Mount Sinai Health Partners
Clinically Integrated Network Newsletter
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Complete Your 2019 CI Program Requirements by the End of the Year
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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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Tai Chi to Fight Your Stress
Tai Chi is a martial art that exercises both the body and mind through coordinated movement and breathing. Tai Chi can be practiced at anytime, anywhere, by anyone! The simple movements are easy to perform even in the tiniest of apartments with the most fragile of joints. Mount Sinai Calm provides free Tai Chi classes to Mount Sinai employees.
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Tai Chi at The Mount Sinai Health System’s Corporate Offices
(150 East 42nd Street)
Thursdays 5:15pm - 6:15pm
4th Floor, Room 4.A.8
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Tai Chi at The Mount Sinai Hospital
Thursdays 5:30pm - 6:30pm
7th Floor Atrium
Guggenheim Pavilion
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Email
4Calm@mountsinai.org
to reserve your spot. Beginners are welcome. Don’t forget to wear comfortable clothes you can move freely in.
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Practice Tips & Transformation
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Team-Based Care: A Case Study at Mount Sinai’s PeakHealth
PeakHealth is a Mount Sinai clinic co-located with Mount Sinai’s IMA practice at 17 East 102nd Street, where high-need, high-risk, high-cost patients with medical and psychosocial complexities get the enhanced support they need to manage their health. This program is currently open to Healthfirst patients.
Team-based care model for high-risk patients
“Patients referred to our program often have a history of high utilization, frequent ED visits and hospitalizations, suboptimal adherence to their medication and treatment plans, and less than ideal connections to primary care,” stated Bernard Ortega, Program Administrator. “Our team of primary care providers, social workers and care coordinators work and communicate very closely together to advance our patients’ medical and psychosocial goals, and overcome barriers.”
PeakHealth is embedded at IMA, and PeakHealth staff joins IMA huddles. Additionally, once weekly, the PeakHealth care providers protect their time so that all care teams can do a patient disposition review.
PeakHealth’s goal is to ultimately transition or “graduate” patients back to their original/referring PCP and close connection and communication is kept with the patients’ primary care providers.
Establishing patient goals
Every patient undergoes a standardized intake process that includes a psychosocial assessment. Areas of need are identified, patients are evaluated on their willingness to make changes, and most importantly, we ask what our patients want to work on. “Our goal is to help patients become as self-reliant and independent as possible in managing multiple chronic conditions, but we first start with what matters most to our patients. We aim to celebrate the accomplishment of these goals, whether it’s successfully showing up for a specialist appointment, or learning when and how to take an inhaler for COPD,” remarked Bernard.
Referring a patient to PeakHealth
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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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