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Minutes: June 23, 2004

  333rd MEETING OF THE MEDICAL SCHOOL COUNCIL
 3 p.m., Wednesday, June 23, 2004
 School of Medicine Administration, Board Room 103


PRESENT: Drs. Awad, Belzberg, Bhattacharya, Blok, Choi, Clark, Cooper, Cormack, Denmeade, Gabrielson, Hillis, Johnson-Greene, Jun, Koenig, Leffler, Liu, Martinez, Martins, Miller, Niv, Roper, Ross, Sandone, Sunness, Walker, Zellars, Mr.Watkins, Mss. McCall and Foy.
 
ABSENT: Drs. Adger, Ain, Campbell, Caterina, Chan, Colecraft, Dintzis, Francis, Hattar, Iacobuzio-Donahue, Kolodkin, Lee, Lorsch, Nicolaou, Pomper, Schulick, Segev, Smith, Sterni, Woolf, Ziegelstein, Mr. Grelotti

GUESTS:  Drs. Baumgartner, Dorman, Heaphy, Williams, Messrs. Bradfield, Gilbert, Wilczek, Zeller, Mss. Beach-Smeltzer, Cruse, and White


I.  Minutes

The minutes of the May 19, 2004 meeting were approved.


 II.  Introduction of New Members – Dr. Douglas Clark 

Dr. Clark welcomed the new members.


III. CPA Update – Dr. William Baumgartner and Mr. Kenneth Wilczek

Mr. Wilczek provided an overview of the Medicare reimbursement process, explaining the three RVU components (work, practice expense, and malpractice), the Geographic Adjustment Factor, and the Medicare Conversion Factor that determine the annual allowable Part B payment for CPT codes.  He discussed the impact of Medicare reimbursement on faculty practice plans noting the median Medicare revenue for faculty practice plans is 15.7% of patient care income; at Johns Hopkins this represents just under 30%.  The aging population is expected to stress the Medicare system.  As teaching hospitals provide the majority of geriatric services, this changing demographic will have adverse financial effects.  Part B reimbursement has not kept pace with inflation and many faculty practice plans report losing money on every Medicare patient.

Dr. Baumgartner discussed the work of the Committee on Medicare Strategies and reported the Institutional Government Relations Office has been active on the political front.  He urged council members to be proactive in contacting congressional leaders on Medicare reimbursement reform issues.  Dr. Baumgartner noted our Medicare revenues are rising each year due to increased volume but expenses continue to exceed the increased revenues.  There was discussion on costs associated with defensive measures that are necessary because of the current malpractice climate. 

Dr. Baumgartner reported the CPA is reviewing the “Not to Compete Policy”.

IV. Subcommittee on Gold Book Revisions and Manual for Clinican Educators

Dr. Randol Barker will present a report to the Medical School Council in the fall. 

V. HIPAA Authorization Form – Mr. Donald Bradfield, Mr. John Zeller, Ms. Susan Cruse, and Ms. Cyntha Beach-Smeltzer

 The council asked representatives of the Development Office and the HIPAA Office to address issues surrounding the form patients are asked to sign at registration authorizing them to be contacted for philanthropic purposes.  Ms. Cruse reviewed the genesis of the form, noting HIPAA regulations require authorization from patients before any philanthropy contacts can be made.  Dr. Clark reported faculty have both logistical and ethical issues relating to the language in the form.  There is concern the form is written at a level many patients may not understand.  Dr. Mike Williams, a member of the Ethics Committee reviewed the form and suggested changes in the first paragraph.  He spoke to the need for clarity and wording that is easily understood.  Dr. Ross asked that the patient population receiving the form be revisited because of the perceptions of disparity in health care.

Dr. Clark suggested a second version of the form be developed based on today’s discussion.  He offered Medical School Council assistance in redesigning the form and determining the appropriate venue for distribution. 

VI. Update on Child Care Issues – Ms. Christine White

Ms. White provided an update on the Child Care Center that opened in 2001.  The center has been very successful in providing a first-class facility for faculty, staff, and students.  The center has a capacity of 124 children and several of the age groups are at capacity.  Since opening, 221 children have been served; there are currently 61 on a waiting list.  A scholarship fund has been established that offers financial assistance on a sliding scale.  The center has just completed a site visit for accreditation and the results will be available in two months.  Bright Horizons Family Solutions, which operates the center, has been named by Fortune Magazine one of the best 100 companies to work for.

Dr. Clark thanked Ms. White for her efforts in bringing the center to fruition.

VII. Continuing Medical Education – Resources for Courses- Drs. David Heaphy and Todd Dorman

Dr. Heaphy provided background data on Continuing Medical Education (CME) activities noting there were 60 programs offered 11 years ago when he was appointed.  Today there are over 400 programs in addition to the Business of Medicine certificate and degree programs.  Many academic institutions seek information on our success when revamping or designing CME programs.  Dr. Heaphy reported 50% of the programs are offered off-site, many out of state.  In discussing the fee structure, Dr. Heaphy reported after operational fees are subtracted, all dollars go to the departments sponsoring the courses.  In 2003 this amounted to $2.5 million.  The Johns Hopkins fee structure is comparable with peer institutions.
 
Dr. Dorman commented the office is a full service operation versus other institutions that may not offer as many services.  An extensive brochure on all aspects of organizing and running a CME course was distributed.  This document outlines all policies, fees, services, and accreditation issues related to offering courses.  An advisory board has been established that works with the CME office in developing policies. 

VIII. Update on Faculty Survey – Dr. Clark

The Faculty Survey is now complete. The data will be analyzed over the summer and a report is expected in the fall.

IX. Upcoming Election of Officers – Dr. Clark

Dr. Clark reminded the council elections for 2004-2005 will take place at the September meeting.  Members interested in being candidates for Chair, Vice-Chair, or Member-at-Large should contact Dr. Clark or Hillis.

X. Other Business

There being no further business this meeting was adjourned at 5:00 p.m.

Respectfully submitted,

Mary E. Foy
Secretary


Future Medical School Council meetings:

All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.

September 15, 2004

October 20, 2004

November 10, 2004

December 15, 2004

January 12, 2005

February 9, 2005

March 23, 2005

April 20, 2005

May 11, 2005

June 22, 2005

 

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