VMS Council to Weigh Proposed Resolutions, Seeks Nominations for Open Seats
The VMS Council (governing board) will meet next Wednesday, September 15th to consider member feedback on four proposed policy resolutions. The resolutions are:
VMS members wishing to attend the Council meeting, which will be held over Zoom from 6:30-8:30 pm, can contact Birdie Powell at bpowell@vtmd.org for the log-in information. VMS also has an upcoming at-large Council seat opening and is open for nominations for the Vice President role. All members are encouraged to express interest and the Council seeks to establish inclusive and diverse representation of members in areas such as medical specialty, practice type, geography, group membership and individual demographics. The resolutions and leadership positions will be voted on at the VMS Member Business Meeting, Saturday, November 6th from 9am – 12pm. Contact Jessa Barnard at jbarnard@vtmd.org for more information.
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CMS Releases Evaluation of Vermont All-Payer Model
Last week, the federal Centers for Medicare & Medicaid Services (CMS) released an evaluation and summary of findings of the first two performance years (2018 and 2019) of Vermont’s All-Payer Model (APM), finding promising results that indicate the APM and Vermont’s Accountable Care Organization, OneCare Vermont, are on the right track toward transforming the way health care is paid for and delivered. The evaluation of the first two years of the model was conducted by NORC at the University of Chicago, an independent research institution, and assesses the implementation and measures effects of the APM.
Key findings of the evaluation of the APM include:
- The APM achieved statistically significant Medicare gross spending reductions at both the ACO and state levels, as well as Medicare net spending reductions at the state level.
- There were statistically significant declines in acute care stays (at the ACO and state levels) and in 30-day readmissions at the state level.
- Evaluators found that stakeholders agree that the APM provides an important, unifying forum for providers, payers, and the state to engage in meaningful discussions about healthcare reform and set goals. The APM is also strengthening relationships among hospitals, community organizations, designated mental health agencies, primary care practices, and other providers.
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Texas Law Banning Most Abortions Takes Effect
By a slim 5-4 vote, the United States Supreme Court did not act this week on a request to stop a Texas law banning abortions after 6 weeks. The law, which has some abortion rights advocates worried that the court might be inclined to revisit Roe v. Wade, a 50-year-old decision protecting a woman’s right to abortion. Here’s more about the law:
- What the law says: Any pregnancy where a heartbeat is detected cannot be aborted. That effectively means that if you’re six weeks pregnant, you can’t have an abortion in Texas. It’s a threshold that occurs before many even know they're pregnant. The law provides no exceptions for rape and incest but makes an exception for medical emergencies.
- The law does something else novel: It incentivizes the public to police abortions. It allows a person — anyone living in the state of Texas — to sue an abortion provider they suspect is “aiding and abetting” abortions after that six-week mark. It sets a $10,000 award for any successful lawsuit to stop an abortion.
- What could happen next: The Supreme Court could still decide to stop the Texas law at least temporarily while lower courts debate its merits. This fall, the justices will hear separate arguments over a Mississippi abortion ban, which could give us a clearer understanding of how this conservative Supreme Court views abortion rights.
The day after the SCOTUS decisions, United States House of Representatives Speaker Nancy Pelosi said that the House will vote on legislation to guarantee access to abortion upon its return to Washington later this month. In Vermont’s upcoming 2022 legislative session, lawmakers will decide whether to pass Prop 5, a proposed amendment to the Vermont constitution aimed at protecting the right to personal reproductive liberty for all Vermonters. If passed, the question would go on the ballot in November of 2022 and Vermont voters will decide if Vermont becomes the first state in the country to explicitly protect reproductive liberty in its constitution.
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AMA Releases Educational Resources to Advance Equity in Health Care
In alignment with its commitment to inform and educate physicians on topics important to health equity, the American Medical Association (AMA) last week announced a series of CME and educational activities aimed at addressing the root causes of inequities, including racism and other structural determinants of health. The new content — featured on the AMA Ed Hub™ Health Equity Education Center and curated by the AMA’s Center for Health Equity— will equip physicians and other learners with core health equity concepts needed to support them as they continue to take action and confront health injustice.
Prioritizing Equity CME video series
COVID Black CME module
Additional new health equity-related modules are scheduled for release throughout the remainder of 2021 and beyond, covering key topic areas such as structural competency, public health, social sciences, critical race theory, and historical basis of disease. An overarching goal of the content is to help learners better understand how systems of power, structures, policies, and practices impact us all.
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AMA, APhA, ASHP Call for Immediate End to Prescribing, Dispensing, and Use of Ivermectin to Prevent or Treat COVID-19 Outside Clinical Trials
Last Wednesday, the American Medical Association, American Pharmacists Association (APhA), and American Society of Health-System Pharmacists (ASHP) issued a joint statement strongly oppose the ordering, prescribing, or dispensing of ivermectin to prevent or treat COVID-19 outside of a clinical trial. The full statement can be found here. Ivermectin is approved by the U.S. Food and Drug Administration (FDA) for human use to treat infections caused by internal and external parasites. It is not approved to prevent or treat COVID-19. Ivermectin is also available to treat certain veterinary conditions; medications formulated or intended for use in animals should not be used by humans. The organizations are alarmed by reports that outpatient prescribing for and dispensing of ivermectin have increased 24-fold since before the pandemic and increased exponentially over the past few months. As such, they call for an immediate end to the prescribing, dispensing, and use of ivermectin for the prevention and treatment of COVID-19 outside of a clinical trial.
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Vermont Medicaid Update on Synagis for Respiratory Syncytial Virus (RSV)
Vermont Medicaid/the Department of Vermont Health Access (DVHA), in coordination with their Pharmacy Benefits Manager Change Healthcare, review data from the National Respiratory and Enteric Virus Surveillance System (NREVSS) to track the epidemic season for Respiratory Syncytial Virus (RSV). Synagis® is indicated for the prevention of serious lower respiratory tract disease caused by RSV in pediatric patients. While peak RSV activity typically occurs between November and March, RSV activity through the traditional 2020-2021 fall/winter season remained very low and as COVID-19 mitigation measures have been relaxed, RSV activity is on the rise. In response to this atypical inter-seasonal change in RSV activity, the American Academy of Pediatrics (AAP) issued Interim Guidance supporting the use of Synagis® in patients who qualify for coverage per current clinical guidelines during periods when RSV incidence is epidemic in the area. The clinical benefit of Synagis® therapy is best realized by timing the administration to coincide with the peak of RSV activity. DVHA will continue to monitor RSV activity and may end the atypical Synagis® “season” when the percent positives on antigen tests is ≤ 10% for 2 weeks or the percent positives on PCR tests is ≤ 3% for 2 consecutive weeks. Prior authorization/order forms should be sent directly to Change Healthcare at 844-679-5366. Additional information and DVHA forms may be found at the following sites:
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State of Vermont Launches Investigation Regarding Long Wait Times for Specialty Care
Last week, in response to a Seven Days story entitled, “The Doctor Won’t See You Now: Patients Wait Months for Treatment at Vermont’s Biggest Hospital,” Agency of Human Services Secretary Mike Smith announced that the State of Vermont will be launching an investigation into the reported long wait times for specialty care appointments at the University of Vermont Medical Center and other hospitals. Ena Backus, the State’s Director of Health Reform, will lead the investigation and said that she will not focus the exploration on any specific hospital and will not confine it to just specialty care. A few days later, the Green Mountain Care Board and the Department of Financial Regulation announced that they would be joining the effort to better understand long wait times for specialty care across the State. Secretary Smith was quoted as saying, ““We are not trying to punish organizations,” he said. “We really do want to understand the challenges across the system and help identify ways to remove the barriers.” John Brumsted, President and CEO of the UVM Health Network, released a statement after the Seven Days story was published and said that the current situation is unacceptable and that COVID-19 care, along with abnormally high patient volumes and intense patient needs, has resulted in a "perfect storm" that has stressed everyone in the entire health care system.
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Vermont Vaccine Update Includes 2021/2022 Flu Season Information
The Vermont Health Department Immunization Program published their "Vermont Vaccine Program Update" for August, 2021. This Update includes important information for health care clinicians on the COVID-19 vaccine, ordering flu vaccine for the 2021/2022 season and setting up flu clinics as well. Click here to read the full Vaccine Update.
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