Diane Calello, MD, represented the Medical Society of New Jersey at a press conference held in Trenton on Wednesday, February 29 as Attorney General Jeffrey S. Chiesa announced a comprehensive statewide ban on all types of synthetic marijuana, which was issued by the Division of Consumer Affairs. According to reported data, between 2010 and 2011 the number of synthetic marijuana exposures reported to poison control centers jumped by an alarming rate of 139 percent nationwide and 711 percent in New Jersey alone. A recent nationwide study funded by the National Institute of Drug Abuse shows synthetic marijuana is the third most commonly abused drug by American high school seniors, after marijuana and prescription drugs.
Dr. Calello is a medical toxicologist at the New Jersey Poison Information and Education System in Newark, NJ, and an attending physician in the Emergency Department at Morristown Medical Center/Atlantic Health System. She spoke on the effects of synthetic cannabinoids and the serious risk they pose to public health and safety.
Earlier this fall, CMS announced a new Advance Payment Model for physician-based and rural Accountable Care Organizations (ACOs) participating in the Shared Savings Program. ACOs selected to participate in the Advanced Payment Model will receive upfront payments that will be recouped from the shared savings they earn. CMS will host a Special Open Door Forum to review the Advance Payment ACO Model and the application template on:
Thursday, January 5, 2012
2:30 P.M. – 4:00 P.M. ET
Special Open Door Participation Instructions:
Dial: 1-800-837-1935 & Conference ID: 39623933
Note that the Advance Payment Model is available to only two types of ACOs:
- ACOs that do not include any inpatient facilities AND have less than $50 million in total annual revenue.
- ACOs in which the only inpatient facilities are critical access hospitals and/or Medicare low-volume rural hospitals AND have less than $80 million in total annual revenue.
On or before the morning of this Special Open Door Forum, a slideshow presentation will be posted to the Advance Payment Model ACO Application Information webpage. A transcript and audio recording of this Special ODF will be posted to the Special Open Door Forum website and will be accessible for downloading beginning on or around Friday, January 13, 2012.
Richard Popiel, MD, MBA, is a member of the Medical Society of New Jersey and President and Chief Operating Officer of Horizon Healthcare Innovations. He will be a featured panelist on Wednesday, December 14th at 8:00 am when MSNJ co-sponsors “Innovation through Collaboration: A Healthcare Transformation Forum” along with Horizon Healthcare Innovations & the NJHA. MSNJ recently asked Dr. Popiel to provide us with his vision on how Accountable Care Organization (ACO) and Patient Centered Medical Home (PCMH) models will transform the way care is delivered in New Jersey.
MSNJ: Please tell us how you became interested in the implementation of Accountable Care Organization (ACO) and Patient Centered Medical Home (PCMH) models.
Dr. Popiel: Most health care leaders agree that our delivery system needs to be reformed when it comes to the quality and cost of care. The status quo of the delivery system is not sustainable, and urgent action is necessary to collaborate with others to transform and improve New Jersey’s health delivery system. Horizon Healthcare Innovations, which is a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, is launching programs, like Patient Centered Medical Homes and Accountable Care Organizations, to deliver improved patient care at a lower cost. We feel these patient-centered care models give our delivery system the best opportunity to help all stakeholders achieve the goals of better health and better care at lower costs.
MSNJ: How do you see health care being delivered in New Jersey in the next 3-5 years?
Dr. Popiel: Over the next five years health care stakeholders will begin to work more collaboratively and focus on improving care coordination, preventive and well care, and help empower patients to take control of their own health. In addition, the way health plans and government entities pay providers will move from a volume-based or fee-for-service approach to one where providers are supported to get and keep their patients healthy. Health Information Technology systems to improve care coordination, as well as using new technologies and various communication methods to engage patients will be critical to transforming the delivery system.
MSNJ: What role do you see insurers having in the marketplace?
Dr. Popiel: Health plans play a leadership role in collaborating with providers to improve quality and make health care more affordable. To this end, health plans can facilitate a more integrated and efficient delivery system. Insurers have comprehensive patient data, strong IT systems and the ability to share this valuable information with doctors, hospitals and other providers. This information can be a tremendous resource and give physicians and hospitals timely data to provide higher quality, more coordinated care for their patients. Business as usual is not the solution. Health plans throughout New Jersey and the country need to step up in a collaborative manner and be a catalyst of change.
MSNJ: Will the financial benefit to physicians be better or worse if they sign up to participate in ACOs or PCMHs?
Dr. Popiel: A key component of these new care models, including ACOs and PCMHs, is to pay physicians and other providers for delivering better care at lower costs. Paying doctors for the number of tests ordered or treatments given doesn’t create a healthier New Jersey. Physicians and provider groups that can get and keep their patient population healthy and provide efficient care may financially benefit from participating in these new programs.
Richard Popiel, MD, MBA, is President and Chief Operating Officer of Horizon Healthcare Innovations, a Horizon Blue Cross Blue Shield of New Jersey company. His scope of responsibilities includes managing all aspects of the company, whose purpose is to launch new models of reimbursement and care delivery with network providers. He continues to serve as a member of the Board of Directors of Horizon Healthcare of New Jersey. He is also a member of the Board of the New Jersey Sharing Network (local Organ Procurement Organization), the local chapter of the American Cancer Society and the George Washington University Alumni Association.
Formerly, Dr. Popiel held the position of Vice President and Chief Medical Officer at Horizon Blue Cross Blue Shield of New Jersey. His scope of responsibilities included all medical management activities at Horizon BCBSNJ including Quality and Care Management, Utilization and Pharmacy Management. Dr. Popiel served as the Chair of the National Council of Physician Pharmacy Executives, a Blue Cross Blue Shield Association council comprised of all Chief Medical and Chief Pharmacy Officers. He also served as the Chair of the Chief Medical Officer Leadership Group at American Association of Healthplans (AHIP) and was a member of AHIP’s Board of Directors.
Dr. Popiel earned multiple degrees while attending George Washington University in Washington, D.C., including a Bachelor of Science and Doctor of Medicine. In addition, he earned a Masters in Business Administration from Northwestern University Kellogg School of Management in Chicago. He completed residency training in Internal Medicine and Emergency Medicine as well as fellowship training in Toxicology. He is Board Certified in Internal Medicine.
Thomas Kloos, MD, is a member of the Medical Society of New Jersey and will be a featured panelist on Wednesday, December 14th at 8:00 am when MSNJ co-sponsors “Innovation through Collaboration: A Health Care Transformation Forum” along with the NJHA & Horizon Healthcare Innovation. MSNJ recently asked Dr. Kloos to provide us with his vision on how Accountable Care Organization (ACO) and Patient Centered Medical Home (PCMH) models will transform the way care is delivered in New Jersey.
MSNJ: Please tell us how you became interested in the implementation of Accountable Care Organization and Patient Centered Medical Home models.
Dr. Kloos: Both models allowed for the first time the elements of population management to occur at the physician level, and are developing mechanisms to make sure the patients who are part of your practice are receiving the care they need, rather than just those who show up in your office on any particular day.
MSNJ: How do you see healthcare being delivered in New Jersey in the next 3-5 years?
Dr. Kloos: I see an absolute need to shift to the development of high performing physician networks with greater collaboration among all stakeholders including the patient.
MSNJ: What role do you see hospitals and insurers having in the marketplace?
Dr. Kloos: Hospitals remain an essential part of the equation especially where opportunities exist for quality programs and transitions of care. Insurers, through development of novel collaborative programs with physicians and hospitals, as well as by placing the right financial incentives in place to drive change, can be the catalysts for new models of care delivery.
MSNJ: Will the financial benefit to physicians be better or worse if they sign up to participate in ACOs or PCMHs?
Dr. Kloos: For primary care physicians, there is no doubt it’s a positive, for specialists who become comfortable in partnering in these models there will also be a benefit in maintaining and expanding their referral base and opportunities for other outcome based payment models such as episodes of care, but it will be outcomes and value driven.
Thomas Kloos, MD, serves as President and Chief Executive Officer of Optimus Healthcare Partners as well as President and Medical Director of Vista Health System IPA. He has been involved in all aspects of IPA development and growth since inception in 1995.
As medical director he managed full professional risk contracting and physician performance during the early years of the IPA. As President, he managed conversion to a messenger model IPA, and developed P4P and novel care coordination programs with major payors in the NJ market. Through the IPA he also advocated and supported primary care practices becoming BTE certified and transitioning to Patient Centered Medical Home (PCMH). On the payor side, he serves as Vice President of the Affiliated Physicians Health Plan, a self funded Multiple Employer Welfare Association (MEWA) in New Jersey with 7,000 covered lives which provide health insurance to small and medium sized physician and health related practices. Dr. Kloos is a board certified Internal Medicine practitioner in Warren NJ, NCQA certified in Diabetes Care, and a NCQA recognized Level III PCMH. He graduated from the University of Louisville Medical School in 1979, and Rutgers University in 1975, according to the website www.optimushealthcarepartners.com
The New York Jets would like to invite you, as part of The Medical Society of New Jersey, to take advantage of an exclusive offer to purchase tickets to NY Jets vs. the Jacksonville Jaguars on September 18, 2011.
This is a great way to share the passion and excitement of Jets football with your friends, family or colleagues in the best stadium in the NFL. The New Meadowland stadium is located in East Rutherford NJ, a quick drive or train ride away from New York City.
Check back soon for details on how you can purchase tickets through MSNJ.
Medicare Changes Annual Enrollment Process
This year, Highmark Medicare Services will not mail CDs to Medicare providers alerting them to the open enrollment period and providing other information. Instead, Highmark will mail post cards. Read more.
Five-Minute Survey on Palliative Patient/Family Interactions & Pain/Symptom Management
Palliative medicine, a relatively new and growing medical subspecialty, is focused on improving quality of life–and quality of care–for seriously ill patients and family caregivers from the time of diagnosis, during aggressive treatments and beyond. Aging baby boomers are expected to double the approximately 90,000,000 Americans now living with serious and life-threatening illness over the next 25 years. While there were almost no palliative care programs in U.S. hospitals just 10 years ago, the Center for the Advancement of Palliative Care (CAPC) reports that, “In the last five years alone, access to palliative care in our nation′s hospitals has more than doubled.”
MSNJ & Samaritan Healthcare & Hospice Survey have teamed up to poll physicians on their confidence level in addressing these issues. Click here to take the five-minute survey
The next Policy & Strategy Panel (PSP) meeting is scheduled for Thursday June 23 at 4:30 P.M. at the Medical Society of New Jersey Conference Center, located at 2 Princess Road in Lawrenceville, NJ. The PSP is a joint meeting of MSNJ’s administrative councils and committees that meets approximately six times per year to develop organizational policy on topics important to the health and healthcare in New Jersey. The physician members of the PSP investigate issues and topics in healthcare and recommend specific policy statements or actions to the MSNJ Board of Trustees. The PSP is co-chaired by the first vice president and president-elect of MSNJ.
The June 23rd agenda includes:
- “Safety Features for High School and Collegiate Football: A Plan to Alter or Eliminate Kickoffs,” presented by Vincent K. McInerney, MD, Chair, MSNJ Committee on the Medical Aspects of Sports, with a special appearance by former New York Jets quarterback, Ray Lucas
- Discussion of determinations of physician scope of practice by health insurers
- E-prescribing principles and pending eRx legislation
- Update on legislation
Licenses Expire on June 30; Physicians Urged to Renew Online
Members are urged to follow the directions in letters sent to them to renew on-line and to participate in a physician workforce survey. Licenses expire on June 30, 2011, unless renewed. Read more.