24 minute read
Chapter Affairs
CHAPTER AFFAIRS
By Gregory K. Griggs, MPA, CAE
NCAFP Executive Vice President
~ FIGHTING FOR YOU ~
Refocusing on You – Like a Laser
In late December and early January, we asked you to complete an extensive Member Needs Assessment, following up on a survey we conducted three years ago. We had originally planned to wait one more year, but with so many changes attributed to COVID-19 over the last year, we moved our timeline forward a year. Over 420 of you answered the call and completed the online survey. Fortunately, those who completed the survey almost perfectly matched the demographic profile of our active members at large.
While the results did not lead to any wholesale changes in our committee structure, it did lead to a significant tightening of our strategic plan to focus specifically on the most pressing needs you brought forth. For this issue of the magazine, I wanted to provide you a quick overview of what you said and what we are doing to try to address your needs.
First, we asked a new question this year, how would you like to see $100 of your dues divided up and used by the NCAFP. Your top three answers were:
1) Reducing Administrative Burden, representing on average 30 percent of your dues
2) Increasing Payment, representing 22 percent
3) and CME Programming, representing 18 percent. Other key areas you identified included workforce pipeline and public health initiatives.
The top market factors you felt would have the greatest impact on Family Medicine over the next three years included:
• Adjusting to value-based payment – 74% of you ranked this as one of your top three concerns;
• The ramifications of COVID – 52% ranked this as a top three-concern; and
• Practice and Health System Consolidation – 46% of you noted this as a top-three concern.
On the top causes of frustration in Family Medicine, you were also very clear:
• Administrative burden caused by payers ranked first with 69% of you ranking it in the top three;
• The growing number of quality metrics ranked second at 63%;
• And Electronic Health Records was third with 46% of members raking it as a top three concern.
So how is the NCAFP adjusted in these areas? First, we have adjusted the name of the Payer and System Advocacy Committee to simply, Advocacy Committee, and added government agencies to the list of groups where the NCAFP wants to strengthen our influence (now including health systems, government agencies and payers). We have also reduced our goals for this committee to four key areas:
A) Decrease the administrative burdens faced by family physicians in their day-to-day practice lives;
B) Work to ensure the value of Family Medicine is maximized;
C) Empower and increase the number of family physicians serving in leadership roles; and
D) Improve access to full-scope Family Medicine for the people of North Carolina.
Our next step will be digging into the specifics of administrative burdens to look at which issues are the biggest pain points for our members (look for a follow up survey from the NCAFP on this in the near future). We want to look at what is taking your time, what is just causing frustrations and what are the issues we can best address on a state level.
As we further examined the result of the Member Needs Assessment, we found that 58 percent of you were very or extremely satisfied with membership in the NCAFP and another 35 percent were somewhat satisfied. Fortunately, only 5 percent of you were not very satisfied, but we know we can work to do even better. Ninety-six percent of you said you were likely to retain your membership, with 83 percent being very or extremely likely. You also told us what you thought were the most important member benefits, and that broke out as follows:
• 82 percent of you said that physician advocacy in state legislative and regulatory affairs were either highly desirable or absolutely critical
• 73 percent said the same about patient advocacy in legislative affairs
• 72 percent said advocacy efforts with large health systems were highly desirable or critical
• 66 percent said private/payer advocacy was the same.
On down the list included member services (59 percent), the Winter Family Physicians Weekend (57 percent), Single Day CME Programs (53 percent) and Virtual CME Meetings (52 percent).
Our membership also valued us very highly for continuing education (57 percent), for practice management needs (64 percent) and for networking opportunities (74 percent). The only organization valued more highly was AAFP for continuing education and practice management, but NCAFP was the highest valued organization in terms of networking.
As a result of this information, goals for our Member Satisfaction and Practice Environment Committee have also been adjusted. The three core goals now are:
1) Improve the practice environment by providing education on different practice styles and opportunities to enhance practice efficiencies/effectiveness.
2) Increase networking opportunities and support for NCAFP members while providing quality education that impacts patient care and the practice of Family Medicine.
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3) Help family physicians thrive (not simply survive) by promoting physician health and wellness and preventing burnout.
Finally, around the Family Medicine workforce, you told us that the following three areas would likely have the most impact on the workforce over the next three years:
- Maintaining work/life balance – a top-three concern for 69 percent of respondents;
- Physicians leaving the profession due to increasing responsibilities unrelated to clinical care (62 %); and
- Identifying, recruiting, and retaining family physicians in North Carolina (55 percent).
You also told us that in general, many of you precept health professional students (medical students, residents, NP students and PA students) but very few of you who precept get dedicated time or reduced responsibilities to teach (only 25 percent of you do).
As a result, we have also updated the core goals of our workforce pipeline committee to include:
- Encourage systems, payers, and others in NC to incentivize precepting, teaching and mentoring.
- Provide opportunities for medical students, residents, and new physicians to learn about job opportunities in Family Medicine.
- And nurture medical student and resident engagement.
Each of these three committees are now much more targeted than they had been in our last strategic plan, trying to address the most pressing concerns you have. In our strategic plan from three years ago we had 19 core goals spread across the three focus areas. This time we are much more targeted with 10 core goals across the three focus areas instead. We believe this will help make your board, committees, and staff much more efficient and agile in meeting our members’ most pressing needs. We were agile during 2020 and really focused on helping each of you deal with the impact of COVID. We think this revised strategic plan will help us continue that agility to best meet your needs going forward.
A Family Medicine Community Podcast www.ncafp.com/ncfmtoday
APRIL - Diabetes Free Prevention Program In this episode of NCFM Today, Dr. Karen Smith, a former president of the NCAFP, talks about her involvement in Diabetes Free NC. Franklin Walker, Vice President of Rural Health Innovations for the NC Medical Society, talks about how physicians can get involved in Diabetes Free NC. Finally, we provide brief updates on efforts to advocate for dedicated teaching time and payment for our state's community preceptors and the role of family physicians in COVID-19 vaccine efforts, particularly combating vaccine hesitancy.
MARCH - Residents & Students in Family Medicine Ryan Paulus, DO, a second-year Family Medicine resident at UNC, discusses continuity of care in Family Medicine and the scope of Family Medicine, and why that drew him to this career. Hannah Smith, a fourth-year medical student at the Brody School of Medicine at East Carolina University, talks about why she chose Family Medicine and what sparked her love affair. Finally, a few brief updates on what's impacting Family Medicine this month.
FEBRUARY - Advanced Medical Homes for Medicaid Learn about the role of the Advanced Medical Home as North Carolina transitions its Medicaid Program to Managed Care. Carol Stanley, Medicaid Transformation Manager for the NC AHEC Practice Support Team, and Nicole Cannady, Practice Support Coordinator and Quality Improvement Coach for the Southeastern AHEC in Wilmington, discuss tools that NC AHEC has available to help primary care practices achieve Advanced Medical Home (AMH) Status, the differences between a Tier 2 and a Tier 3 AMH, and what Family Medicine should be doing now to prepare for Medicaid Managed Care in North Carolina.
2020 ANNUAL REPORT
The State of the Academy
What a year! When 2020 began, little could any of us imagine the challenges that the first global pandemic in over 100 years would bring. But true to our mission and calling as family physicians, our organization and its members adapted quickly, making necessary but tough decisions for our patients, practices, and communities.
2020 began similarly to previous years, with our leaders continuing to advocate for Family Medicine by working to strengthen relationships across healthcare and advancing the interests of our members particularly around issues such as payment, administrative burdens, and the transition to value-based care. But as the pandemic tightened its grip on our communities, a different slate of issues arose, and I am proud to report that our Academy adapted quickly and effectively.
By mid-March 2020, the Academy’s primary concern was getting the latest COVID information to our members in a timely basis. Academy staff immediately adjusted its communications workflows to become a near daily constant in members email boxes. This kept our members informed of important onthe-ground changes with COVID, helped mobilize our overall advocacy response, allowed us to gather actionable data via member surveys and helped connect our member practices to the latest resources. We also educated and kept members informed through a long list of webinars that covered topics as wide ranging as telehealth to applying for financial assistance.
Behind the scenes, Academy leaders also worked in close coordination with the NC Department of Health & Human Services, our state’s insurers, and the legislature to advocate for critically important financial relief, including telehealth payment parity, temporary Medicaid rate increases, and other adjustments to help independent practices and primary care during an unprecedented time. I am particularly proud of the key collaborations we conducted with organizations like the NC Pediatric Society, AHEC, the NC Psychiatric Association, Community Care of North Carolina, and the NC Medical Society.
Alongside professional advocacy, the Academy also adjusted
2019-2020 NCAFP Leadership
Executive Officers
President President-Elect Secretary/Treasurer Immediate Past President Executive Vice President
David A. Rinehart, MD Jessica L. Triche, MD Dimitrios P. Hondros, MD Alisa C. Nance, MD, RPh Gregory K. Griggs, MPA, CAE
At-Large Directors
Talia M. Aron, MD Elizabeth B. Baltaro, MD Jewell P. Carr, MD Garett R. Franklin, MD Shauna L. Guthrie, MD, MPH Brian McCollough, MD Mark McNeill, MD Ying Vang, MD
Academic Position Mark L. Higdon, DO (Novant FMR)
Resident Director Elizabeth Ferruzzi, MD (Novant)
Resident Director-Elect Clayton Cooper, MD, MBA (Duke)
Student Director Katelyn Turlington (WFSOM)
Student Director-Elect Hannah Smith (ECU)
AAFP Delegates & Alternates
AAFP Delegate AAFP Delegate AAFP Alternate AAFP Alternate
Michelle F. Jones, MD Karen L. Smith, MD Richard W. Lord, Jr., MD, MA Robert L. Rich, Jr., MD
its day-to-day operations and the methods used to deliver its core programming of educational events and conferences. Chapter leaders recognized early that in-person events would not be feasible in the short term, and quickly pivoted to providing them through an all-virtual format. Our chapter staff navigated this change exceptionally well, and I am proud to report that the NCAFP was one of the few AAFP chapters not to cancel or postpone an event due to COVID.
Even with these challenges, our organization still pursued its strategic initiatives. Just prior to March’s shutdown we held our 13th annual Family Medicine Day that promotes our state’s exceptional Family Medicine residency programs. Additionally, Family Medicine continues to be well-represented within several of North Carolina’s most influential health policy organizations, including Community Care of NC, the NC Institute of Medicine, NC DHHS, and NC Medicaid.
2020 will be remembered forever. It was a year full of challenges and a time in which all of us had to sacrifice. Thank you for the trust you placed in me and the NCAFP during a most challenging time.
Viviana Martinez-Bianchi, MD
Executive Committee WONCA - The World Organization of Family Doctors
Mott P. Blair, IV, MD
Board of Directors American Board of Family Medicine
Tamieka M.L. Howell, MD
AAFP Commission on Membership & Member Services
Thomas R. White, MD
AAFP Commission on Quality and Practice
Victoria Boggiano, MD
Resident Delegate to the AAFP Congress of Delegates and Resident Member - AAFP Commission on Education
Hannah Smith
AAFP FMIG National Network Coordinator
Erin Clark, MD, DO
Student Member - AAFP Commission on Health of the Public & Science
Clayton Cooper, MD, MBA
Resident Member - AAFP Commission on Membership and Member Services
David A. Rinehart, MD
2019-2020 NCAFP President
Dr. Rinehart attended the University of Virginia and earned his BA in 1978 (Phi Beta Kappa) and his MD in 1982 (Alpha Omega Alpha). He completed his residency in Family Medicine at Charlotte Memorial Hospital in 1985 and was recognized as a national Mead Johnson Outstanding Resident. Dr. Rinehart has enjoyed 34 years of community-based family medicine practice with South Point Family Practice in Belmont, NC, 22 years as an independent group practice and 12 years as part of CaroMont Health. He has been a preceptor for dozens of medical students and nurse practitioner students over the years. Dr. Rinehart has held several leadership and committee positions within CaroMont Health including past Chair of the Physician Leadership Council and immediate past Co-Administrative Physician Lead of the Primary Care Service Line. He is a past Board Chair of Presbyterian Samaritan Counseling Center in Charlotte and has participated in medical mission trips in Honduras and Ethiopia. He has served for the past 18 years as team physician for the local high school football team and has held several leadership positions in his church including Chair of the daycare facility. Dr. Rinehart lives in Belmont with his wife of 40 years and has three grown children and two grandchildren.
2020: A Year in Review –Agility, Opportunity, Success
When we left Asheville in December of 2019, neither the NCAFP Board nor staff would not have guessed that the next year plus would be totally upended by the novel coronavirus SARS-CoV2. We left Asheville with a sense of anticipation and excitement regarding what we could accomplish in 2020. While our goals and activities shifted greatly when our state basically shut down in mid-March of 2020, the NCAFP and all our members showed a sense or resiliency and agility that we may have never seen before. That ability to be agile led to great opportunities and many successes for Family Medicine in North Carolina. The results of two surveys around the impact of COVID-19 on your practice and opportunities your board identified at that time tell quite a story. Here are five opportunities NCAFP developed from those survey results and began to focus on in early May of last year. And we succeeded on every goal.
Opportunity 1: Encourage the state and other payers to provide financial support to primary care practices and ensure stability in telehealth policies.
Outcome: Thanks to the advocacy of the NCAFP and others, the two largest payers in North Carolina (Medicaid and Blue Cross and Blue Shield of NC) stepped up with extra resources and changed numerous policies. Medicaid doubled the per-member, per-month payment that Medical Homes receive for caring for Medicaid beneficiaries. They also quickly changed many telehealth policies under the guidance of NC Medicaid Chief Medical Officer, and NCAFP past president, Dr. Shannon Dowler. Many of these policies have now been made permanent. Blue Cross NC also changed their telehealth policies and continue to pay at parity with in-person visits as this is written. In addition, thanks to extensive advocacy by the NCAFP and the NC Pediatric Society, Blue Cross NC implemented payments to “true up” the income of independent practices when comparing their commercial revenue with 2019.
Opportunity 2: Work with the state to promote awareness on the importance of well-child and adolescent visits that include immunizations. Outcome: This was also a significant collaborative win led by NCAFP and the NC Pediatric Society. The NC Department of Health and Human Services implemented the “Keeping Kids Well” program, providing direct assistance to practices who had care gaps among their Medicaid beneficiaries and promoting the need to keep children coming to their medical home for care. In addition, NCAFP and NC Peds partnered with Pfizer to create a statewide radio Public Service Announcement to promote well child visits and immunizations, with two versions – one in Spanish and one in English. The PSA aired over 300 times on more than 40 radio stations across the state.
Opportunity 3: Advocate for the Legislature to provide direct funding to independent primary care practices.
Outcome: Thanks to a fantastic partnership and joint lobbying efforts of numerous other medical organizations including the NC Medical Society and the NC Pediatric Society, the NC General Assembly allocated $25 million to the NC Medical Society Foundation for distribution to independent practices. Over 640 independent medical practices, including 132 Family Medicine practices, received on average $38,000 of Financial Recovery Program funds each. Thanks to Franklin Walker
Membership Profile
NCAFP’s overall membership increased 2% from 2019.
Active............................... 2,574 Student............................ 1,024 Life.........................................354 Resident..............................364 Inactive.................................. 37 Supporting .......................... 10 Transitional .............................7
TOTAL................................. 4,370
$38
AVERAGE FINANCIAL RECOVERY FUNDS TO FM PRACTICES
Our Membership Growing, Strong and Committed
NCAFP Membership Performance
Market share: 87.9% (AAFP 76.8%) Active member retention: 96.5% (AAFP 93.4%) Resident to Active conversion: 81.6% (AAFP 70.8%) New physician retention: 92.8% (AAFP 86.1%)
7.1%
Resident Member Growth
87.9%
Marketshare
1st Place for XL Chapters 1st Place for XL Chapters 1st Place for XL Chapters 2nd Place for XL Chapters
at the NC Medical Society Foundation for organizing this amazing effort to distribute the funds in a very short period and thanks to the NC General Assembly for appropriating these funds.
Opportunity 4: Continue to educate practices about how to acquire PPE and successfully navigate the DHHS website.
Outcome: NCAFP developed an entirely new section of our website around COVID-19 information including a list of Personal Protective Equipment vendors and provided information about how to acquire PPE through the state Department of Health and Human Services. Along with other like-minded organizations, we also advocated heavily for NC DHHS to provide PPE to independent primary care practices. We even partnered on a project led by Blue Cross NC and Freudenberg Non-wovens to purchase manufacturing equipment and begin making N-95 masks in North Carolina. Finally, we worked with AAFP to offer group discounted pricing on PPE orders from a national non-profit organiza-
Outcome: NCAFP partnered with the NC Area Health Education Centers Program (NC AHEC), Community Care of North Carolina, the NC Pediatric Society, and the NC Psychiatric Association to produce 16 Navigating COVID-19 webinars in 2020. These 16Navigating included webinars on conducting telehealth and virtual visits, innovative ways to do hybrid visits and more. Other webinars in this series included how COVID-19 Webinars to apply for Payroll Protection Program loans from the federal government, and many other clinical tips about dealing with both sick and well patients during an unprecedented pandemic. When we first reviewed the joint survey results with the NC Pediatric Society and developed this list of key opportunities, we could not have guessed we would be successful in addressing all five of these major focus areas, but we did. Thanks to collaboration and cooperation with numerous organizations in an unprecedented way, we were able to meet the pressing needs of our state’s family physicians. While 2020 was not the year we thought it would be, we were certainly successful in meeting the most pressing needs of our members.
Continuing Medical Education
2020 Virtual Spring Symposium – April
Dimitrios “Taki” Hondros, MD – Program Chair 8.00 AAFP Prescribed Credits 215 CME Attendees
2020 Sports Medicine for the Active Patient – August
Karl “Bert” Fields, MD – Program Chair 4.50 AAFP Prescribed Credits 184 CME Attendees
2020 Virtual Winter Family Physicians Weekend – December
Victoria Kaprielian, MD – Program Chair Jay Patel, MD – Program Vice Chair 21 AAFP Prescribed Credits 462 CME Attendees
33+
AAFP CREDITS PRESENTED
861
MEETING ATTENDEES
Chapter Awards & Recognitions
2020 CME Grant Program Delivery
Due to the ongoing concerns with the global COVID-19 pandemic and the continued restrictions regarding larger gatherings and travel, no approvals of new grant programs occurred in 2020. Most of the programs that were held in 2020 were originally planned as live meetings that had to be transitioned to virtual settings. Even with this limitation, NCAFP was still able to provide a total of approximately 9,000 attendee/learners from the chapter partners for our programs.
21 AAFP Chapters included programming funded by NCAFP grants during 2020:
Alabama Alaska Florida Georgia Indiana Kentucky Louisiana Maine Mississippi Missouri Montana New Jersey Ohio Oklahoma
a graduate of Duke University, earning both his undergraduate and medical degrees. He completed his Family Medicine residency training at Charlotte Memorial Hospital and returned to Cherryville in 1988 and began community practice.
Pennsylvania San Diego South Dakota Tennessee Texas Virginia West Virginia
21
CHAPTER PARTNERS
9,000
LEARNERS REACHED
Thomas White, MD
Cherryville, North Carolina 2020 North Carolina Family Physician of the Year
Affectionately known as a ‘hometown’ and ‘Main Street’ family physician, Dr. White currently practices at Hometown Direct Care in Cherryville, NC, a direct primary care practice he founded in 2015. Dr. White’s practice has had a tremendous impact on the health of the community and is a testament that although his practice setting and style have changed, Dr. White’s commitment has never wavered during his 32 years serving the people of Cherryville and the local community. Dr. White is
The NCAFP Foundation promotes the specialty of Family Medicine to medical students in North Carolina. Due to the COVID-19 pandemic, traditional student experiences were paused in 2020. However, student delegations from North Carolina attended state and national virtual conferences and participated in the Foundation's annual research poster presentation. The Foundation also continued to offer scholarships and other opportunities for medical students even with the constraints of the pandemic. Students are encouraged to develop leadership skills through active service on one of the NCAFP’s two Boards or three committees, or by participating in a policy and leadership rotation with the NCAFP.
2019-20 LEADERSHIP
President
Vice-President
Secretary-Treasurer
Physician Trustee
Physician Trustee
Physician Trustee
Physician Trustee
Physician Trustee
Physician Trustee
Physician Trustee
Academy President
Academy President-Elect
Corporate Trustee
Corporate Trustee
Corporate Trustee
Resident Trustee
Resident Trustee
Student Trustee
Student Trustee
Trustee Emeritus Shannon B. Dowler, MD, FAAFP
William A. Dennis, MD
Eugenie M. Komives, MD, FAAFP
Lisa A. Cassidy-Vu, MD
Christopher P. Danford, MD
Cherrie C. Hart, MD
R. Aaron Lambert, MD, FAAFP
Amy E. Marietta, MD, MPH
Susan A. Schmidt, MD
Holly L. Stegall, MD
David A. Rinehart, MD, FAAFP
Jessica L. Triche, MD
Rhett L. Brown, MD, FAAFP - Novant Health
Steve Parker - Curi
John R. Smith Jr., MD - BCBSNC
Brian P. Grave, MD
Ryan M. Paulus, MD
Morgan O. Carnes
Caitlin S. Porter
Maureen E. Murphy, MD, FAAFP
2020 BY THE NUMBERS
• $1,455,910.64 balance of the Medical Student Endowment, effective 12/31/20. • 1,024 Medical Student Members at the end of 2020. • >$40,000 in direct financial support provided for student and resident programs. • $250,000 contributed by Blue Cross Blue Shield of North Carolina. • $15,893 contributed by individuals to the Foundation. • $10,000 contributed by corporate members to the Foundation.
2020 Foundation Contributors
NCAFP members and supporters of the Academy are encouraged to make gifts of on-going significance or annual contributions to the NCAFP Foundation. The following individuals contributed to the Foundation in 2020.
Thank you for your continued support.
Talia Aron, MD Elizabeth Baltaro, MD Monica Barnes-Durity, MD Perry Bartelt, MD David Bate, MD Cathy Belk, MD Mary Bengtson, MD Holly Biola, MD Karolen Bowman, MD Jack Brunson, MD Donna Capps, MD Joshua Carpenter, MD Anh Causey, MD Wendy Coin, MD Clayton Cooper, MD Gary Crawford, MD Wiley Davis, MD William Dennis, MD Andrea DeSantis, DO Deanna Didiano, DO Morgan Ferruzzi, MD Conrad Flick, MD Deepak Gelot, MD Aregai Girmay, MD Anne Gonzalez, MD Paul Gordon, MD Greg Griggs, MPA, CAE Katherine Haga, DO Mary Hall, MD David Hall, MD Scott Harper, MD Michael Harris, MD Brent Hazelett, MPA, CAE Milton Hester, MD Melissa Hicks, MD Tamieka Howell, MD Janice Huff, MD Mishi Jackson, MD Nichole Johnson, MD Jason Jones, MD Michelle Jones, MD Eugenie Komives, MD Krista Kozacki, MD Kelley Lawrence, MD, IBCLC Richard Lord, MD, MA Shelly Lowery, MD Brian McCollough, MD Robert McConville, MD James McGrath, MD Elizabeth McKeon, MD William McLean, MD Maureen Murphy, MD Alisa Nance, MD, RPh Tommy Newton, MD Carl Nordstrom, MD Deborah Norton, MD Daniel Olson, MD Lara Pons, MD Elizabeth Provost, MD Michael Reid, MD David Rinehart, MD Joseph Roberts, MD Mark Robinson, MD George Saunders, MD Charles Sawyer, MD Allen Shepard, DO Karen Smith, MD Jack Spies, DO Barbara Stagg, MD Ying Vang, MD
REGISTRATION IS NOW OPEN AT WWW.NCAFP.COM/SUMMERCME
With an estimated 6.00 AAFP Prescribed Credits, this is a summertime must-do for you and your colleagues. Clinical topics have been selected, and the convenient one-day schedule is designed to advance your knowledge and understanding of common patient issues that you see and treat every day. Planned sessions include: • Adolescent depression • Lupus • Influenza • Hypertension • Diabetes
• Osteoporosis • Obesity management • Sports Medicine • Transgender Patient Care
Visit the conference website for complete schedule information and online registration
Please contact Kathryn Atkinson, CMP, Manager of NCAFP Meetings & Events, at katkinson@ncafp.com, with any questions you may have about this
Spring 2021 fantastic summer CME opportunity.
