New Article NEJM - Chiropractic Physicians as Primary Care Providers - Non-Discrimination Within CCOs

[Guest guest]

Dear colleagues,

Attached is a article just published in NEJM and one of the Co-Authors is Don Berwick, MD. Our Governor who as you know is very supportive of chiropractic physicians has stated repeatedly for those of us wishing to practice at the top

of licensure we can both help address the primary care provider shortage as well as reduce costs etc., etc.

This just out article refers to this issue on page 4 second paragraph “Make Better Use of Nonphysician Providers” however we are indeed physicians and though the reference is to nurses the concept of “Making greater

use of these providers…” would of course apply to chiropractic physicians. Our concern with the freshly developed CCOs which are controlled by traditional medicine (hospital/physician organizations/IPAs) is that they will restrict chiropractic physicians

to only certain services namely involving musculoskeletal medicine (back neck pain stuff…) by only contracting with us for those services versus including annual physical examinations, blood chemistries, resting ECGs, computerized lung function, health and

wellness lifestyle counseling, wellness coaching, and treatment of the 60 most common conditions presenting to a PCP office. In our view colleagues if in fact a chiropractic physician sends a letter of interest to a CCO as per wishing to be within the CCO

network and listing primary care services as services he or she can provide and the CCOs simply refuses to contract with

any DCs for such services it would be a violation of the non-discrimination provisions with the new Oregon statute. This is what the OCA hoped to avoid by spelling it out in administrative rule that CCOs cannot discriminate against other provider types

such as chiropractic and naturopathic physicians as per the delivery of primary care services...we are waiting for the rules to come back to see if they have included our proposed language.

To The Continued Good Fight,

…Vern

-----

Vern Saboe, Jr, DC., DACAN., FICC., DABFP., FACO.

915 19th Ave SE

Albany, OR 97322

phone:

e-mail: vern@...

website: www.drvernsaboe.com

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OCA CCO Health Care Costs Chiropractic Physicians as PCPs NEJM 2012.pdf

[Guest guest]

Well what you are describing is in violation of Oregon law you need to include in your letter of interest as per wishing to join the CCO that you can provide things such as annual wellness physical exams, bloodchemistries, health and wellness counseling, nutritional counseling, lifestyle counseling, conservative (as in non-pharmacological) treatment of the 60 most common conditions presenting to a primary care office e.g., hypertension, diabetes, asthma, etc., forcethe issue and if they refuse file a complaint with the Oregon Health Authority and go through the described appeals process….Vern Saboe -----Vern Saboe, Jr, DC., DACAN., FICC., DABFP., FACO.915 19th Ave SEAlbany, OR 97322phone: e-mail: vern@...website: www.drvernsaboe.com From: bacdoc Sent: Thursday, August 02, 2012 8:18 PMTo: Dr. Vern Saboe; oregondcs ; oregon@...Cc: Dan Beeson; rongrice01; Sunny Kierstyn; Matt Freedman DC; s, D.C.; Charlie Caughlin; Boothby Judith; Corll@...; ajspine1@...; LARRY HANBERG; Seitz; L Herrst DC; Brad Rethwill DC; ' Hacmac'; ' 'Subject: Re: New Article NEJM - Chiropractic Physicians as Primary Care Providers - Non-Discrimination Within CCOs " In the midst of the CCO contracts, as I forwarded to Vern, the one proposed by GOHBI (Ghobi?) for Eastern Oregon relegate Chiropractors to " Non-Physician Providers " which meantcare to be authorized by " Primary referral only--which included MD, DO. PA, FNP " ...--and then working under the stipulations of the weighting scale, depending on the referring " Primarys " diagnosis what we could or couldnt provide....and the fees for serviceswere 20% or more less than Medicare.... The interesting issue in addition to this now becomes watching what Regence BCBSO is doing on October 1st with their " new automatic acceptance " of their new far lower fee schedule to be on panel...If you do not respondand send a letter within 30 days of receiving their correspondence opting out, you are automatically included on the existing panel...with the compensation drop from 25% to 37-49% for the 989XX codes, this creates a major issue for those of us in small ruralcommunities---and even more amazing when I called several docs in our area I was the only one that received the notice...this is not good. Floyd in Hermiston.... New Article NEJM - Chiropractic Physicians as Primary Care Providers - Non-DiscriminationWithin CCOs " Dear colleagues, Attached is a article just published in NEJM and one of the Co-Authors is Don Berwick, MD. Our Governor who as you know is very supportive of chiropractic physicians has stated repeatedly for those of us wishing to practice at the topof licensure we can both help address the primary care provider shortage as well as reduce costs etc., etc. This just out article refers to this issue on page 4 second paragraph “Make Better Use of Nonphysician Providers†however we are indeed physicians and though the reference is to nurses the concept of “Making greateruse of these providers…†would of course apply to chiropractic physicians. Our concern with the freshly developed CCOs which are controlled by traditional medicine (hospital/physician organizations/IPAs) is that they will restrict chiropractic physiciansto only certain services namely involving musculoskeletal medicine (back neck pain stuff…) by only contracting with us for those services versus including annual physical examinations, blood chemistries, resting ECGs, computerized lung function, health andwellness lifestyle counseling, wellness coaching, and treatment of the 60 most common conditions presenting to a PCP office. In our view colleagues if in fact a chiropractic physician sends a letter of interest to a CCO as per wishing to be within the CCOnetwork and listing primary care services as services he or she can provide and the CCOs simply refuses to contract withany DCs for such services it would be a violation of the non-discrimination provisions with the new Oregon statute. This is what the OCA hoped to avoid by spelling it out in administrative rule that CCOs cannot discriminate against other provider typessuch as chiropractic and naturopathic physicians as per the delivery of primary care services...we are waiting for the rules to come back to see if they have included our proposed language. To The Continued Good Fight, …Vern -----Vern Saboe, Jr, DC., DACAN., FICC., DABFP., FACO.915 19th Ave SEAlbany, OR 97322phone: e-mail: vern@...website: www.drvernsaboe.com