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Page 1: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Introduction to the American College of Emergency Physicians

Presented by:Insert Name:Insert Date:

Page 2: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Your Questions Answered: Today’s Agenda Why does ACEP Matter? What are the issues ACEP is working on? How is ACEP making an impact? How does ACEP decide where to focus its efforts? What is ACEP doing to make it easier for me to

practice EM and provide the highest quality care for my patients?

How is ACEP advancing my career? What is the value of my membership?

2

Page 3: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

ACEP’s Mission Statement

The American College of Emergency Physicians promotes the highest quality of emergency care and is the leading advocate for emergency physicians, their patients, and the public.

3

Page 4: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?

The health care landscape is changing. ACEP has been, and continues to be, involved in

shaping the future of Emergency Medicine.

– Health care reform and regulatory implementation– Letters to CMS and other high-level agencies– Residency slots and GME re-distribution– Loan forgiveness options

4

Page 5: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

5

Future income

Page 6: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

6

CMS= Centers for Medicare and Medicaid Services

Page 7: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

7

CMS= Centers for Medicare and Medicaid Services

Page 8: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

8

Uninsured

Page 9: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

9

Coverage Rates by Type of Insurance

Page 10: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

10

CMS-Physician fee Schedule 2014

Physician Fee ScheduleCY 2014 Physician Fee Schedule Final Rule with Comment PeriodThe CY 2014 PFS final rule with comment period was placed on display at the Federal Register on November 27, 2013. In addition to policies affecting the calculation of payment rates, this final rule identifies potentially misvalued codes, adds procedures to the telehealth list, modifies the telehealth originating site definitions, finalizes a policy for chronic care management services for CY 2015, applying therapy caps to outpatient therapy services furnished by CAHs, requires the compliance with state law as a condition of payment for services furnished incident to physician and other practitioner services.  This final rule includes discussions and policy regarding revising the MEI based on MEI TAP recommendations, budget neutrality for the chiropractic services demonstration, physician value-based payment modifier and the physician feedback reporting program, and updating the Ambulance Fee Schedule regulations, Clinical Lab Fee Schedule, physician compare website, physician quality reporting system, electronic prescribing (ERX) incentive program, and Medicare shared savings program.

Page 11: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage,

1999-2010

* Estimate is statistically different from estimate for the previous year shown (p<.05).

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2010.

$5,791

$6,438*

$7,061*

$8,003*

$9,068*

$9,950*

$10,880*

$11,480*

$12,106*

$12,680*

$13,375*

$13,770*

Page 12: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

12

ACA passed 2010

Page 13: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Health Care Reform

The Health Care Reform law -- ACEP worked hard to get specific items included:

• Prudent layperson language extended to group plans• No more “prior approval” needed• Expansion of research opportunities• Regionalization projects

13

Page 14: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

14

ACA being challenged in USSC

Page 15: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:
Page 16: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:
Page 17: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Health Care Reform

17

Page 18: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Health Care Reform

18

Under the new federal rules, patients also can still pick their

primary doctors or pediatricians, and prior approval requirements

for emergency care will be prohibited

Page 19: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Health Care Reform

19

Page 20: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Health Care Reform

20

Page 21: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Letters to Regulatory Agencies

Anesthesia guidelines revised (Jan. 2011) Quality measures (PQRI) Accountable care organizations Value-based purchasing Demonstrate the specialty's value Preserve EM practice models

21

Page 22: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Residency Slot Redistribution

At least 75% of the redistributed residency positions must go to primary care or general surgery.

It is even more imperative that CMS provide as many of the remaining slots to EM residency programs to meet the expected increase in ED visits.

22

Page 23: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Why Does ACEP Matter?-- Loan Forgiveness Options

ACEP understands the incredible burden of debt incurred to become residency trained in EM and support the idea of loan forgiveness if graduates are willing to work in underserved areas.

23

Page 24: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?The Perfect Storm: Health Care Braces for a Crisis

24

Operational Costs Nurse Shortage Technology On-call Liability Inflation

On-Call Specialty Physician Shortage

InpatientBed Shortage

Revenue Medicaid / Medicare Managed care Uncompensated care Stock market

Balanced BudgetAct of 1997

EMTALA

ED Volume Increases

ForeignNationals EMERGENCY

DEPARTMENT

AmbulanceDiversion

Page 25: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- EMTALA

In America,We regard healthcare as a FUNDAMENTAL RIGHT

25

But we fund healthcare AS A PRIVILEGE

Worse, we do so in a “free enterprise system”

Page 26: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- EMTALA

26Source: American Medical Association

SpecialtyPhysicians Affected

Average Bad Debtfrom EMTALA

Emergency Med 100% $138,300General Surgery 76% $25,600Anesthesiology 69% $16,500OB\GYN 52% $4,100Radiology 47% $22,000Internal Medicine 34% $7,000Gen \ Family Prac 31% $4,700Pediatrics 23% $2,400Pathology 13% $3,400Psychiatry 11% $1,200Other Specialties 5% $4,500All Physicians 42% $12,300

Page 27: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- ED as the Safety Net

27

Page 28: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

28

Page 29: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

29

Changing perceptions in D.C.

Page 30: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

30

What is your guess?

What is the value of access to care 24 - 7 - 365

Protected under Federal law

And without any guaranteed reimbursement?

Page 31: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Value of Emergency Medicine

31

Page 32: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Perception of “Unnecessary Visits”

32

Page 33: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Perception of “Unnecessary Visits”

33

Page 34: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:
Page 35: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Crowding & Diversion

ED crowding has become a “national epidemic, says the Institutes of Medicine.

An ambulance is diverted away from a crowded ED approximately once every minute nationwide.

ED patients have faced increasingly long average wait times and ED visit lengths over the past decade. – Especially for those with the most acute illnesses.

In 2006, the average wait time = 37 minutes.Recommended maximum = 15 minutes.

35

Page 36: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Reimbursement

Even if you belong to ACEP for no other reason than to support reimbursement efforts, your membership has more than paid for itselfACEP has the only EM representative on the RUC

ACEP filed compliance disputes against Anthem/Wellpoint and Humana to stop bundling separately billable services in the ED E/M codes.

After California prohibited balance billing, ACEP rapidly created model legislation for states to fight balance billing prohibition laws. The fiscal impact to you = about 30% of revenue comes from balance billing charges for non-contracted payers.

36

Page 37: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Reimbursement

Replace the flawed Medicare payment formula Enact stable, annual physician payment updates

37

Page 38: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- On-Call Issues

On-call specialty shortage resources on www.acep.org

38

Page 39: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What are the issues that ACEP is working on?-- Medical Liability Reform

Specifically addresses the unique environment of the emergency department.

ACEP is working with a coalition of on-call specialty societies to achieve this goal.

39

HR 157 -- Health Care Safety Net Enhancement Act Would amend the Public Health Service Act to deem ED

physicians as Public Health Service employees for purposes of lawsuits stemming from EMTALA-related services.

Page 40: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What more can ACEP due to make an Impact?..........NEMPAC

A voluntary, non-profit, unincorporated association operating as a separate segregated fund of ACEP.

Empowered to solicit, directly or indirectly, and accept voluntary personal contributions from ACEP members.

Makes expenditures in connection with the election of candidates for federal office.

40

Page 41: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP’s PAC rank?

41

Page 42: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:
Page 43: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How can ACEP members make an impact? Join the 911 Network The 911 Network goes into action when there are

critical bills pending and support is needed.

43

Page 44: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How else is ACEP Making an Impact?-- EM Action Fund EMAF

What is the EM Action Fund?– A collective body that can pool limited resources and work to impact health care

reform's regulatory implementation.– Designed to allow our specialty to speak with one voice and one message

Why should you get involved?– The 2010 health care reform law could force you to make a choice – become a

hospital employee or end your practice. – Proposed regulatory changes could reduce your reimbursements by 20 to 40%.

Who is on the EM Action Fund Board?– EMRA, ACEP, AAEM, ACOEP, SAEM– Physician groups , companies, individual emergency physicians

www.acep.org/EMActionFund44

http://www.acep.org/EMActionFund
Page 45: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP decide what to do?-- Democratic Representation

45

Page 46: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP decide what to do?-- Resolutions & Council Meeting

46

CouncilBoard of Director

s

Page 47: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP decide what to do?-- The Board of Directors

Jay A. Kaplan, MD, FACEPPresident-Elect

Rebecca B. Parker, MD, FACEPChair of the Board

Alexander Rosenau, DO, FACEPImmediate Past President

Paul D. Kivela,, MD, FACEPVice President

John J. Rogers, MD, FACEPSecretary-Treasurer

Stephen Anderson, MD, FACEPJames J. Augustine, MD, FACEP

Vidor Friedman, MD, FACEPJon Mark Hirshon, MD, FACEP

Hans R. House, MD, FACEPWilliam Jaquis, MD, FACEP

Debra G. Perina, MD, FACEP

47

Michael J. Gerardi, MD, FAAP, FACEPPresident

Page 48: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP decide what to do?-- Actions Become Policy

48

Council

Page 49: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP decide what to do?-- The “Alphabet Soup” of EM

49

Page 50: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

50

First EM physician to become AMAleader

Steven J. Stack, MD, FACEPChair-Elect, Board of Trustee

Page 51: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

In addition to advocacy, what is ACEP

doing to make it easier for me to practice emergency medicine and provide the highest quality care for my patients?

51

Advocacy is OK, but I just want to be a Great Doc…

Page 52: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Educational Opportunities

Scientific Assembly– Oct. 15-18, 2011 in San Francisco, CA

Leadership and Advocacy Conference Teaching Fellowship EMBRS Workshop

– Emergency Medicine Basic Research Skills Advanced Pediatric Emergency Medicine Assembly ED Directors Academy

52

Page 53: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Educational Opportunities

Annals of Emergency Medicine– The most respected & influential journal in EM– One of the top 100 scientific journals– Dr. Mike Callaham, Editor in Chief, encourages

residents are to get involved by writing articlesfor the “Resident’s Perspective” section

53

Page 54: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Educational Opportunities

LLSA Resource Center (www.acep.org/LLSA) – Four current reading lists (2009, 2010, 2011, 2012) in

one document– List of LLSA prep resources developed by ACEP chapters

ACEP Members also have FREE ACCESS to:– All LLSA articles for the 2009 -- 2012 reading lists– LLSA article summaries, originally published in Critical

Decisions in Emergency Medicine

54

http://www.acep.org/LLSA
Page 55: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- ACEP Bookstore

Resident discounts on all items Even bigger discounts on group

purchases New mobile products available PEER VIII- JUST OUT!

–Remains the gold standard for residents’ annual in-training exam and the board certification qualifying exam.

55

Page 56: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Practice Resources

Clinical Policies Policy Statements Reimbursement

FAQs Contracts and

Job Searching Free webinars

56

Page 57: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me when I’m sued? -- Medical-Legal Support Litigation Stress Counseling Standard of Care Review Panel Online Resources

– “So You Have Been Sued!”– Litigation Stress – a Primer– Medical-Legal policy compendium

57

Page 58: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

58

The Cost of Med-Mal

Page 59: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Ethics

ACEP Code of Ethics regularly reviewed for updates

Reaffirmation Statement for use during litigation

Formal ethics complaint process

59

Page 60: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Personalized Service

One call provides personal assistance on– Reimbursement and billing– Contracts and salaries– Practice management issues– Wellness resources– CME tracking and requirements– Litigation and ethics concerns

60

Page 61: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What is ACEP doing for me?-- Research Support

EMF Research Grants Research Forum

– Annual in conjunction with SA Emergency Medicine

Basic Research Skills (EMBRS) Workshop

61

October 27-28, 2014 in Chicago, ILwww.acep.org/rf

Page 62: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP support my career?-- Work/Life Balance

Wellness Resources on ACEP.org– Under Practice Resources, select Wellness

Hagan Insurance Benefits (see acepinsurance.com)– Guaranteed Issue Life and Disability; Disability Income

Protection; Long Term Care– Term Life, Health, Liability, Home, Auto and Travel

Insurance Financial planning resources

62

Page 63: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP support my career? -- Become a Fellow

Earn a mark of prestigious distinction in your specialty, become a FACEP

Criteria include:– ACEP membership for three years

after graduating residency– Board certification ABEM or AOBEM– Demonstrated leadership in

emergency medicine (chapters,hospitals, committees)

63

Page 64: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

How does ACEP support my career? -- Networking Opportunities

Sections, Committees & Chapters Conferences

– Leadership and Advocacy– Scientific Assembly- follows Annual council meeting

ACEP’s Official Blog – TheCentralLine.org Social Media

– Facebook.com/ACEPfan– @ACEPnews

64

Page 65: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Benefits of Membership: ACEP

65

Benefit ACEP Members Non-Members

Annals of Emergency Medicine FREE $226

ACEP News FREE $150

Scientific Assembly registration discount $635 $835

Discounts on all ACEP-sponsored meetings and educational products

Over $500 in savings Not available

E-mail alerts and updates FREE Not available

Members-only Section of the ACEP LLSA Resource Center

Free Online Access to Every LLSA article:

$500 Value

Not available

Professional growth & networking FREE Not available

Discounts on car rentals, insurance, technology and credit cards

$10 up to thousands Not available

Discounts in ACEP’s Bookstore 15% to 40% Not available

Page 66: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Benefits of Membership: EMRA

66

2011 Antibiotic Guide, 14th Edition Top Pediatric Clinical Problems, 1st Edition Pediatric Qwic Card, 1st Edition Sepsis Card Airway Card Career Planning Guide for

Emergency Medicine, 2nd Edition EM Resident Magazine Subscription to EM:RAP/EMA Evidenced Based Medicine: (EM Practice, Pediatric EM Practice & EM Guidelines) Critical Decisions in Emergency Medicine

25.95 25.95 12.00 12.00 12.00 29.95 Priceless 360.00

628.00

352.00 $1,457.85

Page 67: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Benefits of Membership: EMRA

67

– Liberty Mutual Advantage Program: Save money on car and home insurance

– PEPID: Resident and Student members save 50% on a one-year subscription

– VisualDx (usually $99) available on emra.org for $20– Office Depot: Discounts on more than 6,000 products– Sprint PCS: 10% off phones and service– Nationwide Home Buying Program: Mortgage loans

from SunTrust Mortgage– More Savings & Benefits at

www.emra.org/member_benefits.aspx

Page 68: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Applications can be e-mailed to: academic [email protected]

ACEP National Emergency Medicine Faculty Teaching AwardsNational Emergency

Medicine Faculty

Teaching Award

Recommended for faculty >7 years post-

residency who are ACEP members, Board

certified, hold an academic appointment at

a US allopathic or osteopathic school and

are at the instructor, assistant professor or

associate professor level.

National Emergency

Medicine Junior

Faculty Teaching

Award

Recommended for faculty between 3-7 years post-residency who are ACEP members, Board certified,

hold an academic appointment at a US

allopathic or osteopathic school and are at the

instructor or assistant professor level.

Deadline: April 13, 2015

http://www.acep.org/teachingaward/ 

http://www.acep.org/teachingaward/
Page 69: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

ACEP Medical Student Awards

National Medical

Student Award

·This award is intended to

recognize students who

intend to pursue a career in

emergency medicine, and who

have demonstrated outstanding

patient care and involvement in

medical organizations or the

community. ·Up to 10 students selected each

year.

Deadline:

February 13, 2015

http://www.acep.org/msawards/ 

Medical Student

Professionalism &

Service Award·This award is intended to

recognize students who

excel in compassionate care of

patients, professional behavior,

and service to the community and

or specialty. ·One nominee per medical

school.·Monetary award is decided at the

local level.

Deadline: October 21,

2013-August 4, 2014

http://www.acep.org/msawards/
Page 70: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

ACEP Report Card 2014

70

Page 71: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

71

BE VOCAL! Make your opinion heard

Page 72: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

72

ACEP 14: Chicago-Events

ACEP 14 Kickoff PartyMonday, October 277:30-MidnightNavy Pier-Grand Ballroom

Closing CelebrationWednesday, October 297:00om-11:00pmMuseum of Science and Industry

EMF-Cocktails and Culture ReceptionMonday, October 276:30pm-8:30pm

Research ForumOctober 27-28, 2014McCormick Convention Center

Page 73: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Congratulations! You’ve chosen the best job there is…..but…

73

Page 74: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

What you should do next

74

Page 75: Introduction to the American College of Emergency Physicians Presented by: Insert Name: Insert Date:

Q&A

75


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