EDUCATION

A Winter of Wellness: Essential Tips for Healthcare Providers to Keep Patients Healthy and Engaged

As we embrace the winter months, healthcare providers have a unique opportunity to help patients stay healthy, safe, and informed amid seasonal challenges. With colder weather, increased respiratory illnesses, and the hustle and bustle of the holidays, winter brings both opportunities and obstacles to maintaining wellness. Here are some key areas to focus on this season to ensure patients receive comprehensive and compassionate care:

1. Promote Respiratory Health with Flu and COVID-19 Vaccinations

• Why It Matters: Winter is prime time for flu and other respiratory illnesses, and vaccination is essential for reducing transmission, hospitalizations, and complications. Vaccinating patients can also help alleviate the strain on healthcare systems that typically see increased demand in winter.
• Provider Tips: Offer walk-in flu shot clinics, extend vaccination hours, and set up mobile or drive-through vaccination options when possible. Send digital reminders through patient portals, emails, or texts, and educate patients on the benefits of flu and COVID-19 vaccines to dispel common myths.

2. Managing Chronic Conditions in Colder Weather

• Why It Matters: Colder temperatures and decreased physical activity can impact conditions like diabetes, cardiovascular disease, and arthritis. For patients with chronic conditions, winter can bring additional challenges in maintaining medication routines, scheduling check-ups, and staying physically active.
• Provider Tips: Schedule extra check-ins with patients managing chronic conditions, whether in person or via telehealth, to ensure they’re adhering to treatment plans and staying active safely. Share guidance on safe indoor exercise routines, winterized diet tips, and ways to stay warm while maintaining physical health.

3. Screening and Support for Mental Health

• Why It Matters: The shorter sunlight hours and holiday season can lead to Seasonal Affective Disorder (SAD), heightened stress, and feelings of isolation. Many patients may experience an uptick in anxiety or depressive symptoms, and those already managing mental health conditions may find symptoms worsen in winter.
• Provider Tips: Incorporate brief mental health screenings into routine visits to catch signs of SAD or other concerns early. Share self-care practices that may help boost mood, such as light therapy, regular social interactions, or mindfulness exercises. For patients with symptoms, provide referrals to mental health professionals or connect them with virtual therapy options.

4. Preventing Slips and Falls

• Why It Matters: Icy sidewalks and slick floors make winter a peak time for slips and falls, especially among elderly patients or those with mobility challenges. Preventing falls is crucial for maintaining patient independence and avoiding fractures or other injuries.
• Provider Tips: Educate patients on winter safety practices, including wearing slip-resistant shoes, using handrails, and keeping walkways clear of ice. Consider recommending assistive devices like canes or walking aids, and work with caregivers or family members to make sure patients’ homes are safe and accessible.

5. Addressing Nutrition and Winter Weight Gain

• Why It Matters: Winter and the holiday season often lead to changes in diet, with increased consumption of comfort foods and holiday treats. For patients with dietary restrictions, such as those with diabetes or cardiovascular conditions, these changes can pose health risks.
• Provider Tips: Offer tips on balanced, hearty meals that align with winter cravings but also meet health needs. For patients with limited food access, connect them with local food assistance programs or recommend grocery delivery options. Consider sharing simple, nutritious winter recipes that fit within common dietary guidelines.

6. Encouraging Preventive Screenings

• Why It Matters: Preventive care can sometimes take a back seat during the busy winter months. Patients may be less likely to come in for screenings or may delay appointments due to weather or holiday schedules.
• Provider Tips: Proactively reach out to patients who are due for preventive screenings, such as mammograms, colonoscopies, or cardiovascular screenings. Consider flexible scheduling or virtual visits to minimize barriers, and communicate the importance of staying on top of these routine check-ups even during the colder months.

7. Engaging Patients through Digital Health Tools

• Why It Matters: Winter weather can lead to travel disruptions, making digital tools crucial for continuing patient engagement and follow-up care. Telehealth, patient portals, and mobile apps can all support ongoing care, especially for patients with chronic conditions or mental health concerns.
• Provider Tips: Encourage patients to use telehealth options for follow-up visits, medication management, or health check-ins. If your practice offers a patient portal, remind patients of its features, such as appointment scheduling, medication refills, or secure messaging. Share resources or apps that help patients monitor their health, stay active, or manage stress during winter.

A Few Final Thoughts

By focusing on these essential health priorities during winter 2024, healthcare providers can support patients through the challenges of the season while empowering them to embrace winter healthfully. With compassionate care, proactive communication, and the right tools, providers can help patients stay engaged, healthy, and well-supported through the colder months.

The Importance of Preventive Care Screenings and Wellness Visits

Preventive care screenings and wellness visits allow practices to gather important information about patients, including medical and family history, health risks, specific vitals, and social determinants affecting health (such as housing, transportation, and food). The purpose of these visits is to review each patient's overall physical health and psychological well-being and develop a personalized wellness plan. These visits provide an opportunity for providers to assess and improve the quality of care, engage patients in their healthcare, and foster healthy communities.

The following screenings provide opportunities for wellness discussions and care planning during preventive care visits:

• Colorectal Cancer Screening: Recommended for men and women age 45-75. Colonoscopy every 10 years (or sooner based on results) continues to be the standard of care. Alternatives include a flexible sigmoidoscopy every 5 years, a multi-target stool DNA test (Cologuard) every 3 years, a fecal occult blood test (FOBT) annually.
• Breast Cancer Screening: Mammograms are recommended every 1–2 years for women ages 50–74.
• Body Mass Index (BMI): Calculate BMI annually and discuss ways to improve health through physical activity and nutritional/dietary changes.
• Depression Screening: Conduct a PHQ-2 screening at least annually. If a patient scores higher than 2, administer a PHQ-9 and provide appropriate interventions to address depression.
• Anxiety Screening: Administer a GAD-7 screening annually. If a patient scores higher than 9, further assessment and interventions are warranted to help manage anxiety.
• Unhealthy Alcohol Use Screening and Follow-Up: Administer an AUDIT screening or a single-question screening: “How many times in the past year have you had 5 (for men) or 4 (for women) or more drinks in a day?” Provide feedback on potential harms, high-risk situations, and strategies to motivate reduced drinking.
• Social Determinants of Health (SDoH): Use this tool from the American Academy of Family Physicians (AAFP) to screen patients for SDoH, identify community-based resources, and collaborate with patients to create an action plan that reduces health risks and improves outcomes.
• Tobacco Screening: Provide resources to support tobacco cessation. Access a comprehensive library of tools from the American Cancer Society here.
• Immunizations: Use the CDC's helpful schedules for children, adolescents, and adults. Access CDC Vaccine Schedules here.

QUALITY IMPROVEMENT

Diabetes Mellitus: Documentation, Coding Guidance, and Quality Measures

Diabetes Mellitus (DM) is one of the most prevalent chronic diseases in our population. We would like to provide some tips to help you properly document this condition, code for any complications, and ensure quality measures are met when managing it.

Documentation

The type of DM a patient has, as well as the treatment plan, should be documented in the medical record. If the type of diabetes is not documented in the medical record, the default code is for Type 2 Diabetes Mellitus. The treatment plan is imperative to support the overall medical management of your patient.  

Linking and Complications for Coding

It is also very important that any conditions or complications associated with DM be documented and linked. When documenting a condition that is considered a diabetic complication, always remember to use linking terms such as linking terms such as "due to," "associated with," "secondary to," or "diabetic" to establish the causal relationship between the two conditions. 

Examples with Associated Code:

• Chronic Kidney Disease (CKD) due to Diabetes Mellitus: E11.22 (also document and code the Stage of CKD)
• Peripheral Neuropathy associated with Diabetes Mellitus: E11.42
• Hyperglycemia secondary to Diabetes Mellitus: E11.65 (do not document as Uncontrolled Diabetes)

Diabetes Quality Measures

As an NCQA accredited organization, Medical Associates Health Plans (MAHP) is continuously reviewing our diabetic population to ensure they are receiving the highest quality of care. Ways in which you can assist us with this goal include:

• Ensure the patient’s Glycemic Status is monitored via Hgb A1C testing or a Glucose Management Indicator utilizing Continuous Glucose Monitor (CGM) values.
• Encourage and assist our members in scheduling annual retinal eye exams.
• Measure and review blood pressure to ensure adequate control (<140/90).
• Monitor kidney function via eGFR and urine albumin/creatinine ratio testing.

CREDENTIALING

1099-Miscellaneous Reporting Reminders

• 1099-MISC forms will be sent prior to January 31, 2025.
• We report to the IRS any payments of $600 or more to a TIN in a calendar year.
• Name and address changes for tax forms can be sent to providersetup@mahealthcare.com. Please include a copy of your W-9 along with the details of the necessary changes.

Reminder for Mental Health Counselors and Marriage and Family Therapists

Effective: January 1, 2024

Medicare established a new benefit category for services provided and billed by Mental Health Counselors (MHCs) and Marriage and Family Therapists (MFTs). If you have applied and been approved by Medicare, please send in your Medicare Approval Letter to mahpcredentailing@mahealthcare.com. Once received, your information will be added to the MAHP Medicare Provider Directories, and you will be eligible to provide services to our Medicare beneficiaries.

Important Update: Provider Directory Validation Process

Thank you for your assistance in validating provider directory information every 90 days. Accurate provider directories are essential for enrollees seeking healthcare services.

As a reminder, under the Consolidated Appropriations Act (CAA), health plans are required to verify the accuracy of provider directory information every 90 days. To date, we have sent the information for validation via email and followed up at regular intervals.

We have recently evaluated our process, and following careful consideration, we have decided to shift our focus. Going forward, we will send only one reminder email for outstanding provider directory validation forms.

Pursuant to the Act, providers will be removed from the provider directories if we do not receive your completed validation form by the due date given. Additionally, providers/offices that miss two consecutive provider directory validations are subject to potential contract termination.

We appreciate your timely response each quarter to the provider directory validation request.

HEALTHCARE SERVICES

Season Health for Nutrition Referrals

Season Health is now available to your patients for Medical Nutrition Therapy. This program offers the following services to our patients:

• Virtual visits with a registered dietitian nutritionist
• Expert guidance on eating, cooking, or managing health condition
• Personalized menu of recipes and premade meals
• Two-way text messaging with your Season Health care team member, seven days a week

Refer your patients to Season Health by filling out the online referral form at www.seasonhealth.com/refer to submit electronically, or www.seasonhealth.com/referralform to complete the PDF form and fax to 877-794-1374. 

Medical Nutrition Therapy coverage varies by plan. Please contact Member Services at 866-821-1365 to obtain benefits for your patient prior to referral.

You can view the Season Health Quick Guide to learn more, or access the Season Health Collateral Catalogue for a library of resources. If you’d like to set up a training or meeting with Season Health’s clinical team, please reach out to Adriane Lee at providersupport@seasonhealth.com.

UPCOMING EVENTS

MAHP Holiday Hours

As you prepare to celebrate the holidays, please keep in mind that MAHP will close at 12 PM on Tuesday, December 24th. We will also be closed on Wednesday, December 25th and Wednesday, January 1st.

During this time, our Provider Portal is still available. Additionally, you may contact Member Services at 563-584-4885 for all emergency and non-emergency needs.

We wish you and your family a happy and healthy holiday!

RESOURCES