September 19, 2023

NEED TO KNOW

Join VMS to Learn More About Drug Policy Reform Strategies

This VMS webinar (virtual via zoom) will include national experts sharing the evidence for authorizing overdose prevention centers and eliminating criminal penalties for possessing personal use quantities of illicit drugs, two topics likely to come before the Vermont legislature in 2024.  

With planning assistance from the Drug Policy Alliance

Speakers:

Brandon Marshall, PhD, Professor of Epidemiology at the Brown University School of Public Health, and the Founding Director of the People, Place & Health Collective (PPHC) at Brown University.

Dr. Marshall received a PhD in epidemiology from the School of Population and Public Health at the University of British Columbia and completed postdoctoral training at the Columbia University Mailman School of Public Health.  Dr. Marshall’s work focuses on substance use epidemiology, harm reduction research, and the social, environmental, and structural determinants of health of drug-using populations.   He is the Principal Investigator of multiple NIH-funded projects, including the Rhode Island Prescription and Injection Drug Use Study (RAPIDS) and PROVIDENT, a randomized trial to prevent overdose deaths in Rhode Island. As the Scientific Director of PreventOverdoseRI, Rhode Island's drug overdose surveillance and information dashboard, he works closely with the Rhode Island Department of Health to track, measure, and evaluate efforts to address the state's opioid overdose epidemic.  Dr. Marshall has presented to the Vermont legislature and Vermont Opioid Settlement Advisory Committee on the science behind overdose prevention centers. 

Ryan Kelly, MD, MS, is a University of Minnesota Assistant Professor of Medicine, general medicine hospitalist, and medicine and pediatrics primary care physician at the Community and University Health Care Center, where he also treats opioid dependence. He received his medical training at the Wayne State School of Medicine, and did his residency in Internal Medicine-Pediatrics at the University of Minnesota. He also was honored to serve as a Chief Resident in Internal Medicine at the University of Minnesota, VA site. He has been a buprenorphine-waivered provider since 2016. His primary research interests include quality improvement in both the inpatient and outpatient realms, as well as in education, especially in improving access to care for chemical health.  Dr. Kelly supported efforts at the Minnesota Medical Association to adopt a resolution in favor of decriminalization of simple possession of illicit drugs.

You can register for the webinar here

CMS Holding Vermont-Specific Webinar on New All-Payer Reform Model, Sept 26th 12-1pm


As VMS shared in the Rounds last week, the Centers for Medicare & Medicaid Services (CMS) has announced a new voluntary state total cost of care model – the States Advancing All-Payer Health Equity Approaches and Development (“States Advancing AHEAD” or “AHEAD Model”).   

CMS’s Innovation Center (CMMI) will conduct a webinar specifically for Vermont on Tuesday, September 26 from 12:00-1:00.  The Vermont Agency of Human Services will share webinar registration information as soon as it is available – look for a standalone email from VMS with this information.  Please save the date and time. 

CMS states that the AHEAD Modelwill build upon the work of existing Innovation Center state-based models, including the Vermont All-Payer Accountable Care Organization ( VT ACO) Model, the Maryland Total Cost of Care Model (MD TCOC), and the Pennsylvania Rural Health Model (PARHM). What separates AHEAD work from current state-based models is that CMS will implement AHEAD concurrently across multiple states.

The AHEAD Model will include hospital global budgets as well as a voluntary “Primary Care AHEAD” model for primary care practices, which will include a per member per month case management fee.  CMS will issue awards to up to eight states.  CMS is also planning a webinar on October 17th on the Primary Care AHEAD model and will be sharing more information, as well as slides and an FAQ from a model overview webinar held on September 18th, on the model webpage.

The first Notice of Funding Opportunity (NOFO) application period will be released in late fall 2023. States will have 90 calendar days to apply for a cooperative agreement award during this first application period. The second NOFO application period is anticipated to open in Spring 2024 with a 60-day application period.

Now Accepting Applications for 2024 VMS ERF Clinician Leadership Course

The Vermont Medical Society Education & Research Foundation is pleased to open applications for a 5th statewide Executive Leadership Course beginning in January 2024.

This course is offered in partnership with the Daniel Hanley Center for Health Leadership and Lumunos Wellbeing and is supported by funding from the Physicians Foundation.  Perhaps more than ever before physicians and PAs are being asked to step up and skillfully lead rapid change. Every clinician is being called upon to bring their management styles and skills to the forefront to ensure the best outcomes for Vermont patients. VMSERF is pleased to continue to offer an experiential learning opportunity that will enhance and fine-tune leadership skills and concepts for a statewide cohort of Vermont physicians and PAs.

The course will run from January through November 2024.  It is aimed at individuals with 5 or more years of clinical experience but minimal formal leadership training, with a goal of enrolling 15-20 physicians and PAs from across Vermont.  To apply, submit a CV and brief description of interest to swinters@vtmd.org by November 1st. View the full 2024 brochure, schedule and application information here.

Prevention Council Focused on Opioid Use Prevention Strategies

Vermont's Substance Misuse Prevention Council (SMPC) met this week, and with the continued spike in opioid-related deaths across the State, particularly fentanyl-related, they discussed youth prevention strategies the Council will put before the Opioid Settlement Advisory Committee for 2024.  The Opioid Settlement Advisory Committee makes recommendations to the Vermont Department of Health regarding how the State should use funds received due to opioid manufacturer settlement agreements.  The SMPC made it clear that opioid prevention and intervention is of the highest priority this session, and that they want to prevent more Vermont youth from ever using these highly addictive drugs. The Vermont Department of Health's latest opioid report for September 2023 shows that the number of opioid deaths in Vermont from January through June is higher than the three-year average, and that most accidental deaths involve fentanyl. VMS member Kim Blake, M.D., was also recently featured in a recent BBC article, "How the fentanyl crisis' fourth wave has hit every corner of the US." Dr. Blake speaks about the need for rapid treatment and the potential of harm reduction strategies like overdose prevention sites to save lives. VMS members interested in becoming involved in these committee meetings or with suggestions for opioid use prevention strategies should reach out to jsudhoffguerin@vtmd.org.

Green Mountain Care Board Wraps up 2024 Hospital Budget Deliberations

Last week, the Green Mountain Care Board finalized decisions on 2024 hospital budgets.  In FY24 decisions, the GMCB made adjustments to seven hospitals’ budgets to limit the commercial rate increases allowed, while approving the remainder as submitted.  The GMCB press release can be found here.  Press coverage of the budget decisions can be found here and here.  

American Medical Association Submits Comments Opposing 2024 Medicare Fee Schedule Cuts

Last week, the American Medical Association submitted a final comment letter in response to the Centers for Medicare & Medicaid Services (CMS) proposed rule for the 2024 Medicare Physician Fee Schedule (PFS) and Quality Payment Program (QPP).  The AMA underscored its concerns regarding ongoing conversion factor reductions, specifically a proposed 3.36 percent reduction in the 2024 Medicare conversion factor (CF), which will reduce professional services payments.  While the AMA recognizes that CMS does not have the authority to provide an inflation-based update for physicians, in its letter the AMA strongly urges CMS to use every policy lever available to reduce the proposed reductions for physician services in 2024 and to close the gap between the Medicare physician payment update and the rising cost of practicing medicine.

The AMA’s analysis of the 2024 fee schedule can be found here and advocacy materials asking for Congress’ help in averting 2024 fee schedule cuts can be found here.

MISC.


Anxious Nation Comes to Vermont: Free Film Screenings Statewide


NAMI Vermont, in support with other state community organizations, is bringing the documentary Anxious Nation to communities statewide beginning September 21. These screenings are free to the public thanks to a grant from the Vermont Community Foundation.


The events will feature a documentary screening, facilitated Q&A or panel discussions, and access to free mental health and suicide prevention resources. Screenings are made possible with the support of the American Foundation for Suicide Prevention and the United Way Mental Health Initiative.


View screening locations and times here

Commissioner of Health Public Health Notes from Update and Next Call Thursday, October 5th

The Commissioner of Health, Mark Levine, MD, joined the VMS for a public health update on September 7th. You can find the notes here.

The next Public Health Update will be Thursday, October 5th at 12:30 pm. Hear about the the most pressing public health information affecting the state and nation and have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting.

You can join the zoom meetings here.

Vermont Medicaid Audio-Only Guidance Update

Medicaid providers are reminded that effective 7/1/2023, Vermont Medicaid allows the delivery of  audio-only services limited to the defined list of codes that can be found at https://dvha.vermont.gov/providers/telehealth. This list mirrors what Medicare covers and includes additional codes that are clinically appropriate and align with AMA correct coding guidelines.

A review of claims since 7/1/2023 found that some providers are continuing to bill codes that are no longer allowed as audio-only. Medicaid will consider covering audio-only services that are not on the approved list when unforeseen circumstances require the service to be delivered audio-only. Some services may be delivered using telemedicine with real-time audio and video. DVHA continues to review telehealth coverage and encourages provider feedback by contacting Gainwell Provider Services at 800-925-1706.  You can also contact jbarnard@vtmd.org with questions or concerns.

You Are Invited to the 2024 Vermont Voices of Medicine Advocacy Breakfasts

Please join us in January to meet your lawmakers and to advocate for health care policies 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. Each breakfast starts on specific Thursdays and runs from 7:30-9 AM. 

The Vermont Medical Society (VMS) will be hosting several of the breakfasts with others hosted by the Vermont Academy of Family Physicians, the American Academy of Pediatrics Vermont Chapter, the Vermont Ophthalmological Society, the Vermont Psychiatric Association, the OB/GYN residency program, and Larner College of Medicine medical students. Please RSVP to attend the breakfasts being hosted by the specialty society of which you are a member. The VMS advocacy breakfasts are open to all specialties to attend. Please reach out to Jill Sudhoff-Guerin at jsudhoffguerin@vtmd.org if you have any questions. 

Click here for the list of dates & to register. 

Click here for more information. 


Register Now for the 210th Annual and Collaborative Meeting

The 210th VMS Annual Meeting will be held on November 3rd and 4th in person at Topnotch Resort, Stowe, VT, with virtual options. The weekend will be filled with educational content, time spent with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state.

Register here and nominate Vermont leaders who have provided outstanding contributions to the medical profession, to health organizations and to the welfare of the public for a VMS Leadership Award here.

EVENTS


CARE Series: Lethal Substances and Overdose Prevention

September 26, 2023 from 12pm to 1pm


Join Melissa Volansky, MD, Chief Medical Officer of Lamoille Health Partners on a facilitated discussion and review of:

  • rationale for harm reduction in general medical settings
  • mitigating challenges to detection of adulterants including fentanyl, xylazine and emerging substances
  • harm reduction strategies in the context of Substance Use Disorder Care
  • collaboration with Harm Reduction/Syringe Service Programs
  • collaboration with Peer Recovery

Register here.

Learn more about the series here.


Save the Date: Vermont ACP Chapter Annual Scientific Meeting

September 29, 2023 at Trapp Family Lodge, Stowe, VT

The Vermont ACP Chapter's Annual Scientific Meeting will occur on Friday, September 29, 2023. We are planning for an in person meeting. We will again host a poster competition for resident and student members.

Update your medical knowledge, engage with colleagues, and receive 5 AMA PRA Category 1 CME credits and 5 MOC points.

Meeting details, agenda and registration information will be forthcoming.

Primary Care Sports Medicine and

Wilderness Medicine Conference

October 15 – 17, 2023

Delta Hotel in South Burlington, VT

The 2023 Primary Care Sports Medicine and Wilderness Medicine is designed to update knowledge and skills in the diagnosis and management of common sports medicine and wilderness medicine problems. Topics will include discussions of medical and orthopedic issues. There will be ample opportunity for participants to ask questions and interact with faculty, who hail from the University of Vermont Health Network and local community. The teaching program includes lectures and workshops.

Registration information, full agenda and accreditation details can be found here.

Northern New England Neurological Society Annual Meeting

October 20th - 21st, 2023

Killington Grand Hotel and Resort, Killington, VT

The 2023 NNENS Annual Meeting will take place at the Killington Grand Hotel and Resort and offer updates on the latest treatments and therapeutic options available across the neurology field. This event is open to physicians, past and present neurology residents, nurses and nurse practitioners, physician assistants and other neuroscience professionals. You do not need to be a NNENS member to participate.

Registration information, full agenda, and accreditation details can be found here.

Neurology for the Non-Neurologist 

October 20, 2023

Killington Grand Hotel and Resort, Killington, VT

The Neurology for the Non-Neurologist conference offers the most up-to-date information regarding the treatment of neurologic problems in the primary care setting. This conference focuses on how to diagnose and treat common neurological disorders, order and interpret appropriate diagnostic studies, and provides a guide for therapy and patient care. Primary care physicians, nurses, nurse practitioners, physician assistants, and other medical professionals with an interest in neurology are encouraged to attend.

Registration information, full agenda, and accreditation details can be found here.

Osteoporosis Update for Primary Care November 2, 2023

Hampton Inn Conference Center, Colchester, VT

This conference is designed to improve the skills of the primary healthcare team, as they are often the first to encounter patients who have (or are at risk of developing) osteoporosis. A wide spectrum of diagnostic, management and treatment options will be presented. Topics will include: osteoporosis treatment and fractures, physical therapy and bone health, glucocorticoid-induced osteoporosis, and risks, evaluation and treatment for postmenopausal osteoporosis.

Registration information, full agenda, and accreditation details can be found here.

New England Rural Health Association's Annual Fall Conference

"New Horizons in Rural Health Equity"

November 8-9, 2023

Killington Grand Resort Hotel, Killington VT

This conference is an opportunity for rural healthcare professionals, hospital administrators, educators, students and community leaders to learn from experts in rural topics, and to network with each other. Designed to involve all sectors that impact the health of people in rural New England, this multidisciplinary event gives attendees the opportunity to delve into specific areas of interest or participate in sessions spanning a variety of topic areas.

Register today for NERHA's Fall 2023 Conference and learn more here.

CPT & RBRVS 2024 Annual Symposium

November 15-17, 2023

CPT & RBRVS 2024 Annual Symposium is the world's only medical coding conference where attendees learn about the upcoming changes to the Current Procedural Terminology (CPT) code set and payment policies directly from members of the AMA-convened CPT Editorial Panel, AMA/Specialty Society Relative Value Scale Update Committee (RUC), and CPT and RUC Advisors.

Join virtually to get the first look at the 2024 CPT code set with guidance from the experts, earn continuing education credits, and join over a thousand of your peers for premier coding education at the CPT & RBRVS Symposium!

Register with early bird discounted rates through September 30th here.

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

VTMD.ORG

Vermont Medical Society

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Montpelier, VT 05602

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