October 2014 Newsletter
Volume 3 Number
October 1, 2014
St. Vincent’s Medical Center Positions Itself for the Future as a Founding Member of the “Value Care Alliance”
“St. Vincent’s is proud to be a member of the Value Care Alliance,” stated Dr. Stuart Marcus, president and CEO, St. Vincent’s Health Services. “Our collective vision is to enhance the quality and coordination of care available to residents within the communities we serve. Together we will continue our work to provide high quality, compassionate, and safe care. By doing this in the most cost efficient manner possible, we will lead the transformation of the healthcare delivery system in our region. This will ensure that patients and families receive the services they will need in the future to lead long healthy lives.”
The VCA is the largest collaboration of independent healthcare providers in the state. The seven member hospitals cover the majority of the state geographically and serve approximately 1.3 million people in their combined market areas. In addition to St. Vincent’s Medical Center, VCA members currently include Griffin Hospital (Derby), Lawrence + Memorial Hospital (New London), Middlesex Hospital (Middletown), and Western Connecticut Health Network, which is comprised of Danbury Hospital (Danbury), New Milford Hospital (New Milford), and Norwalk Hospital (Norwalk). Additional healthcare organizations will be added over time.
St. Vincent’s Medical Center has earned national and regional recognition for the compassion of its staff, the commitment to patient satisfaction, and the quality of its care. St. Vincent’s Medical Center is a leader in patient safety and has received the “A” Hospital Safety Score from the Leapfrog Group five consecutive times. It is one of only two hospitals in the state with both the Leapfrog “A” and Nursing Magnet® recognition for nursing excellence. Likewise, U.S. News & World Report named St. Vincent’s Best Hospital in Fairfield County and all of Western Connecticut for two consecutive time periods covering 2013 -2015.
VCA member hospitals and physician organizations will each maintain their strong community focus and independence with local control over governance. This strategic alliance will provide the opportunity to take advantage of the benefits of scale, share best practices, and pursue efficiencies while addressing local market needs. This partnership of like-minded hospitals is unique in Connecticut and sets the stage for innovation and collaboration to jointly develop new services and capabilities among the initial VCA members. The Alliance also will develop and share data and analytical capabilities among its members to enable efficient and effective care management and coordination across multiple settings of care. As a result, the VCA is a nimble organization that is well positioned to be responsive to payer, employer, and consumer needs.
“St. Vincent’s participation in the Value Care Alliance is one more example of Ascension’s commitment to transforming healthcare through the development of clinically integrated systems of care,” said Patricia Maryland, Dr.PH, President, Healthcare Operations and Chief Operating Officer, Ascension Health. “Collaborative efforts like this one will help us to more seamlessly provide person-centered care of the highest quality across the continuum.”
Billing for Transitional Care Management
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. This past month we received data from CMS on all 48 episodes of care. From this information, 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.
On January 1, 2015, we will become accountable for the quality and cost of at least one of the 14 episodes that have been chosen and are listed below. In April, July and October 2015, we can transition additional episodes of care. By October 2015, Phase 1 will end and all participants will be in Phase 2.
As was noted in last month’s newsletter, SVHP will be the facilitator and assist in helping participants redesign care. NaviHealth was chosen by the Board as our financial convener and assume financial risk. NaviHealth will be holding a 2 day summit with SVHP and the SVMC Leadership to review the implementation plan, the process timeline and program goals and key performance indicators. In preparation for this summit, the Transitional Leadership Committee has been meeting to map out processes as the patient moves from each setting. We anticipate that this work will positively overflow to the transitions of all patients between each of the settings and across the clinically integrated network.
Care Coordination–Preventing Falls
Assessing fall risk is a daunting task any time of the year. However, as the temperature drops, the risk of falls rises. Perhaps that is why the National Council on Aging (NCOA) chose September 23rd (the first day of fall) as their Falls Prevention Awareness Day.
According to the NCOA, an older adult is seen in an emergency department for a fall-related injury every 15 seconds. The association encourages patients to talk to their health care providers and to ask for a falls risk assessment. They have several great resources, including a great infographic to hang up in your office, available online at www.ncoa.org.
Over the course of the summer we visited nearly all of the practices and discussed the importance of falls risk assessments, especially given their status as a formal metric under the MSSP ACO contract.
Here are how some of the primary care practices in our network have begun to incorporate fall-risk screening into their daily workflow.
– Prime Healthcare of Southport. Dr. Sarfraz and his team spoke with their EMR vendor and asked them to add a way for them to document fall risk assessments. Sure enough, the vendor was able to add a space to document fall risk assessments, and generate a reminder for patients who were overdue.
– Santiago Escobar, MD. Dr. Escobar had been routinely using a checklist for his Medicare patients. After showing us the checklist, SVHP compared it to the technical specifications outlined for the ACO MMSP contract and found it to be complete and usable after only a minor adjustment.
– Hervey Weitzman, MD. Dr. Weitzman’s office also began using the falls risk assessment (and depression screening tools) routinely with all Medicare patients. He saves time by having his medical assistant do the screenings with the patients in the waiting room prior to seeing him and then, during the actual visit, he reviews the results with them. Once the visit is complete, he scans the results into the medical record for documentation. Dr. Weitzman has even had a few instances where he has referred patients to an in-network home health agency for physical therapy that was warranted based on the results of the screenings he was performing.
– Primary Care Associates. Dr.’s Joshi, Sekerak, and Tristine’s office quickly began operationalizing the fall risk screening tools provided to them and are now use them with all Medicare patients. Similar to Dr. Weitzman’s office, Primary Care Associates gives the screening to the patient while the patient is roomed and then the physician reviews the results with the patient during the visit. Lastly, the results are scanned into the patient record to ensure proper documentation.
There are other practices who had already been routinely conducting and recording falls risk assessments including those of Dr. Asgari, Dr. Cremin, and Dr. Weisman and Dr. Shin. Kudos to all of the practices who have figured out unique ways to implement the screening and make it part of their daily routine for taking care of Medicare patients.
No matter where you are on the implementation continuum whether you are looking for help finessing an already existing process, or implementing a new process, please do not hesitate to call our Care Coordination & Integration Department for assistance. We will research the best practice tools and tips available to assist you.
Billing for Transitional Care Management
If you would like a laminated copy of the above information, please email Karen O’Driscoll, Director of Professional Relations at firstname.lastname@example.org.
Perfect Serve Doc Link
St. Vincent’s is pleased to announce the deployment of Perfect Serve Doc Link to our medical staff members. Perfect Serve is 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. St. Vincent’s has purchased accounts for all active members of the medical staff and has loaded the app with the contact information of the members. This 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.
You will receive a packet of information that has been mailed to your primary office address. The packet will include your User ID and Password (noted at the top of the introduction letter), instructions on how to download the app and activate your account, and an overview of the Perfect Serve features. If you need assistance while activating your account, the contact information for the Perfect Serve help desk is noted in the packet.
St. Vincent’s is pleased to offer this at no cost 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 when you receive your packet. The Medical Executive Committee members have piloted the tool for the past month and found it to be very useful.
Diabetes Prevention Program
The Fairfield Department of Health will be running a free, CDC-approved program for pre-diabetics. This is an evidence-based Diabetes Prevention Program aimed at people with a high risk of developing Diabetes. It will be held weekly and participants are expected to attend regularly. Monthly follow up will occur after the culmination of the program. Preference is given to Fairfield residents but the program is open to residents of all towns. Participants are required to show bloodwork that proves they are pre-diabetic prior to starting. This program will begin October 15th, please have patients register by October 8th if they are interested in participating.
This is a great resource to utilize that could truly benefit your patients who are at risk for developing Diabetes. Below is information about the program.
Please join me in welcoming Cardiologists Jonathan Brier, Alan Radoff, Ron Nudel, Jeremy Nadelmann, Martin Plavec and Rebecca Streeter along with Tina Mulinski, APRN. The group has offices in Hamden, Branford, Cheshire, North Haven, West Haven and Shelton. To schedule an appointment, please call 203-773-3055.
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