May 2014 Newsletter
Volume 3 Number 5
May 1, 2014
St. Vincent’s Health Partners Assister Enrolls over 450 CT Residents In Access Health CT
Assisters Provide Support to Help Uninsured Make Important Decisions on Healthcare Coverage
St. Vincent’s Health Partners would like to congratulate Christina Cano, SVHP’s Care Coordinator Associate and Maritza Santiago, In-Person Assister for St. Vincent’s Medical Center, for their outstanding achievement as designated Access Health CT Assisters. Both women were selected in September of 2013 to participate in the training and certification process for the Assister program for Access Health CT, Connecticut’s official health insurance marketplace whose primary mission is to increase the number of Connecticut residents who are insured, lower their costs, promote health and eliminate health disparities.
As a physician health organization, St. Vincent’s Health Partners was eager to participate in the assister program as a way to help improve the health of area residents through encouraging access to a wider range of insurance options. The two women were selected for their role because of their knowledge of the insurance process and their commitment to the goals of both Access Health CT and SVHP.
“We are so pleased and proud to have been selected to participate in the Assister program,” said Dr. Thomas Raskauskas, CEO. “The hard work of Christina and Maritza, who we selected for this important work, exemplifies our deep-rooted relationships in the community. We are thrilled with their outstanding achievement in helping us reach those uninsured and underinsured individuals who need access to insurance but don’t know where to start.”
As Assisters, Cano and Santiago both worked extensively to achieve some of the highest numbers of the approximately 300 Assisters state-wide. Christina Cano worked 1,135 hours, engaged 1,682 and enrolled 477 Connecticut residents into the new healthcare program. Maritza Santiago worked 559 hours engaging 2,093 and enrolling 385. According to the latest data provided by the National Institute of Pension Administrators, Fairfield County had the greatest number of enrollments in the state of Connecticut.
As Assisters, Cano and Santiago were required to undergo background checks, 34 hours of training and pass a certification exam with a minimum score of 80 percent. Once a designated, Assisters are equipped to provide individuals and families the ability to make educated decisions about their healthcare coverage. They also provide consumers with support enrolling in a variety of health insurance coverage options including subsidized health insurance, Medicaid and HUSKY programs.
The Assister program is a federally-funded grant program established through the Affordable Care Act (ACA). The Navigator and Assister Outreach Program is the result of a unique partnership between Access Health CT and the State of Connecticut’s Office of the Healthcare Advocate (OHA). The program has played a key role in Access Health CT’s community outreach efforts in bringing the ACA directly to the people.
“Assisters provide the education and guidance our residents deserve to help them make the right health plan choices,” said Access Health CT CEO, Kevin Counihan. “We are impressed and delighted with the enthusiasm and commitment of the Assisters to make affordable health insurance a reality in Connecticut.”
For more information please visit www.accesshealthct.com/outreachprograms
CMS eHealth Information
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.
Meaningful Use Hardship Exception Information
As part of the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated payment adjustments to be applied to Medicare eligible professionals who are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Programs. These payment adjustments will be applied beginning on January 1, 2015, for Medicare eligible professionals. Medicaid eligible professionals who can only participate in the Medicaid EHR Incentive Program and do not bill Medicare are not subject to these payment adjustments.Medicare eligible professionals who are not meaningful users will be subject to a payment adjustment beginning on January 1, 2015.This payment adjustment will be applied to the Medicare physician fee schedule (PFS) amount for covered professional services furnished by the eligible professional during the year (including the fee schedule amount for purposes of determining a payment based on the fee schedule amount). The payment adjustment is 1% per year and is cumulative for every year that an eligible professional is not a meaningful user. Depending on the total number of Medicare eligible professionals who are meaningful users under the EHR Incentive Programs after 2018, the maximum cumulative payment adjustment can reach as high as 5%.Because payment adjustment are mandated to begin on the first day of the 2015 calendar year, CMS will apply a prospective determination for payment adjustments. Therefore Medicare eligible professional must demonstrate meaningful use prior to the 2015 calendar year in order to avoid the adjustments.
Eligible professionals that have not participated in the EHR incentive program and would like to participate for the Program Year 2014, have until October 1, 2014 to successfully attest and avoid the 1% payment reduction for Medicare Part B claims.
If you have not previously participated in the EHR Incentive Program and would like to submit a Hardship Exception Application, you MUST submit your application NO LATER THAN MIDNIGHT EDT ON JULY 1, 2014.
Hardship exceptions will be granted only under specific circumstances and only if CMS determines that providers have demonstrated that those circumstances pose a significant barrier to their achieving meaningful use.
Information on how to apply is also posted on the CMS EHR Incentive Programs website: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/paymentadj_hardship.html
Below is the Incentive Chart from CMS.
Provider Engagement and Transitions of Care Educational Series
Health reform is happening at a rapid pace. To aid the membership in keeping up with the latest regulations and information on health reform, St. Vincent’s Health Partners, in partnership with Fairfield County Medical Association, offers educational programs with CMEs available.
Thank you to those that attended our last program titled “THE DOCTOR IS IN ONLINE” by Dr. John Stively, Assistant Chief Medical Officer with PhoneDOCTORx. Dr. Stivley discussed the future of telemedicine in the healthcare delivery system. Some of the top trends driving telehealth/telemedicine are 1) employers using and encouraging the use of telehealth and telemedicine for their workforce, 2) increased legislative support, 3) the Affordable Care Act, 4) hospital readmissions and 5) increase in clinical mobility and applications.
The telehealth and telemedicine market in North America in 2011 was $6,139,000,000. It is projected that by 2016, the market will be $15,468,506,000.
The diagram below describes the difference between telehealth and telemedicine.
Care Coordination and Clinical Integration in the Community
Integrating Specialist and Primary Care Expertise in the SVHP Neighborhood- Part 2: A work in progress!
There are more than 40 specialties represented in the SVHP neighborhood. Thousands of referrals and consults are done each year across the neighborhood. As a patient or as a provider, what is your experience in that process? What do you wish would be smoother?
Last month, we referenced SVHP specialist practices who asked what they can do to improve their consult and feedback loop, after learning from other ‘neighbors’ that the process of setting up a consult can be difficult or that no information comes back after the consultation.
Here is an update on the work in progress this past month being done by one of those practices. The practice manager has (1) worked with the electronic medical record (EMR) software company and has been able to add fields to accommodate additional information about the referring physician; that makes it easier when the time comes to send information back to the referral source (2) she has automated the process for ensuring that the consult information is consistently faxed back to the referring physician for new patients and is currently working on how to do the same for existing patients and (3) she has also modified the patient intake form to include referring information and information about the PCP. These changes are expected to make it easier to consistently follow up in a timely manner to referral sources with the consult feedback, all consistent with the SVHP Playbook.
Provider Discount Program
Webster to host series of free business events
Helping healthcare practices and other small businesses manage their finances more efficiently is the focus of Webster Bank’s celebration of Business Month. During the month of May Webster will be hosting a series of free networking events for small business owners.
Attendees will have the chance to network with their peers and take part in discussions on fraud awareness, real estate financing and other topics. Financial and lending professionals will also be on hand to discuss ways to improve cash flow, obtain financing and other financial solutions for small businesses.
Each event will also feature exclusive business offers from Webster Bank. Attendees can take advantage of special savings on cash flow solutions, business banking products and other financial products for small businesses.
For more information about Webster’s Business Month celebration, contact Jace D’Amico at 203.962.5839 or firstname.lastname@example.org.
Please help SVHP welcome the newest member of our staff: Kyle Lanning, JD! Kyle is SVHP’s first Integration Associate and will be working in SVHP’s medical management services department. The role leverages data from the patient’s Medical Home to focus office resources on managing outstanding preventative and chronic disease requirements; ultimately improving the health of the population. Kyle holds a BS in Business Technology Management from Clarkson University and a JD from Quinnipiac University School of Law (including a concentration in Health Law, with Honors). His educational background enhances SVHP’s clinical integration processes and adds a new dimension to the organization.
Dr. Thomas Raskauskas, CEO/President, (203) 275-0202; email@example.com
Dr. Michael Hunt, Chief Medical Officer/Chief Medical Information 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; email@example.com
Alvino Williams, Jr., IT Analyst/Clinical Integration, (203) 275-0207; firstname.lastname@example.org
Christina Cano, RN, BSN Care Coordinator Associate, (203) 275-0212; email@example.com
Gretchen Cavaliere, Administrative Assistant, (203) 275-0201; Gretchen.firstname.lastname@example.org