July 2013 Newsletter

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Monthly Newsletter

Volume 6 Number 1

July 1, 2013

Contracts

One of the many benefits of membership in the PHO is the ability to negotiate contracts with third party Payors. If anyone approaches you or your office staff regarding contracts, please contact Karen O’Drsicoll, Director of Professional Relations.

St. Vincent’s Health Partner’s announced the collaboration with Accountable Care Associates (ACA), of Springfield, Massachusetts, in a CMS Medicare Shared Savings contract. Under this new agreement, SVHP agrees to take on a shared responsibility for the care of a defined population of Medicare patients while assuring active management of both the quality and cost of that care.

The ACO will reward providers for improving care management and limiting unnecessary expenditures while continuing to provide patients freedom within the SVHP network. The success of the ACO model in fostering clinical excellence while simultaneously controlling costs depends on its ability to incentivize hospitals, physicians, post-acute care facilities, and other providers involved to form linkages and facilitate coordination of care delivery. By increasing care coordination, SVHP will help reduce unnecessary medical care and improve health outcomes, leading to a decrease in utilization of acute care services.

St. Vincent’s Health Partners also announced the collaboration with Anthem Blue Cross and Blue Shield on a new model of provider reimbursement. Under this new arrangement, SVHP will focus on the management of chronic disease and preventive health of their patients.

In moving to a patient-centered accountable care model, Anthem and SVHP, have agreed on quality metrics on hypertension, diabetes, management of tobacco use and identifying obesity, in addition to industry standard primary care based metrics that together support better coordinated and effective population management.

Over the next few weeks, Dr. Raskauskas, Dr. Hunt and Karen O’Driscoll will be visiting the practices regarding the details of the contract.

 

urac

 

SVHP has been selected to become an early adopter for URAC clinical integration and anticipate becoming accredited this fall. Our Clinically Integrated Network will be evaluated on a clinical management plan that includes the adoption of metrics, review of data and escalation if outcomes are not met. A process of tracking, monitoring, reporting, and documenting provider non-adherence and requirements for recording clinical outcomes is required. Once accreditation is achieved, SVHP will be one of the first PHO’s in the country to achieve such high recognition. SVHP will also meet the FTC guidelines of avoiding anti- trust for contracting purposes.

URAC, an independent, nonprofit organization, is well- known as a leader in promoting health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry.

As many of you are aware, SVHP has chosen MedVentive as our IT platform. We are currently in the implementation phase of the roll-out and data extraction has begun in some practices.  With the roll- out, many members have questions with regards to MedVentive. Below is an overview.

medventive_logo

 

The McKesson MedVentive system is a Knowledge- based technology platform that enables and supports a clinically integrated network. MedVentive’s integrated features are supported by a common enterprise data platform, enabling operational efficiencies and data integrity to support coordinated, collaborative care delivery. The MedVentive platform captures and aggregates multiple data sources, including data from numerous electronic health record (EHR) and practice management (PM) systems, to create a truly integrated solution. The MedVentive platform serves two related yet different needs, population management and risk management.

The McKesson MedVentive Population Manager

Enterprise Quality Registry Platform supports:

Blue_Bullett     All patients, including Medicare and Medicaid

Blue_Bullett    Collaborative management to a common set of care guidelines

Blue_Bullett    Care coordination to promote efficiency

Blue_Bullett    Finding and managing gaps in care

Blue_Bullett   Proactive work flows

Blue_Bullett   Measuring improvement

The McKesson MedVentive Risk Manager is a Quality, Cost & Utilization Reporting tool that supports:

Blue_Bullett   Eligibility-defined populations

Blue_Bullett   Cost, utilization and quality management

Blue_Bullett   Episodes of Care

Blue_Bullett   Predictive Modeling

Blue_Bullett   Drug spend (substitution work flow)

Blue_Bullett   Length of stay / Readmission

Blue_Bullett   Imaging and ED use reporting

Blue_Bullett   Network management

Blue_Bullett   Leakage

Blue_Bullett   Physician Profiling: PCP & Specialist

Blue_Bullett   Incentive management

The McKesson MedVentive clinical intelligence platform is a hosted Software-as-a-Service (SaaS) / ASP solution. The web based application can be accessed from anywhere using an Internet browser and a secure login. There are no hardware requirements, making it incredibly simple to deploy.

Education Programs

Please join us for our monthly provider education programs co-sponsored by Fairfield County Medical Association. Each event will include dinner and CMEs will be earned.

Thank you to those that attended our program on Patient Centered Medical Home on Monday, June 3rd, with Dr. Thomas Meehan, CEO of Qualidigm.

Below is a schedule of upcoming events:

Wednesday, August 7th, 6:00-8:00 p.m.

Patient Engagement St. Vincent’s Medical Center

Hawley 2

Laurie Murray, RN, DSN, Patient Centered Outcomes Consultant Regional Manager For Total Therapeutic Management and contractor for Agency for Healthcare Research and Quality (AHRQ), will be the speaker.

 

Thursday, October 3rd, 6:00-8:00 p.m.

The Hub of Medicine: How the Emergency Department Can Help Optimize Navigation and Care Coordination in a Medical Home

St. Vincent’s Medical Center, Hawley 2

Dr. Frank Illuzzi, SVMC, Department of Emergency

Medicine, Chairman, will be the speaker.

Please contact Karen O’Driscoll, Director of Professional Relations by email karenodriscoll@stvincentshealthpartners.org or refer to our website www.stvincentsheatlhpartners.org to register for the programs.

Website

Visit our website, www.stvincentshealthpartners.org , for information regarding Electronic Prescribing and EHR Incentive Programs through CMS. Each week there are new articles under the “News” tab and a

Monthly Featured Article that we feel are important to our members.

Remember to use the Physician Directory Search area when recommending physicians to your patients.

Coming soon to the website, under the “Meet The

Team” tab, the Board of Directors will be highlighted.

 

pcmh logo

Need more information on the Patient Centered Medical Home (PCMH)? The link below provides important definitions, principles and helpful information for understanding the PCMH concept.

http://www.huskyhealthct.org/providers/pcmh.html

 

ct health network

Some of our Primary Care offices have been working with Community Health Network of Connecticut, Inc., to assist them with the PCMH application. If you are interested in learning more, please contact Karen O’Driscoll, Director of Professional Relations at (203)

275-0205 or karenodriscoll@stvincentshealthpartners.org.

 

SVHP Staff Update

Congratulations to Colleen Swedberg, Care Coordinator with SVHP, who recently completed the highly recommended ‘Moderate Care Manager Program’ webinar course offered by the Practice Transformation Institute (PTI) in Michigan. This course provides an overview of the existing best practice approaches available in the care management of patients with chronic diseases and many tools which will be made available for use by the physician led practice teams in our membership. Topics varied from

‘Working and Thriving in a Patient Centered Medical Home’ to ‘Evidence Based Guidelines for Ambulatory Practices’. For members interested in having their care managers take this course, information about future onsite and webinar based courses can be found through the following link at PTI:

http://www.transformcoach.org/moderate-care- manager-program/

 

Contact Information

Dr. Thomas Raskauskas, CEO/President, (203) 275-0202; thomas.raskauskas@stvincentshealthpartners.org

 

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

 

Brenda Reig, RN, MSM, Director of Clinical Quality, (203) 275-0204; brenda.reig@stvincentshealthpartners.org

 

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

 

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

 

Alvino Williams, Jr., IT Analyst/Clinical Integration, (203) 275-0207; alvino.williams@stvincentshealthpartners.org

 

Colleen Swedberg, MSN, RN, CNL Care Coordinator, (203) 275-0209; colleen.swedberg@stvincentshealthpartners.org