June 2014 Newsletter
Volume 3 Number 6
June 1, 2014
CMS has initiated Bundled Payments for Care Improvements (BPCI) initiative, an innovative new payment model. Under the BPCI initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. BPCI has four models of care, which link payment for multiple services beneficiaries receive during an episode of care. We are working with our hospital partner, St. Vincent’s Medical Center and our skilled nursing partners, Lord Chamberlain, St. Joseph’s Manor and The Jewish Home on Models 2 and 3. Models 2 and 3 involve a retrospective bundled payment arrangement where actual expenditures are reconciled against a target price for an episode of care.
We will be expanding Medical Management Services in the current Anthem contract. We are 6 months in to our contract with SmartHealth and are initiating our medical management component.
Preliminary discussions continue with Aetna, CIGNA and Medicaid.
As the Health Insurance Exchange continues to expand and with the new open enrollment coming this fall, we continue to work with all insurers for opportunities for our network.
We will keep you upraised of updates 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 staff regarding contracts, please contact Karen O’Driscoll, Director of Professional Relations.
St. Vincent’s Medical Center Receives an “A” For Safety
Congratulations to our Flagship Hospital for receiving an “A” for safety!
For the fifth consecutive time, St. Vincent’s Medical Center has received an “A” Hospital Safety Score from the Leapfrog Group, an independent, national nonprofit run by employers and other large purchasers of health benefits. St. Vincent’s currently is the only hospital in Fairfield County, and one of only three out of 27 rated hospitals in the state to meet the criteria required for the “A” safety score. St. Vincent’s is one of only two hospitals in the state to receive all “A”s from the Leapfrog Group since the inception of the twice-yearly ranking in Spring 2012.
Over the last few years, St. Vincent’s has transformed itself into an organization known for safety, teamwork and collaboratin in the delivery of clinical care while providing a patient experience that is compassionate and caring. It began by mandating a “high reliability” safety training program for every employee regardless of position. The implementation of the safety program has resulted in numerous awards for St. Vincent’s in addition to the “A” Hospital Safety Score.
St. Vincent’s is one of only two hospitals in the state to receive both the Leapfrog “A” and Nursing Magnet recognition, the highest national award for nursing excellence. St. Vincent’s was also named a Top Performer on Key Quality Measures by the Joint Commission, the leading accreditor of national health care organizations, and was featured as a model of a high reliability organization by both the Joint Commission and the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) educational website for hospitals. U.S. News and World Report named St. Vincent’s Medical Center Best Hospital in Fairfield County and in all of Western Connecticut for 2013-2014 in its Best Hospitals Survey.
McKesson Population Manager™ supports clinical integration and population management needs. McKesson’s sophisticated enterprise collaboration platform and clinical registry tool provides the needed IT infrastructure to facilitate clinical integration as well as robust performance improvement tools to help providers earn all of their quality incentive revenue.
The roll-out of Population Manager has begun and the Go-Live date is scheduled for Thursday, June 5th. Phase 1 will consist of bringing on three practices. Phase 2 will consist of bringing on approximately 10-12 additional practices, followed by phase 3 in which the remaining practices will go-live.
McKesson has developed a Care Management software program and has asked SVHP to beta test the software. The application supports the creation of a single dynamic care plan which is developed through a process of both manual and automated assessment. The assessment and care plan content delivered within the application includes a subset of McKesson’s InterQual Coordinated Care Content. The program supplements Population Manager and will provide the Care Coordination department with a tool to document and track interactions with our patient population.
Highlights of the Press Ganey 2014 Strategic Insights Report and What They Mean to SVHP
by Erika Foster, Integration Associate
The Press Ganey Strategic Insights Report for 2014, titled Reducing Suffering: The Path to Patient-Centered Care, addresses the need for patient-centered care through the key driver of health care: improving patient outcomes. The focus of this improvement lies in the reduction of patient suffering. The report notably highlights that this suffering can be broken down into inherent suffering associated with the physical conditions of the patient and avoidable suffering associated with the patient-system interactions that can cause stress and anxiety. Typically these two areas are viewed as separate and the latter is seen more in the scope of mental health but the report highlights their interdependence, as this avoidable suffering can lead to poorer physical outcomes. Addressing both of these kinds of suffering is what makes patient-centered care a holistic approach that puts the needs of the patient above everything else.
The report follows this insight with three areas within the health system that analytics can be used to identify the sources of patient suffering and act on them to improve patient health: system based analysis, physician performance analysis, and physician-employee engagement analysis.
This “Suffering Framework” is a great explanatory model as to why care coordination is key to making these system-wide improvements. Reducing variability in these patient-system interactions everywhere from setting up the initial appointment to post-discharge follow-up is what can reduce and even eliminate this avoidable suffering. By addressing the variability in a previously disjointed system, and allowing for coordination across all spheres, we can eliminate stressors such as fear or anxiety due to poor coordination and teamwork, lack of respect towards patients, and loss of trust in providers. Minimizing variation across the health care landscape will put all providers on the same page which will allow for easier implementation of future improvements and allow for a continuum of care across all services rather than disjointed and episodic care.
In the St. Vincent’s Health Partners Network, we have taken this challenge of reducing variation to heart and The Playbook is our biggest asset in working towards this goal. The Playbook outlines the best practice guidelines in everything from chronic disease management to transitions of care. By utilizing this resource we can further reduce variability in our network which will lead to less stress and suffering during transitions for the patient and overall improved patient health outcomes.
The physician performance analysis section of the report goes on to explain how reducing patient suffering and system variability affects patient perceptions of their care and providers. 15.7% of medical practice patients fall within the high risk category for defecting from their current provider. 90% of this attrition risk can be addressed by ensuring providers and team members work together, coordinate their efforts and behave courteously towards patients. Proper care coordination and team work allows the practice to function better and to utilize their resources. This data shows that patients can see that and are making their decisions regarding their providers based on these factors.
Overall, this year’s Strategic Insights report highlights the role data is playing in helping to improve our health systems. This data can help us to create a more clinically coordinated network that will improve overall patient outcomes and their confidence in their providers.
Understanding CMS’s New Proposal on Meaningful Use
On Tuesday, May 20th, CMS released a Notice of Proposed Rule Making (NPRM). “This proposed rule that would change the meaningful use stage timeline and the definition of certified electronic health record technology (CHERT). It would also change the requirements for the reporting of clinical quality measures for 2014.” In December 2013, CMS announced that it would add a 3rd year to Stage 2 in 2016 and the start of Stage 3 would be delayed until 2017. The proposed rule formalizes that intention. The proposed rule offers substantial flexibility to provider so that if a provider cannot fully implement 2014 criteria in 2014, they can attest using 2011 criteria that includes enhanced criteria under a 2013 upgrade of 2011.
Despite the proposed ruling, SVHP is recommending that any provider that does not currently have an electronic health record, submit the EHR Hardship Application. Should you have any questions regarding the application, please contact Dr. Michael Hunt at 203-275-0201 or email@example.com.
Additional information is also available on the Medicare and Medicaid EHR Incentive Programs website.
Provider Engagement and Transitions of Care Educational Series
“Data Privacy and Cyber Liability: What Every Healthcare Professional Should Know.”
Wednesday, June 25th,
7:00-8:00 AM Hawley Conference Room
12:00-1:00 PM Seton Room
Robert Price, CPCU, Senior VP of HUM International New England, LLC will discuss what Cyber Liability is and why data privacy is important.
Continental Breakfast will be provided at the 7:00 AM presentataion.
Lunch will be provided at the 12:00 PM presentation.
To register or for further information, please contact Karen O’Driscoll, Director of Professional Relations at firstname.lastname@example.org or (203) 275-0205.
CMS eHealth University Resources
The Centers for Medicare & Medicaid Services (CMS) eHealth initiative aligns health information technology (Health IT) and electronic standards programs. Together these eHealth initiatives will help the health care industry deliver higher quality care and reduce costs. The CMS eHealth programs include:
- Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs
- Quality Measurement
- eRx Incentive Program
- Administrative Simplification
CMS is working with the health care industry to deliver high quality and efficient health care. The eHealth programs will help improve the health care system, such as:
- Capturing and tracking health information electronically
- Increasing privacy and security of health information
- Better informing patients about their care, and
- Reducing provider paperwork through administrative simplification
Stay informed about the latest eHealth news:
- Subscribe to the eHealth Listserv
- Read our blog at www.cms.gov/eHealth/
- Follow us on Twitter (@CMSGov) and join the eHealth conversation by using the #CMSeHealth hashtag.
Provider Discount Program
More new vendors have been added to our program, at your request! Please consider supporting our partners!
Auto, Home and Personal Umbrella Liability Insurance not only for you but also for employees of your practices!
Physicians First Messages
Our goal at Physicians First Messages is to meet the needs of the medical profession in a changing environment by providing reliable, professional receptionist service at a cost effective flat rate. This is achieved by being a 100% medical receptionist service and giving our clients:
- Reliable, professional answering service – a service that both you and your patients will have confidence in.
- Alpha-paging, numeric paging, text to cell, dialout and patching – you will always have confidence that your messages will always get to you the way you prefer.
- Cost-effective, flat rate billing – manage your practice by lowering and stabilizing your monthly costs.
- Daily fax or E-mail service – delivery of all messages daily to your fax or in real time to your E-mail address.
- Latest Technology – two-way paging with e-mail, guaranteed messaging and a full range of wireless services.
- Special Rates for group practices – call for rates for two or more physicians
- Month to month agreement – we earn your business each and every month with no long-term commitment.
Website where customers can access messages in real time, manage their on-call schedule or office information
Dedicated text messaging line. Store our text number in your cell for easy communication and/or reply back to texts we send you!
To help make sure you have secure fraud controls in place to protect your organization’s finances, review this check list on a regular basis.
To learn more about Webster Bank, please contact Jace D’Amico at email@example.com or 203-962-5839.
We are sad to announce that Christina Cano, our Care Coordinator Associate, has left SVHP to further her education and become an APRN. We are hopeful that once she has completed her schooling, Christina will return to the PHO as a member provider and continue to assist SVHP in providing quality care to our patients! We wish Christina luck in her schooling!
We are also happy to introduce Erika Foster, Integration Associate! Erika started with SVHP on May 5th. As an Integration Associate, Erika will be assisting the clinical staff in population management and focus office resources on the care of patients within the SVHP network, with the intention of improving the overall health of the population while supporting open communication between our network of providers. She is a recent graduate of Drexel University with a degree in Psychology and a minor in Business Administration. Please help me in welcoming Erika to our team!
Dr. Thomas Raskauskas, President/CEO, (203) 275-0202
Dr. Michael Hunt, Chief Medical Officer/Chief Medical Informatics Officer, (203) 275-0203 firstname.lastname@example.org
Anthony Brockman, Director of Information Technology, (203) 275-0206 email@example.com
Colleen Swedberg, MSN, RN, CNL, Director for Care Coordination and Integration, (203) 275-0209 firstname.lastname@example.org
Karen O’Driscoll, Director of Professional Relations, (203) 275-0205
Alvino Williams, Jr., IT Analyst/Clinical Integration, (203) 275-0207
Kyle Lanning, JD, Integration Associate, (203) 275-0204
Erika Foster, Integration Associate, (203) 275-0208
Gretchen Cavaliere, Administrative Assistant, (203) 275-0201