Healthcare Systems & Finance Committee

Chair: 

 

 

Co-Chair: Michael I. Bennett, MD

 

 

 

 

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Committee Links:

Committee Member Communication

Committee Documents, Minutes and Resources

Healthcare Systems and Finance additional Documents & Resources

Healthcare Systems and Finance Newsletter Column

Healthcare Systems and Finance Circle (Announcements & Discussions for all MPS members)

Healthcare Systems and Finance Forums (originated by Committee Chair)

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Report Parity and CPT Coding Issues Here (moderated)

 

 

2017 Health Care Finance Committee Report (Michael Bennett, MD, Tanya Korkosz, MD)

 

We have thrived under the leadership of Greg Harris, who also advanced our agenda on the APA level by participating in the mind-numbing relative value committee. Unfortunately, he had to reduce his ties to our committee as part of his moving into a new job at Blue Cross Blue Shield. He will always remain welcome. Tanya Korkosz, who has actively managed our interface and regular meetings with Blue Cross, moved into Greg’s leadership role as Co-Chair. Thanks, Tanya.

Under her leadership, we maintained a close working relationship with Blue Cross. We had good input into the development of their standards for auditing coding violations and also helped explain other, less consequential audits to our members. We (and particularly Phil Burke) are trying to restore regular meetings with Harvard Pilgrim but experienced setbacks due to leadership changes there.

Thanks to Paul Wood and Sam Rofman, we’ve developed a good working relationship with Tufts. On all fronts, we’ve tried to improve the prior authorization process. There’s now a universal form for Massachusetts, but it’s done little to improve the fact that the prior authorization procedure is overused, inevitably time consuming, and mainly useless.

 

 


HEALTHCARE SYSTEMS AND FINANCE (MANAGED CARE) (The committee is being renamed in 2014 to better align with the APA structure and to better reflect the work of the committee and the presidential charge.)

Charge: Advocate for the interests of MPS members in clinical practice and their patients within entities that finance the provision of health care services.   This charge includes direct advocacy (with private and public insurers, regulators and legislators), communication with and education of MPS members and as an “early warning system” for member concerns.   The committee is additionally charged with an advisory role to the MPS Council and Executive Committee in urgent or timely issues that may arise in these areas.

Role(s): Primary (Working Committee, Advocacy, Education (newsletter), Out- reach), Secondary (Advisory, Education (major CME))

Mission Statement: The mission of the Healthcare Systems and Finance includes the following:
1. Advocacy - meet regularly and foster long-term working relationships with insurers to advocate for patients and providers
2. Legislation & Parity - meet with regulators to advocate parity and non- discrimination, advise the Council, Executive and Legislative Committees
3. Communication - communicate with MPS members, primarily via a regular monthly column in the newsletter & on the website
4. Education  -  sponsor  periodic  CME events on practice-related issues
5. Member Concerns - field MPS member front-line concerns and questions, answer questions when possible, incorporate concerns into the overall mission of the committee and liaison with APA on these concerns
6. Integration of Care – plan to incorporate a new sub-focus on ACOs, mental health  and  primary  care  integration, plan  to  liaison  with  Public  Sector Committee and sponsor a CME program focused on this area
7. “Ad hoc” issues – nimbly respond to ad hoc issues that arise unexpectedly; e.g. PMP and Psychiatrist members-in-training, telemental health.

Meeting(s): Monthly (third Tuesday of the month), Quarterly meetings with insurers, plus other meetings as necessary

Chair: 
Co-Chair: Michael I. Bennett, MD

Members: Rebecca Allen, Michael Bennett, Bruce Black, Jean Boyd, Philip Burke, Gregory Harris, Hon Ho, Pat Kaufmann, Tanya Korkosz, Laura Kramer, Steve Locke, Kirk Lum, Jason Mondale, Arthur Papas, Daniel Shaw, Sally Sveda, Marcia Tracy, Paul Wood.

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From THE CONSTITUTION AND BYLAWS OF THE MASSACHUSETTS PSYCHIATRIC SOCIETY 

Article XVI –Committees

There shall be the following standing Committees of the MPS: Executive, Nominating, Membership, Constitution and Bylaws, Fellowship, Ethics and Continuing Medical Education.

The President may establish or eliminate other committees or other organizational entities as may be necessary to implement the objectives of the MPS.

All Chairs of MPS committees or other entities are to be appointed yearly by the President [except where otherwise specified in the Constitution and Bylaws and shall be limited to three consecutive terms] unless this term limit is overridden by a two-thirds vote of the MPS Executive Committee.

No member of the MPS or organizational unit thereof shall speak in the name of, or encumber the funds of, the MPS unless such power is specifically granted by the MPS President or by a formal action of the Council of the MPS.

Article XVII –Attendance

Attendance at meetings of the Council, committees or other organizational entities: shall be open to all members of the MPS except for the meetings of the Ethics Committee. All organizational entities of the MPS may go into Executive Session.