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Clinically Integrated Network Newsletter
August 18, 2021
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Welcome Brent Estes, and Farewell Ed Lucy!
Please join us in extending a warm farewell and congratulations to Edward A. Lucy on his retirement. As Chief Payer Contracting and Administration Officer for the health system and Chief Contracting Officer for MSHP, Ed played an integral part in the formation and development of the MSHP IPA and our Clinically Integrated Network (CIN). Under Ed’s leadership, the health system has shifted more of the health system’s reimbursement strategy to value-based models, including large-scale, value-based contracts with managed care payers across Commercial, Medicare and Medicaid lines of business. A key negotiator in all of the payer contracts that we are pleased to offer our CIN providers, Ed was also instrumental in implementing the CIN funds flow program to compensate MSHP’s community-based primary care providers for the work our CIN does to optimize patient care and outcomes.
Joining us as Mount Sinai’s SVP and Chief Managed Care Officer is Brent Estes. Welcome to MSHP, Brent! Most recently SVP, Business Development at Advocate Aurora Health, Brent led development of an integration plan to drive system-wide care coordination and improve operating margin, as well as sponsored a joint venture with a national health insurer to deliver a high-performance network in multiple markets. Prior to that, Brent served as SVP of Business and Network Development for Rush University Medical Center. At Rush he designed and executed a multi-year payer contracting strategy, and transformed a physician-hospital organization operating model into one of the most mature clinically integrated networks in the nation.
Ed – it has been our pleasure to work with you all these years and we thank you for your major contribution.
Brent – we feel lucky to have such an accomplished leader ready to advance our population health management goals.
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Join Us Tonight! Mind Matters ECHO
Join us this evening, from 5:30-6:30 pm for our second-to-last meeting in our first depression module: Managing and Understanding Side Effects of SSRIs and Other Commonly-Prescribed Antidepressants. Sign up here.
Have a case to share with the group? Submit it here.
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Next Condition Management CME Event: September 21st
The next MSHP Condition Management CME Event will be on September 21, from 6:00-7:30 pm and will focus on excellence in managing COPD and vascular disease. Dr. David Steiger, Dr. Peter Faries, Dr. Jeffrey Olin, and Dr. Soma Brahmanandam will share the latest evidence-based practices for managing COPD and vascular disease in the outpatient setting.
We invite all primary care physicians, pulmonologists, vascular surgeons, nurses, physician assistants, and nurse practitioners to join us for an insightful and engaging evening of learning.
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Town Hall: September 29th
The next MSHP Town Hall Gathering will be on September 29, 2021, from 6:00-7:30 pm. The agenda will be as follows:
- Health System Updates
- COVID-19 Updates: Delta variant, booster shots, office management
- Review of MSHP’s PCP Performance Reports and Action Items
- Meeting your 2021 CIN Requirements
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CI Performance and Patient Opportunity Reports
We have placed a suite of customized reports in your practice’s main OneDrive account. Please review these reports to identify how you and your practice are performing in the 2021 CI Program and to identify patients in need of outreach. Quality gap data is delayed but forthcoming as soon as possible. To discuss or help operationalize these reports, please do not hesitate to contact your Population Health Manager and/or Provider Support Specialist. Feel free to also send us an email, or call us at 877-234-6667.
Join us at our next Town Hall Gathering to learn more.
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The Passing of Pinkus Szuchmacher, MD |
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With heavy hearts, we acknowledge the passing of our colleague, Pinkus Szuchmacher, MD. We are grateful to have known Dr. Szuchmacher, a dedicated Mount Sinai vascular surgeon and member of MSHP’s Board of Managers Finance & Audit Committee.
Dr. Szuchmacher saved and improved countless lives after emigrating from Brazil in 1965 to spend 50 years in practice caring for patients and training residents at Elmhurst Hospital, Booth Memorial, New York Hospital of Queens, Mount Sinai, and Mount Sinai Queens.
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His zest for life was infectious, and his fierce dedication to his patients and his family made him an inspiration to all who were blessed to know him. He lived life to the fullest, with an incredible depth of intellectual curiosity, passion for new ideas, compassion and patience for everyone he taught, a profound generosity of spirit, and irrepressible energy and sense of humor and joy. A community fixture, Dr. Szuchmacher will be sincerely missed by faculty, colleagues, and patients. |
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Updated Laboratory Quick Guide
Every dollar counts for your patients. That’s why we want to remind you of a sure way to help reduce out-of-pocket costs for your patients: choosing in-network laboratories. Please use payer preferred laboratories when requesting lab services. Click here for our updated Laboratory Quick Guide.
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Welcome New MSHP Providers!
We'd like to extend a warm welcome to all new provider members who recently joined our clinically integrated network.
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Primary Care
Sonia Chokshi, MD
Internal Medicine
Bethany Medical Clinic of New York, PLLC
New York, NY
Ruby M. Harmon, MD
Pediatrics
Harmon Pediatrics, PC
New York, NY
Preeti J. Parikh, MD
Pediatrics
Westside Pediatrics, PC
New York, NY
Specialty Care
Erico R. Cardoso, MD
Neurological Surgery
Richmond Health Partners IPA LLC
Brooklyn, NY
Nancy C. Fontana, AUD
Audiologist
ENT and Allergy Associates
Port Jefferson, NY
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Robert D. Huang, MD
Otolaryngology
ENT and Allergy Associates
Iselin, NJ
Francesco Rotatori, MD
Cardiology
Radiology Associates of Brooklyn
Brooklyn, NY
David Zelman, DO
Diagnostic Radiology
Radiology Associates of Brooklyn
Brooklyn, NY
Advanced Care Practitioners
Angela M. Cusumano, PA
Physician Assistant
Simply Dermatology, PLLC
Melville, NY
Kristen A. Franceschina, PA
Physician Assistant
Bobby Buka MD, PC
New York, NY
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MSHP Board of Managers Spotlight: Dr. Jankowska
Meet Danuta A. Jankowska, MD, board member of Mount Sinai Health Partners’ Board of Managers. Dr. Jankowska is a member of our clinically integrated network, practices Internal Medicine in Manhattan and is in her first year serving on the board. We recently caught up with Dr. Jankowska to learn about her experience on MSHP’s Board.
What do you like most about serving on MSHP’s Board of Managers?
By serving on MSHP's Board of Managers, I have the opportunity to aid in providing effective governance and enhancing policies necessary to fulfill the network’s goals of attaining higher quality of care for patients. I am also able to engage with MSHP physicians in the care and decision-making process. Read more.
What do you hope to accomplish while serving on MSHP’s Board of Managers?
As a longstanding member of MSHP, my goal is to enhance performance through improving the quality, safety and cost-efficiency of the healthcare we deliver. My focus is on determining more effective strategies to achieve excellence in delivery of high-quality care for our patients, while also improving relations with payers to achieve better claims reimbursement. Read more.
Interested in serving on MSHP’s Board of Managers?
Be on the lookout for nomination information in your inbox in Fall 2021.
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MOC Training for SNP Providers
EmblemHealth
CMS mandates all providers participating in the VIP Bold and Reserve Networks to complete the Special Needs Plan Model of Care (SNP MOC) training annually.
Action Needed by October 25, 2021:
Bright Health
CMS requires all participating providers participating with Bright Health’s D-SNP and C-SNP plans to complete annual Model of Care (MOC) training.
Action Needed by December 31, 2021:
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EmblemHealth July Newsletter
- Information about the New Provider Portal
- Claims timely filing info to be aware of
- HEDIS record requests: you should release records upon request
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Cigna Newsletter
Cigna shared their third quarter Network News. A few highlights include:
- COVID-19 Updates
- Policy Updates
- Home blood pressure monitoring
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Health System Transformation in the Pandemic Years
To discuss health systems’ response to COVID-19, lessons learned, and the industry's future, Becker's Hospital Review and Cardinal Health convened a group of healthcare leaders for a virtual advisory call in spring of 2021 to facilitate best practice and idea sharing. Read the white paper featuring Denise Prince, Senior Vice President and COO, Population Health at the Mount Sinai Health System.
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Becker’s Healthcare Podcast with Denise B. Prince |
Denise B. Prince, SVP and Chief Operating Officer for Population Health, discusses trends that she is seeing, how her strategies are evolving, thoughts on the competition, and more on the Becker's Healthcare Podcast. Listen here.
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We Find a Way: Mount Sinai Launches National Brand and Advertising Campaign |
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Mount Sinai has unveiled a new brand identity and advertising campaign, “We Find a Way,” that showcases the people and innovators who are relentlessly advancing medicine and health. The campaign is meant to inspire and remind New Yorkers and those beyond that Mount Sinai—which developed new protocols, diagnostics, and therapeutics that saved thousands of lives during the COVID-19 pandemic and more recently performed the first successful tracheal transplant in the world—is setting a different health care standard and a Mount Sinai way.
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Do You Have Outstanding CI Program Requirements?
On August 2nd, you received a communication from us regarding your CI Program status and outstanding participation requirements and deadlines. Please do not delay in completing them.
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P: 877-234-6667
F: 646-537-1481
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