|
|
Clinically Integrated Network Newsletter
December 17, 2020
|
|
Season’s Greetings and Happy Holidays from All at MSHP
We are thankful to have such an outstanding network of clinicians, office managers, and practice staff. As we conclude a particularly challenging year, all of us at MSHP want to take a moment to recognize the tireless commitment you have made to the success of the clinically integrated network and your patients. We all wish you the happiest of holidays and a wonderful start to the new year.
|
|
Answers to Your Diabetes and Heart Failure Questions
Questions asked and answered during the November 11 CME event on ambulatory excellence in diabetes and heart failure management are available on the Chronic Condition Management Hub. Visit the Hub to read questions and answers from the event's participants and presenters, watch the meeting recording, and more.
|
|
Thank You for Attending the December 8th Town Hall
Thank you to all who attended our final Town Hall of 2020 on December 8th. If you missed the meeting or want to review any of the information presented, you can view the recording or download the slides. We look forward to continuing these in 2021!
|
|
Mount Sinai Health Partners is Excited to Welcome Two New Directors to our Team!
Meet Shirley Chen, MD, Medical Director of Employed Physician Engagement and Clinical Integration and Jaime Khemraj, MD, MBA, Director of Practice Transformation. We spent some time speaking with them on what they’re most excited for in their new roles and more!
|
|
 |
Shirley Chen, MD, Medical Director of Employed Physician Engagement and Clinical Integration
|
|
|
|
Jaime Khemraj, MD, MBA, Director of Practice Transformation |
|
|
|
What were your previous roles before coming to MSHP?
Shirley Chen (SC): I came to Mount Sinai from Philadelphia where I recently completed a General Internal Medicine Fellowship at the University of Pennsylvania. My work focused on health services research and quality improvement work on chronic disease management in primary care. I also practiced clinically as a general internist in the outpatient and inpatient settings.
Jamie Khemraj (JK): I previously worked at Ryan Health, a Federally Qualified Health Center, where I held several roles, including Director of Quality Improvement and Interim CMO. I also practiced as a family medicine physician and Medical Director of their West 97th Street location.
What is your role at MSHP and what excites you the most about it?
SC: My medical director role at MSHP supports physician engagement and clinical integration among the employed physician groups in the Queens network. It’s been exciting to begin to get to know the different practices in Queens and the local healthcare environment that providers are working in to better tailor and implement population health initiatives.
I’m also practicing as a primary care physician in Astoria and I’ve enjoyed working personally with the incredibly diverse patient population and getting a sense of the challenges that they face.
JK: I joined MSHP as the Director of Practice Transformation. I’m excited about the opportunity to create value-based workflows in partnership with MSHP leaders and in support of employed and voluntary practices. Most of all, I look forward to the relationships that I can build with practices through active listening to their needs.
What is something your colleagues may not know about you?
SC: I love cooking and baking! Like many others, I’ve gotten into baking all things sourdough since the pandemic and moved my sourdough starter to New York with me.
JK: I love to travel to various places in the world, especially with my 78-year-old mom. It gives me an opportunity to learn about other cultures and watch my mom accomplish amazing feats for her age, such as climbing the Pyramids of Giza or the Great Wall of China.
|
|
|
|
Dr. Robert Fields, CMO of MSHP, on Deferred Care Due to the Pandemic
Although emerging 2020 data has shown steep decreases in screenings, tests, imaging, and acute case volumes, the effects on the population’s health will not be clear until 2021. But the early data indicate how providers and health plans financially responsible for the health of patients could face challenges. Learn more.
|
|
MSHP Pharmacy Team Featured in ASHP Communique
At the height of the COVID-19 pandemic, many physicians and ancillary staff from ambulatory care clinics across the Health System were redeployed to the inpatient setting to care for the surging patient volume. During this time, Mount Sinai’s population health pharmacy team was tasked by system leadership to identify and implement methods to expand access to care. The pharmacy team successfully implemented or expanded care management transitions of care service, Medicare Annual Wellness Visits (AWVs) and Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) services. Read more about the team’s innovative work.
|
|
|
|
Making Meaningful Change
Relationships between health systems and community-based organizations can be fraught with issues like inconsistent funding and community mistrust of health systems, but a strong partnership can make meaningful change in a community. This Q&A blog post highlights the perspectives of health system leader, Dr. Robert Fields, and CEO of a community-based organization, Shoshanah Brown, on the challenges and opportunities they've faced in their partnership to address social needs.
|
|
Top Tier 2021 Coverage and Quick Guides
Mount Sinai continues to offer MSHS faculty, staff, and their eligible dependents access to a Top Tier network in 2021 at a level of coverage that has the least out-of-pocket cost for quality healthcare service. There are two Top Tier networks:
- Mount Sinai Health System Top Tier administered by UMR, a division of United Healthcare
- Mount Sinai South Nassau Top Tier administered by Empire BlueCross BlueShield
Click the links below to access the 2021 Quick Reference Guides that include member ID card images and address benefits, copays and deductibles, claims submission, prior approval processes information, and other relevant information.
|
|
United Healthcare Evaluation and Management Reimbursement Change
Effective January 1, 2021, United Healthcare will be updating their reimbursement policy to follow the revised 2021 Evaluation and Management (E&M) CPT® coding and guideline changes from the American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS).
|
|
United Healthcare Medicare Advantage Prior Authorization and Site of Service Rules Update
For dates of service on or after January 1, 2021, for United Healthcare Medicare Advantage Plans there are expanded prior authorization requirements and site of service medical necessity reviews to include certain procedures/CPT® codes. Click here for details.
|
|
New Bloodless Medicine and Surgery Program
The Bloodless Medicine and Surgery Program aims to provide quality care for patients who want to minimize or refuse the use of blood products as a treatment option. There are many excellent reasons to reduce transfusions and blood-based products: Avoiding unnecessary transfusions gives all patients improved chances of reduced infection and often leads to quicker recovery. Careful blood management conserves blood during shortages. In addition, some patients avoid donor blood or blood products for personal or faith-based reasons. If you are interested in learning more about this program or have patients who can benefit from bloodless care services, please email sandra.gilmore@mountsinai.org.
|
|
Population Health in the Literature |
|
Four Strategies to Make Telehealth Work for Elderly Patients
|
|
Complete Your CI Requirements by the End of the Year
All providers must complete their CI program requirements by the end of the year to remain compliant with the Clinical Integration Program. Review the requirements here.
|
|
Sign up to Receive Inpatient/ED Alerts for your Patients
Be in the know every time your patients are admitted or discharged from the hospital or the ED by subscribing to the Subscription Notification Management web tool on MSHP’s Provider Portal. The tool is designed to allow you to choose when and how often to receive real-time patient hospitalization alerts sent directly to you via EMR direct message, email and/or text message.
|
|
P: 877-234-6667
F: 646-537-1481
|
|
|
|
|
|
|
|
