Archive for February, 2016

Nomination of Leonard D. Reeves, MD, FAAFP to the 2016 AAFP Board of Directors

L Reeves (2)Leonard D. Reeves, MD, FAAFP

It is with bold excitement that the Georgia Academy of Family Physicians has nominated Leonard D. Reeves, MD, FAAFP for the 2016 AAFP Board of Directors.

Dr. Reeves has a rich background and has served both the Georgia Academy and the American Academy.  He was President in 2009-2010 and previously served as Chair of the Education and Research Committee.  Dr. Reeves is currently a GAFP voting delegate to the AAFP Congress of Delegates.

We are enthusiastic about his ability to have a national platform to expand his leadership and vision of family medicine.

Dr. Reeves believes that the time is now to stand up for Family Medicine, and that…

  • Adequate Healthcare for America is a must…
  • Patient Centeredness is what people want…
  • Healthcare is a team sport, not an individualized event…
  • We need more students choosing Family Medicine…
  • We need more physicians in the rural underserved areas…
  • We need more Family Physicians…

FAMILY PHYSICIANS ARE THE ANSWER…FAMILY MEDICINE IS THE RIGHT THING!

He says that the future of America’s Health depends on taking care of the sick, comforting those in need and preventing disease! Family Medicine does all of these things!

“The Right thing for Family Medicine is to stress how essential we are to the Nation’s Healthcare system.

We need to take care of patients, prevent illness and let people know about the inequities that abound in healthcare, including adequate compensation. We need incentive pay to put physicians where they are needed not just where it is beneficial to the business of medicine!”

He will be the voice of family medicine at the AAFP for all of us!

New Family Medicine Residency Program in South Georgia Opening July 2016

Colquitt Regional has launched Georgia South, a new Family Medicine Residency Program, in an effort to encourage young doctors to train and practice in South Georgia. The hospital received national accreditation from the American Osteopathic Association, and will begin recruiting for its first class of three residents that will start July 1, 2016. This program is only the 2nd residency program in Southwest Georgia, and the first in over two decades. “Our long-term vision is for Colquitt Regional to be a premier academic center for medical education and this is a great step in that direction,” said hospital CEO Jim Matney.

South Georgia has a shortage of primary care doctors, and the new residency program will focus on training and recruiting physicians who will stay in the area to practice. Residency programs are important to communities, especially in rural and underserved areas because physicians are more likely to stay and practice within 60 miles of their residency programs. This program allows the region to grow its own doctors, rather than relying solely on recruiting from outside the area. This medical training program will have significant medical and economic impact in Moultrie. As the residency program begins producing physicians, the estimated economic impact is over $1.5 million per new physician and the creation of five new jobs supporting the physician.

The residents will train at the hospital and in outpatient clinics. The three-year program will enroll three residents per year, for a total of nine when the program is fully developed. The program’s Medical Director will be local family physician and GAFP member, Dr. Kirby Smith. Dr. Smith has been in practice in Moultrie for over 20 years and brings a wealth of experience and compassion to teaching new family medicine doctors. Under his guidance, the residency program will train residents, and develop opportunities that specifically target the community need in Colquitt County. “I am proud to be part of the new residency program in Colquitt County,” said Dr. Kirby Smith. “As a member of this community and as a physician, I see this as a chance to train young doctors in rural medicine who will stay to become part of our physician workforce. We hope to see their families become engaged members of our community and that the physicians themselves will have a positive impact on the quality and availability of healthcare across the region.”

Behind Every Family Physician is a Bigger Mission. We Invite You to Become a Part of Ours Today!

Founded in 1987 by the Georgia Academy of Family Physicians (GAFP), The Georgia Healthy Family Alliance is the non-profit arm of the GAFP. The Alliance is the only charitable organization in Georgia whose objective is to improve access to quality health care through initiatives and programs led and supported by the care and generosity of family medicine specialists.

The Alliance relies upon the leadership, support and generosity of family physicians and community partners to fulfill our mission. With your support and generosity, the Alliance will:

  • Award $25,000 in Community Health Grants to GAFP members and the nonprofit organizations to which they volunteer their time in communities throughout Georgia
  • Provide health education to 2,000 Georgia children participating in Tar Wars – a tobacco education and prevention program offered by the Alliance at no cost to Georgia schools

The good work done by GAFP members both inside and outside of their practice has never been more apparent with GAFP members applying for Community Health Grants to fund free breast cancer screenings, diabetes education workshops, nutritional counseling for underserved populations throughout Georgia and more.

A gift at any level will have a powerful impact on the lives of thousands of Georgia citizens, enabling the Alliance to bolster our community health grants. All donations to the annual campaign are recognized in the GAFP newsletter, on the Alliance website and at the Annual Scientific Assembly in November.

  • The Legacy Club ($1,000 +)

The Legacy Club encompasses a select group of leaders, deeply committed to strengthening their communities and leading the way for community health. Members are invited to an exclusive luncheon during the Annual Scientific Assembly.

  • Patron ($500)
  • Benefactor ($250)
  • Sponsor ($100)
  • Friend ($50)

 

The Georgia Healthy Family Alliance is a 501 (c) (3) tax-exempt organization and all donations are tax-deductible.

My 2016 Pledge to The Georgia Healthy Family Alliance is:

 

___ $1,000 Legacy Club

___$500 Patron

___$250 Benefactor

___$100 Sponsor

___$50 Friend

 

I would like to honor this pledge with (Please check one):

___A one-time payment of the entire pledge to be received on ____(date)

___A bi-annual payment to be received on __________ and ___________ (dates)

___Monthly donations deducted from my credit card beginning__________(date)

Payment:

____ My Check is enclosed (Payable to Georgia Healthy Family Alliance)

____Please charge my credit card _________________________Card # _____CVN

_______Exp. Date___________________Name on Card _________Zip Code

Other : _______________________________________________________

Contact Information:

Name _____________________________________________________________

Address ___________________________________________________________

City/State/Zip Code__________________________________________________

Telephone ________________________Email_____________________________

Signature __________________________________________________________

For questions, or to submit your pledge, please contact:

Georgia Healthy Family Alliance

3760 LaVista Road, Suite 100 Tucker, GA 30084-5641

404.321.7445 Phone / 800.392.3841 Toll Free/ 404.321.7450 Fax

Email: ksinkule@gafp.org

To make a donation online, visit us at www.georgiahealthyfamilyalliance.org

Medicaid Update – New Preventive Visits Policy

Effective January 1, 2016, the Department of Community Health will implement a change to its existing physician office visits policy in order to allow Medicaid eligible members to have access to preventive health services. Members 21 years of age and older will now be able to access one preventive health visit each calendar year (CY) and 10 office visits (evaluation and management codes 99201 to 99215) each CY. The Department encourages primary care practitioners (PCPs) of the following types to perform the preventive health visits: physicians (internists, family physicians, or OB/GYN specialists), certified nurse practitioners, or physician assistants. FQHCs and RHCs may bill for these provider types performing preventive health visits within the FQHC or RHC. Additional office visits (above the 10 visits) will still be available based upon documentation and supporting medical necessity that must be sent to Alliant/Georgia Medical Care Foundation (GMCF) for review. This policy change supports the Department’s goal to improve the health outcomes of our enrolled Medicaid members by allowing them to establish a medical home and receive preventive health services. The establishment of a medical home will also support the Department’s efforts to reduce hospital re-admissions.

Providers may bill ONE (1) preventive health visit (993XX) for a member annually (between January and December of the CY). Providers must use one of the following ICD-10 diagnosis codes when billing the preventive health visit code: Z00.00 or Z00.01 (Encounter for adult examination). Each member is allowed 10 office visits (992XX) per CY without prior authorization. The following preventive visit codes are billable for this policy change:

99385 or 99395 (Adults 21 through 39 years of age). This code is currently open for members under the age of 21 years in the Health Check program (COS 600),

99386 or 99396 (Adults 40 through 64 years of age), and

99387 or 99397 (Adults 65 years and older).

The Georgia Medicaid Management Information System (GAMMIS) will be configured to align with these changes. We anticipate the configurations will be complete by the second quarter of CY 2016. Providers may begin billing for the preventive health visits in January 2016. Reimbursement will not be available until GAMMIS is configured according to the new policy. Please keep your claims timely for the future mass adjustment.

If you have any questions regarding this policy change, please contact HPE’s Customer Call Center at 1-800-766-4456.

Public Health Spotlight – Oral Health Impacts Overall Health and Quality of Life: Why Medical Providers Should Invest in Oral Health

Oral health is an essential and integral component of a person’s health throughout his or her life1 especially for school-aged children. Poor oral health and untreated infections can negatively impact the quality of life for school-aged children. Both the National Institute of Dental and Craniofacial Research and the National Education Association cite research showing American children miss 52 million hours of school each year due to oral health issues.

Strengthening the primary care delivery system, and investing in oral health disease prevention in the medical practice can contribute to improving the overall health of children, especially very young children. According to the 1999-2004 National and Nutritional Examination Survey (NHANES), approximately 42% of children ages 2 to 11 years have dental decay in their primary teeth. After decreasing from the early 1970s to the mid-1990s, the prevalence of dental decay in children has been increasing, particularly in young children ages 2 to 5 years.2

Dental decay is an infectious disease caused by a disruption in the normal balance of oral bacteria and overgrowth of cariogenic organisms (primarily Streptococcus mutans, S. sobinus, and lactobacilli) as a consequence of a diet high in carbohydrates and sugar.  Late stage interventions waste healthcare dollars and introduce significant risk to young patients requiring extensive, restorative, dental treatment, which often requires sedation in a hospital setting. To make a difference in the health of school-aged children it will take the disciplines of both the primary care providers and dental teams to reduce the burden of oral disease.

Developing a coordinated oral health care effort in Georgia between medical providers and dental providers can make a difference. The vast majority of infants and young children in Georgia see their primary care provider on a routine basis for well child care visits and immunizations. Thus, offering fluoride varnish to high risk children without access to a dental home through their medical providers can help to prevent and arrest dental decay. Evidenced-based studies indicate oral health prevention is cost-effective and saves children from pain and lost days of school.

In Georgia’s rural areas, and some urban areas, access to a dental practice often has significant barriers for children and adults.  We know oral health prevention works, but many of Georgia’s citizens with low oral health literacy lack the preventive services and proper oral home care habits to prevent diseases.  Poor oral health status exists in vulnerable populations, including diverse social and cultural backgrounds, low economic status, and low levels of education.

Many of the habits that contribute to higher levels of oral disease can be changed with support and education from medical and dental providers. While a dental practice provides an ideal dental home, when a dentist is not available the pediatric/family medical provider can fulfill the oral health care needs of their patients from a preventive approach until a dentist can be accessed and a dental home can be established. The members of the Georgia Academy of Family Physicians (GAFP) serve Medicare and Medicaid patients and could best reach these populations with oral health education and preventive fluoride varnish services for children.  Medicaid will also reimburse the fluoride varnish services provided for children.

Significant barriers to oral health services not only affect children, but adults as well. The Institute of Medicine (IOM) July 2011 report,Improving Access to Oral Health Care for Vulnerable and Underserved Populations, states that millions of Americans are not receiving dental care because of “persistent and systemic” barriers that disproportionately affect children, seniors, minorities, and other vulnerable populations.3 While cavities are the most common chronic disease for children and teenagers, older adults are at a higher risk of losing their teeth as they age. 2

Here are a few risk factors to consider when determining a patient’s need for anticipatory guidance, home care education, and fluoride varnish:

  • Having decay is a risk factor for getting more decay. For example,  if a mother/caregiver has decay, more than likely the child will have decay; if a child’s siblings have had decay then the child has a higher risk for decay; and if a child has had decay in the past, then they will have a higher risk for more decay.
  • Children in Women, Infants, and Children Supplemental Nutrition Program (WIC), Head Start, or Medicaid are at higher risk than are children in the general population due to lower income levels.
  • Tooth location:
  • For teens and adults: Decay most frequently occurs in the back teeth due to grooves and pits where plaque and food particles are most likely to collect.  View the back teeth for breaks in the enamel requiring restoration (cavitation) during a screening and assist the patient in getting an earlier referral before emergency services are needed.  Plaque and food debris in the grooves of back teeth suggests oral home care education is needed along with a referral to a dental home.
  • For younger children, pre-school age, most decay begins on the top front teeth, right at the gum or gingival line.  It begins as a white decalcified area, progresses to brown, cavitates to small holes, and eventually breaks down the tooth.  If fluoride varnish is placed on the teeth in the earliest stage, the white decalcified state, and homecare instructions are given and followed, progression of the disease can be arrested, and often times reversed.
  • For patients of all ages, recommend that the family monitor:
  • Certain foods and drinks: Foods that cling to teeth for a long time, such as milk, ice cream, honey, table sugar, soda, raisins and other dried fruit, and sweetened desserts (dietary counseling)
  • Frequent snacking or sipping: Steady snacks, sipping sweetened beverages, and sipping cups filled with fluids other than water can contribute to oral deterioration due to the constant acid exposure (dietary counseling).
  • Timing and frequency of brushing: Teeth should be brushed soon after eating and drinking (oral hygiene instruction).
  • Fluoride: Fluoride is a naturally occurring mineral that helps protect against cavities and can even reverse the earliest stages of tooth decay. Georgia has achieved recognition for community water fluoridation, with almost 97% of the population using community water receiving the benefits of fluoridation.  Many people with access to good tap water with fluoride, consume sweetened beverages and sports drinks instead of drinking tap water. If a patient can’t brush during the day – instruct them to swish with fluoridated water and swallow at night (preventive strategies and dietary).
  • Dry mouth: Lack of saliva due to certain medications can reduce the buffering effect of saliva and natural protection against the acid manufactured by decay-producing bacteria. To counteract dry mouth, patients can use a fluoridated toothpaste and drink and swish with water often (education on pharmaceutical use).
  • Gastroesophageal reflux disease (GERD) can erode teeth and contribute to significant tooth damage. Patients can use medication to control their acid reflux and its effects on their teeth (preventive services and prescriptions).

Fluoride Varnish for Infants and Children

  • Why the recommendation for the first dental visit at age 1 year?  Fluoride varnish can reduce the primary maternal dental flora in the infant’s mouth (mother’s or caregiver’s transmission of bacteria to infant’s mouth), during eruption of the primary dentition. A multi-faceted approach includes ensuring the woman gets referred for dental services pre-, during, and post pregnancy and that the infant receives his or her oral health exam at age one.
  • What is it? Most fluoride varnishes are lacquers containing 5% sodium fluoride in a pine plant resin base. Fluoride varnish provides a highly concentrated, temporary dose of fluoride to the tooth surface. The varnish holds fluoride close to the surface of the tooth for a longer period of time compared to other concentrated fluoride products.  Unlike the low-dose fluorides available over the counter, such as fluoride toothpaste, highly concentrated fluoride products, like fluoride varnish, must be applied by a healthcare professional in Georgia.
  • How does it work? The fluoride varnish becomes concentrated in the outer enamel surfaces when applied after teeth erupt into the mouth. Dental plaque and saliva act as fluoride reservoirs to enhance the remineralization process. In addition, fluorides interfere with the decay-causing bacteria colonizing on teeth and reduce their acid production; thus, slowing demineralization.
  • How long does it stay on the teeth? The fluoride hardens on the tooth as soon as it comes into contact with saliva, allowing the high concentration of fluoride to be in contact with tooth enamel for an extended period of time, about one to seven days.
  • Is it easy to apply? Varnish application is quick and easy. Inadvertent ingestion is also less likely, making it helpful for application with infants, toddlers, developmentally disabled individuals, or people with severe gag reflexes.
  • The recommendations: The CDC (2001) and ADA (2006) recommend at least biannual application, at six-month intervals, to control dental decay in primary and permanent teeth for moderate, or high, risk children.

Several studies have shown that fluoride varnish is efficacious in reducing decay in the primary teeth of high-risk children. Varnish placement is quick and easy. Medicaid will reimburse medical practitioners for the oral health education and fluoride varnish application. Single dose fluoride varnish application packets make placement easy and efficient. By offering patients oral health guidance and fluoride varnish you can help your patients have a healthier smile.

Contact:  Carol Smith, RDH MSHA

Director of Oral Health

Georgia Department of Public Health

404-657-3138

Carol.smith@dph.ga.gov

References

  1. S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health. Retrieved from http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/Documents/hck1ocv.@www.surgeon.fullrpt.pdf
  1. Barker, L. Dye, B., , Lewis, B. Smith, V. Tan, S., , Thornton-Evans G, et al. (2007). 1988-1994 and 1999-2004). Trends in oral health status: United Sates 1988-1994 and 1999-2004Vital Health Stat 11, (248), 1-92.
  1. Improving Access to Oral Health Care for Vulnerable and Underserved Populations (2011 July 13). Retrieved from www.iom.edu/Reports/2011/Improving-Access-to-Oral-Health-Care-for-Vulnerable-and-Underserved-Populations.aspx
  1. Fluoride Varnish: an Evidence-Based Approach Research Brief. (2007). Retrieved from http://www.kdheks.gov/ohi/download/Flvarnishpaper.pdf