Current Bulletin

  • New Opportunity for Independent Primary Care Practices in NC

    This week, Aledade, Inc., an organization that partners with primary care physicians to build and lead Accountable Care Organizations (ACO), joined with North Carolina-based Emtiro Health, LLC, to work together to support independent physician practices in a new, physician-led ACO. The new ACO will launch in January 2019.

    In the new partnership, Emtiro Health will assist by providing direct support to the practices through care coordination and management. They also will help the participating practices develop systems and work flows to ensure success and that the practice will reap the benefits of participation in the Medicare Shared Savings Program (MSSP).

    Aledade is actively recruiting practices for the ACO throughout the state. They offer expertise in the move to a value-based payment model that allows physicians to remain independent by focusing on preventive care, care coordination, population health management and analysis of patient claims and electronic health record data to identify patients who need help before serious medical needs arise.  Aledade is also exploring partnerships with other payers, as they have in other markets.

    “Running an independent primary care practice today brings with it a range of financial and operational challenges,” said Karen Smith, MD, a North Carolina Medical Society (NCMS) member and family physician in Raeford, NC. “I believe that transitioning to value-based care will help my practice remain independent while I continue providing the high quality, personalized care my patients deserve. I know my practice needs a partner to take our journey in value-based care to the next level. That’s why I’ve chosen to partner with Aledade to help us navigate toward better care at lower cost. Aledade offers us the technology, tools and support we need to succeed, allowing us- the physicians- to focus on quarterbacking our patients’ care.”

    Dr. Smith went on to highlight that Aledade offers enhanced technology to promote movement toward true interoperability.  “To have a competent organization like Aledade to support our practice at a very reasonable cost makes a huge difference,” she said.

    NCMS Board member, Art Apolinario’s, MD, practice Clinton Medical Group, also recently signed on with Aledade.

    “We are excited to be in the search for like-minded, independent practices that want to improve access to value-based care, while remaining independent,” Dr. Apolinario said. “Independent primary care practices can be nimble, creative and community focused in continuing to provide high quality care in a value-based setting. Aledade”s informatics expertise, and expertise in ACO’s, makes them a welcome partner in our future care strategies.”

    If you would like more information about Aledade, please contact Angela Diaz at

    The Aledade ACO provides an excellent opportunity for independent primary care practices that see Medicare patients to join together with other similarly situated practices and receive outstanding support from Aledade and Emtiro to successfully navigate the rapidly changing health care landscape,” said Melanie Phelps, NCMS Senior VP for Health System Innovation and Deputy General Counsel. “As Medicaid and commercial payers in NC increase their emphasis on value-based arrangements, now is the time to connect with a partner that has an excellent track record, technology platform and understanding of value-based arrangement.”

    The North Carolina Medical Society (NCMS) has long been working to nurture ACOs and the value-based payment system they represent. Over 6 years ago, the NCMS initiated the Toward Accountable Care (TAC) Consortium and Initiative, which produced a valuable series of toolkits for practices and various specialties interested in making the move to value-based care. Browse the toolkits.

    The ACO Council, which brings together North Carolina ACOs that are part of the MSSP and Next Gen program for Medicare, along with the NC Population Health Collaborative, which gathers all those with an interest in the move to value and population health, have become must-attend meetings. Participants share best practices and discuss the challenges they face.

    Staff from the NCMS routinely visit ACOs across North Carolina to discuss their successes, challenges and how the NCMS can help.

    “We are encouraged when we hear about the strides being made,” said Phelps, who recently completed a tour of ACOS in the triad and the Charlotte areas. “And we are inspired to keep going when we hear how much these practices appreciate the resources we offer, and the forum for ideas and mutual support provided by the ACO Council, for instance. It can be lonely out there on the frontier of health care transformation. I’m glad we can offer resources, connections and moral support.”

  • Memorial Service for Joe Cupolo This Saturday at the NCMS

    A memorial service for North Carolina Medical Society (NCMS) Director of Member Services for the eastern region of the state, Joseph Cupolo, III, is scheduled for Saturday, June 16, at 4 p.m. at the NCMS headquarters in Raleigh. If you would like to attend the service, please contact Evan Simmons at or 919-833-3836.

    A GoFundMe page also has been started to assist Joe’s family with medical bills and other expenses. If you would like to donate in Joe’s memory, please visit

    Joe passed away on Wednesday, May 23, after a brief battle with amyloidosis. He was 59 years old.

    Joe, who started at the NCMS as Associate Director for Member Services in 2015, was respected for his friendly, low-key — yet persistent — approach to attracting new NCMS members, and was much admired for his eternally upbeat and positive attitude. He will be greatly missed by his NCMS family — both staff and the many physicians and physician assistants he came to know during his time here.

    Family and a strong work ethic were important to Joe. As he said in his welcome article in the internal NCMS newsletter: “I grew up in a family of Italian bread bakers in Brooklyn, NY, and when I turned 3-years-old my dad decided that in order to spend more time with me, he would take me out with him on his delivery route. It was back then when my work ethic was formed since I can still hear Dad saying: ’Joey, if you want to eat, you have to work.’”

    He began his sales career as part of his family’s bakery business eventually moving to corporate sales with Wonder Bread/Hostess Cake in New York City, ultimately becoming responsible for $25 million in annual sales and overseeing 10 branch managers and 100 sales reps.

    Joe moved to North Carolina in 2007 and went to work as an account executive for Capitol Broadcasting and Curtis Media Group.

    Along the way, he earned his bachelor’s degree in biology (he was pre-med) at Siena College in Albany, NY.

    NCMS CEO Robert W. Seligson had this to say about Joe: “Joe Cupolo, also known as ‘Broadway Joe’ for his love of New York,  was one of the most kind, caring and thoughtful human beings that I ever knew. He was a dedicated, loyal employee whose strong work ethic set the bar for others to follow. He was a kind soul whose contributions to the medical profession will not be forgotten. He had a very positive outlook on life and showed incredible strength and resolve during his illness.”

    Joe is survived by his wife, Lisa Ditta-Cupolo, and his daughter, Alexa Jensen, who just graduated from high school. He also is survived by his mother, Grace Cupolo, his sisters, Gina Provenzano and JoAnn Wallace, and brother, John Cupolo. Joe was predeceased by his father, Joseph Cupolo Jr.

    Our condolences and sympathy go out to Lisa and Alexa and all of Joe’s family and many friends.

  • How To Keep Up on NC Legislative News Affecting Your Practice

    The North Carolina General Assembly is hurtling toward the end of its short session, which likely will conclude by July 1. The North Carolina Medical Society (NCMS) government affairs staff is busy tracking all the proposed legislation that could impact the practice of medicine in our state. Go to our Legislative Blog to search by category for those bills that are moving through the process toward becoming law. The information is updated daily, so you can track the progress of each piece of legislation.

    For a weekly summary of the action at the General Assembly, watch NCMS’ Senior Vice President for Advocacy and Advancement Chip Baggett’s, JD, Bowtie Briefing video, sent to your email inbox every Friday.

    Also, consider the NCMS Foundation’s and NC MGMA’s Lunch and Learn Webinar next Tuesday, June 19, at noon, when Chip will give you the latest on what is happening on Jones Street. Register here. This webinar is free but you must be registered to attend. Space is limited so register early! After you register, you will receive an emailed confirmation with webinar and phone-in instructions.

  • AMA Filing Amicus Brief to Protect Coverage and Insurance Reforms

    The following remarks were presented to the House of Delegates at the AMA’s Annual Meeting during Tuesday’s business session by Dr. Gerald E. Harmon, Chair, AMA Board of Trustees.

    The AMA, joined by specialty societies, will file an amicus brief in the case of Texas vs. the United States to oppose a lawsuit that seeks a result contrary to longstanding AMA policy and advocacy to expand coverage and implement key health reforms.  If the plaintiffs in the suit are successful, the following provisions of the Affordable Care Act would be null and void:

    • Patients would no longer would have protections for pre-existing conditions
    • Children would no longer have coverage under their parents’ health insurance plan until age 26
    • Insurers would no longer be held to the 85% medical loss ratio, meaning they could generate higher profits at the expense of coverage and payments for services
    • 100 percent coverage for certain preventive services would cease
    • Annual and life-time dollar limits could be reinstated, leading to more bankruptcies due to health care costs

    Each of these provisions has broad, bipartisan and public support.

    The lawsuit seeks to change the federal government’s health policy through the courts, rather than through the legislature, which would violate the principle of separation of powers.  If the plaintiffs were successful, federal policy would roll back to 2009 without any substitute in place. This suit adds further disruption to an insurance market that has been harmed by premium increases and political battles that undermine coverage and enrollment.

    At the time of its passage and ever since then, the AMA has acknowledged that the ACA has flaws and policymakers need to fix problems, gaps and unintended consequences of this law. The association continues to press for action to stabilize the individual market and recently achieved repeal of the Independent Payment Advisory Board after several years of AMA and Federation advocacy.

    With health insurance coverage having already eroded this year, an unfavorable decision at the district court level would cause further disruption, uncertainty, spark additional premium increases and cause further declines in coverage.

    Separate amicus briefs aligned with the AMA’s position have or will be filed by hospital, insurer and patient groups.  The AMA’s amicus brief continues its long-time advocacy to achieve coverage for the uninsured as well as insurance market reforms important to patients and physicians.

    In response to this announcement by Dr. Harmon, representatives of the Texas Medical Association, which supported the suit filed by the state of Texas challenging the constitutionality of the Affordable Care Act (ACA), publicly objected to the AMA’s plans to file the amicus brief.

    “We fervently urge the AMA not to file a brief in this case at this time,” David Henkes, MD, chair of the Texas Delegation to the AMA House of Delegates said on the floor of the house. “The ACA is an extremely unpopular political symbol in our state. Should the AMA file a brief in this case, I have no doubt it will interfere with our work on key state issues such as liability reform, scope of practice, insurance reform, Medicaid, public health and graduate medical education.”

  • Your Thoughts on EMRs – This Month’s Snapshot Survey Results

    Last Wednesday, June 6, we queried North Carolina Medical Society (NCMS) members on their attitudes toward electronic medical records (EMR) and ways in which the NCMS might address any challenges. Here is what you told us:

    • The vast majority (87 percent) of you agree an EMR could be useful, but believe the reality has fallen far short due to many factors.
    • Echoing that sentiment, 71 percent believe an EMR is necessary in today’s health care environment, but needs to be refined to offer useful clinical insights through robust and reliable data analytics.
    • About a third of respondents (31 percent) revealed their practice uses scribes or voice recognition software to ease data entry burdens; while another third (31 percent) depend on their EMR vendor to address challenges.
    • Nearly a third (27 percent) expressed they were at a complete loss for how to make EMRs work to benefit physicians and patients.
    • To address the problems with EMRs, most of you supported the idea of an NCMS forum to share best practices around EMR use as well as convening a task force to examine the challenges and make recommendations for action. Open ended responses on ways the NCMS might help ranged from advocating with governmental agencies to change EMR requirements to suing EMR vendors. Other suggestions included ‘starting over’ with newly designed templates and better system integration.

    These results will inform the NCMS Board of Directors at their July 14 meeting, when they discuss how your Medical Society can help address the challenges around EMRs. Thank you for taking our monthly Snapshot survey, which offers NCMS leadership valuable insights into our members’ opinions and concerns and helps guide decision making. Watch for the next survey in your email inbox on Wednesday, July 11.

    As an added incentive to complete the quick, 5-question survey, we give away six $100 Amazon gift cards. The winners this month include: Christina Flannelly, MD,Frederick McIntyre, PA-C, Nicole Aristy, MD, FAAP, Brian McGrath, MD,and Mark Moeller, MD.

  • NCMS Launches ‘Bedside Manners’ Podcast

    Next time you have a 20- to 30-minute commute, workout or walk and want to listen to something interesting, tune in to the North Carolina Medical Society’s (NCMS) new podcast, Bedside Manners. Each episode discusses an issue of importance to the physician-patient relationship and features a North Carolina health care colleague or expert.

    The first three podcasts cover physician burnout; Medication Assisted Treatment or MAT and unconscious bias and its effect on health outcomes. New episodes will be added each month, so check back frequently.

    Update: You now may subscribe to the podcast on iTunes. Look for it under the North Carolina Medical Society.

  • NCDHHS Data Shows Progress Combatting Opioid Crisis

    The state is beginning to see success in its efforts to combat the opioid crisis, according to data now available on a new dashboard developed by the NC Department of Health and Human Services (NCDHHS). The oversupply of prescription opioids is being reduced and access to treatment and recovery services has increased, the data show.

    For instance, in the fourth quarter of 2017, there were 20 million fewer opioid pills dispensed statewide, compared to the same period the year before when 141 million were distributed.

    A year ago, NCDHHS joined with community partners to develop the North Carolina Opioid Action Plan, which established 13 data metrics to track and monitor North Carolina’s opioid epidemic. The metrics track progress toward five overarching goals: reducing deaths, reducing oversupply of prescription opioids, reducing drug diversion and illicit drug flow, increasing naloxone access and increasing access to treatment and recovery services.

    The metrics are updated quarterly in the new dashboard. Visit the Opioid Action Plan Data Dashboard for additional statistics and information. Learn more about the Opioid Action Plan and other steps being taken to turn the tide of opioid addiction in North Carolina. Read the press release announcing the new data dashboard.

  • NC Public Health Division Addresses Synthetic Opioids and Ebola Outbreak in Congo

    A microscopic view of the ebola virus.

    The state’s Division of Public Health recently issued clinician memoranda regarding life threatening coagulopathy problems associated with the use of synthetic cannabinoids and the outbreak of the Ebola virus disease (EVD) in the Democratic Republic of Congo.

    Coagulopathy Problems Associated with Synthetic Cannabinoid Use

    This Provider Memo and CDC Health Advisory contain background information and recommendations regarding life threatening coagulopathy problems associated with the use of synthetic cannabinoids.

    For more information on this please review the following CDC websites:

    If you have any questions, please contact the Office of Environmental Epidemiology at 919-695-2662.

    Ebola Virus Disease

    The US Centers for Disease Control and Prevention (CDC) is advising health care providers in the United States to continue to obtain a travel history from all patients seeking care. Clinicians should promptly isolate patients that have symptoms compatible with EVD and a recent (within 21 days) history of travel to the affected areas in the Equateur Province of DRC, pending diagnostic testing. Providers should also consider other infectious disease risks that are much more common in returning travelers, including malaria.

    If any of your patients meet these criteria please call the Communicable Disease branch for assistance at 919-733-3419. Additional information is available here.

  • NCMS Photo Contest Tradition Continues – Deadline to Submit Is June 29!

    2016 Photo Contest Winners

    Enter your best shot by June 29, 2018, and your photographic image may grace the walls of thousands of medical practices throughout the state as part of the North Carolina Medical Society (NCMS) 2019 Calendar. The categories are: nature (landscapes), North Carolina (images of locations within the state), travel (images beyond North Carolina) and wildlife.

    Learn more about the contest rules, how to submit your work and the prizes.

  • NCMS Foundation’s Kanof Institute for Physician Leadership Featured

    Read the latest “Grantee Perspective” piece focused on the North Carolina Medical Society (NCMS) Foundation’s Kanof Institute for Physician Leadership on The Physicians Foundation webpage. The Physicians Foundation, a nonprofit 501(c)(3) organization that seeks to empower physicians, recently awarded a grant to the Kanof Institute for Physician Leadership (KIPL) to support its leadership development curriculum. In the Grantee Perspective piece, Kristina Natt och Dag, PhD, MA, Vice President, Leadership Development, for the NCMS, shares how the KIPL has partnered with The Physicians Foundation to assist North Carolina physicians to be the drivers and agents of change toward patient-centered health care. Read the article.

    If you are interested in applying to a KIPL leadership development program and joining the ranks of the hundreds of KIPL alumni who are health care leaders across North Carolina, visit the KIPL website to learn more and apply.