December 3, 2024

NEED TO KNOW


Legislative Breakfasts Just Around the Corner – Register Today!


Please join us in 2025 to meet your lawmakers over coffee and a light breakfast. These breakfasts, which will be held in the cafeteria at the Vermont Statehouse in Montpelier, are an informal opportunity to educate lawmakers on ways to improve Vermont's practice environment and health care system.  You don’t need any prior advocacy experience to join! Each breakfast starts on specific Thursdays at 8-9:30AM.  The first all specialty/VMS breakfast kicks off on January 15th.  Register here.


The dates for all breakfasts are:

VMS/All Specialties – January 15

Medical Student Interest Group – January 28 (12:30-2pm)

OBGYN/ACOG – February 5

Family Physicians – February 19

Pediatrics – March 19

Vermont Ophthalmological Society – March 26

Family Physicians – April 2

VMS/All Specialties - April 16

Family Physicians – April 30


Please reach out to Jill Sudhoff-Guerin at jsudhoffguerin@vtmd.org if you have any questions and be sure to register to receive important logistics and policy updates before your breakfast.

UVMHN Submits Response to GMCB Budget and Enforcement Orders

Last week, UVM Health Network submitted a detailed letter and grid response to the Green Mountain Care Board’s budget orders that resulted in the Health Network announcing administrative and service cuts two weeks ago (see prior Rounds coverage here).  The response outlines findings in the GMCB orders and responds to those findings in areas including excessive cost growth, wait times, provider productivity, executive salaries, quality ratings, commercial prices, ability to reliably budget, and impacts of supporting the Larner College of Medicine.   Also this week, VMS member and child and adolescent psychiatry fellow Dr. Nat Mulkey authored a commentary regarding the budget dispute.  A commentary by the Vermont Psychiatric Association was published last week.

DFR Releases Draft Bulletin Regarding Prior Authorization, Step Therapy Exemptions

The Department of Financial Regulation has released a draft bulletin to clarify the application of Act 111 of 2024 to health insurers, health care providers, and consumers.

The draft bulletin covers aspects of Act 111 related to:

  1. PA Exemption
  2. Claims Editing
  3. Step Therapy

Comments on the bulletin are due by December 13th and DFR has a goal to release a final bulletin no later than December 18th as the provisions of the law go into effect on January 1st.   Please share any questions or feedback with Jessa Barnard at jbarnard@vtmd.org to include in comments to DFR.  Per DFR guidance, the PA exemption will initially only apply to primary care providers participating in the Blueprint for Health.  VMS continues to advocate for the exemption to apply to all primary care providers, as intended in the law, and has been meeting with law makers, payers and DFR to advocate for this change to go into effect as soon as possible.  More details regarding how PA exemptions will be operationalized will also be sent to clinicians directly by each payer. 

OneCare Vermont Announces New Leadership

OneCare Vermont (OneCare) today announced key leadership transitions to lead the organization in its final year of operation.

Tom Borys, currently serving as OneCare’s chief financial officer, has been appointed interim CEO and CFO. He will replace Abe Berman, who was instrumental in founding OneCare in 2012 and returned to the organization as chief executive officer in 2023. Berman will be stepping down in mid-December to join TapestryHealth. The OneCare Board of Managers also announced the election of Jennifer Gilwee, MD, to the position of board chair. Dr. Gilwee, who has served on the board since 2021, currently chairs the Population Health Strategy Committee and is the division chief of General Internal Medicine at the University of Vermont Medical Center. Dr. Gilwee will succeed Anya Rader Wallack, who has served as board chair since May of 2022.

Borys and Dr. Gilwee will oversee the organization’s work as it prepares to wind down operations by the end of 2025. The Board affirmed that all programs, investments, and waivers will continue through 2025 as planned and approved by OneCare’s Board of Managers.

VDH Health Alert - Testing for Tuberculosis

Since October 21, four cases of active pulmonary Tuberculosis (TB) disease have been reported in Vermont. The cases are not linked and there is no evidence that TB infection occurred in Vermont. People identified as close contacts to active cases and people with increased risk for TB are recommended to receive testing for TB infection. Diagnosing and treating people with latent TB infection (LTBI) prevents the development of TB disease. However, before initiating treatment for LTBI, TB disease must be excluded.

Free, in-person training: Diagnosis and Management of Latent TB Infection

Register for a training at the Delta Hotel in South Burlington on Thursday, December 5 from 4:00 p.m. to 7:00 p.m. Dinner will be served. This is a CME accredited sponsored activity by the Global Tuberculosis Institute and the Vermont Department of Health. Click here to register for the training.

Requested Actions 

  • Test for TB Infection - Test patients with risk factors for infection with tuberculosis and those who are at high risk for developing TB disease once infected.
  • Evaluate for TB Disease - All patients with a positive test result for TB infection should be evaluated for active TB disease before starting treatment for LTBI.
  • Treat for LTBI if TB Disease is Excluded - LTBI treatment regimens are outlined in the 2020 Guidelines for the Treatment of Latent Tuberculosis Infection.

Read full HAN Here.

 

VMS Foundation Seeking Board Members

The VMS Education and Research Foundation (VMSERF) is actively seeking new Board members. The Board typically meets 2-3 times per year for 1 ½ hour virtual meetings.  If you are passionate about recruiting and educating the next generation of Vermont physician leaders, please consider joining our Board! 

The VMSERF is a 501(c)(3) nonprofit charitable organization sponsored by the Vermont Medical Society and organized to support charitable, educational, and scientific activities in the field of health.  Currently the Foundation runs two main programs:

  • A Physician Executive Leadership Institute Foundational Course, which offers an experiential learning opportunity to enhance and fine-tune valuable leadership skills and concepts for a statewide cohort of Vermont physicians and PAs.  Read more at https://vtmd.org/physician-executive-leadership-institute/
  • The Mildred Reardon Scholarship, which awards an annual $10,000 scholarship to a University of Vermont Larner College of Medicine third year student committed to practicing medicine in Vermont to ensure Vermonters in all parts of the state continue to have access to excellent medical care.  Read more at: https://vtmd.org/mildred-reardon-student-scholarship

For more information, please contact Jessa at jbarnard@vtmd.org.

MISC.

Next Commissioner Call, This Thursday - December 5, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members this Thursday, December 5th at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on November 7th. Notes from the call are here.

January 2025 Virtual Healthcare Ethics Education Series

Starting on January 9th, 2025, the Vermont Ethics Network will be hosting a four-part virtual series on Contemporary Issues in Healthcare Ethics.

Session topics will include:

  • January 9, 2025 - Artificial Intelligence
  • January 14, 2025 - How Health Care Can Outgrow Bias
  • January 21, 2025 - Dementia Related Issues
  • January 30, 2025 - Incapacitated Refusals & Vermont's Ulysses Clause

Speakers and official titles will be released soon - keep an eye on VEN’s News & Events page and make sure you have signed up for our email reminders so you get the latest information.

Seeking Interest in History of Medicine

Dr. Dale Magee of Massachusetts is seeking more New Englanders interested in the history of medicine.  Please see his note below and contact him at dalemagee@gmail.com for more information.

We could use more on the History of Medicine!  It is interesting, provides perspective for contemporary events and is fun!  I am exploring establishing the New England History of Medicine Society and I hope that you are interested.

In Central Massachusetts we have enjoyed a number of activities appealing to a broad audience.  These have included lectures, a medical history book club, local tours, international tours, and displays as well as a forum for collectors to chat.  I am exploring making these available to a wider audience and helping those interested in expanding the offerings to suit their local audience.  This is not an academic endeavor, but, rather, is aimed at all clinicians and the public (depending on the program).  If you are interested in learning more or helping please contact me.

Vermont Clinician Prior Authorization Impact Survey Still Open

VMS has launched a survey to inform policy makers regarding the impact of prior authorizations on your health care facility/practice and patients. This survey was requested by the Vermont legislature in Section 7(a) of Act 111 of 2024 to measure the impact of the law on prior authorizations both before and after the law goes into effect on January 1. Thank you in advance for your assistance in completing the survey! Your input is very important!  Contact the Vermont Medical Society with questions at https://vtmd.org/contact-us.

Please find the links below. 

Clinician Survey Link. Intended for clinicians who participate in the prior authorization process.

Practice Administrator Link. Please have the practice or facility staff familiar with the prior authorization process and staffing at your location complete this survey for your practice. Please only complete once per facility/practice.

EVENTS

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

October 2024 – March 2025

AMA STEPS Forward® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

For more information about offerings from UVM CMIE, visit here.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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