Talking to Patients About Tobacco Cessation


Research shows it takes multiple efforts to finally give up tobacco, the number one cause of preventable death and disease in the country. Patients want to hear about the benefits of tobacco cessation from their health care providers, and these should be discussed at every visit because it may take multiple conversations before the patient decides to make a quit plan.

Some tips about talking to patients include:

  • Ask about their tobacco use, and listen to their hopes and concerns about quitting
  • Inform them of the new benefit, and let them know you can help them try new medication and counseling options until you find the one that works for them.
  • Prescribe medications and offer evidence-based support
    • Counseling – Individual or Group, provided by your clinic (Coding and prescription details available online here)
    • Referral to the Kansas Quitline (1-800-Quit-Now)
  • Follow up with appointments or conversations about how the interventions are working

In Kansas, the expanded KanCare benefits provide a better chance for patients to have successful outcomes. Let patients know about the benefits today.


Expanded KanCare Benefits for Tobacco Cessation


For patients enrolled in KanCare, a newly expanded benefit for tobacco cessation is now available! KanCare now covers medications and counseling for tobacco users to make multiple quit attempts per year. The expanded benefit will help physicians and staff work with patients to find the right combination of treatments to quit for good.

Expanded benefits include:

Medications: Comprehensive, barrier-free coverage of all FDA-approved medications:

  • Chantix, Bupropion, all nicotine replacements (patch, gum, lozenge, inhaler, nasal spray)
  • Evidence-based combinations of medications (e.g., concurrent patch/lozenge)
  • No prior authorization or copays

Counseling: No annual or lifetime limits

  • Individual (Billing Codes 99406/99407)
  • Group Counseling (Billing Code s9453)

The majority of patients using tobacco will make at least one quit attempt this year. Medications plus counseling double their chances for a healthier life.

Visit KAFP online to download an information card about the expanded benefits and find additional resources for your patients and staff.


Influenza Resources for You

AAFP/IAC Express

Influenza season is now under way. This week is National Influenza Vaccination Week (NIVW), December 2–8. Check out the NIVW toolkit which includes videos, communication hints, matte articles to submit to newspapers, animated graphics, and more!

This flu season, Familydoctor.org is setting out to serve you and help patients by providing an impressive library of assets you can use in social media to talk to patients about the flu and prevention. Check out the Familydoctor.org Guide for the Flu Season toolkit. Facebook and Twitter posts, graphics, GIFs, videos and articles are available for you to use on social media networks to educate patients on the flu and prevention. Also watch for KAFP posts on Facebook and Twitter and like and share!

This is a great time to vaccinate your patients who have not yet been protected against flu and to remind your patients who have not been vaccinated to be sure they get protected. Influenza vaccination is recommended for everyone six months of age and older. As a reminder, vaccination efforts should continue through the holiday season and beyond. Peak influenza activity does not generally occur until February. Read the CDC Weekly U.S. Influenza Surveillance Report.



Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018

Rural Policy Research Institute

The Quality Payment Program (QPP) was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The QPP consolidates existing Medicare pay-for-performance programs – the Physician Quality Reporting System, the Physician Value-based Payment Modifier, and the Medicare Electronic Health Record Incentive Program for Eligible Professionals – into a unified, cohesive program. MIPS is one of the two tracks of the QPP program and the regulatory framework for MIPs was originally provided by MACRA and CMS’s calendar year (CY) 2017 QPP final rule. This brief discusses changes to the original MIPS regulatory framework brought about by the Bipartisan Budget Act of 2018 and the CY2018 QPP final rule. Read it: Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018.


National Influenza Vaccination Week: December 2-8

CDC Flu Blog-A-Thon
IAC Express

National Influenza Vaccination Week (NIVW) is an awareness week focused on highlighting the importance of influenza vaccination. NIVW will be observed this year on December 2–8. This is a great time to vaccinate your patients who have not yet been protected against flu and to remind your patients who have not been vaccinated to be sure they get protected.

For millions of people every season, the flu means a fever, cough, sore throat, runny or stuffy nose, muscle aches, fatigue, and miserable days spent in bed. Millions of people get sick, hundreds of thousands are hospitalized, and thousands to tens of thousands of people die from flu each year.

CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against seasonal flu viruses. This season, CDC recommends that providers use any licensed, age-appropriate influenza vaccine (Inactivated influenza vaccines (IIV), Recombinant influenza vaccine (RIV), or live attenuated influenza vaccine (LAIV4)) with no preference expressed for one vaccine over another.

The 2018-2019 U.S. flu vaccines have been updated for this season. Learn more about the vaccine options available this season and Key Facts about Seasonal Flu Vaccine.


Trends in Hospital System Affiliation, 2007-2016


A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis: Trends in Hospital System Affiliation, 2007-2016

Previous work by the RUPRI Center showed significant growth in hospital system membership among non-metropolitan hospitals from 2007 to 2012. Re-examining data from the American Hospital Association through 2016 shows continued growth in system membership among all categories of hospital size, location, and Critical Access Hospital (CAH) status. However, the growth rate in system membership declined in metropolitan hospitals in the South census region and non-metropolitan CAHs in all census regions. The analysis also indicates that non-metropolitan CAHs and hospitals make up a small portion of hospitals in the largest healthcare systems. Non-metropolitan hospitals and non-metropolitan CAHs face unique challenges given the demographics of the population they serve, payer mix, and reimbursement levels.

Additional Resources: Trends in Hospital Network participation and System Affiliation, 2007-2012

Evidence Shows Early Prediabetes Intervention Works


As the number of U.S. patients diagnosed with type 2 diabetes surges to new levels, researchers know interventions that could delay or prevent the disease are underused. A paper outlining that argument titled “Evidence for the Prevention of Type 2 Diabetes Mellitus,”(jaoa.org)was published in the November issue of The Journal of the American Osteopathic Association. The authors of the paper found that the best consistent results came from long-term lifestyle intervention programs such as the Diabetes Prevention Program (DPP).  A cost-effectiveness modeling study of widespread implementation of the National DPP for Medicare beneficiaries showed a 37 percent reduction in new-onset diabetes at a cost savings of $1.3 billion over 10 years.  Read entire article.




Influenza Season is Here; Resources to Help You Vaccinate Your Patients 

IAC Express

Influenza season is now under way, and CDC has reported three influenza-associated pediatric deaths. One pediatric death occurred during the 2018–2019 season and two occurred during the 2017–2018 season. Last season, there was a record-setting number of pediatric deaths in the U.S. (185), so be sure to protect all your patients for whom vaccination is recommended. Check out the CDC Weekly U.S. Influenza Surveillance Report, FluView.

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public:


Great American Smoke Out – Nov 15, 2018


The Kansas Academy of Family Physicians is joining physicians across the U.S. in celebrating the annual Great American Smoke Out on Thursday, November 15. Kansas has seen a decrease in the number of residents using tobacco, yet thousands still struggle with their tobacco addiction. It often takes 7 to 9 quit attempts before successfully overcoming tobacco. Patients indicate that a healthcare provider’s advice to quit is a strong motivator in taking the first step. As a family physician, you are a motivator!

If you are interested in the latest tobacco training and resources for your practice, please visit the KAFP website for details. Two free resources that may interest you:

New Alternatives for Performance Improvement Activity Credit


ABFM recognizes that in 2018 many family physicians already have ongoing performance improvement initiatives and regular reporting of related measures that meet the criteria for PI activity for family medicine certification. A new Self-Directed Performance Improvement (PI) Project pathway is now available through your Physician Portfolio that allows you to report customized improvement projects specific to your practice environment, regardless of the scope of care you deliver.

How to get started:

  • For the Self-Directed pathway for 1-10 physicians, members can simply login to their ABFM Physician Portfolio, select Access Performance Improvement Activities from the main screen, and choose the ABFM Self-Directed Performance Improvement Project: Clinical.
  • For the Organizational option (groups of more than 10 family physicians), go to https://theabfm.mymocam.com/organizations/ for more information.

There are many additional (PI activities that you can choose from to complete your PI requirement including AAFP-sponsored Performance Navigator activities, PICME approved activities, and METRIC modules, which can be found on the AAFP website. NCQA recognition programs, CPC+ participation, Bridges to Excellence recognition, PI activities from other member boards, and a host of approved options from local, state, regional and national entities may also qualify for your PI requirement. Information about all of these activities can be found in your Physician Portfolio under Performance Improvement Activities on the ABFM website.

Given these alternatives that offer flexibility and relevance to individual practice, the ABFM plans to retire the PPM modules by May 1, 2019. Diplomates will be provided enough time to complete the modules that they have in on progress. Beginning in November 2018, Diplomates that begin a new PPM or have a PPM in progress will be reminded when the PPMs will expire. For questions about how to meet the PI activity or use the new platform, please contact Ann Williamson at (859) 687-2503.