Now Available: 2024 Clinical Integration Program Materials

The 2024 CI Program has five components:

1. Clinical Integration Participation Requirements
2. Quality Performance Metrics (QPM) Program
3. Clinical Documentation Metrics (CDM) Program
4. Efficiency Performance Metrics (EPM) Program
5. NEW: In-Network Integration Metric (bonus points only)

Please review the communication (adult PCPs | pediatricians) we sent on February 13 to learn more about the available program materials, including a timeline checklist, tip sheets, and more. You can also access these materials through our website (login required).

TONIGHT: MSHP CIN Town Hall on United/Oxford Negotiations Update

To keep you apprised of the status of our ongoing negotiation efforts with UnitedHealthcare, we invite you to join us for a town hall to hear updates and information regarding how you may be impacted as a voluntary provider who is part of Mount Sinai’s CIN. Please bring any questions you have.

TONIGHT, February 27 at 6:00 pm

Click here to enter the Zoom meeting

Passcode: 173222

If you have any questions about your network status or the impact of this negotiation process on your practice we are available to help:

• Contact your population health manager or specialist
• Email Kenneth Shen, MD, Medical Director for CIN voluntary practices
• Email MSHP or call us at 877-234-6667

2024 Top Tier Guides Now Available

Mount Sinai continues to offer Mount Sinai Health System and Mount Sinai South Nassau faculty, staff, and their eligible dependents access to a Top Tier network in 2024 at a level of coverage that has the least out-of-pocket cost for quality healthcare service.

Mount Sinai Top Tier Network is administered by UMR, a division of UnitedHealthcare and Mount Sinai South Nassau’s Top Tier Network administered by Aetna.

Please see below for guides that address rates, benefits, copays and deductibles, ID card images, claims submission, prior approval processes information, and other relevant information:

• 2024 Mount Sinai Health System Top Tier Program administered by UMR
• 2024 Mount Sinai South Nassau Top Tier Program administered by Aetna

For questions regarding MSHS member benefits, please contact UMR, a division of UnitedHealthcare at 877-233-1800. For questions regarding Mount Sinai South Nassau member benefits, please contact Aetna at 833-880-0375.

Welcome to MSHP, Dr. Kenneth Shen!

Please join us in welcoming Kenneth Shen, MD, MBA to MSHP in his role as Medical Director, Physician Engagement and Clinical Integration. Continue reading to get to know a bit about Dr. Shen's background, goals, and his promise to our CIN members.

Please tell us a bit about your educational and professional background that led you to this role.

Starting in medical school, I started to take an interest in population-level application of healthcare ideals. This continued into my pediatrics residency, as I realized I was passionate about large-scale health trends and implementation of preventative care and value-based care.

Prior to Mount Sinai, I worked for a health tech start-up using their platform to drive practice-level value-based care initiatives. I appreciated the problem-solving creativity and fast-paced environment of the start-up world, but I hated being so removed from the provider side. At Mount Sinai, I have the opportunity to impact societal health, work with passionate and experienced community providers, and get back to clinical practice as well.

What are you most looking forward to in this role?

I’m truly looking forward to the problem-solving aspect of the role. Every practice is different, these VBC initiatives can be complex, and it’s up to each member of both of our teams to come together to figure out the best workflow solution for each staff.

What keeps you up at night regarding population health?

I’m equally concerned about the clear need for more widespread preventative care across our health care system and the increasing responsibilities and stressors that many primary care doctors feel that prevent them from doing the aspects of the jobs that they love. It’s our job to use our resources and knowledge to help improve both of those problems at the same time.

What do you like to do outside of work?

Watching the NBA, watching the Green Bay Packers (go Jordan Love!), and continuing my personal quest to reach competency in home cooking and baking.

Is there anything else you’d like the CIN to know about you?

While I’ve worked with a lot of practices big and small, across the country, I may not know exactly and specifically what you and your practice are going through. But I promise I’ll always listen and try to understand, and I’ll always try to help. 

Use Your Patient Opportunity Report to Close Care Gaps

On January 24th, we uploaded your practice's customized patient opportunity report (POR) to your OneDrive account.

This report includes all patients with open care gaps who are attributed to your practice based on the latest information we have from payers. Use these reports for patient outreach to: 

• Identify cohorts of patients that need visits to re-engage in care
• Close quality care gaps
• Manage and document chronic conditions

Questions about your POR? Contact your Population Health Manager or Population Health Specialist, email us, or call us at 877-234-6667.

Congratulations to Brendan Carr, MD, MA, MS on being named Chief Executive Officer of the Mount Sinai Health System

Brendan Carr, MD, MA, MS, a nationally recognized leader in academic medicine and health policy, will be our next Chief Executive Officer. He will chart a strategy for Mount Sinai’s next chapter, and will oversee all critical strategic, operational, and business-building areas of the Health System, including our eight hospitals, the Icahn School of Medicine at Mount Sinai, and more than 400 ambulatory locations and physician practices.

Kenneth L. Davis, MD, will become Executive Vice Chairman of the Mount Sinai Boards of Trustees once Dr. Carr moves into his new role early next year. 

Dr. Carr joined Mount Sinai in February 2020, just before New York City became the initial epicenter of the COVID-19 pandemic in the United States. He played a critical role during the pandemic and led local, regional, and national initiatives focused on improving emergency response and critical care capacity. 

Dr. Carr is currently Mount Sinai Professor in Emergency Medicine at Icahn Mount Sinai and Chair of Emergency Medicine for the Mount Sinai Health System. As a renowned emergency physician and health policy researcher, he has focused on building regional systems of emergency care, especially for trauma, stroke, cardiac arrest, and sepsis, and developing innovative delivery system solutions to create a more distributed and accessible acute-care delivery system. He has served in an advisory role to domestic and international organizations and is a member of the National Academy of Medicine.

Learn more

Dr. Arshad Rahim on Merging Medicine and Business for Value-Based Care

Our very own Dr. Arshad Rahim, Senior Vice President and Chief Medical Officer for Population Health, was recently a guest on the Healthcare Disruptors podcast.

Dr. Rahim and host Ohad Arazi discuss the intersection of medicine and business, and why populations need to "get a lot more health for the amount of healthcare we deliver." They also talk about the benefits of handheld ultrasound, the role technology plays in workforce optimization, and advice for healthcare leaders looking to leverage innovation.

Thank you for joining us at our January Town Hall Gathering and February Mind Matters Meeting

A sincere thanks to all who took time out of their busy schedules to join us for our January Town Hall Gathering and February Mind Matters meeting.

If you weren't able to join us live, or would like to review the information presented:

• Visit our Media Library (log-in required) to view the Town Hall slide deck and recording 
• Visit the Mind Matters page to download the slides and watch the recording

We look forward to reconvening in the upcoming months!

Thank you for sharing your feedback

Our 2024 Annual Provider and Office Manager Experience Surveys are now closed. We appreciate all who took the time to share their feedback with us. We are reviewing all of the responses and look forward to better serving you and the entire Clinically Integrated Network.

EmblemHealth Provider Newsletter

EmblemHealth shared their January provider newsletter which includes policy updates, updates to the prior authorization list, information about 2024 benefit plans, and more.

Behavioral Health Care Access

Ensure your patients are aware that their insurance provider must cover behavioral health benefits with no session caps. This quick guide explains how to find treatment and services and includes information about understanding insurance coverage and benefits.

Welcome to MSHP!

We'd like to extend a warm welcome to the newest members of our Clinically Integrated Network:

Primary Care

Christina Jones, MD

Family Medicine

Gynecology & Integrative Women's Care, PC

New York, NY

Nastassia Verbitska, MD

Pediatrics

Bodhi Medical Care, LLC

New York, NY

Specialty Care

Muneeb Shah, DO

Dermatology

DB Dermatology PLLC

New York, NY

Anne Wold, MD

Obstetrics & Gynecology

Goncharov Medical PC

New York, NY

Advanced Practice Providers

Jessica Miller, NP

Nurse Practitioner

Gynecology & Integrative Women's Care, PC

Brooklyn, NY

Alexander Pennise, PA

Physician Assistant

MiDoctor Primary Care/Eastside Physicians of NYC, PLLC

New York, NY