November 2013 Newsletter
Volume 2 Number 10
November 1, 2013
St. Vincent’s Health Partner’s announced the collaboration with St. Vincent’s Health Services in their SmartHealth contract. SmartHealth is St. Vincent’s Health Services employee health plan, which covers over 5000 lives. Under this new agreement, SVHP agrees to take on a shared responsibility for the care of the beneficiaries while assuring active management of both the quality and cost of that care. Open enrollment will begin November and the contract will become effective January 1, 2014. Employees will be encouraged to visit the SVHP website to search for physicians participating in the SmartHealth contract.
Contract discussions and negotiations are in process with 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.
The First Annual SVHP Board of Directors Retreat was held on Saturday, October 10, 2013, at the Bridgeport Holiday Inn. Dr. James Barr, CMO and VP Physician Network Development for Optimus Healthcare Partners was the speaker. Dr. Barr has extensive experience in the Patient Centered Medical Home model. Greg Kotzbauer from the Dartmouth Institute for Health Policy and Clinical Practice was the moderator.
Discussion centered around strategic planning and the direction of growth for St. Vincent’s Health Partners.
Care Coordination and Reporting
The SVHP staff has been compiling and analyzing data, and is putting together a systematic approach to 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.
User Acceptance Training (UAT) for Population Manager has begun. The UAT process is an opportunity for St. Vincent’s Health Partners to use the solution and validate that it matches the configuration agreed upon in the Planning & Preparation Phase of the McKesson Population Manager implementation. The Purpose of UAT is to review the deliverables and to focus on the system configuration and any necessary issue reporting, issue resolution, and retesting to ensure a deliverable product solution that meets the needs of St. Vincent’s Health Partners.
The SVHP Playbook: A Collaboration in Action
A huge THANK YOU to all that attended the October 10th Educational Program entitled “The SVHP Playbook: A Collaboration in Action.” And a special THANK YOU to our panelists, Dr. Ben Weisman, Dr. Santiago Escobar, Dr. Rahul Gupta, Dr. Doodnauth Hiraman and Kathleen Woods!! Your input into the program, made it truly successful!
Here is a brief summary of the presentation:
Why did we choose the name “playbook”? A playbook is a collection of tactics, methods or processes. It is a notebook or document that outlines and describes a strategy for a certain sport, organization or activity. It is a notebook with techniques and vocabulary relating to game plays as well as information about team formations.
What is the correlation to the SVHP Playbook? The SVHP Playbook is a notebook that embodies all of the principles of CLINICAL INTEGRATION. It demonstrates the recommended MINIMUM REQUIREMENTS to SUCCESSFULLY MANAGE PATIENTS in each environment and transfer them between patient care locations. It is SVHP’s notebook of techniques and vocabulary relating to population management as well as addressing transitions of care so the patient can successfully move between levels of care. So when a patient is being discharged from the hospital to a skilled nursing center and then to home with home care, there will be clear communication between the continuums of care and certain procedures will be put into place to make the transition successful.
A Clinically Integrated Network is a network where physicians work together systematically, to improve their collective ability to deliver high quality, safe and valued care to their patients and communities.
Some of the areas that we are working together on the Inpatient side are: 1) readmission rates, 2) medication reconciliation and 3) care coordination. On the Outpatient side, quality metrics that we are monitoring include Preventative Health, in particular wellness exams, immunizations, mammograms and pap smears. We are also monitoring metrics associated with Chronic Disease management particularly with regards to Diabetes, CHF, Asthma and COPD. Utilization metrics that will be used on the
Inpatient side will be 1) length of stay, 2) antibiotic use and 3) blood products/transfusions. In the Outpatient setting, utilization metrics that will be measured will be 1) inappropriate use of Emergency Room, 2) inappropriate advanced radiology and 3) costs per patient per month for Emergency Room, Pharmacy, Inpatient, Outpatient and Radiology.
The panel discussion was centered around 3 case studies focusing on the successes and opportunities for strengthening patient transitions in our network. This lead to positive dialogue arising from observations made by the panel participants and the audience.
By putting the Playbook into practice, measuring the metrics and putting the patient at the center of their care, we will improve quality outcomes, increase patient satisfaction and decrease cost of care.
While the SVHP staff was dressed up in football jerseys, the tailgating consisted of nachos, chicken wings and chili, there was a spoof on the football theme and fun was had by all, the message was serious that SVHP and its members are leaders that will change the culture of healthcare in Connecticut.
For those of you that were not able to attend, the SVHP Playbook is available on a thumb drive for all practices. The SVHP staff will be visiting the practices over the next few weeks to distribute the thumb drives.
Enhancing Access and Continuity is one of the six standards for PCMH Recognition. Consumer Access to Services and Information is also a measured standard for URAC Accreditation. To address these standards, Office Hours for all SVHP practices will be listed on the website. The SVHP team is currently working on gathering this information from each practice and will be adding this to the Physician Search area on the website
These standards also include after hour coverage. We are encouraging our members to please refer your patients to the St. Vincent’s Urgent Care Walk Ins for after hours coverage for treatment of non-life threatening illness and injuries. The centers have complete diagnostic services including lab, EKG and x-ray. With the upcoming holidays quickly approaching, the St. Vincent’s Urgent Care Walk Ins will be providing extended hours. Additional information can be found at www.stvincentshealthpartners.org/st-vincents- medical-center-urgent-care-walk-ins/.
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 firstname.lastname@example.org.
Medical Malpractice Insurance Program
St Vincent’s Health Partners is pleased to announce a new medical malpractice insurance program for our members. We are partnering with HUB Healthcare Solutions and National Specialty Insurance Company to offer a discounted medical professional liability insurance program that is significantly more competitive than the insurance most physicians have now and was more competitive than the other proposals we received. HUB Healthcare Solutions has an office in Fairfield and they are one of the largest insurance brokers in New England. They represent over 3,000 physicians and they truly understand the needs of physicians and how to make their practices more financially successful. National Specialty is an “A” rated insurance company with support that is very familiar with CT.
HUB Healthcare can also assist you with insurance for Data Privacy & Security (HIPAA protection & cyber liability) and Regulatory Insurance (Defense cost and penalties for billing errors) with discounted premiums as a member. St Vincent’s Health Partners has purchased insurance for both to protect its assets from the ever increasing liability presented by cyber liability/HIPPA fines and audits by Medicare/Medicaid. Contact Karen O’Driscoll, Director of Professional relations at email@example.com or at (203) 275-0205 to find out more and set up an initial meeting.
Access Health CT Assisters
St. Vincent’s Medical Center and St. Vincent’s Health Partners, Inc. are excited to introduce our Access Health CT Assisters, Maritza Santiago and Christina Cano. Maritza and Christina will work together with other Certified Assisters throughout Fairfield County to assist the county’s more than 50,000 uninsured and underinsured residents in accessing health care coverage.
Access Health CT is Connecticut’s Official Health Insurance Marketplace whose mission is to increase the number of Connecticut residents who are insured, lower their costs, promote health and eliminate health disparities.
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). Navigators and Assisters are certified by Access Health CT to provide consumers with support enrolling in a variety of health care coverage options including subsidized health insurance, Medicaid and HUSKY programs.
Certified Assisters have passed a background check, signed Privacy, Security and Conflict of Interest statements, completed 40 hours of training, passed a certification exam, and carry photo ID badges. They help consumers enroll using Access Health CT issued secure laptops to ensure privacy and security.
The role of Assisters is to bring health care reform directly to the people through education, engagement and enrollment. Assisters are committed to health equity and empowerment – helping consumers make informed decisions about health coverage and self-advocate.
Through providing culturally and linguistically and appropriate access, Assisters educate consumers on the ACA and health care coverage, present Access Health CT coverage options, assess and respond to consumer needs, review enrollment documents, shop and compare plans, and enroll consumer with website.
St. Vincent ’s Medical Center (primarily Emergency Department and Inpatient) referrals w i l l be sent to Maritza Santiago. PHO members’ practice locations (Urgent Care, MSG, and independent offices) will refer to Christina Cano. Both will participate with hosted community events to enroll consumers.
St. Vincent’s Health Partners, Inc. Assister
Christina Cano, RN, BSN, Care Coordinator Associate
2754 Main Street
Bridgeport, CT 06606
Phone (203) 275-0212
Fax: (203) 275-8688
St. Vincent’s Medical Center’s Assister
762 Lindley Street
Bridgeport, CT 06606
Phone (203) 576-5522
Fax (203) 581-6521
SVHP Contact Information
Dr. Thomas Raskauskas, CEO/President, (203) 275-0202; firstname.lastname@example.org
Dr. Michael Hunt, Chief Medical Officer/Chief Medical Information Officer, (203) 275-0203; email@example.com
Brenda Reig, RN, MSM, Director of Clinical Quality, (203) 275-0204; firstname.lastname@example.org
Anthony Brockman, Director of Information Technology, (203) 275-0206; email@example.com
Karen O’Driscoll, Director of Professional Relations, (203) 275-0205; firstname.lastname@example.org
Alvino Williams, Jr., IT Analyst/Clinical Integration, (203) 275-0207; email@example.com
Colleen Swedberg, MSN, RN, CNL Care Coordinator, (203) 275-0209; firstname.lastname@example.org
Christina Cano, RN, BSN Care Coordinator Associate, (203) 275-0212; email@example.com