N.H.'s Prescription Monitoring Program - An Update

New Hampshire became the 49th state to adopt a prescription monitoring program (PMP) when then-Gov. John Lynch signed SB 286 into law in June 2012.

The PMP law requires pharmacists to report data when dispensing class II, III or IV controlled drugs.  That data will allow prescribers to electronically query the PMP before writing a prescription for a controlled drug for a particular patient.  The new program will help all physicians, not just emergency physicians, to appropriately prescribe controlled drugs without fear of over- or under-prescribing these substances.

New Hampshire's Limited Network......

This week I’d like us to consider the new Health Insurance Marketplace in New Hampshire. You may have heard that only one insurer decided to participate and so, for now, the marketplace is limited in carriers and the one carrier has a limited network. Anthem will have 11 lines and will release details of the plans later this week, sharing representative examples of the rates people will pay.

NHMS Explores Physician Buddy Support System to Help in Time of Need.

To test a physician's reflexes, one need only say the words "malpractice lawsuit."  Virtually all of us have a visceral reaction when we talk about litigation.  While the financial costs of malpractice are what dominate the headlines, the emotional toll associated with malpractice is often much higher.  Because of this, NHMS has been very active for malpractice reform with legislative solutions such as Early Offer, I'm Sorry, and the 519-B Malpractice Panel law.

It is important we remember that individual physicians who are sued often experience fear and isolation -- feelings that affect their confidence and that may alter, or even end, their practice.  Once a suit has been lodged against us, we are immediately instructed by our lawyers to not talk to anyone about it -- thus cutting us off from our personal and professional support networks.  This isolation may last years, as cases crawl through the legal system, and have long term effects on the individual physician.

NHMS Facilitating Connections and Best Practices.

This week the AMA had its interim meeting in Hawaii and while I didn't have the opportunity to attend, I was able to watch some of the proceedings via the net.  I was particularly struck by the comments of AMA President Jeremy Lazarus. You can watch his full presentation Here. In talking about how to move forward with implementing health care reform and creating a model of care integration Dr. Lazarus said, "Our loftiest aspirations are exactly what's needed now to transform our health care system...and that physicians can accomplish great things when they work together."  He also indicated that even with increased partnerships within medicine, physicians will need to build connections with those outside of medicine to address the social determinants of health such as housing, employment and education and their impact on individual health.  

NHMS Focusing Advocacy Efforts To Address Excessive Alcohol Consumption.

All of us know the human costs of excessive alcohol consumption. In our work we see the impact on individuals, families and communities in human terms. Problem drinking is something we see all too often. New Hampshire ranks among the top five heaviest drinking states. Some estimates place us first in per capita beer consumption while at the same time we rank 49th in access to substance abuse treatment. An estimated 96,000 residents are in need of treatment for excessive drinking but only 4% of them receive treatment.  Unfortunately, these statistics and our patients' stories have had little impact in garnering attention to expand prevention and treatment given the current economic environment until now. Last Friday, New Futures released a report that quantifies the costs of excessive alcohol intake on New Hampshire in dollars and cents and the results are shocking.

NHMS Membership - Two More Please

Our practices are attached to the swinging pendulum of healthcare debt, reimbursement and corporate drivers.  This blog is not intended to highlight the potential trends of ACOs, hospital mergers and acquisitions, or the impact they will have on the quality of physicians’ professional practices and our patients.  After all, so many providers are well aware of the changes on the horizon.  Many more healthcare professionals are intimately aware of business practices and much more willing to partner with or be employed by healthcare organizations than to weather it alone.  This, too, is part of the swinging pendulum that physicians should be mindful of.  There can be some very positive outcomes for all, but it is important to remain at decision tables and as proactive stakeholders.  To do so, it is essential for physicians to grow more robust and cohesive groups in order to be proactive agents of change.

NHMS Physician Opinion Survey

Last week you received an email from me announcing the NHMS physician opinion survey and yesterday, we launched it.

For NHMS to better represent its members and carry-out its mission -- to bring together physicians to advocate for the well being of our patients, for our profession and for the betterment of the public health – we need your input.

NHMS Supports Important Health Policy Areas.

A central role of NHMS is to work on policies to enhance the public's health and the practice environment.  At our most recent executive council meeting, we voted on two important health policy areas:  

1.  The New Hampshire Society of Eye Physicians and Surgeons brought forth an issue that some hospitals were not open to negotiating their service call relationships with specialty providers.  Following a spirited discussion of the nature of service call and our professional obligations, we unanimously voted to support physicians as they seek to pursue meaningful negotiations in providing service coverage. 

Moving Towards Medicaid Expansion

Because of our hard work on expanding coverage to the uninsured in New Hampshire, I was asked to serve on the Medicaid Expansion Study Commission and I wanted to share some updates from this.  The Commission was set up to give the State more time to study expansion so that the Legislature can possibly come back for a special session this fall so that we can take full advantage of federal funds.  So far we have met three times and have been given background information on the Medicaid program, what it costs and who it serves, and options for expansion.  In NH, Medicaid is a 50-50 partnership between the federal and state governments.  Under expansion, the newly covered population would be 100% financed by the federal government for 3 years and then would titrate down to 90% by 2021 and the state would be responsible for 10% into the future. 

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