September 2013 Newsletter

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Monthly Newsletter

Volume 2 Number 8

September 1, 2013

Contracts

A meeting with the Anthem Provider Network Team and the SVHP staff was held on Wednesday, August 28th to discuss the roles of each team member and their responsibilities. The following reports will be made available from Anthem:

  • Attribution Active Report
  • Attribution Inactive Report
  • Emergency Room Report
  • Hot Spotter Report
  • Inpatient Authorization Report
  • Medical Cost Target Report
  • Performance Scorecard Report

The SVHP staff will compile data, analyze and systematically deliver the actionable information to each physician practice site. A SVHP staff (Professional Relations, Quality, and or Care Coordination) onsite visit will be discretely scheduled each month (same day and time) to discuss in-depth analysis with actionable suggestions. Each quarter, Dr. Hunt will present physician specific data with analysis during the onsite meeting. Remember that continuous daily care coordination will be ongoing and will incorporate local processes.

Contract discussions and negotiations are in process with SmartHealth, Cigna, Connecticare and United Healthcare. We will continue to update you through the website, emails and the newsletter.

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’Driscoll, Director of Professional Relations.

URAC Update

SVHP has received official notice from URAC that they are in receipt of our application and we have been given the okay to use the “In Process” seal for Clinical Integration, as seen below.

In-Process CI (2)

The Accreditation process includes electronic submission of processes and an on-site visit with interviews of all SVHP staff. It is anticipated that the electronic submission will be complete by September 20th.

We are also pleased to announce that Dr. Raskauskas and Brenda Reig will be attending the URAC Quality Summit “Raising the Bar on Quality: The New Wave of Health Plan Accreditation, Data Analytics and Clinical Integration” September 30- October 2, 2013 in Washington DC. Dr. Raskauskas has been asked to present on “The Importance of Clinical Integration.”

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.

Practice Employee Benefit Programs

St. Vincent’s Health Partners, Inc.  is pleased to announce a new service to our members. We are partnering with Omega Financial LLC and AmWins Group Benefits to offer comprehensive employee benefit programs. The programs will include group medical, dental, vision, life, disability, retirement plans. We have carefully selected these representatives/agents as they are experts in their field. For members who are interested, Omega Financial LLC and AmWins will provide a complete analysis and comparison of your current program(s). As members, you will also have access to many unique benefits and discounts. Please contact Karen O’Driscoll, Director of Professional Relations at karenodriscoll@stvincentshealthpartners.org or at (203) 275-0205 to find out more and set up an initial meeting.

IT Update

MedVentive Population Manager is currently pulling data from 14 practices with an additional 3 practices to be added over the next week.  The “go-live” date is October 14th.

McKesson Risk Manager TM, project kick off meeting is scheduled for September 13th with MedVentive/McKesson and the SVHP staff. McKesson Risk Manager TM, allows you to analyze and improve the entire spectrum of cost and quality challenges such as patient profiling, Pay-for-Performance (P4P) management, generic prescribing, HEDIS compliance and more.

Education Programs

Thank you to all that attended the program on August 7th, entitled “Using AHRQ Resources to Improve Patient Engagement and Improve Health Care.” Laurie Murray, RN, DSN, Regional Manager North East for AHRQ’s Patient Centered Outcomes Program and Eileen Birmingham, MD, MPH,

Patient Centered Outcomes Consultant for AHRQ’s Effective Health Care Program in the greater Metropolitan New York region were the speakers. If you were not able to attend but would like the resources that were provided, please contact

Karen O’Driscoll, Director of Professional Relations at karenodriscoll@stvincentshealthpartners.org.

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.

Below is a schedule of the upcoming event:

“The SVHP Playbook:  A Collaboration in Action”

Thursday, October 10th, 6:00-8:00 p.m.

St. Vincent’s Medical Center, Hawley 2

This program will be extremely important to attend as the St. Vincent’s Health Partners Playbook will be introduced and distributed. The playbook will then be operationalized to be used by all practices.

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 the top 10 most popular EHR Systems, Call to Action Alerts from FCMA and Top 100 Docs. 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. The directory can be searched by Physician name, City, Zip Code, Specialty and/or Practice Name.

If your practice has a website and would like to have a link on the SVHP website, please contact Karen O’Driscoll, Director of Professional Relations at karenodriscoll@stvincentshealthpartners.org.

ahrq-logo

AHRQ, the Agency for Healthcare Research and Quality, is dedicated to improving the quality, safety, efficiency and effectiveness of health car for all Americans. It is 1 of 12 agencies within the U.S. Department of Health and Human Services.

Working with the public and private sectors, AHRQ builds the knowledge base for what works-and does not work-in health and health care and translates this knowledge into everyday practice and policymaking. The focus areas are: 1) comparing the effectiveness of treatments, 2) quality improvement and patient safety, 3) health information technology, 4) prevention and care management and 5) health care value.

Please visit their website for FREE patient education materials. http://ahrqpubs.ahrq.gov/OA_HTML/ibeCZzpHom e.jsp

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

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

Jacquie Jacovino, Administrative Assistant, (203)275-0201; jacquie.jacovino@stvincentshealthpartners.org