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Physicians Advancing Health Care

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a newsletter for the medical communityTulsa Medicine»

SEPTEMBER 2016

PRESIDENT’S LETTER Peter P. Aran, M.D.

MACRA/CPC Plus: What You Need To Know Now For The September 15, 2016 Deadline

(NOTE: Previously we have written that with the time crunch everyone has these days wenaturally triage what we are going to read and when to read it. If you are currently seeingMedicare patients read on. If not, read this later at your leisure.)

In previous newsletters we have written about the new Medicare guidelines that will apply to almost all doctors caring for patients over 65 years old. The program is the Medicare Access Chip Reconciliation Act (MACRA) and if the current requirements stand is set to start January 1, 2017. Each physician must choose one of the two tracks in which to participate. As you recall 80-90% of doctors will choose the track entitled MIPS (Merit Based Incentive Payment System). The rest will apply for the Alternative Payment Model (APM) track. Here are the links to the previous newsletter articles about MACRA/CPC Plus.

http://tcmsok.org/mc/wp-content/uploads/2016/06/201607.pdfhttp://tcmsok.org/mc/wp-content/uploads/2016/06/201606.pdf

Those that choose the APM model track have two main advantages or benefits. The first is that they do not have to participate in MIPS which is the more complicated of the two tracks and the second is that they will receive a 5% bonus of their previous year’s medicare payments for each of the next 5 years for participating.

But to qualify for the APM track you must be enrolled in a designated Centers for Medicare and Medicaid Services (CMS) program. We have written about one of these programs now underway in Oklahoma called the Comprehensive Primary Care (CPC) Initiative. Only 480 practices in the United States located in 7 sites were part of that and 62 of those practices were in Oklahoma. The program was successful enough that CMS decided to expand it to 5000 practices in 14 states and Oklahoma was just chosen this summer. The CPC practices and any other practice can apply but the timeline to apply is short. It started on August 1, 2016 and goes until September 15, 2016. You still have time to submit your application and should do so by going to the CMS website at www.CMS.hhs.gov. When the site opens up double click on the banner at the top of the page called Innovations. The page will open up and while you could read about the 60 plus initiatives underway at the Center for Medicare and Medicaid Innovations (CMMI) just go to the search bar and start typing in Comprehensive Primary Care Plus-the link will pop up, double click again and all the information you need to apply will be there.

Even though CMS has tried to make these processes easy I don’t think they always are. You should familiarize yourself with the information of course and decide what is best for you and your practice. Then you should designate someone to take the time to complete the application. On page 2 we republished the list of Tulsa area doctors that have been involved in the CPC program and most everyone has found it beneficial for their patients and themselves and plan to participate in CPC Plus. I would ask you to contact the colleagues on the list that you know and get their feedback.

The Oklahoma State Medical Association (OSMA) and its editor Dr. Michael Pontious as well as the OSMA president Dr Sherri Baker will be writing about these programs over the next months as we await the final requirements due out before November 2016. The timelines are tight, especially for CPC Plus, and we want you to be as informed as possible.

To participate in a one-hour CPC+ Practice Open Door Forum, click on the link below and register for one of seven dates offered (August 30, September 6, 7, 12, 13, 14 or 15).

https://innovation.cms.gov/Files/x/cpcplus-practiceeventscalendar.pdf

AS I MENTIONED IN MY LETTER ON PAGE ONE, THE FOLLOWING IS A LIST OF TULSA AREA DOCTORS THAT HAVE BEEN INVOLVED IN THE CPC INITIATIVE.Jenks Family PhysiciansDr. Andrew Driscoll DonnellyDr. Brian LewisDr. Brent WakefieldOU PhysiciansDr. James CrutcherDr. Jason DeckDr. Syeachia DennisDr. Douglas IvinsDr. James MillarDr. Barbara MillerDr. Louis MulkeyDr. Linda Oberst-WalshDr. Alton RaeDr. John TiptonDr. L. Janelle WhittDr. John CarmentDr. Oliver CerqueiraDr. F. Daniel DuffyDr. Martina JelleyDr. Bernadette MillerDr. John SchumannDr. Carmen VesbianuDr. Michael WeiszDr. William YarboroughSt. John ClinicDr. Kimerly AshlockDr. Marjorie BennettDr. Bruce BennettDr. Laura BilbruckDr. Theron BlissDr. Curtis CogginsDr. Michael CooperDr. Jon CoxDr. Brian CrottyDr. Afsar EmeryDr. Helen FranklinDr. Andrew GordonDr. Harleen GrewalDr. James HanlonDr. Paul HigbeeDr. Erick HillDr. William JamesDr. Chitralekha KathuriaDr. Christopher KlotzDr. Brent LaughlinDr. Cynthia MaloyDr. Michael Maxwell

Dr. Trudy MilnerDr. Robert NiebergallDr. Robert PaulsenDr. Jacqueline PetrayDr. James PhoenixDr. Mitchell PrestonDr. Terroll RamseyDr. Robert SheplerDr. Tracy SmithDr. Kevin SteichenDr. Stephen SuttonDr. Charles TeterDr. Yvan ThomasDr. Ethel Vasquez HarmonDr. Michael VuDr. Rebecca WackowskiDr. Peter WengerUtica Park ClinicDr. Andrea AdamsDr. Khalid AlyDr. Paul BattlesDr. Robert BoylesDr. Michael CainDr. Mark CalleryDr. Christopher ChowDr. Debra ColpittDr. William CookDr. Tobin CrowDr. Martin DavisDr. Sarah ElneserDr. Clayton FlanaryDr. Matthew FowlerDr. Catherine GaffneyDr. Kristine GalichDr. Jeffrey GallesDr. Yancy GalutiaDr. Ron GannDr. Michael GebetsbergerDr. Scott GhereDr. Michael GietzenDr. Randy GrellnerDr. Robert HightowerDr. Jeffrey HowardDr. Christopher HunterDr. Beau JenningsDr. Lisa KingDr. Frank KondosDr. Colm McCauleyDr. Mary Mills

Dr. Russell MoneypennyDr. Dana MorrelDr. Paul MorrisonDr. Ronald OglesbyDr. Johnie OwensDr. Keith PattersonDr. George PendellDr. Geoffrey PlumleeDr. Gary PostelwaitDr. Jason RiffeDr. David RingDr. Patti ShawDr. Kelly ShulerDr. Michael WardDr. Terence WilliamsDr. Mercedes ZanoWarren ClinicDr. Jack AldridgeDr. Scott AsakevichDr. Dina AzadiDr. Sharon BarnesDr. Vincent BryanDr. Gary CannonDr. Brent DennisDr. Mira GeorgyDr. Frances HaasDr. Robert HaugerDr. Donald HigginsDr. Matthew JohnstonDr. Insung KimDr. Lance KingDr. Joseph KoenigDr. Felicia LeeDr. Colin MaroukDr. Christy MayfieldDr. Gary McBrydeDr. Gerard McNultyDr. Joseph MooreDr. Randall RaineDr. Tito RazdanDr. Bart RiderDr. Vincent RomanDr. Joseph SchlechtDr. Rim TabbaaDr. Sudip TripathyDr. Kellie Van TuylDr. Ranilo VasquezDr. Robert VillarealIndependent PracticesDr. Steven Wiseman

IN MEMORIAM BOYD O. WHITLOCK, JR., MD, August 27, 2016

NEW MEMBER’S

BRITNEY M. ELSE, D.O.Family Medicine & Sports Medicine, OSU Riverside Primary Care, 9645 Riverside Parkway Ste C (74137). (918) 209-5170. Pre-Med: Montana State University, Billings, MT, 2000-2003 & Northeastern State University, Broken Arrow, OK, 2003-2004. Medical Education: Kansas City University of Medicine and Bio-Sciences, 2007-2011. Residency: University of Missouri, Kansas City, MO, Family Medicine, 2011-2014. Fellowship: Eastern Oklahoma Orthopedic Center/University of Oklahoma, Sports Medicine, 2014-2015.

JEFFREY A. JOHNSON, M.D.Emergency Medicine, Green Country Emergency Physicians, 1120 S Utica (74104). (918) 579-6090. Pre-Med: Oklahoma State University, Stillwater, OK, 1994-1998. Medical Education: University of Oklahoma, Oklahoma City, OK, 1998-2002. Residency: Louisiana State University Charity Hospital, New Orleans, LA, Emergency Medicine, 2002-2006.

VALERIE N. JOLLY, M.D.General Surgery, Warren Clinic, 10507 E 91st St #450 (74133). (918) 307-3170. Pre-Med: Oklahoma State University, Stillwater, OK, 1997-2001. Medical Education: University of Oklahoma, Oklahoma City, OK, 2001-2005. Residency: University of Oklahoma, Oklahoma City, OK, Surgery, 2005-2010.

PAUL A. BERRY, M.D.Plastic & Cosmetic Surgery, Warren Clinic, 6465 S Yale Ave Ste 101 (74136). (918) 502-7175. Pre-Med: University of South Florida, Tampa, FL, 1994-1998. Medical Education: Washington University, St. Louis, MO, 1999-2004. Residencies: Texas A&M HSC, Scott & White Memorial Hospital, Temple, TX, General Surgery, 2004-2007 & Plastic Surgery, 2007-2010.

WHAT DO MEDICAL STUDENTS AND WILD ANIMALS HAVE IN COMMON?

THEY BOTH LOVE THE ZOO!!Tulsa County Medical Society hosted a lunch/social/zoo visit for OU and OSU medical students and residents and their families on Saturday, August 27th. This event follows a TCMS hosted luncheon for first year medical students at both schools where 107 OSU students and 26 OU students joined TCMS. Pictured are OSU student Allon Gillispie & his guest Emily Keith on the right and OU student James Brigance & his wife Anna on the left.

KEEP AN EYE OUT...FOR YOUR 2017

TCMS/OSMA DUES STATEMENT

that will be mailed on 10-3-16 If you want to pay now call

918.743.6184 or go to http://tcmsok.org/online-payment/online-dues/

PAY BY 12-31-16 AND HAVE A CHANCE TO WIN A $300.00

Q.T. GIFT CARD. THE WINNER WILL BE DRAWN

AT THE JANUARY 11, 2017 BOARD MEETING

Tulsa County Medical Society5315 South Lewis AvenueTulsa OK 74105-6539

ADDRESS SERVICE REQUESTED

PRSRT STDU.S. Postage

PAIDPermit No. 418

Tulsa, OK

TulsaMedicine

jared w. buchan, assistant v ice president

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How Life Insurance Can Benefit Your Estate

Life insurance isn’t just a short-term way to protect your family’s livelihood. It may also be a valuable estate-planning tool.

“Having life insurance in your estate plan offers several benefits,” says Woody Hughes, Vice President and Director of Insurance for BOK Financial Corporation, the parent company of Bank of Oklahoma. “It may help families more efficiently pass along their assets while also helping with long-term tax-planning.”

Here are three ways life insurance may be useful in your estate planning:

1. Providing financial protection to loved ones Life insurance—which provides an immediate payout after the policyholder passes away—can help ensure that your loved ones have the financial resources they need after you die. For example, parents may get life insurance to help cover their children’s living expenses or other specific costs once both parents pass away. If the parents deplete most of their assets while they are alive, they at least know their children will have the insurance proceeds as an inheritance.

Life insurance can also be used to fund a trust that provides income to, say, an adult child with a disability, a child who is not good at managing money, or a child under the age of 18.

Unlike “term” life insurance—which only provides coverage over a set period, such as 20 years—a “permanent” insurance policy builds cash value and will cover you throughout your lifetime. “Though the premiums you pay are typically higher than with term insurance, permanent coverage is often preferred because it avoids the risk that you’ll outlive the coverage period,” Hughes says.

2. “Equalizing” the Estate If you own a business or property that will be left to a particular family member, having life insurance can ensure your other heirs get a fair share of your estate. For example, a married couple that owns a business valued at $5 million that one child will inherit may take out a $5 million life insurance policy with the proceeds going to another child.

Such an insurance policy can be set up so the death benefit rises over time along with the expected value of the business—so the two gifts will still be roughly equal in value if you pass away in 20 or even 40 years, Hughes says. “Having insurance makes some complicated estate-planning issues, such as business or real estate ownership, much simpler to settle,” he adds.

3. Minimizing tax consequences Individuals and couples concerned about their heirs facing estate taxes after they pass away might get life insurance to pay those taxes. This prevents heirs from having to liquidate assets to cover them. (Currently, the top federal estate and gift tax estate rate is 40%, with an exemption of about $5.5 million per individual—$11 million for married couples. Some states have an estate or inheritance tax, as well.)

Life insurance can also reduce overall tax obligations. Insurance proceeds are typically income-tax-free, and when an insurance policy is put in an irrevocable life insurance trust (ILIT)—a trust specifically designed for holding life insurance—they can also be exempted from your taxable estate. ILITs have special rules and the beneficiary often cannot be changed once the trust is created, so it’s important to work with an estate-planning expert who can help you set it up correctly.

Working with Bank of Oklahoma When shopping for life insurance, it’s important to work with an experienced financial advisor who can find you the right policy and right amount of coverage for your unique situation. Policies must be structured carefully to ensure they meet your specific estate-planning goals.

Moreover, you should only consider policies from insurers with a strong financial rating—as you may be relying on that insurer for decades.

“Bank of Oklahoma works closely with a robust team of professionals who perform due diligence on insurance carriers and select only those with high ratings and strong historical performance,” Hughes says. Moreover, clients have access to investment, insurance and trust advisors who can help them incorporate insurance into their financial plans.