Archive for November, 2015

Coming to the Windy City?

The AAHPM & HPNA Annual Assembly is 100 days away! Since the Assembly is being held in the Academy’s backyard we’ve come up with 100 suggestions of places to eat and things to do while in Chicago. See what AAHPM members are looking forward to in Chicago.

Watch Twitter and Facebook for the daily #100inChicago feature. Missed a day or two? Don’t worry, we will be adding each location to the list here (in no particular order).

1. Museum of Science and Industry
2. Café BaBaReeba
3. Gibsons Steakhouse
4. Pequod’s Pizza
5. The Second City
6. Chicago Architecture Foundation Tours
7. Chicago Chapel in the Sky Tour
8. Chicago Botanic Garden
9. Chicago History Museum
10. Wrigley Field
11. Geja’s Café
12. Holy Name Cathedral Tour
13. Broadway in Chicago – Historic Theatre Tours
14. Palmer House Hilton’s “History is Hott” Tour
15. Maggie Daley Park
16. Adler Planetarium
17. Shedd Aquarium
18. Skydeck Chicago
19. 360 CHICAGO
20. Museum of Contemporary Art Chicago
21. Art Institute of Chicago
22. Bella Bacinos
23. Garrett Popcorn
24. Mr. Beef and Pizza
25. Mr. D’s Shish-Kabobs
26. Central Gyro
27. Goose Island Brewery Tour
28. Gene and Georgetti
29. The Rosebud
30. Bulls Game
31. Lakefront Segway Tour
32. Brunch at The Signature Room at the 95th
33. Walking Tour of Chicago
34. Chicago Theatre
35. Publican
36. Judy Istock Butterfly Haven at the Peggy Notebaert Nature Museum
37. Chicago Shakespeare Theater on Navy Pier
38. Scooter’s Frozen Custard
39. DuSable Museum of African American History
40. Music Box Theatre
41. Chicago Cultural Center
42. Chicago Riverwalk
43. The Magnificent Mile
44. National Museum of Mexican Art
45. J. Parker
46. Myopic Books
47. Kingston Mines
48. Cadillac Palace Theatre
49. Goodman Theatre
50. Annoyance Theatre & Bar
51. Lookingglass Theatre Company
52. Blue Man Group
53. Chicago Symphony Orchestra
54. Victory Gardens Theater
55. Field Museum
56. Lyric Opera of Chicago
57. Driehaus Museum
58. Apollo Studio Theater
59. The Den Theatre
60. Logan Square Studio
61. Smart Museum of Art
62. Uptown Underground
63. ComedySportz Theatre
64. Chicago Flower & Garden Show Navy Pier
65. Gene & Jude’s
66. Northlight Theatre
67. 2nd Fridays on the Chicago Cultural Mile
68. Acadia
69. Borinquen Lounge
70. Ann Sather
71. Evolve Bistro at Art Institute
72. Honky Tonk BBQ
73. Old Fashioned Doughnuts
74. Palace Grill
75. Buddy Guy’s Legends
76. McCormick & Schmick’s Seafood & Steaks
77. Lou Malnati’s Pizzeria
78. Mercat a la Planxa
79. Museum of Contemporary Photography
80. Lincoln Park Zoo
81. Cemitas Puebla
82. Cookie Bar – Gluten Free Bakery
83. Girl & the Goat
84. Mindy’s Hot Chocolate
85. Taste of Peru
86. The Purple Pig
87. Kumas
88. 90 Miles Cuban Cafe
89. Carnivale
90. Sheffield
91. Las Tablas
92. Green Mill
93. Revolution Brewing
94. La Pasadita
95. White Palace Grill
96. Tre Kronor
97. Smoke Daddy
98. Molly’s Cupcakes
99. Irazu
100. Luxbar

There are many more than 100 things to do and places to eat while in Chicago for the Annual Assembly. Below you will find more suggestions for you while on your trip.

Experience the St. Patrick’s Parade and river dyeing Saturday, March 12. Purchase green Hospice Hero and Palliative Power socks at the AAHPM Resource Center.
16th Street Theater
A Red Orchid Theatre
American Theater Company
Avanti Caffé
Take a Carriage Ride on Michigan Avenue
Chicago Chop House
Chicago Cut Steakhouse
Chicago Pizza and Oven Grinder Co.
Chilam Balam
Chuck’s Southern Comforts Cafe
Clarence F. Buckingham Memorial Fountain
Corn Productions at Cornservatory
DMK Burger Bar
Eataly
Fogo de Chao Chicago – Bring your Assembly badge to receive 15% off bill March 8th – March 12th.
Garfield Park Conservatory
Gino’s East
Giordano’s
Gorilla Tango
Grant Park
Laugh Factory Chicago
Lawry’s
Lifeline Theatre
Madison Street Theatre
Maggiano’s Little Italy
Michael Jordan’s Steakhouse
Millennium Park
Morton’s
Navy Pier
Nottoli
Pastoral
Philly’s Best
Ponce
Raven Theatre
Rockit Burger Bar
Smith & Wollensky
Smoque BBQ
Stage 773
Steppenwolf Theatre Company
Las Tablas
The Mercury Theater Chicago
The Violet Hour
Theo Ubique Cabaret Theatre
Trap Door Theatre
Tuscany

Visit AnnualAssembly.org for more information and to register!

New FAAHPM – Rebecca A. Aslakson, MD PhD FAAHPM

Congratulations to Dr. Rebecca Aslakson who recently earned the designation Fellow of the American Academy of Hospice and Palliative Medicine. This new Fellow of the Academy was asked – what would you say is the biggest opportunity for the field of Hospice and Palliative Medicine? We are sharing her answer in this post.

“For me, the biggest opportunity in HPM is identifying, studying, and implementing natural moments in daily life and routine medical care to proactively incorporate palliative care and advance care planning. Many providers consider palliative care approaches only when a patient reaches late stage disease – a cancer patient has already progressed through three rounds of chemotherapy or the ALS patient is now possibly needing ventilatory support. The opportunity is to move “upstream” and to find new moments and ways to integrate HPM, particularly by primary palliative care providers. How can a primary care physician incorporate elements of advance care planning with any new diagnosis of prostate cancer? How might a surgical team include advance care planning into the medical workup prior to a colectomy? What simple things can ICU teams do to improve patient symptom experience? And, for whatever reason, if primary teams are unable to take these opportunities to improve patient care, then how can we build a system so that these issues are instead addressed by specialist palliative care providers? We need data to support that these “upstream” approaches improve meaningful patient, family, and healthcare system outcomes and then we need ways to disseminate both the data and the practices. These are immense opportunities to improve medical care experience by all patients and their loved ones!”

Advancement to fellowship status within the academy honors dedication to and scholarship in the field of the hospice and palliative medicine. This distinction represents a minimum of 5 years of membership, participation in AAHPM activities, letters of recommendation, and board certification in hospice and palliative medicine. Dr. Aslakson will receive the designation during the Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association in Chicago, IL on Saturday, March 12, 2016.
Check back regularly for posts from other Fellows.

Medicare Pay for Advance Care Planning Doesn’t Fall That Short

By Phil Rodgers, MD FAAHPM
AAHPM Public Policy Committee Co-chair and RUC Advisor

Dr. Jennifer Brokaw’s article from Time magazine linked in the 11/10 SmartBrief concludes that CMS payment for advance care planning (ACP) services, that will start January 1, 2016, is inadequate to support the time necessary for physicians and qualified providers to provide advance care planning services. The article reaches this conclusion by citing that reimbursement amounts are limited to ‘initial’ palliative care consultation and ‘follow-up’ consultations, and thus do not allow payment for longer, more involved ACP and goals of care discussions.

Dr. Brokaw’s attention to the topic is very welcome, but her article may leave readers confused as to the use and value of the new CPT codes for advance care planning. Specifically, the new Current Procedural Terminology (CPT) codes would allow payment for ACP services of any length, including the long, complex discussions that are a practice staple of hospice and palliative care providers. 99497 (~$86) can be billed for the first 30 minutes of ACP services on a given day, and 99498 (~$75) can be billed for each additional 30 minutes of service performed on the same day, with no limit. There are no frequency limitations to these codes, so they may be used as often as the need arises.

They may be also be used in addition to most other inpatient and outpatient evaluation and management (E/M) codes, provided that the time counted to bill the ACP codes is only counted for ACP services, and not also used to meet time-based criteria for an E/M code. There are a few E/M codes (like those for some critical care services) alongside which the new ACP codes cannot be billed—so do read the fine print, preferably with your practice’s billing professional or consultant.

It is important to note that while CMS issued no specific documentation requirements for use of the new ACP CPT codes, they will be subject to audit. In fact, Medicare contractors may be watching a little more closely given that these codes are new, and there is an interest in making sure they are billed only when the services are delivered. As always, make sure you are documenting (in detail) the services that you perform.

I do agree with Dr. Brokaw that the new Advance Care Planning CPT codes are not a solution to better payment for advance care planning and palliative care services. They are, however, an important step in the right direction. In fact, AAHPM worked with other medical specialty societies to advance the new CPT codes for advance care planning, including presenting data from member surveys to the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) which suggested relative values for the codes to CMS.

For more information, please review the CMS fact sheet and full text of 2016 Medicare Physician Fee Schedule Final Rule.”

New FAAHPM – Kevin A. Ache, DO FAAHPM

Congratulations to Dr. Kevin Ache who recently earned the designation Fellow of the American Academy of Hospice and Palliative Medicine. This new Fellow of the Academy was asked – what brought you to the field of Hospice and Palliative Medicine? We are sharing his answer in this post.

“One morning on inpatient rounds, I walked into an elderly patient’s room in the beginning of my second year as a Family Medicine Resident. Her story was one that we as physicians hear much too often. She came into the Emergency Room with shortness of breath exacerbated by her congestive heart failure. It was her fourth admission in as many months.

I feel that as physicians we are trained to “fix the problem” at any cost. We continue to treat aggressively despite asking what the patient wants. We lose sight of the overall picture including the most important aspect, quality of life. Of course, this is different for everyone and I feel that it is our duty to explain to all of our patients and their families the different options they have in regards to their medical treatment. We need to present their disease process in a way they can understand, not just telling them that “their numbers are looking better/worse”. I want everyone to understand that they have the ultimate choice in how we treat their illness. Whatever decision they make I will respect, but I feel that as a profession we have lost sight of this and it is my job to help them maneuver down this journey we call life. This is what brought me into the field of Hospice and Palliative Medicine.”

Advancement to fellowship status within the academy honors dedication to and scholarship in the field of the hospice and palliative medicine. This distinction represents a minimum of 5 years of membership, participation in AAHPM activities, letters of recommendation, and board certification in hospice and palliative medicine. Dr. Ache will receive the designation during the Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association in Chicago, IL on Saturday, March 12, 2016.

Check back regularly for posts from other Fellows.

Highlights of the November Issue of the Journal of Pain and Symptom Management

Listed below are a few articles from the most recent issue of the journal:

Fentanyl Buccal Tablet vs. Oral Morphine in Doses Proportional to the Basal Opioid Regimen for the Management of Breakthrough Cancer Pain: A Randomized, Crossover, Comparison Study
Sebastiano Mercadante, Claudio Adile, Arturo Cuomo, Federica Aielli, Andrea Cortegiani, Alessandra Casuccio, and Giampiero Porzio

A Pilot Randomized Controlled Trial of a Holistic Needs Assessment Questionnaire in a Supportive and Palliative Care Service
Nisar Ahmed, Philippa Hughes, Michelle Winslow, Peter A. Bath, Karen Collins, and Bill Noble

Usability and Acceptability of the QDACT-PC, An Electronic Point-of Care System for Standardized Quality Monitoring in Palliative Care
Arif H. Kamal, Dio Kavalieratos, Janet Bull, Charles S. Stinson, Jonathan Nicolla, and Amy P. Abernethy

Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers
Jennifer Tjia, Lee Ellington, Margaret F. Clayton, Celeste Lemay, and Maija Reblin

To access the articles, you must subscribe to JPSM or be a member of the American Academy of Hospice and Palliative Medicine (AAHPM). For further information on the Academy, call 847.375.4712 or visit aahpm.org.

Submitted by: David J. Casarett, MD, MA, Senior Associate Editor, JPSM