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“Great is the art of beginning, but greater is the art of ending”.
As I ponder these words spoken by Henry Wadsworth Longfellow, I think about what they mean to me. This is my last TMGMA Newsletter as president of the organization. The art of ending is complex for me. This year has served as a reminder that life is constantly changing and is always full of chal-lenges. As leaders we must adapt to change quickly, execute decisions promptly, and communicate these changes effectively in order to not only sur-vive but to succeed. This year has brought on a very unique challenge for all of us. As TMGMA wrapped up a very successful Fall Conference last Sep-
tember at the DreamMore Resort, who among us could have predicted that this year we would all be dealing with a pandemic? Our world has changed. Social distancing, wearing masks, daily tempera-ture readings, are all part of our new “normal”. Each day we are met with the challenges of quarantined staff, medical supplies shortages, and navigating new laws and mandates from the government. We have new acronyms to interpret which include PPP Loans, FFCRA, APP, and COVID. We are rewriting our office policies and protocols to address closed waiting areas, social distancing, proper mask usage and when to quarantine. Webinars, Zoom meetings and Virtual conferences are now our “go-to” learn-ing modes.
Life as we know it as Administrators and Medical Managers has changed! Now, more than ever, TMGMA has become a necessity to leaders in healthcare. While we were forced to cancel our Spring and Fall Conferences, we have developed new ways to provide resources for our members. We have broadcast webinars, held town hall meetings, published newsletters and introduced a List Serv to help us all stay connected. I have heard so many of you say that without the consistent support from TMGMA peers and affiliate members throughout this past year, you would have struggled. There is a sense of security in knowing while you may not have all the answers, you have a source you can turn to, to find the answers.
THRIVE 2020!! My last “official” piece of advice to you, as president, is to encourage you to sign up for this extraordinary virtual educational opportunity! Never before have we been able to offer so much education virtually and literally at your fingertips. If you have not had a chance to review the agenda, please do so now! Sign up today. You will not want to miss it! It will be the event of the year!
As my term comes to an end, I want to thank you for allowing me to serve as your president. It has been an honor and a privilege to work with the incredible people that serve on the Executive Board, Leadership Committee and you the members. I also want to thank our Executive Director, Rebekah Francis, for keeping all of us on track throughout this challenging year. Our yearly business meeting is on September 17. It will be held virtually, which is new to us this year. At that time, it will be my pleas-ure to introduce the new members to the Executive Board and Leadership Chairs. I hope you will join me in welcoming these members to their new positions.
Thank you again for permitting me to serve as the TMGMA president this year. I have learned so much from this opportunity. I will forever be grateful.
Cathy Faulkner, FACMPE
President , Tennessee MGMA
TMGMA ENEWS September/October 2020
Preferred Malpractice Provider
New Body of Knowledge and Exam Specifications
Medical Practice Management has always and will continue to evolve and change. To ensure that board certification continues to be the most effective, and contemporary assess-ment of skills and abilities, the ACMPE exam blueprint has been updated. After 2 years of development, a new Body of Knowledge (BOK) resource will be released in October and new exam specifications will be intro-duced in December. In addition, a new study guide, workbook, practice assessment (mock scenario-based and multiple-choice exam) and an updated preparation series will be re-leased to assist you in attaining your certifica-tion. A Job Analysis Survey was conducted using healthcare professionals to identify and priori-tize the critical tasks of the profession. The data was then used to calculate the relative proportions of each subject area, or domain, and reviewed and compiled by subject matter experts. The following shows the test specifications with a mixture of multiple choice and scenario based questions.
The ACMPE Board Certification examination will begin reflecting the new BOK framework December 2020. Information can be found by visiting our Body of Knowledge page.
Certificate Programs – Now Available • Telehealth Certificate is now available on
demand. “Best Practices for Optimizing a Successful Telehealth Program”.
• Patient Access Certificate is coming in September!
• Financial Management Certificate is com-ing in November!
• Additional certificates will be offered soon including domain specific. Please visit our ACMPE Certificates page for more infor-mation.
Why should you get certified?
Find out why by clicking here!
ACMPE Article Assessments:
• New Article Assessments are available!
• Article Assessments are a great way to
earn credit. Contribute to your ACMPE
continuing education hours by taking as-
sessments with select MGMA Insights arti-
cles. Each assessment is worth one AC-
MPE credit hour.
• You can find this continuing education op-
portunity by visiting our Article Assess-
ment page. There are currently around 30
insight articles to choose from.
DeAnna Brown, FACMPE [email protected]
Check out your new dashboard
Log on to MGMA to see the new and improved
dashboard with enhancements to access the
benefits that help you the most! Those fea-
tures include:
• Personalized tiles
• Professional development and quick ac-
cess
• Easy renewal access
• Featured resources
ACMPE Member Community
Subscribe to the ACMPE Member Community
on the MGMA website for a source of great
information including networking with col-
leagues, obtaining study advice, and general
exam prep ideas!
Ready to Test? It’s on Demand!
• ACMPE exam registration is on-demand.
ACMPE program participants can register
and sit for their exams with as little as two
days’ notice any time of the year.
• On-demand Testing FAQ attached to email
and uploaded in member community.
• Over 500 Scantron testing locations - up-
dates are posted at https://
www.scantron.com/site-closures-delays/.
IMPORTANT – CORONA VIRUS SCANTRON
UPDATES- Until January 1, 2021 registrants
may select Live online-proctored format from
the safety of your own home. To become
board certified, you must register for and pass
both the multiple choice and scenario based
exam requirement
ACMPE CHAMPIONS VOLUNTEER
OPPORTUNITY
• A self-lead volunteer commitment, to en-
courage peers in the pursuit of ACMPE
programs and share awareness of the AC-
MPE value in our industry. Their assistance
will raise our credentials even higher with
more recognition in healthcare manage-
ment. ACMPE Champions are encouraged
to connect with Forum Reps and work to-
gether to uphold our credentials.
• The volunteer role is a minimum of a one-
year commitment.
Did you know that you can use the MGMA Live webinars toward your CEU requirements? All of the upcoming live webinars can be found on the MGMA Events page found here https://www.mgma.com/events. There are also a few new webinars that you can register for and at-tend every month!
TMGMA ANNUAL MEETING
September 17th
1:00pm(EDT)/12:00pm(CDT)
Due to the postponement of this year's Fall conference we are holding our annual busi-ness meeting virtually on Thursday, Sep-tember 17th from 1:00-1:20pm (EDT).
We will share committee reports and seek approval for our 2020-2021 Executive Council. To access our agenda and 2019 minutes, please click here.
All Active members are requested to attend.
Contact Rebekah Francis for a link to the
registration invitation.
Tennessee Medical Association was successful in special session passing two bills to significantly change the land-scape of organized medicine during the COVID-19 pan-demic. It did this by working diligently to pass bills on tele-medicine and liability control in the special session. To learn more about this please check out the upcoming edi-tion of Topline. As Tennessee moves towards general elections it is im-portant to note that IMPACT, the political action arm of the association, was successful in 22 out of 23 races it sup-ported. While many of these races do not have an oppo-
nent in the upcoming General Election, IMPACT needs your help to continue to push organized medi-cine's agenda and elect physicians and physician-friendly candidates across this state. IMPACT will be focusing heavily on Sen. Dr. Steve Dickerson’s race in Nashville. Dr. Dickerson is a TMA member and an anesthesiologist member of Nashville Academy of Medicine. You can donate to IMPACT here. Recently, the Department of Health and Human Services (HHS) issued the latest update to its Fre-quently Asked Questions document regarding payments from the Provider Relief Fund, established as part of the CARES Act to support providers responding to COVID-19. Additional resources can be found on the TMA COVID-19 resources page.
AMA issues letter to HHS regarding considerations for the general public seeking SARS-CoV-2 PCR diagnostic testing.
TMGMA works closely with both MGMA and TMA Government Affairs staff to provide our members with the
latest legislative & regulatory information. For more information on how you can get involved or questions on
any legislative issue, contact your TMGMA Legislative Liaison Sharon Cannon, FACMPE.
Register today for the Medical Practice Excellence Conference and receive a $100
discount by entering the: STATE100
LEGISLATIVE UPDATE
With 2020 being a year full of uncertainties, flexibility became a necessity for Nashville MGMA. Our monthly meetings were held at one of the local area hospitals. Little did we know after our February meeting, we would not be able to meet in person for what now ap-pears to be the remainder of the year. Nashville had become a COVID hot spot with shut-downs and numerous restrictions. We had to quickly evaluate alternative ways to continue to connect and meet the educational needs of our members. The result was our transition to virtual meetings.
By functioning virtually, we continue sharing valuable and informative topics to our mem-bership. Once a month we present our meetings in the same format as our in-person meet-ings with chapter announcements, sponsors, and speakers. The topics scheduled for the remainder of the year for our membership are “Managing Your Workforce in a COVID World”, “Leadership is a Choice”, and “Collaborative Health”.
These current topics assist in addressing the mission of Nashville MGMA which “is to im-prove the effectiveness of medical group practices and the knowledge and skills of those who lead them.” One of the many benefits our chapter offers to members is the opportunity for development and growth. We encourage our members to network and connect with each other. Whether looking for another leader to discuss issues, to share insights about their practice or for a mentor to assist with direction, we strive to meet the need. Our group consists of a host of practice leaders, board members, affiliate members, Tennessee MGMA board members, as well as seven Fellows in the American College of Medical Prac-tice Executives and seven Certified Medical Practice Executives.
In addition to monthly meetings, in a typical year, Nashville MGMA has 1-2 social(s) and our annual Holiday Party at a local restaurant in Nashville. While we are hoping for the Holiday Party, we are discussing contingency plans just in case. We truly miss seeing eve-ryone.
Our regular members are our heroes and we appreciate the struggles and challenges they have faced and continue to face in their medical practices this year. Last month to reach out to our heroes, we delivered gift bags with some sweet treats and a note to express our gratitude for the service they provide to our local healthcare community. Nashville MGMA is committed to continuous exploration of additional methods to provide development and growth opportunities and ways to connect with our member community.
Laura J Watkins, FACMPE, CPC Nashville MGMA President
LOCAL CHAPTER SPOTLIGHT NASHVILLE MGMA
How medical practices can improve pricing transparency
By Tolu Ajiboye
About 5.4 million Americans have lost their health insurance due to the
coronavirus pandemic. Researchers estimate that by the end of the
year, over 10 million people will no longer have employer-sponsored
health coverage linked to job loss as a result of the pandemic.
With these shifts, more and more patients will pay for healthcare ser-
vices out-of-pocket. Patients' price sensitivity will also likely be height-
ened by these circumstances, which could have a negative impact on medication adherence.
Consequently, it is critically important for medical practices to assess their current price transparency
level and develop ways to improve it. Recent data reveals that nearly all patients want information
about costs for healthcare services. An Accenture survey reported that "91% of consumers would like
pricing information from providers in advance of care".
Here are some ways you can increase price transparency at your practice.
Make costs public
Giving patients easy access to pricing lists can help increase price transparency significantly. It allows
patients to plan ahead financially for services they may need. It also reduces the workload for your
front office staff who would otherwise have to repetitively answer questions about costs from patients
over the phone or via email.
To do this, put up the out-of-pocket costs for the most common healthcare services on your website. A
simple "service- price' template is sufficient.
It doesn't have to be limited to just your practice's website too. You can also include these costs on
welcome packets or whatever print material you hand out to patients at intake, if any.
Make sure to clarify that the costs are merely estimates, and may not reflect the final bill. If possible,
succinctly explain that precise pricing cannot be given until there's an assessment of the patient's indi-
vidual circumstances/case.
Improve health literacy
Many patients become confused or feel overwhelmed when navigating healthcare services and costs.
By creating and sharing educational material that helps patients understand how healthcare pricing
works, you improve health literacy. This then improves patients' ability to trust and use pricing infor-
mation optimally.
These materials can be guides, newsletters, infographics, and other written or graphic resources. Your
local pharmaceutical reps can help supply this information for medications and products.
Update costs regularly
If you've added out-of-pocket costs for general healthcare services at your practice to your website,
you should update them as soon as they change. This ensures that patients are coming across accu-
rate and up-to-date pricing information at all times. Be sure your care team is aware of any updates,
and consider creating an internal database that staff can check regularly.
Use a patient assistance portal
Finding cost-effective medications is paramount, and patient assistance portals can supply information
about a myriad of financing options. The RxVantage patient assistant portal is powered by search and
updated in real-time. Simply search by drug name and zip code for a list of available programs and eli-
gibility requirements. The portal gives you access to download application forms, access coupons, and
find grant information effortlessly to share with your patients.
Doing this shows your patients that you are dedicated to giving them the best price points for their
healthcare needs, and making sure they can afford their medication.
Benefits of increasing price transparency at your practice
Increasing price transparency helps to build trust and loyalty to your prac-
tice. It also enhances your patient’s experience and could help improve
outcomes. While it may seem like patients want to know the costs for
healthcare services so they can price shop, that's not always the case.
Almost half (46%) of people who want healthcare costs information wish
to use it for financial planning.
For more information about this article, please contact RxVantage at [email protected] or
866.464.2157
Contributing resources: New York Times, Accenture
TEXT TMGMA TO 33550
September 15th: Washington Update
Presenter: Drew Voytal, Associate Director
MGMA Government Affairs
In a climate of significant legislative and regulatory changes reshaping the healthcare landscape in
response to the COVID-19 pandemic, this timely program will present an update on the current state
of federal healthcare policy affecting medical groups. Attendees will gain a deeper understanding of
these changes and their impact on the day-to-day activities of medical group practices, in addition to
being directed to clarifying resources. Specific topics include updates to the CARES Act Provider Re-
lief Fund, Paycheck Protection Program, Medicare telehealth flexibilities, 2020 Medicare Quality Pay-
ment Program, and a host of other timely issues.
Learning Objectives:
• Learn about new or pending federal policy changes
• Understand how legislative and regulatory initiatives affect your daily work
• Identify resources available to assist you
October 13th: Social Media in the Medical Practice: Risks,
Rewards and Reputation Management
Presenter: Loretta Maddox, MS, FACMPE
Medical practices must understand the importance of the appropriate use of social media in the medi-
cal practice. A nurse posting a photo of a patient on Instagram after a successful procedure, a recep-
tionist posting a selfie on Facebook with a list of the day’s patients in the background, or a physician
responding to a negative comment spotted on Google, can lead to potential HIPAA and reputation is-
sues. This presentation will outline how to identify and reduce risks associated with the use of social
media, as well as how to appropriately use social media for marketing purposes. Identify risks associ-
ated with the use of social media by workforce members involving protected health information and
ways to mitigate those risks. Use social media to promote the practice without violating HIPAA. Man-
age the reputation of the practice and individual providers by developing strong policies and proce-
dures and training for the entire workforce.
Understanding the Requirements of Section 1557
In the Fall of 2016, many of you may remember the scram-
ble to comply with the posting requirements of Section
1557 of the Affordable Care Act (ACA). Some of you may
remember thinking, "What is Section 1557"?
Four years later and with the addition of a final rule, some
of you may still wonder what it means and how it applies to
your practice.
What is Section 1557?
Section 1557 is the nondiscrimination provision of the ACA. It has been in effect since the ACA's en-
actment in 2010, and the Department of Health and Human Services (HHS), Office for Civil Rights
(OCR), handles enforcement. The law prohibits discrimination based on race, color, national origin,
sex, age, or disability by applying and enforcing the following civil rights statutes:
• Title VI of the Civil Rights Act
• Title IX of the Education Amendments
• Section 504 of the Rehabilitation Act
• Age Discrimination Act
These protections extend to individuals participating in:
• Health programs or activities which receive funding from HHS
• Health programs or activities administered by HHS
• Health Insurance Marketplaces and all plans offered by issuers in Marketplaces
Does Section 1557 apply to my practice?
Healthcare providers who receive federal financial assistance (FFA) from HHS are considered covered
entities under this Rule and must comply with the provisions. Some common types of FFA received by
healthcare providers are payments from Medicaid programs, Medicare Parts A, C, and D, and grants
or credits from other federal programs, including the Medicare Incentive Payment System (MIPS) or an
Alternative Payment Model (APM) under the CMS Quality Payment Program.
How did the Final Rule change Section 1557?
On June 12, 2020, HHS announced a final rule that made some changes to Section 1557. One major
change was the definition of "on the basis of sex." The 2016 Rule redefined discrimination "on the ba-
sis of sex" to include gender identity and termination of pregnancy. Gender identity was defined as
"one's internal sense of gender, which may be male, female, neither, or a combination of male and fe-
male."
The U.S. District Court for the Northern District of Texas concluded that including gender identity and
termination of pregnancy in the definition of "on the basis of sex" was contrary to the Religious Free-
dom Restoration Act and the Administrative Procedures Act. In October of 2019, the Court vacated and
remanded the requirements as unlawful. The Department of Justice has taken the position that discrim-
ination "on the basis of sex" does not include gender identity or sexual orientation and that gender
identity is not a protected category under Title IX.
The final rule also made changes from an administrative standpoint by removing the mandate for cov-
ered entities to include notices and taglines in all significant publications. The requirement to post the
notice and taglines in physical locations where services are provided remains in effect, but if your prac-
tice has been including this information with billing statements, newsletters, and any other significant
publications, you can stop. The cost savings for the removal of this requirement is estimated at $2.6
billion for covered entities.
All applicable laws that prohibit discrimination based on race, color, national origin, disability, age, and
sex will continue to be enforced by HHS under Section 1557. However, the enforcement will be accord-
ing to the meaning of each of these longstanding civil rights statutes.
Key Points from the Final Rule
• Individuals with disabilities must be able to have physical access to healthcare facilities and appro-
priate communication technologies if they are visually or hearing-
impaired.
• Limited English Proficiency (LEP) individuals must continue to be
provided qualified language translators and interpreters. The Rule
maintains its limitation on the use of minors and family members for
translators and interpreters. It also adds flexibility to providers in
meeting the obligations of providing translators and interpreters by
allowing providers to follow the four-factor analysis.
• Covered entities must submit an Assurance of Compliance,
which states that they will comply with all nondiscrimination laws and regulations.
• The 2016 Rule's definition of "on the basis of sex" is removed and replaced with the interpretation of
"on the basis of sex" under Title IX.
• The requirement to include nondiscrimination notices and taglines in all significant communications
is removed.
• HHS returns to the enforcement structure that enforces each of the civil rights statutes separately
and removes the single enforcement under the 2016 Rule that risked confusion or inappropriate appli-
cation across the different laws.
• HHS revises the scope of enforcement to only include entities principally engaged in healthcare and
the healthcare activities of other entities if HHS funds the activities.
• The final rule adds a provision stating that Section 1557 will be enforced consistent with other stat-
utes, including the Religious Freedom Restoration Act, federal conscience-protection laws, the Church,
Coasts-Snowe, Weldon, Hyde, and Helms Amendments, and the First Amendment to the Constitution.
What do I need to do to be compliant?
The OCR has received a number of
complaints regarding discrimination in
healthcare since Section 1557 has
been effective. During the COVID-19
pandemic alone, the OCR has dealt
with the States of Alabama, Connecti-
cut, Pennsylvania, and Tennessee re-
garding complaints associated with
alleged discrimination under these pro-
visions. Healthcare providers must en-
sure compliance with Section 1557 as
well as the other longstanding federal civil rights statutes.
For a quick check of your compliance, make sure you are doing the following:
•Post a Notice of Nondiscrimination in a prominent location within the practice and on your website's
home page.
•Post taglines in at least the top 15 languages spoken by individuals with Limited English Proficiency
(LEP) in the State(s) in which you provide services in a prominent location within the practice and
on your website's home page.
•If you have more than 15 employees, designate a person responsible for handling grievances, and
adopt grievance procedures. This provision was removed from Section 1557 in the 2020 final rule;
however, it is still a requirement of Section 504 of the Rehabilitation Act.
•Have access to qualified interpreter and translator services for your LEP patients and auxiliary aids for
visually or hearing-impaired patients.
•Ensure that your facility is accessible for individuals with disabilities.
•Train your workforce on your policies and procedures that prohibit discrimination.
For questions about this article, please feel free to contact Loretta Maddox by email at
[email protected] or call 801-701-2969.
Loretta Maddox, MS, FACMPE, CHC
Sr. Compliance Consultant
Healthcare Compliance Pros
http://info.healthcarecompliancepros.com/loretta
TMGMA is working with UT at Chattanooga and Clayton State University on a research study that aims to describe the challenges that outpatient medical clinic practice administrators face with determining the right volume of telehealth post the emergent issues of early Covid-19 pandemic. Recognizing that practices had to pivot to respond to the early pandemic pressures, we are interested in understanding your decisions and thoughts about the immediate change and what the future “right size” for telehealth will be.
This Outpatient Medical Clinic Administrator Survey is a one-time survey, which should take approxi-mately 30 minutes to complete. It does not have to be completed all at one time. We recognize this is a large ask for busy leaders and are very appreciative of your participation. Results of the research will be shared with TMGMA members.
If you have questions, thoughts or comments, please contact either researcher:
Deborah Mullen, PhD, Greg Vital - Franklin Farrow Associate Professor in Healthcare Administration at the University of Tennessee at Chattanooga, Gary W. Rollins College of Business [email protected], 952-212-9053
Vinod Vincent, PhD, Assistant Professor of Management at the Clayton State University’s College of Business, [email protected], 678-466-4523
TELEHEALTH SURVEY COMING SOON
PARTICIPATE IN TMGMA’S
PEER TO PEER INITIATIVE
The Peer to Peer Initiative was created, in an effort, to help fulfill TMGMA’s Mission state-ment by providing resources through educa-tion, mentoring, networking and advocacy. This initiative is an informal connecting of med-
ical practice managers in Tennessee in a one on one professional peer to peer relationship. TMGMA will work to identify practice managers who wish to have a peer to connect with on a regular basis. TMGMA will provide the communication link between managers and check in from time to time to en-sure the relationship is fulfilling the goals of the initiative. Potential participates do not have to be members of TMGMA. Guidelines: The initiative is simple. It consists of regular calls between participants. These calls can
be monthly, bi-monthly, or at a minimum quarterly. And every effort will be made to have one face to
face encounter annually. This can be at a conference or any other venue that is convenient. The idea
is to establish a collaborative, supportive, educational relationship preferably between managers in
similar specialties.
To find out more about the program or to sign up to participate, please contact Rebekah Francis at [email protected].
