2013 Annual General Meeting Economics committee report
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1 2013 Annual General Meeting Economics committee report Dr Hamish Hwang, Chair Dr Ahmer Karimuddin, President Mrs Tanyss Bugis Dr Sharadh Sampath Dr Nam Nguyen Dr Mark Dickeson Dr Samaad Malik
2 Economic report Brief overview New fees Implemented Approved, awaiting implementation Approved, awaiting funding Fee changes 2012 Master agreement allocation 2012 Recruitment & Retention Fund
3 Please visit our website to download this presentation
4 Brief Overview
5 Overview We have built on previous successes and had two very successful years Average income for our section has increased from $266,377 in to $352,916 in We are now the 10 th highest average earning section (excluding pathology) Please refer to econ report from previous years on website
6 2007/ / /12 RADIOLOGY RADIOLOGY OPHTHALMOLOGY OPHTHALMOLOGY OPHTHALMOLOGY RADIOLOGY CARDIOLOGY CARDIOLOGY CARDIOLOGY GASTROENTEROLOGY GASTROENTEROLOGY GASTROENTEROLOGY NEUROSURGERY VASCULAR SURGERY UROLOGY UROLOGY UROLOGY VASCULAR SURGERY CARDIAC SURGERY NEUROSURGERY OTOLARYNGOLOGY ALLERGY & IMMUNOLOGY OTOLARYNGOLOGY NEUROSURGERY NEPHROLOGY NEPHROLOGY CARDIAC SURGERY OTOLARYNGOLOGY ALLERGY & IMMUNOLOGY GENERAL SURGERY VASCULAR SURGERY RESPIROLOGY ALLERGY & IMMUNOLOGY RESPIROLOGY CARDIAC SURGERY NEPHROLOGY GENERAL SURGERY GENERAL SURGERY RESPIROLOGY DERMATOLOGY DERMATOLOGY DERMATOLOGY OBSTETRICS & GYN. CRITICAL CARE OBSTETRICS & GYN. ORTHOPAEDIC SURG. OBSTETRICS & GYN. CRITICAL CARE CHEST SURGERY ORTHOPAEDIC SURG. ORTHOPAEDIC SURG. INTERNAL MEDICINE ENDOCRINOLOGY CHEST SURGERY RHEUMATOLOGY CHEST SURGERY ENDOCRINOLOGY NEUROLOGY ANESTHESIOLOGY ANESTHESIOLOGY ANESTHESIOLOGY INTERNAL MEDICINE INTERNAL MEDICINE PLASTIC SURGERY RHEUMATOLOGY RHEUMATOLOGY ENDOCRINOLOGY NEUROLOGY PLASTIC SURGERY GENERAL PRACTICE PLASTIC SURGERY NEUROLOGY PEDIATRICS GENERAL PRACTICE PEDIATRICS HEMATOLOGY/ONCOLOGY HEMATOLOGY/ONCOLOGY GENERAL PRACTICE PSYCHIATRY PEDIATRICS HEMATOLOGY/ONCOLOGY INFECTIOUS DISEASES PSYCHIATRY PSYCHIATRY PHYSICAL MEDICINE PHYSICAL MEDICINE PHYSICAL MEDICINE GERIATRIC MEDICINE INFECTIOUS DISEASES INFECTIOUS DISEASES EMERGENCY MEDICINE GERIATRIC MEDICINE GERIATRIC MEDICINE CRITICAL CARE EMERGENCY MEDICINE EMERGENCY MEDICINE
7 New fees
8 New fees implemented use of mesh for hernia repair extra $62.13 Supposed to be revenue neutral Due to gross overbilling MSP introduced restriction to , , 71616, 71623, 71624, 71625
9 New fees implemented Negotiations with MSP have been difficult MSP agreed to allow billing of if we reduced the fee to $27.22 then delayed implementation We may have to leave fee as is
10 New fees implemented Can t be billed with pediatric fees primary inguinal hernias initial incisional hernia with mesh 71623/4 lap incisional with mesh Component separation +/- mesh
11 New fees implemented Overhaul of upper GI endoscopy fees See billing seminar from last year on website for details No, you cannot bill with unless you are willing to reduce the colonoscopy fees to pay for it
12 New fees implemented Lap non-anatomic liver resection $ Lap segmental hepatectomy $ Lap liver 2+ segments $ Lap right hepatectomy $ Lap left hepatectomy $ Approved for new fee fund = $24,000 All C procedures Eligible for 07001
13 New fees implemented Transanal Endoscopic Microsurgical Resection of rectal tumour - $900 Must use insufflating operating proctoscope Approved for new fee fund = $68,000 C procedure Eligible for 07001
14 New fees implemented Specialist Discharge Care Plan for complex patients - $75 LOS >4 days Discharge Plan must be given to patient at time of discharge and sent to GP within 24h Download template at e_planning_template.pdf Claim on day of discharge
15 New fees awaiting implementation Consultation for management of malignancy $ Cost $290K Effective April 1, 2013 Should only be billed only with histologically confirmed malignancy The fee will be reduced if it is over-billed
16 New fees awaiting implementation Special office visit for malignancy $47.64 Cost $290K Effective April 1, 2013 Can be billed 2 times per 6 months Should only be billed only with histologically confirmed malignancy
17 New fees awaiting implementation Laparoscopic distal pancreatectomy with splenectomy $ Laparoscopic distal pancreatectomy with splenic preservation $ Approved for new fee fund = $9,000 C procedure Eligible for 07001
18 New fees awaiting implementation Laparoscopic internal drainage of pancreatic pseudocyst $ Did not qualify for new fee fund because fee guide already open or laparoscopic (annual cost $3000) C procedure Eligible for To fund this requires your vote
19 New fees awaiting implementation Laparoscopic hepatotomy for drainage of abscess or cyst (single) - $ Laparoscopic hepatotomy for drainage of abscess or cyst (multiple) - $ Did not qualify for new fee fund because fee guide already open or laparoscopic (annual cost $3000) C procedure, eligible for To fund this requires your vote
20 New fees approved, awaiting funding Temporary or delayed abdominal closure with VAC Applied for a fee of $500 which was rejected by MSP MSP recommends billing ($339.60) or ($425.82) for initial placement of VAC and ($123.30) for subsequent VAC changes under GA
21 New fees approved, awaiting funding Active wound management per 5% BSA We argued that the area affected is equivalent to %15 BSA and therefore should be billed x3 ($369.90) for each VAC change MSP agreed but did not qualify for new fee fund = $32K To fund this requires your vote
22 New fees approved, awaiting funding Special hospital visit for malignancy $40.56 Can be billed 2 times per 6 months Cost $183K Did not have enough money from allocation to fund this
23 New money summary mesh fee = $273K Laparoscopic liver resection = $24K TEM = $68K Laparoscopic pancreatectomy = $9K 2012 Allocation = $679K Total to Section = $1.06M ( allocation = $5.77M)
24 Please see handout New fees Thank you to Steve Chung, Ed Solano and Manoj Raval for helping with application for successful new fees Thanks to David Konkin for help with other applications We encourage other members to suggest new fees (not fee increases) Questions about new fees?
25 Fee changes
26 Fee changes General surgery consultation Fee is temporarily increased to $99.21 from April 1, 2012 to April 1, 2013 Retro pay Jan 31, 2013 remittance Will revert to $97.77 April 1, 2013 This was done because new malignancy consultation could not be applied retroactively to April 1, 2012
27 71700 Fee changes MSP agreed to change description New description Closure of congenital or acquired anal fistula with rectal advancement flap Emergency visit when specially called Not paid within 10 post-op days
28 2012 Master Agreement Allocation
29 2012 fee increases Our allocation was relatively small ($679K) compared to 2006 ($5.7M) We were only able to fund the special consult and office visit for malignancy
30 2012 fee increases Outstanding passed motions: Per 2010 AGM: Increasing existing laparoscopic fees to max 10% differential Estimated cost $520,000 (assuming $1.3M) Per 2011 AGM: Access to 1 st assist of the day and Office Anoscopy fee Estimated cost $369,000
31 2012 fee increases Outstanding passed motions: Per 2011 AGM: Increase remaining fees based on comparison with Alberta fee values Increase fees <0.65 Alberta s fee value first Increase fees <0.80 next Increase fees <1.00 last No increase to fees greater than or equal to Alberta s equivalent fees
32 2012 fee increases Outstanding passed motions: Per 2012 AGM: Special hospital visit for malignancy $40.56 Can be billed 2 times per 6 months Cost $407K
33 2012 fee increases Laparoscopic internal drainage of pancreatic pseudocyst Laparoscopic hepatotomy for drainage of abscess or cyst (single/multiple) Estimated cost $6,000 MOTION: that the Executive of the Section of General Surgery are enabled use money allocated to the Section to fund the above fees at 25% the open fee value
34 2012 fee increases Temporary or delayed abdominal closure with VAC Estimated cost $32,000 MOTION: that the Executive of the Section of General Surgery are enabled use money allocated to the Section to change the fee schedule so that fee code can be billed x3 for VAC changes under GA
35 2012 Recruitment and Retention Fund
36 2012 R&R fund The Section received $1.3M in 2006 to increase the colorectal fee series We put a tremendous effort into our R&R submission We retained a labour lawyer to help polish our submission ($13K) Thanks to Amanda Johner, resident rep, and Rona Cheifetz for their assistance
37 2012 R&R fund The crux of our argument was that we have the lowest number or surgical oncologists per capita in the country A major factor impeding recruitment is lack of resources Therefore we need funding for special consult/office visit for malignancy and to increase cancer surgery fees to offset the lack of resources Award to be announced March 31, 2013
38 Please visit our website to download this presentation
2013 General Surgery Retreat Economics Update. Dr Ahmer Karimuddin, President Dr Hamish Hwang, Economics Chair Mrs Tanyss Bugis, Executive Director
2013 General Surgery Retreat Economics Update Dr Ahmer Karimuddin, President Dr Hamish Hwang, Economics Chair Mrs Tanyss Bugis, Executive Director Please visit our website generalsurgeons.ca Follow us
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