– Day 277
– 5.88% rate in micro-clusters
– 4.63% statewide rate with micro-clusters
– 4.21% statewide rate without micro-clusters
– 193,551 tests conducted
– 69 fatalities
– 3,924 hospitalizations
– 742 ICU patients
– 373 intubations
– Gov showed a PSA on COVID safety guidelines
– Outlined “living room spread”
– Gov warned of a COVID spike through the holiday season
– Gov referenced his 5-point plan:
– Manage hospital load
– Increase and balance testing
– Keep schools (K-8) open when safe
– Small gatherings are the #1 cause for spread
– Prepare for vaccine distribution
– Gov: the goal is to flatten the curve post-New Year
– Evaluate the effectiveness of the vaccine program
– 75-85% of population must be vaccinated for the economy to return
to normal (experts estimate this will be reached around June-September)
– NY panel will review federal approval process for the vaccine
– Black, Brown, and poor vaccine inclusion is vital
– Undocumented community cannot be excluded
– Gov: there must be federal funding for vaccine distribution
– CDC issued prioritization recommendations, conforming to NY guidelines:
– Frontline healthcare workers and vulnerable/elderly citizens
– Pfizer will be enough doses for 170,000 New Yorkers
– Vaccines will be prioritized for residential health care facilities
– Doses are expected to arrive on December 15th
– Nationwide, the federal government estimates that we will have enough doses to vaccinate ~20 million people (6% of Americans)
– NYS expects additional allocations of Moderna and Pfizer’s vaccine this month
– On vaccine batches, what are the Governor’s expectations?
– Gov: the state’s plan is to vaccinate nursing home residents and staff
– Nursing home residents and staff in NY: 210,000 individuals
– We may get a Moderna batch at some point
– We expect an additional Pfizer vaccine in 21 days
– Where is living room spread information coming from, and does this change the Governor’s thinking on indoor dining/other businesses?
– Mujica: The information comes from contact tracing data
– Gov: social behavior has changed because of social distancing regulations
– On nursing homes, why not reach out to critics and address nursing homes on a regular basis?
– Gov: the criticism is politically motivated
– NYS, in relation to other states, is currently the 46th lowest in terms of nursing home deaths
– Gov: there are so many topics to discuss along with nursing homes
– On hospital capacity, are any states reaching critical mass?
– Gov: ending elective surgery expands hospital capacity
– The second phase is to expand hospital beds by 50%
– The third step is to create field hospitals, but staff will be limited
– On vaccines:
– Gov: the goal is to have the fastest vaccination program in the country
– “I will be the first person to stand up and take the vaccine”
– The plan identifies regions, how do we choose geographically where vaccines go?
– Mujica: we will be able to cover every nursing home in the state in the first allocation of vaccines
– Will the state develop a list of priorities?
– Zucker: we are creating a list but not every person will get the vaccine because there has to be consent
– Health care workers and residential care facilities will be prioritized.
– We need 210,000 vaccines to cover all residents and staff
– Between the first Pfizer batch and the Moderna batch, we will cover all residents and staff
– Gov: there will be residents or staff that refuse to take the vaccine
– There will likely be rolling shipments of vaccines every 7 days
MSSNY Survey Finds 80 Percent of NY Physicians Plan to Get Immunized When Vaccine is Widely Available
MSSNY Press Release Issued on 11/30:
According to a survey conducted by the Medical Society of State of New York, nearly 80% of New York State’s community and hospital-based physicians plan to become immunized with the COVID-19 vaccine when it becomes widely available.
Only 7.5% of physician respondents to the survey indicated that they would not receive the vaccine.
The survey also reported that three-quarters of physicians’ patients are asking about the safety and efficacy of the vaccine. However, nearly 70% of physicians estimated that at least half of their patients will receive the COVID-19 vaccine once it is widely available.
When asked, nearly 70% of the physicians reported that they believe that communicating to their patients that they themselves have been immunized with the COVID-19 vaccine would be the most effective way of combatting vaccine hesitancy. Over two-thirds of responding physicians believe that having a state-wide educational campaign on the importance of being immunized against COVID-19 would be instrumental in also combatting vaccine hesitancy. Physicians also believe that another essential component is having statewide educational brochures and flyers (46.50%) that can be distributed to patients along with a prepared script on the importance of getting the vaccine with an explanation of safety (41.76%).
“This survey clearly shows that community and hospital physicians are prepared to receive the COVID-19 vaccine when it becomes widely available and that by immunizing themselves, they can send a strong message to their patients that being immunized is the best protection possible,” says MSSNY President Bonnie Litvack, MD.
Sixty-six percent of physicians stated that vaccine hesitancy is the biggest obstacle in getting New Yorkers vaccinated; 61% believe that NOT having an adequate supply of the COVID-19 vaccine could be another obstacle. Nearly 50% of responding physicians indicated that having a sufficient supply of the COVID-19 vaccine was of concern while ensuring that there is equitable access to the vaccine; 39% cited concerns about the safety and efficacy of the vaccine.
Along with traditional immunizers, such as the community and hospital-based physicians, the survey asked physicians about regional and local points of distribution (PODs) to administer the vaccine. Almost 65% of physicians indicated that they thought their patients would have safety concerns regarding COVID-19 spread due to the number of people that would be at a POD location and 61% thought that their patients may not be able to travel to the locations of the POD. Over 48% thought that screening for medical contraindications and who would be administering the vaccine would be of concerns to patients; 43% are concerned about language barriers.
“New York physicians stand ready and able to begin the process of immunizing New Yorkers and the Medical Society of the State of New York believes that the trust patients have in their physicians will go far in combatting vaccine hesitancy,” says MSSNY President Bonnie Litvack, MD. “Community-based physicians’ practices are located in New York’s rural, suburban, and urban areas and more often than not, those physicians speak the language of their patients, and most importantly, have the trust of their patients. As physicians, we must all work together to immunize all New Yorkers with the COVID-19 vaccine.
“We must change the course of this pandemic, and the best way to do it is through a vaccine,” says Dr. Litvack.
Click here to read Spectrum News story on the MSSNY survey.
Click here to read the Crain’s item on the survey. The text is below:
PHYSICIAN VACCINATION: The Medical Society of the State of New York said this week that nearly 80% of community- and hospital-based physicians surveyed plan to become immunized with a Covid-19 vaccine when it becomes widely available. Nearly 70% of physicians surveyed reported that they believe communicating to their patients that they themselves had been immunized would be the most effective way of combating hesitancy. (Crain’s, 12/1)
MSSNY Survey on COVID-19 Vaccine Hesitancy
The physician survey on COVID-19 vaccine hesitancy is still open for those who have not yet taken it. This survey is being conducted following media reports that the healthcare workforce and patients may not participate in getting the vaccine. If you haven’t already done so, please take the survey here.
CMS 2021 Medicare Physician Payment Schedule Released Yesterday
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released the 2021 Medicare Physician Payment Schedule Final Rule, which provides long-overdue increases for office visits, but also imposes significant cuts in other areas. MSSNY has set up a grassroots letter for physicians to send to Senators Schumer and Gillibrand, as well as their respective member of Congress, to urge Congress to “waive budget neutrality” and prevent these cuts from going forward: Urge Congress to Prevent Huge Medicare Cuts! (p2a.co). MSSNY has also been working with AMA and other state medical societies to urge Congressional action to stop these steep cuts while permitting the positive E&M changes to go forward.
Office and Outpatient Evaluation and Management (E/M) Visits
Last year, CMS finalized an important policy change in the 2020 Medicare Physician Fee Schedule Final Rule when it adopted CPT guidelines to report office and outpatient E/M visits based on either medical decision making or physician time and reduce unnecessary documentation. These changes were made effective on Jan. 1, 2021 to allow for extensive education on use of the new guidelines and revised codes.
CMS also adopted the relative value recommendations made by the AMA/Specialty Society RVS Update Committee (RUC) for the office and outpatient E/M visits, which will lead to significant payment increases for these services in 2021.
The final 2021 E/M policies differ from the RUC recommendations in one important respect: although the surgical specialties participated in the RUC survey and their data and vignettes were incorporated into the RUC recommendations, CMS did not apply the RUC recommended values to the visits bundled into global surgical payments.
The January 2021 office visit guidelines and descriptions; an AMA Ed Hub tutorial; detailed RUC recommendations, data, and a vote report are all posted on the AMA website and may be obtained via www.ama-assn.org/cpt-office-visits.
Budget Neutrality Adjustments
By law, significant increases in Medicare physician payment rates must be offset by across-the-board decreases. This budget neutrality requirement means that the RUC recommendations for the office and outpatient E/M visits would lead to an approximate 5% payment reduction affecting physicians and other health professionals who do not report office visits. This reduction was doubled to more than 10% as a result of other policy changes made by CMS. In particular, despite concerns about a lack of clarity in its definition and estimated utilization, CMS finalized a new code, G2211, to be reported in addition to the CPT codes for office visits which requires an additional budget neutrality offset of about $3 billion.
Despite the consensus of the AMA and the Federation that CMS should waive the budget neutrality impacts of the Medicare E/M policies in light of the COVID-19 public health emergency, CMS has finalized a significant budget neutrality adjustment. The CY 2021 physician payment conversion factor is $32.41, a decrease of $3.68 from the CY 2020 conversion factor of $36.09. This is a decrease of 10.2%. The CY 2021 anesthesia conversion factor is $20.04, a decrease of $2.15 from the CY 2020 conversion factor of $22.20.
Because the Administration does not offer any relief from the budget neutrality cuts in the final rule, the AMA strongly urges Congress to avert the more than 10% cut as physicians are experiencing substantial economic hardships due to the COVID-19 public health emergency. Cuts of this magnitude are problematic for all services, but we are extremely concerned that these cuts will directly impact care to COVID-19 patients, as payments for hospital visits, critical care visits, and home visits are among those being slashed.
Department of Health Survey on Telehealth During COVID-19 State of Emergency
The New York State (NYS) Department of Health (The Department) is conducting a survey of All Health Care Providers to gain knowledge of providers’ experiences using telehealth during the COVID-19 State of Emergency. The Department will use the results of this survey to inform post-pandemic telehealth policy development.
The information gathered from this survey will be shared with, and help inform the work of, the Reimagine New York Commission. More information on the Reimagine New York Commission can be found here.
The survey should take approximately 20 minutes to complete and can be found here. All clinicians are encouraged to respond; however, please limit to one survey response per individual clinician. The Department is interested in gathering perspectives from clinicians from the same organization, especially if they have different perspectives. Please submit your survey responses as soon as possible; the survey will close on December 15th.
With the rapid transition to telehealth during the State of Emergency, providers may have received surveys from multiple state agencies. Surveys administered over the summer by the Department’s Office of Quality and Patient Safety (OQPS) had a focus on provider well-being and the Office of Mental Health (OMH) survey had a focus on consumer experience with behavioral health services. For providers who are exclusively an OMH-licensed provider and who previously participated in the comprehensive OMH survey, we welcome your responses but understand if you do not have the resources to complete another survey at this time.
Below are COVID-19 telehealth guidance resources issued by New York State and referenced in the survey:
- Medicaid Update Special Edition: Comprehensive Telehealth Guidance
- FAQs on Medicaid Telehealth Guidance during the Coronavirus Disease 2019 (COVID-19) State of Emergency
- Webinar: New York State Medicaid Guidance Regarding Telehealth, Including Telephonic, Services During the COVID-19 Emergency
- Department of Health Weekly Health Provider Webinars
- Division of Financial Services: Information for Insurers and Providers on Coverage for Telehealth Services
- Office of Mental Health: Use of Telephone and Two-Way Video Technology by OMH-Licensed, Funded or Designated Providers and Clients Affected by the COVID-19 Pandemic
- Office of Addiction Services and Supports: Telepractice FAQs
- Office for People with Developmental Disabilities: Interim Guidance Regarding the Use of Telehealth/COVID-19
Hospital-Based Elective Procedures in Erie County to be Postponed
The New York Department of Health sent a notification to Erie County hospitals today that requires “all hospitals in Erie County to postpone all non-essential elective procedures, until further notice.” Governor Cuomo had announced in a Monday press conference that these elective procedures would be postponed as of this Friday, December 4, as a result of the need to prioritize health care services given the high percentage of positive Covid cases in Erie County and the sharp uptick in hospitalizations.
The notice further states that “This directive does not apply to elective procedures at ambulatory surgery centers, office based facilities or free standing diagnostic and treatment centers at this time.”
Calling All MSSNY Social Media Ambassadors!
MSSNY has created a gallery of social media assets for both our Peer to Peer (P2P) program, which offers physicians, residents, and medical students an opportunity to talk with a peer about life stressors, and our “Masking Up” campaign to stop the spread of COVID-19.
Please download and share to your social media accounts to help get the word out:
Interested in Learning How to Use Social Media?
MSSNY is planning an upcoming Zoom “Social Media in Medicine” presentation for physician members interested in getting involved with social media. If interested in participating, please contact email@example.com for more information.
Updates to US Blood Pressure Validated Device Listing
On December 1, NORC at the University of Chicago announced updates to the US Blood Pressure Validated Device Listing (VDL™). Launched in April 2020, the VDL assists providers and patients in identifying blood pressure (BP) devices that have been validated for clinical accuracy as determined through an independent review process.
With the addition of nine new device models, two manufacturers, and three BP device types (Ambulatory Blood Pressure Monitoring, Automated Office Blood Pressure, and Community Kiosk), the VDL now features 25 device models and five manufacturers, including A&D Medical, Hillrom-Welch Allyn, Microlife, Omron, and PharmaSmart.
On the heels of the Surgeon General’s Call to Action to make hypertension control a national public health priority and create tailored strategies aimed at improving reach and equity, the expansion of this list is a significant step towards every person with hypertension having access to a validated BP device to use in partnership with their physician. Ensuring major device manufacturers share their testing data and results for independent review is critical to reducing the devastating impact of hypertension on vulnerable communities.
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