Mount Sinai Health Partners
Clinically Integrated Network Newsletter
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September 27, 2019
- Program Engagement and Privacy Training requirements must be completed by this date. Click here to login to CILC and complete these requirements.
- Your Q3 quality reporting is also due by this date. Click here to view the 2019 Clinical Integration Program Requirements Timeline Checklist.
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October 29, 2019
- Mount Sinai Health Partners CME Event: Practice Management for Success in Population Health: Pharmacist and Medical Assistant Staffing. For PCPs and practice managers. Register here.
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CME Event This October — Practice Management for Success in Population Health: Pharmacist and Medical Assistant Staffing
Tuesday, October 29, 2019
5:30pm – 6:30pm: Registration and Dinner
6:30pm – 8:00pm: CME event
150 East 42nd Street
New York, NY 10017
Click here
to register.
If you do not already have an account, you'll need to create one and then return to the landing page, or search "
Practice Management for Success in Population Health" and then register.
Please note that attending this meeting will fulfill part of the 2019 Clinical Integration Program's Practice Engagement requirement of attending a least one in-person meeting per year.
The Icahn School of Medicine at Mount Sinai is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Icahn School of Medicine at Mount Sinai designates this live activity for a maximum of 1.5
AMA PRA Category 1 Credits
™.
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Q3 Quality Reporting Due October 11, 2019
You received notification in early September regarding the Q3 quality reporting process. As a reminder, all necessary materials are available in your
BOX.com
account. Please review these materials and submit your quality reporting by
Friday, October 11th.
The reporting process for Q3 is similar to the reporting process for quarters 1 and 2, as some providers will be submitting their materials via the Lumeris tool, some will be submitting manually, and others will be doing a combination of both:
For PCPs reporting via the Lumeris, Accountable Delivery System Platform (ADSP)
Tool
– your preliminary quality datasheet is available in your BOX account. Please review and make any necessary updates in ADSP. To review the September communication, please
click here.
Please be sure to log onto this tool and submit the necessary information to close care gaps as this will favorably affect your quality performance and, importantly, our overall collective contract performance. At a minimum, practices must document and attach supplemental information for the following two measures:
- Controlling High Blood Pressure
- Diabetes Management: HbA1c Poor Control (>9.0%)
For PCPs reporting manually
– your personal reporting templates are available in your Box account. Please review and submit the necessary quality reporting tools. To review the September communication, please
click here.
For PCPs reporting both the Lumeris, ADSP tool and manually
– If you have fewer than 10 patients in your denominator for any of the measures, you will need to report manually for the balance of those patients. The preliminary quality datasheet (located in your BOX account) will advise whether or not MSHP has sufficient claims for each measure.
For any questions, please review the
Quality webpage
(behind log-in) on the MSHP website.
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The Results Are In – MSHP Board of Managers 2019 Election
Thank you to the candidates who ran for these seats and for your participation in the nomination and election processes
.
Congratulations to the newly elected members:
Manhattan Voluntary PCP:
Michael Yaker, MD
Manhattan Voluntary PCP:
Sonia Gidwani, MD
Manhattan Voluntary Specialist:
Jason Moche, MD
Manhattan East-Side Employed Provider:
Andrew Leibowitz, MD
Non-Manhattan Employed Provider:
Herb Lempel, MD
Please note that elections only took place in the specific territories that had open seats. Therefore, only providers who practice in these regions were eligible to vote.
To view a full listing of the 2019 MSHP Board of Managers,
please click here
and scroll down on the page and select
BOARD.
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MSHP’s Provider Experience Survey: Thank you for your feedback!
For the second year we distributed our Provider Experience Survey to gather feedback on the communications, services, and resources MSHP offers. We’re delighted to report that the majority of you felt very satisfied or satisfied with the communications you receive from MSHP across all channels. Additionally, your perceived value of MSHP has improved since 2018 in terms of helping your practices deliver quality care, lessening administrative demands of payers, providing access to payer networks, and improving practice economics. We appreciate your feedback as we are continuously working to ensure your experience with us is meaningful, actionable, and engaging!
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Tip of the Month: See Which MSHP Payers You Participate With Using the Health Plan Participation Summary
Visit the
Payer Contracts page
on the MSHP website to access your individualized Health Plan Participation Summary and see which of the MSHP contracted payers you are participating with and the dates you are active with each payer.
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Practice Tips & Transformation
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Improving Your Practice’s Finances
Physicians Practice explains 5 metrics that providers should be aware of in assessing their practice’s financial well-being. They suggest tracking your net collections, average collections per visit, days in A/R, unexpected denials, and posting lag in order to identify gaps in staff education and denial trends.
Read the full article here.
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Population Health in the Literature & Media
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Population Health in the Digital World: Wearables and AI
This
article from the Harvard Business Review
discusses several programs that use wearables to track patient health remotely and offers key takeaways to effectively use this technology for improved outcomes. Early returns are positive: Grady Hospital, the largest public hospital in Atlanta, saved $4 million in preventable readmissions thanks to an AI tool and the UK’s National Health Service launched a pilot program that increased treatment adherence to 96%, compared with the industry average of 50%.
Click here to read more
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Hospital of the Future: A Conversation with Niyum Gandhi, EVP and Chief Population Health Officer, MSHS
Our Chief Population Health Officer, Niyum Gandhi, sits down with Dorie Klissas, Chief Marketing Officer, to discuss how Mount Sinai is changing the model of care in the health system, prioritizing keeping people healthy, and what this means from a financial, logistical, and organizational standpoint.
Watch here
.
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Cigna Policy Updates: Claims and Precertifications
Cigna has a number of new claims updates regarding Drug-Eluting Devices for Use Following Endoscopic Sinus Surgery, orthotic prescriptions with no evaluation, vitamin D testing, spinal-fusion related services, venus angioplasty, and more.
Click here to view them all
.
Cigna also has also added 29 CPT codes, 8 new HCPCS codes, and 44 existing CPT codes to their precertification list. To view an outline of these monthly precertification updates, as well as the complete list of services that require precertification of coverage, log in to the Cigna for Health Care Professionals website (
CignaforHCP.com) and click Precertification Policies under Useful Links. If you are not registered for the website, go to
CignaforHCP.com and click Register Now.
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EmblemHealth Supplemental Utilization Management Pre-Authorization List
Effective September 1, 2019, EmblemHealth has an updated Utilization Management Pre-Authorization list with site of service rules which apply to Commercial and Medicaid lines of business.
Click here
to view the updated list.
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P: 877-234-6667
F: 646-537-1481
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