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CPBJ Extra Blog

Talking priorities with the Pennsylvania Medical Society

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Presidents rotate yearly at the Pennsylvania Medical Society, so Executive Vice President Mike Fraser is the organization's de facto CEO.

I tell you this because I got to sit down with Fraser last week and talk about what he has identified as the organization's priorities since assuming the role earlier this year. PAMED represents physicians, and frankly it was a nice change of pace to talk about them instead of regulations.

If you've been paying really close attention, you may remember that last year I wrote about the big medical coding change called ICD-10 that will take effect in October 2014. It apparently hasn't gotten any smaller in the interim: Fraser said that's looming large for physicians right now.

Fraser also said the society is focused on preserving the medical team, which in essence means making sure that those with lower medical qualifications remain under the supervision of a physician instead of offering services on their own.

The issue has been cropping up in a variety of ways, he said, but in addition to addressing those individually the society also sees a need to make a strong case for its overarching argument that effective medical teams need to be headed by doctors.

Beyond all that, Fraser said, he has found that physicians also want to effect action on issues they consider important to public health, such as gun violence and e-cigarettes.

Finally, the society is working with physicians to respond to a major industry shift. On that, I decided to let Fraser speak for himself:

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On related notes, these are good reads.

After graduation, medical students express both satisfaction and concerns

Solving the shortage in primary care doctors

Fixing the doctor shortage – my two cents

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The slowdown in health care cost growth is a subject lots of wonky people like to opine on, based on what I've seen. But as you might expect, they don't all agree on what caused it. Talk to some people and you'll hear that it's the recession; others will tout Obamacare. This paper says neither, instead pinning it to "the rise in high-deductible insurance plans, state-level efforts to control Medicaid costs, and a general slowdown in the diffusion of new technology, particularly in the Medicare population."

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First Arkansas and now Iowa have gotten federal approval for their "take Medicaid expansion funds and use it to buy private insurance instead" plans. What do you think that says about the probability of Corbett's Healthy Pennsylvania request succeeding?

Apropos of that, I'm going to seize this opportunity and tell you it amazes me how many times I have seen maps on states' Medicaid decisions list Pa. as having said yes to expanding Medicaid. It really hasn't happened yet, folks.

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Speaking of other states, California is pretty forthcoming with its state-run Obamacare marketplace results. Major points to note here are that its enrollment really picked up in December, and that at last report 21 percent of its enrollees were between the ages of 18 and 34.

That last is significant because, well, mix matters. There need to be enough young, healthy people in the exchanges to keep them from going into a Death Spiral, and the Obama administration's much-cited, pre-glitchy-website goal was a total of 7 million enrollees the first year, 2.7 million — roughly 38 percent — of them between 18 and 35, where health tends to abound.

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Finally, once upon a time — back when Obamacare's free preventive services started rolling out — I said I'd like to see how many people actually used them. This is a partial answer.

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