The Medical Economics and Management Committee Is Working for You

November 20, 2008

By Laura B. Powers, MD, FAAN

The Committee's Mission

In our current difficult economic climate, the Medical Economics and Management Committee (MEM) is working hard to ensure the financial viability of neurology practices.

Committee Structure

Members of MEM participate in a wide range of activities. These include:

• Improving diagnosis, evaluation, and management and procedure coding
• Determining the value of physician work and practice expense
• Identifying and promoting health information technology, practice management tools, and education
• Advancing health policy to better serve our patients
• Fostering excellence in third-party payer policy and relations

To best address these issues, the MEM oversees three subcommittees: Coding, Practice Management and Technology, and Payment Policy.

Coding Subcommittee

The Coding Subcommittee is dedicated to optimizing neurologic diagnosis, evaluation and management, and procedure coding and reimbursement. We send representatives to:

1. The ICD-9-CM Coordination and Maintenance Committee, which creates and maintains the diagnosis coding system.
2. The CPT Advisory Committee, which works with the American Medical Association’s (AMA) CPT Editorial Panel to create and maintain evaluation and management and procedure codes.
3. The Relative Value Update Advisory Committee (RUC), which works with the AMA’s Relative Value Update Committee to determine physician work and practice expense values for reimbursement for individual CPT codes.

Practice Management and Technology Subcommittee

The Practice Management and Technology Subcommittee (PM&T) works to improve neurology practice management and recommends ways to leverage health information technologies for greater practice efficiency. As part of this work, the subcommittee strives to help Academy members choose the right electronic health record (EHR) system for their practices. The subcommittee published its third Electronic Health Records Vendor Report in July 2008, complementing previous reports from 2006 and 2007. Each of the reports compares EHR products based on a live demonstration provided by vendors using identical scripts relevant to neurologists’ needs. These reports have been widely downloaded and provide a great service to members, assisting in the initial research stages for those considering EHR adoption. The PM&T Subcommittee is tracking the issue of e-prescribing, especially in regard to the financial incentives as a result of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

Payment Policy Subcommittee

The Payment Policy Subcommittee aims to develop positive working relationships with private payers. Payers are now regularly sending medical coverage policies to the Academy for review and comment. The subcommittee hopes that this new transparency and level of cooperation will make the process easier for Academy members. Members also have the opportunity to share problems and experiences with specific payers on the Payment Policy page in the Practice section of AAN.com.

Member Education

MEM and its subcommittees work to educate members in important practice areas. Key activities include educating physicians, physician managers, and office staff on coding and reimbursement issues; adoption of electronic health records; and developing tools to assist practicing neurologists in running a more efficient practice. For example, members of the Coding Subcommittee of the MEM have developed Evaluation and Management (E/M) templates specific to the needs of neurologists. The templates have proven a useful tool for Academy members. Additional coding tools are available to assist members in appropriately coding for procedures and services they provide.

Collaboration

The MEM collaborates with a number of other groups within the Academy, including working with the Practice Improvement Subcommittee of the Practice Committee to develop coding information specific to AAN practice guidelines (referred to as "case studies"). These case studies include a patient scenario along with information on the appropriate ICD-9 and CPT codes associated with that topic/guideline. The addition of case studies to the guidelines has helped neurologists more easily incorporate guideline recommendations into their practices.

Our Volunteers and Staff

Of course, the mission of the MEM and its subcommittees could not be accomplished without major commitments of time and effort from dedicated and knowledgeable committee and subcommittee members and staff. Their work greatly improves the professional lives of neurologists.

The MEM needs help to reach its goals. If you are interested in coding, health information technology, practice management, or health policy (public and private), the MEM wants to speak with you about getting involved. Current MEM members are happy to mentor new individuals interested in assisting with the group’s activities and who wish to assure our effectiveness in the future. If you want to become involved, contact Amanda Becker at abecker@aan.com for information on how to become a part of this vital group within the Academy.

Author Disclosure

Within the past 24 months, Dr. Powers served as an expert witness in a case involving documentation, and in another case regarding traumatic brain injury. She also acted as a consultant in one additional case.

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Disclaimer: The opinions expressed in this posting are those of the author only and do not represent the views of the American Academy of Neurology or any of its affiliated subsidiaries.

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