November 2014 Newsletter
Volume 3 Number 11
November 1, 2014
We are excited to announce that we are entering our second year of our contract with Anthem. Through our collaborative work with Anthem, we have been able to decrease the number of care gaps and help you, our providers, close the loop on outstanding tests, procedures and missed appointments and improved our out of network usage tremendously.
Our contract remains the same for the upcoming year. The only change is the “Patient Centered Primary Care Program” is now being called “The Enhanced Personal Health Care Program”. This program empowers primary care physicians to engage in those comprehensive primary care functions that move toward a coordinated, evidenced based care model that has the greatest impact on achieving the Triple Aim of improved quality, patient experience and affordability. This program helps redesign the current payment model to move from volume based to value based payment and aligns incentives to those primary care physicians that are recognized as a Patient Centered Medical Home practice.
For questions regarding how SVHP can assist your practice in being recognized as PCMH, please contact Karen O’Driscoll, Director of Professional Relations at (203) 275-0205 or via email at firstname.lastname@example.org.
Bundled Payment for Care Improvement Initiative (BPCI)
The BPCI initiative consists of 2 phases: The first phase is the “preparation” period in which CMS shares data with participants and participants prepare for possible implementation and assumption of financial risk. Once approved by CMS, the participants can enter into a BPCI Model Agreement with CMS and begin Phase 2.
We are currently in Phase 1-the “preparation” phase. We selected 14 episodes of care (listed below). Due to an overwhelming response to the expansion of the program, participants will have an opportunity to transition into Phase 2, which is known as the “risk-bearing” phase.
As was noted in previous newsletters, SVHP will be the facilitator and assist in helping participants redesign care. NaviHealth was chosen by the Board as our financial convener and will assume financial risk.
On October 8th and 9th, NaviHealth held a 2 day summit which consisted of a Kick-off, a Clinical Operations meeting and a Data File/Exchange meeting. NaviHealth reviewed the implementation plan, the process timeline and program goals and key performance indicators. The initial Go-Live date was scheduled for January 1, 2015, however, we were informed by NaviHealth that CMS has delayed releasing additional data until mid November. Therefore, the team decided to defer the Go-Live date until April 1, 2015. This delay will allow us to operationally and functionally test our processes and prepare for a successful roll out on April 1st. Weekly update calls have been scheduled to review the status of the project.
In preparation for the April 1st roll out, the Transitional Leadership Committee has been meeting on a monthly basis. This month’s meeting was held on Thursday, October 23rd. Topics that were covered were a review of the BPCI timeline was well as follow up from the NaviHealth Summit meetings. The group then broke out into 4 teams to discuss the new post acute care transitions tools and made recommendations for changes to enhance the tools. The next Transitions Leadership Committee meeting will be held on Thursday, November 20th at 1:00 PM in the Hawley conference room.
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.
Complex Chronic Care Coordination Coding
Good news for Primary Care Physicians!! Starting on January 1, 2015, under the new CMS Chronic Care Management Program, CMS will reimburse providers $41.92 for furnishing specified non face to face services to qualified beneficiaries within a 30 day period. (CMS will be releasing HCPCS code in November.) A qualified beneficiary is a fee for service Medicare beneficiary with “two or more chronic conditions expected to last at least 12 months, or until the death of the patient, that place the patient at significant risk of death, acute exacerbation/decompensation or functional decline; 20 minutes or more; per 30 days.”¹ The 20 minutes must be non-encounter based follow up care. The provider must inform the patient of the service being provided, obtain written consent and keep a copy of the document in the patient’s medical record.
Chronic Care Management (CCM) services must contain the following elements:
- A Patient Centered Plan of Care that is regularly updated and a copy given to the patient
- Access to health care providers (24/7) to allow patients timely contact to address urgent chronic care needs
- Offer enhanced opportunities (via telephone, secure messaging) for the patient to communicate with the team and/or caregiver
- Continuity of Care with care team and assure access to successive appointments
- Medication monitoring and recommended preventive care services
- Manage care transitions between settings
- Coordination of home and community based services
¹ Source: Final Rule – The Office of the Federal Register – CMS 1612 FC – Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015
Perfect Serve Doc Link Update
Last month, St Vincent’s announced the deployment of PerfectServe, an app for your iPhone or Android mobile device that allows you to quickly connect with other SV medical staff members via HIPAA secure text messages and phone calls. This app will allow you to easily text or call any active member of the St. Vincent’s staff. The app also allows you to block Caller ID when calling patients from your cell phone. Your cell phone number will not appear to the patient and Perfect Serve overcomes anonymous-caller ID block. The app is free and is offered to enhance the physician-to-physician communication among the medical staff members and ensure communication is HIPAA compliant. Please take advantage of this tool and activate your account today.
Below is a quick update on the implementation of the PerfectServe Secure Calling and Texting Application Solution:
- 155 providers have activated PerfectServe on their phone. Allied Health members now have accounts.
- Providers find the best feature of PerfectServe is that you can call patients from your cell phone and your primary office number appears on their Caller ID. They are unable to view your cell phone number and the call is secure.
- PerfectServe offers easy access to SVMC’s contact list of credentialed providers and their cell/primary office number.
- PerfectServe offers secure texting of patient information to your colleagues while maintaining HIPAA compliance. Your texts can be hacked.
- If you are unable to find a physician in the contact, this may be due to your IOS8 update. Go to the top of the contact list, pull down the list at the letter A and you will see it update the list with the latest providers
- Need your User ID and Password? Simply contact Donna Consiglio at 203-576-5437, Manager Physician Services, SVMC.
- Need help downloading the App and activating your account? Call the PerfectServe help desk at 1-877-844-7727. They are very helpful!
We hope you find this App useful. The providers who have activated their accounts are very happy with the tool.
Please join me in welcoming Pediatrician, Taesun P. Chung, MD to St. Vincent’s MultiSpecialty Group and SVHP! Board certified in Pediatrics, Dr. Chung is accepting new patients at her practice at 2000 Post Rd, Suite 305, Fairfield. To make a referral, please call (203) 254-3242.
Please also help us welcome Dr. Stevan Marjanovic. Dr. Marjanovic is affiliated with Women’s Health CT at 3180 Main Street, Bridgeport. To contact Dr. Marjanovic, please call (203) 374-0404.
Dr. Thomas Raskauskas, President/CEO, (203 275-0205
Dr. Michael Hunt, Chief Medical Officer/Chief Medical Informatics Officer, (203) 275-0203
Anthony Brockman, Director of Information Technology, (203) 275-0206
Colleen Swedberg, MSN, RN, CNL, Director for Care Coordination and Integration, (203) 275-0209
Karen O’Driscoll, Director of Professional Relations, (203) 275-0205
Sophia Jackson, RN, Care Coordination Associate, (203) 275-0212
Kyle Lanning, JD, Integration Associate, (203) 275-0204
Erika Foster, Integration Associate, (203) 275-0208