New! Timely Info for FPs!

2007 Physician Quality Reporting Initiative (PQRI) Update

Medicare Announces the Measure Specifications for the Physician Quality Reporting Initiative

Farmington Hills, MI (April 5, 2007) -The Centers for Medicare & Medicaid Services (CMS) announced the posting of detailed specifications for the 74 measures included in the 2007 Physician Quality Reporting Initiative (PQRI). To view the measures, please visit:

www.cms.hhs.gov/PQRI/15_MeasuresCodes.asp#TopOfPage.

The 2007 PQRI quality measures relate to important processes of care that are linked to improved healthcare quality outcomes. They are evidence- and consensus-based measures that reflect the work of national organizations involved in quality measure development, consensus endorsement, and adoption. These include the American Medical Association Physician Consortium for Performance Improvement, the National Committee for Quality Assurance, the National Quality Forum, the AQA Alliance and other physician and non-physician professional organizations. The professional organizations are also assisting CMS in providing PQRI education and assistance to their members.

The specifications have been posted well in advance of the statutory deadline of July 1, 2007. This is to help eligible professionals to identify measures applicable to their practices and to prepare for submission of quality data in advance of the July 1, 2007 start date of the program. CMS anticipates a small number of additional specification changes, which may expand the applicability of the measures to additional eligible professionals.

The PQRI measures apply to services that eligible professionals provide to Medicare beneficiaries in their offices and other settings. CMS is implementing an extensive outreach and education plan to assist eligible professionals to understand the program and the measures and to implement processes to efficiently capture the quality data that is to be reported under the PQRI program.

PQRI establishes a financial incentive for physicians and other health practitioners to participate in a voluntary quality reporting program. Eligible professionals who successfully report data for a designated set of quality measures may earn a bonus payment, subject to a cap, of 1.5 percent of total allowed charges for covered Medicare physician fee schedule services provided during the reporting period of July 1, 2007 to December 31, 2007.

“CMS is committed to becoming an active purchaser of high quality, efficient health care, and the PQRI program is an important step in that transformation,” said CMS Acting Administrator Leslie V. Norwalk.

Also, on March 27, 2007 a national conference call took place that explained PQRI. For a limited time a recording of that call is available. The information to hear the recording, access the PowerPoint slide presentation and written transcript are all available at:

www.cms.hhs.gov/PQRI/Downloads/PQRIAudioReplay_28Mar07.pdf.

Questions regarding PQRI should be submitted through the PQRI Web site, www.cms.hhs.gov/pqri/, or by contacting Bonnie Mauch, MPRO project coordinator at (248) 465-7333 or bmauch@mpro.org.

National Procedures Institute Courses

The National Procedures Institute has an exciting line-up of courses to start off the new year! Whether you want to stay close to home and join us in our hometown of Midland, Michigan, or you want to get away from the winter weather and enjoy some sunshine, we have the courses you are looking for!

Please visit our website at www.NPInstitute.com to see the details and prices for all these courses, as well as the rest of our 2007 schedule. Or, call us at 800-462-2492 with questions! We look forward to seeing you at one of the courses!

John L. Pfenninger, MD, FAAFP, Director
4800 North Saginaw Road
Midland, MI 48640
989-631-4664

CDC Announces the Opening of the 2006-2007 Flu Gallery

Are you looking for educational materials about influenza and the flu vaccine? CDC's Flu Gallery contains educational materials for use during the upcoming influenza immunization season. These materials reflect CDC's vaccination recommendations and highlight the benefits of influenza vaccination. The Gallery contains print materials such as flyers, posters, and brochures, in color and black and white, English and Spanish. Many of the materials can be reproduced on an office printer. You can also have the materials printed by a professional (offset) printer.

We encourage you to visit the online gallery often because, as vaccine supply information changes, we will upload new materials that address expanded audiences, or new recommendations about which groups vaccine should be directed toward. Additionally, if vaccine supply is still strong toward the end of November, we will post "late season" promotion materials to the gallery which will remind people that it is not too late to get vaccinated against influenza in December and beyond.

The Flu Gallery can be found at www.cdc.gov/flu/gallery

What’s New With Immunizations?

By Barbara Wolicki, R.N., B.S.N. and JoEllen Wolicki, R.N., B.S.N., Michigan Department of Community Health

The world of immunizations has been changing rapidly. Information about some of the key changes and newly-licensed vaccines is summarized below. The Advisory Committee on Immunization Practices (ACIP), consisting of 15 experts in fields associated with immunization appointed by the Secretary of the Department of Health and Human Services (HHS), advises the director of CDC and Secretary of HHS on control of vaccine-preventable disease and vaccine usage. Recommendations of the ACIP are published in CDC’s Morbidity and Mortality Weekly Report (MMWR). The ACIP recommendations for vaccines can be found at: www.cdc.gov/nip/publications/acip-list.htm

Influenza vaccine has some expanded recommendations this year. The ACIP recently voted to recommend that children 6 months through 4 years of age receive injectable influenza vaccine on a routine basis. Routine vaccination is also recommended for children aged 6 months and older with a medical problem such as asthma, sickle cell, diabetes, or heart disease. Persons who live with or care for infants and children at increased risk for influenza, including brothers, sisters, parents, grandparents, babysitters and daycare workers, should also get the flu vaccine. Influenza vaccination is recommended for anyone living with or caring for children less than 5 years of age. Children younger than nine years of age who are receiving influenza vaccine for the first time should receive two doses of vaccine. Injectable vaccine doses should be separated by at least four weeks. There should be at least six weeks between doses of the intranasal vaccine for those children 5–9 years of age receiving this vaccine for the first time.
- Health care workers should get the flu vaccine every fall. Unvaccinated health care workers are a key vehicle for the transmission of influenza in health care settings. Protect yourself, your colleagues, and those who trust their care in you. Get vaccinated against influenza this year, and every year, and encourage your co-workers to do the same.
- There are a number of other persons for whom annual vaccination is recommended, in addition to the groups listed above. The ACIP Prevention and Control of Influenza recommendations can be accessed at the website where all the vaccine recommendations are posted: www.cdc.gov/nip/publications/acip-list.htm
Human papillomavirus virus vaccine (HPV) was recently licensed to protect females 9-26 years of age against HPV. The ACIP has voted to recommend that this vaccine routinely be given to girls when they are 11 to 12 years old. The vaccination series can be started as early as nine years of age at the discretion of the health care provider. The recommendation also includes girls and women 13-26 years old because studies show that they will also benefit from getting the vaccine. The vaccine should be administered before onset of sexual activity (i.e., before women are exposed to the viruses), but females who are sexually active should still be vaccinated. HPV should be administered intramuscularly as 3 doses according to the following schedule:
- First dose: Now
- Second dose: 2 months after the first dose
- Third dose: 6 months after the first dose
HPV is the leading cause of cervical cancer in women. The vaccine is highly effective against four types of the HPV virus, including two that cause about 70 percent of cervical cancer. On average, there are 9,710 new cases and 3,700 deaths from cervical cancer in the United States each year. It is important to note that HPV vaccine does not replace the need for routine screening for cervical cancer. Nor does this vaccine protect against other sexually transmitted diseases including HIV and herpes virus.
Zostavax vaccine was licensed to protect persons 60 years and older from getting shingles. Once a person has had chickenpox, the varicella zoster virus (VZV) remains dormant in their body. When immunity to VZV wanes, the virus can reactivate, causing herpes zoster (HZ) which is known as shingles. One dose of this vaccine is expected to boost VZV-specific immunity and decrease occurrence of shingles. It is not intended for treatment of shingles or post herpetic neuralgia (PHN). ACIP is expected to release provisional recommendations sometime in August.
Rotavirus vaccine (RV) is back but different—this one is a bovine strain vaccine vs. the rhesus strain of the last one. To assure safety with any vaccine, it should be given as licensed and/or recommended. The guidelines are: 1) 1st dose should be given between ages 6-12 weeks, 2) allow 4-10 weeks between doses and 3) no doses should be given after 32 weeks of age. RV is a 3-dose live, oral vaccine; regurgitated doses are not repeated. You may offer liquids/foods before or right after administration. Be sure to read up on the special situations and precautions prior to using.
Hepatitis A vaccine (hep A) became a routine vaccine for children 12-23 months of age in January 2006. To make it easier to remember who to vaccinate, just keep in mind these two things: is the child at least 12 months of age and was he born on or after January 1, 2004? If yes, this child should receive a dose of hep A vaccine today and another one 6 months later. Make sure you are using vaccine for pediatric patients.

For more information about these or other vaccines for children and adults you may contact your local health department or the Michigan Department of Community on the web at www.michigan.gov/immunize or 517-335-8159.

Are You Considering an EHR?

Through the Doctor’s Office Quality – Information Technology project, MPRO, Michigan’s Quality Improvement Organization, is working with small-to-medium sized physician practices that deliver primary care to support the adoption and use of electronic health records. If you office is considering implementing an EHR or has already implemented an EHR and would like assistance in office process redesign, we encourage you to apply for this free assistance. Assistance will include assessing information technology readiness, assisting with the effective implementation of systems and associated work flow changes to achieve quality and patient safety as well as assistance in the implementation of evidence-based clinical quality improvement guidelines.

Click Here to Apply for FREE Assistance Today!

Also, Free Online EHR Vendor Demonstrations!

MPRO, Michigan's Quality Improvement Organization, is offering free online EHR vendor demonstrations. The selection of an EHR for your practice is one of the most important decisions your office will make when adopting an EHR. If you are considering purchasing an EHR here is an easy way to become familiar with top EHR vendors without leaving the comfort of your office or home. Click here to see the upcoming dates for these live, interactive demos. The demonstrations will last approximately one hour. Please see the flier for details of each demo and register for those you are interested in viewing. Once you have registered, you will be sent the dial-in instructions for each event. Visit MPRO for other upcoming demonstrations and to learn more about MPRO's DOQ-IT program. If you are interested in free assistance from MPRO in EHR adoption and work flow process redesign, visit MPRO and complete a Request for Assistance form.

Take Advantage of the Health Plan Complaint Form

The MAFP and AAFP need your input on private payer issues to track payer trends and develop advocacy efforts to reduce concerns with payments from private payers. AAFP voted to use the AMA’s Health Plan Complaint Form and HIPAA Complaint Form with the agreement for the AMA to send quarterly reports to the AAFP on family physician complaints.

Click here to see the actual forms. Please use these forms to assist the MAFP and AAFP in advocacy efforts for you, our members. You are not asked to identify yourself other than whether or not you are a physician and in what county/city/state your practice is located.

New Website for Medicare

The Medicare intermediary for Michigan is Wisconsin Physician Services (WPS), the largest Part B intermediary in the country. They have a new website, http://www.wpsmedicare.com. Any physician can get updated information on Medicare at this site and the information is specific to the Michigan region. These are also the individuals to contact with Part B questions. Physicians can also get on the Wisconsin Physician Services Medicare listserv and receive weekly news on Medicare Part B for free.

Your Academy is Hard at Work for You!

MAFP Brochures are Available

See the Academy's General Brochure. (PDF file 2 pages/401 KB. More about PDFs.) Print and copy it for use in your office!

Patient Educational Materials

Family physicians and patients can find several excellent educational materials at familydoctor.org and www.immunize.org. Take a minute to look at these sites.

The National Institute of Neurological Disorders and Stroke supports research on the brain and nervous system and publishes information for the public on many of the most common neurological disorders. FREE copies of publications may be ordered through the Institute's Brain Resources and Information Network (BRAIN).

Confused by Thousands of Medical Abbreviations?

There is a special site for many medical abbreviations and other information for family medicine physicians and offices. Click here to address your questions - Medical Abbreviations.

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