.7991-A) requiring every physician’s office to post a sign regarding how a patient can file a misconduct complaint with the OPMC.  Let the Governor know that this proposal would create unnecessary distrust in the physician-patient relationship and unfairly singles out physicians.

This legislation is also unnecessary because this information is already easily available through a simple internet search.  With nearly 10,000 complaints already made each year to OPMC (resulting in only a few hundred actual disciplinary actions), it is clear there is already strong public awareness of this oversight body. You can send a letter and tweet to the Governor opposing this baffling legislation here.


Congress Back to Business – Urge Them to Work for a Stimulus Deal!
With the U.S. Congress back in Session after its August recess, please urge our Senators and  Representatives to work to achieve a deal on a new stimulus package to assist community based physician practices in responding to the devastating losses from earlier this year. A letter/tweet can be sent from here.

A recent MSSNY survey demonstrates that New York physicians faced historic losses in their practices as a result of the COVID-19 outbreak, threatening the continuity of care for their patients and continued employment for hundreds of thousands of New Yorkers.  The CARES Act provided some needed funding to help somewhat offset these losses but nowhere near enough.

Please also urge Congress to reject misguided efforts pushed by the insurance industry to address surprise medical bills in a manner that is inconsistent with New York’s heralded approach.

Both the US House and US Senate have advanced their respective stimulus proposals, but they are still far apart in negotiations.  The House Democratic proposal, the HEROES Act, includes a number of positive items, including adding significantly more funds for the CARES Act health care provider relief pool, a re-starting of the Medicare Advance payment program and a significant bump in funding to assist state governments such as New York to prevent large cuts to Medicaid health care provider payments.

The Senate GOP proposal, which while more narrow also contains a number of important programs, such as re-starting the Medicare Advance payment program, increasing funding for the CARES Act health care provider relief pool and additional protections from medical liability arising from treatment or responding to the Covid-19 pandemic.

Please urge Congress to put aside partisan differences and work towards a deal to help protect patient access to community-based physician care.  Send a letter and/or tweet from here.


CDC Study: COVID-19 Patients Twice as Likely to Report Dining in Restaurant
U.S. adults who test positive for COVID-19 are more likely to have dined at a restaurant in the past two weeks, a new CDC study suggests.

Researchers analyzed data on 314 U.S. adults who received a COVID-19 test at an outpatient testing site or healthcare center in 10 states from July 1-29. They also polled study participants on what community-based activities they participated in two weeks prior to the test.

Of the 154 who tested positive, 42 percent reported having close contact with someone diagnosed with COVID-19 in the past two weeks. Only 14 percent of respondents who tested negative reported the same.

Researchers found no significant differences in reported participation in the following activities among patients who tested positive for COVID-19:

  • Shopping
  • Going to an office, gym, or hair salon
  • Gathering with fewer than 10 people in a home
  • Using public transportation
  • Attending a religious gathering

However, people who tested positive were about two times more likely to have dined at a restaurant in the past 14 days compared to people who tested negative.

The research does not differentiate between indoor and outdoor dining, which is one limitation of the study, researchers said.

To view the full study, click here.


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12% of Physicians Are Considering Leaving Medicine and 7 Other Findings About the US Physician COVID-19 Experience
About 54 percent of U.S. physicians said they have treated COVID-19 patients in person, and another 26 percent report treating coronavirus patients over the phone or via video, according to a new Medscape report.

The survey polled 7,414 physicians from eight countries, including 5,005 physicians from the U.S. The survey was conducted between June 9 and July 20.

Eight findings from U.S. physicians’ survey responses:

  1. Emergency medicine physicians (94 percent) and nephrologists (89 percent) are the top two specialists treating COVID-19 patients in person.
  2. Twenty-three percent of physicians report lacking appropriate personal protective equipment when treating COVID-19 patients.
  3. Around 5 percent of physicians said they have been diagnosed with COVID-19.
  4. Sixty-two percent of physicians said their income decreased since the beginning of the pandemic, with 33 percent reporting their income decreased by 11 percent to 25 percent.
  5. Approximately 64 percent of physicians report higher burnout since the pandemic started.
  6. Forty-six percent said they are lonelier due to stay-at-home and social distancing guidelines.
  7. About 25 percent of physicians are planning to retire earlier than planned as a result of their experiences treating COVID-19, and 12 percent are considering leaving medicine.
  8. Forty-three percent of physicians said their workplace offers activities to help clinicians with stress and grief. (Sept.11 Becker’s Hospital Review)

UK Testing Vaccine May be More Effective When Inhaled Rather than Injected
The AP (9/14) reports scientists at Oxford University and Imperial College London “are beginning a small study comparing how two experimental coronavirus vaccines might work when they are inhaled by people instead of being injected.” The scientists “said a trial involving 30 people would test vaccines developed by both institutions when participants inhale the droplets in their mouths, which would directly target their respiratory systems.”

Reuters (9/14) reports both vaccine candidates are “being tested in trials through intramuscular injection, but scientists from Imperial said that vaccines delivered via inhalation could potentially deliver a more specialized response.” Chris Chiu of Imperial’s Department of Infectious Disease said there is evidence influenza vaccines can be more effective when inhaled, “We are keen to explore if this may also be the case for SARS-CoV-2 and whether delivering COVID-19 vaccines to the respiratory tract is safe and produces an effective immune response.”


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Classifieds

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.Rhinebeck Estate for Sale A world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.
The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.


Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale: 715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building. Windows on Park Avenue and 70th Street. Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent