VCU names Arturo P. Saavedra dean of VCU School of Medicine and VCU Health Executive VP for Medical Affairs

Via VCU News

Virginia Commonwealth University has announced that Arturo P. Saavedra, M.D., Ph.D., has been named dean of the VCU School of Medicine, effective April 15. He also will serve as VCU Health System executive vice president for medical affairs.

Saavedra comes to VCU from the University of Virginia where he is chair of the Department of Dermatology and president and interim chief executive officer of University of Virginia Physicians Group. In these roles, Saavedra partners with other leaders to drive continuous improvement in the quality and value of care in addition to setting strategy and ensuring operational and financial performance of the physicians’ group. His appointment follows a national search.

Prior to his current roles…

Read the Full Story at VCU News

Updated 2023 Medicare Physician Payment Schedule Conversion

The Centers for Medicare and Medicaid Services has alerted the American Medical Association that the agency has released updated national Medicare physician payment files that incorporate the changes in the Consolidated Appropriations Act of 2023.

Specifically, in response to concerted advocacy by organized medicine, Congress reduced the 4.5% cut to Medicare physician payment by increasing the 2023 conversion factor by 2.5%. The updated 2023 Medicare physician payment schedule conversion factor will be $33.8872. The previously finalized conversion factor was $33.0607. The 2022 conversion factor was $34.6062.

ALL IN: Caring for Virginia’s Caregivers Initiative Launches to Improve and Protect Clinician’s Mental Health and Well-Being

Leading Virginia Healthcare Organizations Partner with National ALL IN: WellBeing First for Healthcare Coalition to Promote Strategies Focused on Supporting Clinicians, Healthcare Workforce

RICHMOND, VIRGINIA, December 14, 2022 – The Virginia Hospital & Healthcare Association (VHHA), the Virginia Nurses Association (VNA) and the Medical Society of Virginia (MSV) are jointly supporting a new statewide initiative to enhance healthcare organizational efforts to protect the mental and emotional well-being of healthcare professionals. Led by the ALL IN: WellBeing First for Healthcare coalition, co-founded by the Dr. Lorna Breen Heroes’ Foundation and #FirstRespondersFirst, the ALL IN: Caring for Virginia’s Caregivers initiative seeks to support Virginia hospitals and health systems in redesigning their workplace environments to help team members feel valued and supported.

“Coming off three years of pandemic duty and immediately transitioning into an intense flu and respiratory syncytial virus (RSV) surge has been challenging for hospitals, health systems and their team members who have bravely dealt with the strain of working under these extraordinary conditions,” said Sean T. Connaughton, president and CEO of VHHA. “Our shared goal as a hospital community is to make Virginia the healthiest state in the nation. Achieving that means caring for patients and communities as well as taking care of the healthcare professionals who offer comfort and compassionate medical care to people in need. Doing this involves concerted efforts to strengthen our hospital and health system work environments through supportive staff programs. Through the first-of-its-kind ALL IN: Caring for Virginia’s Caregivers partnership framework, we are leveraging national expertise with local experience and perspective to address healthcare workforce burnout challenges and support those clinicians who are there for us and our communities 24/7/365.”

Hospitals and health systems participating in the initiative commit to:

“We have long been committed to making tangible tools readily available to physicians and being a safe, understanding place to get guidance on how and where to seek well-being and mental health support without judgment or punishment,” said Melina Davis, CEO of MSV. “We’re excited to build on our work and expand our overall capacity, so all Virginia’s healthcare teams have the support they need to stay well and prevent burnout.”

The initiative’s programming is developed around ALL IN’s Healthcare Workforce Rescue Package, which include the top evidence-based actions healthcare leaders can take to support their workforce and build a foundation for a long-term system well-being strategy, including:

  • Pursue Operational Efficiencies: Identify and remove low-value work, such as reducing electronic health records (EHR) clicks for common workflows and minimizing inbox notifications;
  • Designate a Well-Being Executive: Appoint one person with operational authority to align all clinician well-being efforts; and
  • Do More than Employee Assistance Programs (EAP): Ensure adequate mental health care by providing quality mental health counseling, standing-up a peer-support program and offering psychological first aid training.

“The health and culture of every practice setting, including hospitals and health systems, plays an important role in the happiness and well-being of its nurses and other clinical staff,” said Janet Wall, CEO of VNA. “Nurses are critical to the health of Virginia and we’re eager to collaborate to address the underlying system challenges that are preventing workplaces from being healthy work environments.”

The initiative is being launched with a calling to Virginia hospitals and health systems to remove one of the most substantial barriers clinicians face to their mental health and well-being: fear of losing their job because of overly broad and invasive mental health questions on credentialing applications that may be stigmatizing or cause reluctance to seeking appropriate treatment. The hospitals and health systems that audit and change language on credentialing applications will be recognized as being ALL IN for prioritizing clinician well-being and be awarded as a WellBeing First Champion.

“Mental health questions were often added to credentialing applications out of a misplaced desire to protect patients and families from clinicians who might not be fit to give care. Yet there is no evidence they serve that function,” said Corey Feist, co-founder of ALL IN: WellBeing First for Healthcare and president of the Dr. Lorna Breen Heroes’ Foundation. “When clinicians are afraid to seek the mental health care they need, they may find themselves unable to work due to burnout or behavioral health disorders. Some, like my sister-in-law Lorna, may turn to suicide.”

“That’s why national leaders, including the American Medical Association, American Hospital Association, Joint Commission, National Academy of Medicine and the U.S. Surgeon General, have also called on removing this barrier. Ensuring that clinicians can access necessary mental health care not only benefits their well-being, but also improves the health of our entire country. Patient outcomes will improve when we prioritize clinician well-being, because to care for others, clinicians must also be cared for,” continued Feist.

For hospitals and health systems interested in being recognized as a WellBeing First Champion, visit ALL IN’s online portal to verify your organization’s credentialing applications are free from unnecessary mental health questions.

About ALL IN: WellBeing First for Healthcare

ALL IN: WellBeing First for Healthcare, co-founded by #FirstRespondersFirst and The Dr. Lorna Breen Heroes’ Foundation, is as a coalition of leading healthcare organizations committed to:

  • Advancing a state where the wellbeing of the health care workforce is prioritized, and individual health care workers feel valued and supported so they can sustain their sense of purpose and meaning in their work; and
  • Making beneficial progress against persistent mental health and wellbeing challenges that disadvantage our healthcare workers, and therefore, our healthcare systems and the future of public health.

About the Medical Society of Virginia

The Medical Society of Virginia (MSV) serves as the voice for more than 30,000 physicians, residents, medical students, PAs and PA students, representing all medical specialties in all regions of the Commonwealth. The association was founded in 1820 and is headquartered in Richmond, Virginia. MSV strives to advance high-quality healthcare and make Virginia the best place to receive care and practice medicine.

About the Virginia Health and Hospital Association

The Virginia Hospital & Healthcare Association is an alliance of 110 hospitals and 25 health delivery systems that develops and advocates for sound healthcare policy in the Commonwealth. Its mission is to achieve excellence in both healthcare and health to make Virginia the healthiest state in the nation. Its vision is through collaboration with members and stakeholders, to ensure the sustainability of Virginia healthcare system, transform the delivery of care to promote lower costs and high value across the continuum of care and to improve health for all Virginians.

About the Virginia Nurses Association

The Virginia Nurses Association is the professional organization representing the interests of the more than 118,000 registered nurses in the Commonwealth of Virginia, inclusive of all areas of specialization, clinical settings and work environments. We are the voice of nursing, protecting practice by ensuring that nursing’s priorities are incorporated into legal and regulatory decisions, and ensuring our voice and influence at the Capitol and growing grassroots efforts.

Surgical Technologists: Register with Board by December 31

Please review the information below regarding the surgical technologists who need to be grandfathered in for certification by the Board.

54.1-2956.12. Registered surgical technologist; use of title; registration.

A. No person shall hold himself out to be a surgical technologist or use or assume the title of “surgical technologist” or “certified surgical technologist,” or use the designation “S.T.” or any variation thereof, unless such person is certified by the Board. No person shall use the designation “C.S.T.” or any variation thereof unless such person (i) is certified by the Board and (ii) has successfully completed an accredited surgical technologist training program and holds a current credential as a certified surgical technologist from the National Board of Surgical Technology and Surgical Assisting or its successor.

B. The Board shall certify as a surgical technologist any applicant who presents satisfactory evidence that he (i) has successfully completed an accredited surgical technologist training program and holds a current credential as a certified surgical technologist from the National Board of Surgical Technology and Surgical Assisting or its successor, (ii) has successfully completed a training program for surgical technology during the person’s service as a member of any branch of the armed forces of the United States, or (iii) has practiced as a surgical technologist or attended a surgical technologist training program at any time prior to October 1, 2022, provided he registers with the Board by December 31, 2022.

Spanberger Urges U.S. House & U.S. Senate Leadership to Support Virginia Healthcare Providers Amid Flu, RSV Surge

According to the CDC, Virginia Ranks Among Top 10 States with Highest Level of Hospital Visits for Flu, Flu-Like Illnesses

Virginia Physicians and Healthcare Providers Are Scheduled to Receive a More Than Eight Percent Cut to Their Medicare Reimbursements During the Worst of Flu Season

WASHINGTON, D.C. — U.S. Representative Abigail Spanberger today urged U.S. House and U.S. Senate leadership to prioritize support for physicians and other healthcare providers in the end-of-year government funding package amid surging cases of respiratory illnesses in Virginia and across the country.

Virginia is experiencing one of the worst surges of flu and flu-like illnesses in the country. According to the Centers for Disease Control and Prevention (CDC), Virginia ranks among the top 10 states in the country for hospital and clinic visits for respiratory illnesses. The Virginia Department of Health (VDH) reports that Virginia surpassed last year’s peak a full two months ahead of the typical start to flu season.

If new support is not included in the end-of-year government funding package, Virginia physicians and healthcare providers will receive a more than eight percent cut to their Medicare reimbursements due to expiring legislative provisions and looming budgetary cuts beginning on January 1. Patients and providers across the country would be left in an unstable financial situation, threatening access to care for patients as the surge of influenza worsens.

In a letter sent to House Speaker Nancy Pelosi and Minority Leader Kevin McCarthy, as well as Senate Majority Leader Chuck Schumer and Minority Leader Mitch McConnell, Spanberger urged leadership to prioritize inclusion of relief from cuts to Medicare reimbursements for Virginia hospitals, urgent care centers, and physician offices in the end-of-year package to fund the government. Additionally, the Congresswoman outlined the consequences for patients and healthcare providers as a result of expiring legislative provisions and looming budgetary cuts if Congress does not act.

“As you continue your work on an end-of-year government funding package, I urge you to prioritize relief from dramatic cuts to Medicare reimbursements for physicians and other healthcare providers on the front line of responding to a surge in respiratory illnesses in Virginia and across the country,” wrote Spanberger. “If Congress does not act, Virginia’s physicians and healthcare providers are scheduled to receive a more than eight percent reduction to their reimbursements during the worst of the flu season.”

Spanberger continued, “These substantial cuts to reimbursements, along with high rates of patients with respiratory illness and ongoing staff shortages, have already put tremendous financial pressure on Virginia’s healthcare providers, especially safety net providers that work in underserved communities. To address this issue, Congress should include in the end-of-year funding bill provisions that will mitigate these cuts, create stability and predictability around physicians’ reimbursements, and protect seniors’ access to care as hospitalization rates surge.”

Read the full letter.

Amid doctor shortage, NPs and PAs seemed like a fix. Data’s in: Nope.

via AMA

An examination of cost data for the South Mississippi system’s accountable care organization (ACO) revealed that care provided by nonphysician providers working on their own patient panels was more expensive than care delivered by doctors.

This prompted Hattiesburg Clinic leaders to redesign the clinic’s care model and to publish their findings. Hattiesburg Clinic employed a total of 26 physician assistants (PAs) and nurse practitioners (NPs) in 2005 and today there are 118. Along with certified registered nurse anesthetists and optometrists, they are part of a team of 186 nonphysician providers at the clinic, also called advanced practice providers (APPs).

“Over the past 15 years, in the face of physician shortages, especially in primary care, Hattiesburg Clinic made decisions to expand our care teams with the use of advanced practice providers,” says a study entitled “Targeting Value-based Care with Physician-led Care Teams” that was published in the Journal of the Mississippi State Medical Association.

“Focusing specifically on primary care, because our shortage of physicians there was so dire—due to retirements, massive panel sizes and lack of medical students entering primary care residencies—we allowed APPs to function with separate primary care panels, side by side with their collaborating physicians,” the study adds.

In hindsight and “with a wealth of internal data,” which includes cost data on more than 33,000 patients enrolled in Medicare, “the results are consistent and clear: By allowing APPs to function with independent panels under physician supervision, we failed to meet our goals in the primary care setting of providing patients with an equivalent value-based experience.”

A private multispecialty clinic with more than 300 physicians, Hattiesburg Clinic is a member of the AMA Health System Program. Its ACO was ranked first in quality in its cohort in 2016 and 2017, amongst a total of 471 other participants, and has been recognized by the Centers for Medicare & Medicaid Services (CMS) for delivering high-quality care at a low cost.

The 2017–2019 CMS cost data on Medicare patients without end-stage renal disease and who were not in a nursing home showed that per-member, per-month spending was $43 higher for patients whose primary health professional was a nonphysician instead of a doctor. This could translate to $10.3 million more in spending annually if all patients were followed by APPs, says the analysis. When risk-adjusted for patient complexity, the difference was $119 per member, per month, or $28.5 million annually…

Continue reading at AMA

8 Ways for your Patients to Stay Healthy for the Holidays — and Beyond!

During this hustle-bustle season it’s important to remind your patients to stay focused on their health. First, they want to be able to enjoy family, friends, and festivities throughout the holidays. Second, they’ll want to be at their best for whatever the new year brings, like a big vacation or a family wedding. And last, their annual “be healthier” new year’s resolution is already on their mind. The truth is your patients can start fulfilling their resolution to be healthier right now — there’s no need to wait until January!

To help you help your patients, we’ve created a list of 8 great ways to stay healthy for the holidays — and beyond. We’ve written the tips so you can share them with your patients. And guess what? They all apply to you, too!

Wash Your Hands

The top way to stay healthier all the time is simple: Wash your hands! With colds, flu, RSV, and COVID-19 making the rounds right now, frequent hand washing will get rid of most germs that can make you sick. Plus, it prevents germs from being transferred to other surfaces — and to other people. For the best results, use soap and warm water, and dry with a clean towel. When you’re out and about, or if soap and water isn’t available, an alcohol-based hand sanitizer with at least 60% alcohol is a great Plan B.

Get Moving

Exercise at every age is good for your heart, brain, mood, and bones. If you’re not already regularly exercising, start with small changes like taking the stairs or choosing a parking spot farther from the door. Walking is also a terrific entry to exercise. If you’re already exercising, take it up a notch with extra cardio or adding something new to your routine. Remember: Before starting any exercise, it’s always a good idea to consult your doctor.

Get Your Zzzs

Most adults need 6 to 8 hours of sleep each night. Teens need 8 to 10, and school-aged kids need 9 to 11. Are you and your family getting enough? Sleep impacts everything from mood and concentration to your blood pressure and your heart. Go to bed earlier, keep your bedroom cool, and click off electronics — including your phone and TV — to get a better, more restful sleep.

Focus on Heart Health

Keep your heart healthy at every age! Reducing your risk for heart disease starts with maintaining a healthy lifestyle and managing health conditions like high blood pressure and diabetes. Eating fiber-rich foods like fruits, vegetables, and whole grains will help you lower your triglyceride level and reduce plaque in your arteries, reducing your overall risk for heart disease. Choose lower-fat dairy products like milk and yogurt. Prioritize fish, lean meats, and skinless poultry, or even try eating meatless occasionally.

Power Up Your Food

Eat your superfoods! Superfoods are loaded with vitamins and minerals plus antioxidants that protect your body against cell damage and disease. Superfoods don’t have to be fancy, expensive, or even complicated. The simple blueberry is a superfood VIP packed with fiber, vitamin C, and antioxidant disease-fighters — eat them plain or put them on your oatmeal. Other superfoods to add to your be-healthier menu include: Brussels sprouts, apples, kale, spinach, sweet potatoes, carrots, chia seeds, and salmon.

Say Yes to Calcium

You know calcium is essential for healthy bones and teeth, but it’s also important for your muscles, nerves, hormones, and blood flow. It’s the most abundant mineral in your body, making good calcium intake fundamental for good health. Though milk is a fantastic source of calcium, it’s not the only one that gets an A+ for calcium. A cup of yogurt has at least as much calcium as an 8-ounce cup of milk, and a 1-ounce piece of Swiss cheese rates close behind. Pack even more calcium into soups and sides with dark leafy greens like kale and collards. Yes, vegetables have calcium, too!

Stay Hydrated

Drink your water! Why water? It’s good for everything from organ health and preventing infections to sleep quality and mood regulation. Don’t wait to drink water until you’re thirsty, because that means you’ve waited too long. Funny enough, thirst can also mask itself as hunger. So especially if you’re watching what you eat, try a glass of water before you reach for a snack. Need more pizzazz in your glass? Flavor your water with lemons, oranges, berries, or cucumbers.

Make Time For You

When your to-do list is jam-packed, it’s too easy to push your own needs to the bottom of the list. To stay happy and healthy you need to make time for yourself. Self-care helps you manage stress, lower your risk of illness, stay focused, and increase your energy levels. Make time to do things that make you happy. Try meditation. Reconnect with an old friend. Go for a walk. Take a timeout to read a book or cuddle a pet. The important thing is to focus on you.

Here’s to happy, healthy holidays and a great start to a healthier new year!

Harry L. Gewanter, MD, FAAP, MACR
MSV President


The information contained in this article is for educational purposes only and does not constitute health care advice.

CMS Prior Authorization Proposed Rule May Streamline PA Processes

The American Medical Association (AMA) applauds the Centers for Medicare and Medicaid Services (CMS) for expeditiously releasing the Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule, which would place new requirements on Medicare Advantage (MA) plans, state Medicaid and Children’s Health Insurance Program (CHIP) Fee-for-Service programs, Medicaid and CHIP managed care plans, and Qualified Health Plan issuers on the Federally Facilitated Exchanges to streamline prior authorization (PA) processes to reduce physician practice burdens and prevent patient care delays.

While we are still digesting the 400-page rule, we expect it to align with our PA reform campaign, which is a pillar of the AMA Recovery Plan for Physicians. Importantly, the rule reflects the AMA’s successful advocacy to address PA programs in MA plans, as they were excluded from a previous iteration of the rule that CMS released in late 2020. The AMA’s initial review suggests that the rule will bring much-needed transparency to both plans’ PA requirements and program metrics, such as approval/denial rates and average PA processing time. We look forward to providing our feedback to CMS within the 90-day comment period.

As you recall, after garnering more than 300 bipartisan cosponsors, H.R. 3173, the Improving Seniors’ Timely Access to Care Act of 2022, passed the House of Representatives via voice vote in September. The associated score from the Congressional Budget Office (CBO) for this legislation, however, was $16 billion. This high score was driven by what the AMA perceives as an incorrect assumption that reductions in prior authorization subsequently permit physicians to perform more services, which, in turn, leads to higher spending for Medicare Advantage plans. The release of this regulation is supposed to play a positive role in reducing the total CBO score.

Congressional leaders are already in the process of trying to obtain a new CBO score in hopes that it is substantially lower and, as a result, more politically viable. The timing of a new CBO score, however, is unclear. In the meantime, we will continue to urge Congress to pass the bipartisan Improving Seniors’ Timely Access to Care Act before the end of 2022.

Research Agenda: Addressing Clinician Burnout in the Department of Veterans Affairs

AcademyHealth has just released their final report on research needed to address clinician burnout for the Department of Veterans Affairs: Research Agenda Outlines Next Steps in Addressing Clinician Burnout within the Department of Veterans Affairs (VA) | AcademyHealth

Key recommendations:

  1. Prioritize research on interventions to address burnout at the organization or system levels. The biggest gap in the existing evidence base on clinician burnout is not its drivers or causes, but how to effectively address it across teams, divisions, and whole systems.
  2. Capitalize on the variation between VAMCs to study the comparative effectiveness and costs of interventions to address burnout, specifically which approaches work for whom and under which circumstances. Also, there is the opportunity to learn from “positive deviants,” identifying VAMCs with low rates of clinician burnout, and leveraging their approaches at an organizational level.
  3. Leverage the VA’s ability to conduct large, controlled studies across sites and/or clinician types, particularly for “whole system interventions” with varying components. Findings should be widely disseminated and implemented across VA sites and share their learnings with health systems nationally and globally.
  4. Focus on the effectiveness of burnout interventions on clinicians of color and other dimensions of diversity and identity that affect the clinician’s interactions with healthcare staff and patients. This is a salient gap in the evidence.
  5. Include studies on the role of effective VA leadership (from senior leaders to supervisors of frontline staff), including strategies for leadership training and support, trust in leadership, and approaches for leaders to create and sustain a welcoming and supportive culture were all aspects of the priority questions.

Thank you to MSV leader Dr. Russell Libby for his part in this important work!

Chopin. The Space Concert | A Benefit to Celebrate Science and the Arts and Support Efforts in Ukraine

November 2022 marked two spectacular space-related news events. The new era of space exploration officially kicked off with the launch of the NASA Artemis mission which will pave the way for future human lunar exploration, and the announcement of the most exciting musical experience: Chopin. The Space Concert. The timeless music of Frédéric Chopin will be performed live alongside the unique NASA space footage.

The Medical Society of Virginia (MSV) and the Alliance for Innovation Polish American Foundation (AFI) will co-sponsor Chopin. The Space Concert on Saturday, March 18, 2023, at the National Air and Space Museum’s Steven F. Udvar-Hazy Center in Chantilly, Va.

This is the third time the MSV and AFI have joined together to share the relationship between the arts and science, but the first time the general public have been able to participate in person in this event featuring the award-winning film, Chopin. The Space Concert, by Director Adam Ustynowicz and music by Polish composer, Frédéric Chopin. Renowned Polish musicians will perform the timeless music of Chopin live at the event bringing new dimension and depth to experience the elegance of space and music.

The need to connect and experience the full range of senses and emotions was the driving force for a breathtaking initiative Chopin. The Space Concert. The music of Frédéric Chopin first reached space thanks to an American astronaut of Polish origin – Colonel George D. Zamka who was one of the members of the STS-130 mission. In February 2010 he took a CD with the music of the great Polish composer on board of the Space Shuttle Endeavour.

Colonel Zamka said: “I am one of several million Americans with Polish roots. The music {of Chopin} would be a way to celebrate the friendship and heritage between two great countries, the United States and Poland.”

This year’s concert expands the theme of human imagination, brotherhood, and freedom with the goal of helping the people of Ukraine. Through Chopin. The Space Concert, AFI and the MSV are raising awareness and funds to establish a Center of Excellence to train and support Polish and Ukrainian medical specialists in Polytrauma (Traumatic Brain Injury, PTSD, Acute Stress Disorder) in Poland. The Center of Excellence is being developed in collaboration with the Medical Society of Virginia and the National Center for PTSD, a program of the U.S. Department of Veterans Affairs.

Ticket information and sponsorship opportunities will be available soon.