May 2015 Newsletter

SVHP logo 3

Monthly Newsletter

Volume 4  Number 5

May 1, 2015

ICD-10 Updates

Like it or not, the transition to ICD-10 is scheduled to begin in a little less than 6 months. According to a study by the Aloft Group released last quarter, nearly half of US healthcare providers have completed only 25 percent or less of their ICD-10 implementation process. Another study, this one conducted by the MGMA, found that less than 10 percent of practices have made significant progress to prepare for the transition.[1]

Yet, not all the news and information surrounding the impending ICD-10 implementation is negative. Many providers are well on their way to ensuring they and their staff receive the appropriate education to take advantage of all the positives the new codes will bring. Some experts suggest that that thanks to the specificity and detail required by the new ICD-10 codes, providers will likely see a reduction in claim denials for medical necessity as a result of insufficient information.

For groups like St. Vincent’s Health Partners, the new codes will serve an even greater purpose. As an organization that is radically innovating new models of population health management, and assisting providers in caring for their patients, the new code set will provide a rich and complete picture of each patient interaction, leading to more information and even better coordination of efforts.

Success with ICD-10 starts with proper documentation. No amount of voluminous coding books will help fill in the gaps left by inadequate documentation. Here are some additional details that will be required in the new ICD-10 code set:
• Axis of classification,
• Site of occurrence,
• Laterality, and
• Trimester specificity for pregnant women.

ICD-10 will also feature expanded drug and alcohol codes, complication codes, and combination codes – all of which will require additional detail and documentation to successfully navigate.
Last but not least, it’s important to note that having an EHR does not absolve providers of the responsibility to upgrade their documentation strategies. While many EHR systems now give providers the ability to enter the level of details that will be required under ICD-10, many vendors still have a way to go. In fact, a WEDI study published in 2013 indicated that 20% of vendors would not be ready to even beta test their ICD-10 compliant products until 2014.[2] For a list of questions to ask your vendor, see the article from EHR Intelligence in the additional resource section below.

The transition to ICD-10 continues to be a tough journey for many but the most recent delay has given providers the much needed time to prepare. One way to ensure a successful transition to the new codes is to first ensure proper documentation strategies are being implemented. ICD-10 will require greater specificity and provider documentation needs to reflect this change or the consequences (to both the patient and the provider) could be severe. Providers who equip themselves with new documentation habits and strategies will fare much better in the coming transition to ICD-10. Those who do not, will struggle to catch up and will make it much more difficult on themselves and their support staff.
For more information on ICD-10 and updating your documentation strategy, see the following resources:

AAPC: ICD-10 Documentation Example
http://www.aapc.com/icd-10/icd-10-documentation-example.aspx

CMS: How will ICD-10 Affect Clinical Documentation
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD-10-News-Documentaton-and-ICD-10[1].pdf

EHR Intelligence: Top ten ICD-10 readiness questions to ask your vendors
http://ehrintelligence.com/2013/07/10/top-ten-icd-10-readiness-questions-to-ask-your-vendors/

Healthcare IT News: ICD-10 starts at clinical documentation
http://www.healthcareitnews.com/news/icd-10-starts-clinical-documentation

PhysiciansPractice.com: Improve Clinical Documentation for ICD-10
http://www.physicianspractice.com/blog/improve-clinical-documentation-icd-10

[1] Becker’s Hospital Review. (2014, March 06). 5 Notable Surveys on ICD-10 Readiness. Retrieved fromBecker’s Hospital Review: http://www.beckershospitalreview.com/icd-10/5-notable-surveys-on-icd-10-readiness.html
[2] Bresnick, J. (2013, July 10). Top ten ICD-10 readiness questions to ask your vendors. Retrieved from EHR Intelligence: http://ehrintelligence.com/2013/07/10/top-ten-icd-10-readiness-questions-to-ask-your-vendors/

Transitions Leadership Committee Update

The Transitions Leadership Committee continues to meet on a monthly basis to discuss opportunities to strengthen relationships to improve transitions of care. This month’s meeting was held on Tuesday, April 21st

The objective and focus of the meeting were reviewed and follows:
• The Transitions Leadership Committee will discuss opportunities to strengthen relationships to improve transitions of care.

In recognizing the tremendous efforts of this team, we will highlight positive improvements and communications throughout the network each month. Examples from this month’s meeting include the following:
• SVMC Case Management Huddles have been occuring regularly and are working well
• There is still work to be done, but the transitions of patients from teh hospital to the SNFs and/or Home Health Agencies have improved
• There has been tremendous improvement with communication to the Home Health Agencies from SVMC
• St. Joseph’s Manor is including Home Health Agencies in their discharge planning meetings

Dr. Raskauskas lead a discussion regarding High Value Network versus Narrow Network. The following is an overview of the discussion:
• Narrow Network versus High Value Network
oNarrow Network does not take into account quality and appropriate utilization of care; only financially linked
• High Value Network
o Active collaboration between the insurer and its providers. Patient engagement, patient satisfaction, high quality, improved patient safety
o Data sharing to keep track of costs and appropriate utilization of resources in an approopriate setting
o Lower costs is an essential component of a high value contract
o Referral of patients to our High Value Network providers is imperative, along with a shared vision by our providers of a higher vision of care. Examples of such care includes Hospice,

Palliative Care, ESRD, Diabetes and Cardiac Care
• Success of the bundle payments is dependent on our work together with our high quality network partners on post discharge processes from SVMC to our Post Acute Care facilities
• Quality Metrics in relation of fee for service reimbursement–70% of the dollars are i Post Acute Care settings
• SVMC hospital system is in the 99th percentile in CT for patient being sent to a SNF rather than their home setting. Working to lower this percentile and utilize HHAs

Mini case studies were presented that represent our network transistions processes and ongoing discussions followed by an update of the Network Continuous Quality Improvement Process.

We anticipate that the work that is done in these meetings will positively overflow to the transitions of all patients between each of the settings and across the clinically integrated network.

The next meeting will be held on Thursday, April 21st from 1:00 PM-2:30 PM in Hawley 1 Conference Room.

PCMH Recognition:

Congratulations to the following practices for achieving Level III Patient Centered Medical Home Recognition!

corey-jaquez
Corey Jaquez, MD
Trumbull Medicine
17 Church Hill Road
Trumbull, CT 06611
Phone: (203) 696-3550
Fax: (203) 696-3559

anna-pankratov

Anna Pankratov, MD
Fairfield Medicine
2355 Black Rock Turnpike
Fairfield, CT 06825
Phone: (203) 696-3560
Fax: (203) 696-3563
AND
Westport Medicine
225 Main Street, Suite 101
Westport, CT 06880
Phone: (203) 222-0902
Fax: (203) 222-0908

richard-j-sekerak.ashx

Richard Sekerak, MD
Primary Care Specialists
5520 Park Avenue, Suite 208
Trumbull, CT 06611
Phone: (203) 371-8000
Fax: (203) 371-8006
rachel-e-sheiman.ashx
Rachel Sheiman, MD
Penfield Pediatrics
325 Reef Road, Suite 103
Fairfield, CT 06824
Phone: (203) 696-3580
Fax: (203) 696-3584

edward-m-tristine.ashx

Edward Tristine, MD
Primary Care Specialists
5520 Park Avenue, Suite 208
Trumbull, CT 06611
Phone: (203) 371-8000
Fax: (203) 371-8006

 

Member Updates:

Please join us in welcoming Fairfield County Pathology Consultants, LLC as new members to St. Vincent’s Health Partners.

eugene-h-lewis

Dr. Eugene Lewis and his staff are located at SVMC Laboratory, 3rd floor.

 

Please also help us welcome Cambridge Health and Rehabilitation Center as one of our High Value Post Acute Care Partners! Cambridge is located at 2428 Easton Turnpike in Fairfield. For more information, please call (203) 372-0313 or visit their website at www.cambridgem.com.

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Contact Information

Dr. Thomas Raskauskas, President/CEO, (203 275-0205
Thomas.raskauskas@stvincentshealthpartners.org

Dr. Michael Hunt, Chief Medical Officer/Chief Medical Informatics Officer,
(203) 275-0203
Michael.hunt@stvincentshealthpartners.org

Anthony Brockman, Director of Information Technology, (203) 275-0206
Anthony.brockman@stvincentshealthpartners.org

Colleen Swedberg, MSN, RN, CNL, Director for Care Coordination and Integration,
(203) 275-0209
Colleen.swedberg@stvincentshealthpartners.org

Karen O’Driscoll, Director of Professional Relations, (203) 275-0205
karenodriscoll@stvincentshealthpartners.org

Karen Julian, RN, BSN, Care Coordination and Integration Manager,
(203) 896-0215
karen.julian@stvincentshealthpartners.org

Sophia Jackson, RN, Care Coordination Associate, (203) 275-0212
Sophia.jackson@stvincentshealthpartners.org

Mina Gasdia, RN, Care Coordination and Integration Associate, (203) 896-0214
mina.gasdia@stvincentshealthpartners.org

Kyle Lanning, JD, Integration Associate, (203) 275-0204
Kyle.lanning@stvincentshealthpartners.org

Asma Ahmed, Healthcare IT Applications Support Intern, (203) 275-0211, asma.ahmed@stvincentshealthpartners.org

Erika Foster, Integration Associate, (203) 275-0208
Erika.foster@stvincentshealthpartners.org

Susanne, Salgado, Communications and Operations Associate, (203) 275-0201
Susanne.salgado@stvincentshealthpartners.org