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Inside this edition:

Message from the President

Are you concerned about the risks of electronic communication, including the use of social media, audio/video recordings, email and text messaging?  Do you know how to mitigate those risks?  Plan to attend the 2016 TNACS Annual Meeting to learn more about this and other pertinent issues for your surgical practice. Here are just a few more highlights:
  • Special guest and ACS President David Richardson, MD, FACS
  • Payment reform in TN and Washington, DC
  • The value of NSQIP for rural surgeons
  • The latest activities of the TN Surgical Quality Collaborative relative to the effect of operating time, transfusions, and the ICough program on surgical outcomes
  • The latest in trauma and cancer care
  • Surgical Jeopardy
  • Fun at the Redbirds Baseball Game
Register today!!

TN Surgeons Participate in ACS Leadership & Advocacy Summit

A group of TN Surgeons including Drs. William Edwards and Gayle Minard, who are TNACS Governors, and Drs. Max Langham, Heath Giles, and Bart Clements visited Senators Lamar Alexander and Bob Corker during the ACS Advocacy Summit.    The group discussed MACRA implementation, the surgical workforce, and funding for cancer and trauma care.     Members of the U.S. House of Representatives were visited as well.

During the Leadership Summit, issues relative to Chapter and surgeon leadership were discussed.  These included improving communication skills, the use of social media, reducing disparities, and emotional intelligence.   TNACS Vice-President Dr. Ingrid Meszoely, TNACS Governor Dr. Tony Haley, TNACS Councilor Dr. Lee Morisy, Dr. Walter Merrill, and Dr. Ken Sharp also attended portions of the meeting.

From NewsScope

April 22, 2016

Bill Introduced in House Calls for Study of Surgeon Shortage Areas

On April 15, Reps. Larry Bucshon, MD, FACS (R-IN), and Ami Bera, MD (D-CA), introduced H.R. 4959, the Ensuring Access to General Surgery Act of 2016. This legislation would direct the Secretary of the U.S. Department of Health and Human Services (HHS) to conduct a study on the designation of Surgical Health Professional Shortage Areas (SHPSAs). The legislation specifies that the study must include recommendations for legislative or administrative action regarding a general surgical SHPSA designation. The SHPSA designation would provide the Health Resources and Services Administration (HRSA) with a valuable tool for increasing patient access to surgical care. 

A growing body of evidence indicates an increasing shortage of surgeons who are available to serve the nation's patient population. A shortage of general surgeons is a component of this crisis. Accordingly, the American College of Surgeons (ACS) is urging policy makers to recognize that only surgeons are uniquely qualified to provide certain necessary lifesaving procedures. Currently, Health Professional Shortage Areas (HPSAs) designations exist for primary care, mental health, and dental care providers. HRSA defines a HPSA on the basis of whether the area’s patient population is underserved. 

In light of shortage of surgeons, the ACS believes that research is necessary to determine what constitutes a surgical shortage area and where these areas exist. The ACS encourages Fellows to take action. Log on to SurgeonsVoice and let your member of Congress know you support H.R. 4959. In addition, the ACS issued letters of support for H.R. 4959. For more information, contact Carrie Zlatos, Congressional Lobbyist, at

Laying The Foundation For Success Under MACRA

One of the easiest and most useful tasks surgeons can undertake in preparation for the upcoming changes to the Medicare physician payment system is to learn and become comfortable with the use of seven acronyms. They are:

MACRAMedicare Access and CHIP Reauthorization Act - Legislation enacted in April 2015 that repealed the sustainable growth rate (SGR) formula and set the stage for two new physician payment pathways, specifically MIPS and APMs. Physicians will choose the pathway in which they participate. The legislation also included an extension of the Children’s Health Insurance Program (CHIP).

Physician Payment Pathways

APMsAlternative Payment Models - Payment models that incorporate the use of quality metrics, certified electronic health record technology, and provider assumption of upside and downside financial risk.

MIPSMerit-based Incentive Payment System - The new fee-for-service payment system created by MACRA that will base annual payment updates on four factorsQualityResource UseMeaningful Use of EHRs, and Clinical Practice Improvement Activities.

Four Factors

PQRSPhysician Quality Reporting System - A Medicare quality reporting program. Currently, physicians are penalized if they fail to report PQRS quality measures.  PQRS data collected in 2017 will be used as the basis for the Quality portion of the MIPS program in 2017.

VBMValue-Based Modifier - A Medicare quality program used to measure the value of care provided by comparing quality and cost. Currently, payment rates may be adjusted up or down depending on an individual physician’s Quality and Resource Use Report. Starting in 2019, the VBM will be used as the basis for the Resource Use portion of the MIPS program.

EHR-MUElectronic Health Record-Meaningful Use - A Medicare quality program used to determine if eligible physicians are actively engaged in the use of certified electronic health record technology.  Starting in 2019, and after some anticipated modifications, EHR-MU will be used as the basis for the Meaningful Use portion of the MIPS program.

CPIAClinical Practice Improvement Activities - A new category of activities created by MACRA as a means of measuring efforts by physicians to improve their practice and/or their work toward participation in APMs.

In the coming year, as we move toward the implementation of MACRA, it is imperative that Fellows begin to develop an understanding of both payment pathways and the components and requirements included such that they might maximize their individual opportunity for success.


David B. Hoyt, MD, FACS 
Executive Director, ACS 

Patrick V. Bailey, MD, FACS 
Medical Director, Advocacy, Division of Advocacy and Health Policy 

Save the Date!

2016 TNACS Annual Meeting
July 22-24, 2016
Memphis, TN

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