July 2014 Vol. 1, Issue: 2

Practice Management Workshop Held This Weekend

July 18-20 the AAAAI is sponsoring its ninth Practice Management Workshop dedicated to the business of A/I practice. This unique AAAAI annual event focuses on the day to day issues that all A/I physicians face in practice—whether in solo private practice, a multi-specialty group or the academic setting. Coding, social media, practice vital signs and Meaningful Use are just a few of the highlights. Onsite registration is still available for the meeting this weekend in Atlanta.


RSL Matters

Update on Medicine Compounding Legislation
Since last month’s issue of Practice Matters, the National Conference of State Legislators (NCSL) updated its website about compounding legislation around the country. This is a rapidly moving issue and we strongly encourage all state A/I leadership: 1) review the information here; 2) independently review your individual state’s legislation; 3) collaborate with your state medical society so they can provide any assistance as needed and appropriate; and 4) let your AAAAI regional Governor know if compounding becomes an issue in your state. This is a complex issue that will need to be addressed on the local level but we are here to help as appropriate.

Volunteer Faculty Needed for AAAAI Clinical Rotation Curriculum
AAAAI has a clinical rotation curriculum that community-based allergists can use to offer a comprehensive allergy/immunology elective to medical students and residents. Serve as volunteer faculty to: help promote our specialty, enhance your reputation and referral base within your community and increase your satisfaction with the private practice of medicine.

Choosing Wisely Resources for You and Your Patients
Are you familiar with the AAAAI’s list of “10 Things Physicians and Patients Should Question”? This list of evidence-based recommendations is part of the ABIM Foundation’s Choosing Wisely initiative and describes tests and procedures that have the potential to be over utilized.

[Did You Know? Members can visit the AAAAI’s Continuing Education Center for access to a variety of practice improvement modules and self-assessment activities that count for Maintenance of Certification.]

Practice Changers

We are pleased to announce we have partnered with the editors of JACI: In Practice to bring you monthly "Practice Changers" from recently published journal articles. Highlighting cutting-edge information will keep you current and assist you in educating patients and physicians who rely on the expertise of our specialty!

Wet Wrap Therapy in Children With Moderate To Severe Atopic Dermatitis in a Multidisciplinary Treatment Program. By Noreen Heer Nicol et al.

National and international atopic dermatitis guidelines discuss treatment of the condition based on severity and include Wet Wrap Therapy (WWT). Although WWT was first described in the atopic dermatitis treatment literature in 1987, only 15 studies of WWT have been published. This study is the largest to date of patients treated with WWT using a validated outcomes tool and the only one where WWT was administered under direct nursing supervision. WWT plays an important role as an acute therapeutic intervention for managing moderate to severe atopic dermatitis. WWT should be considered as a treatment option ahead of the systemic therapies for patients failing topical therapy.

Penicillin Skin Testing is a Safe and an Effective Tool for Evaluating Penicillin Allergy in the Pediatric Population. By Stephanie J. Fox and Miguel A. Park

Penicillin skin testing is safe and effective in the evaluation of adult patients with a history of penicillin allergy, but has not been validated in the pediatric population. This study confirms the safety and validity of penicillin skin testing in the pediatric population and enables clinicians to have a robust discussion with the parents of pediatric patients with a history of penicillin allergy regarding penicillin skin testing.

Advocacy Matters

AAAAI Provides Comments for 21st Century Cures Initiative
Earlier this year, the House Committee on Energy and Commerce announced the 21st Century Cures Initiative "to take a comprehensive look at what steps we can take to accelerate the pace of cures in America." After the Committee solicited comments from medical and patient groups regarding the key questions it will examine, the AAAAI responded. Our comments focused on research needs in a variety of areas including allergy immunotherapy, asthma, food allergy, drug allergy, and immunologic diseases.

AAAAI Seeks Broader Utilization of Allergy Immunotherapy
The AAAAI has been pushing for a multi-agency initiative of the U.S. Department of Health and Human Services (HHS) to examine the cost-effectiveness of allergy immunotherapy (IT) and methods to promote broader utilization. This effort got a significant boost in March, when a group of prominent U.S. Senators sent a letter to former HHS Secretary Kathleen Sebelius.

In her response to the letter, Sebelius notes that the Agency for Healthcare Research and Quality and National Institutes of Health (NIH) are planning to hold a multi-agency expert workshop on IT effectiveness including a focus on asthma. NIH officials have indicated this workshop will be held in 2015. The report from this workshop will offer AAAAI the opportunity to advocate new research initiatives as well as Centers for Medicare & Medicaid Services (CMS) policies aimed at expanding utilization of immunotherapy. The AAAAI will continue to work with AHRQ and NIH regarding this planned workshop.

Update on Sustainable Growth Rate
In mid-March, the AAAAI wrote to House and Senate Committee leaders to support legislation that would permanently repeal the Sustainable Growth Rate (SGR), the formula used by CMS to control spending for physician services provided to Medicare beneficiaries.

The bill under consideration in March included a number of important physician payment reform provisions including a report on barriers to chronic care services and a provision to increase the availability of Medicare claims data for research to improve the quality of care. However, lawmakers were unable to agree on a source of reductions elsewhere in the budget to pay for the estimated $138 billion cost of the SGR repeal. Instead of a permanent repeal, Congress staved off the 24% reduction that would have occurred on April 1 with another temporary “fix” bill to prevent the cuts. The bill also includes a 0.5% increase in payments to physicians through December 31, 2014, and then freezes reimbursement levels for the first quarter of 2015. Now that Congress has passed another 12-month delay of the scheduled cuts, little action is expected on this issue until next year.

Practice & Policy Matters

CMS Posts 2015 Proposed Physician Fee Schedule
The Centers for Medicare & Medicaid Services (CMS) posted the 2015 Proposed Physician Fee Schedule on July 3 for an open comment period. The CMS Physician Fee Schedule is the most important regulatory announcement of each year. In addition to policies affecting the calculation of payment rates, the 2015 Proposed Physician Fee Schedule includes: details on potentially misvalued codes, adding procedures to the telehealth list, a process for added transparency in development of payment rates, and provisions relating to implementation of separate payment for chronic care management services. The proposed rule also announces changes in the Physician Quality Reporting System (PQRS), Meaningful Use, use of the Value Based Modifier, and other quality payment programs.

It’s important for members to be aware of this proposed rule. We will keep you informed as the AAAAI works with Hart Health Strategies and others to analyze the proposed rule and develop a response strategy. Based on what is described in the rule, we will also keep you updated on any changes you need to know.

New Edition of AAAAI Practice Management Guide Available
The new fifth edition of the AAAAI Practice Management Resource Guide has over 200 pages of invaluable practice strategies developed by experienced allergists. It includes: a completely revised billing and coding guide with ICD-10 implementation strategies; major updates to the EMR chapter with regards to selection strategies, Meaningful Use and mobile technology; an expanded guide for marketing and referral development with new social media strategies; and an updated chapter for doing clinical research in the allergy practice.

Reminder: Submit Comments on Practice Parameter Draft and Drug Allergy Measures
You are invited to consider and comment on two important documents that are currently out for review. First is the draft of Contact Dermatitis: A Practice Parameter Update – 2014 from the Joint Task Force on Practice Parameters. The second is draft Drug Allergy Measures from the Joint Task Force on Quality Performance Measures.

AAAAI Members Named to National Quality Forum Panel
The AAAAI is a member organization of the National Quality Forum (NQF), which is a nonprofit, nonpartisan, public service organization committed to transforming our healthcare system to be safe, equitable and of the highest value. NQF recently invited nominees for a Cost and Resource Use Measures panel focused on pulmonary. David M. Lang, MD, FAAAAI, and Alan P. Baptist, MD, MPH, FAAAAI, were both appointed, which is the first time there has been more than one A/I representative on an NQF panel. Dr. Lang currently serves on the AAAAI Board of Directors.

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