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Clinically Integrated Network Newsletter
July 20, 2022
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Upcoming Events
August 10, 2022
September 8, 2022
MSHP Virtual Town Hall Gathering
September 14, 2022
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Review Your 2021 CI Index Score
You will soon be receiving your 2021 Clinical Integration (CI) Index Score and supporting patient documentation in your practice’s OneDrive account.
As a reminder, providers who earn a CI Index score of 60 or above and who have met their 2021 CI participation requirements are eligible for a 2021 performance-based incentive payment. Incentive payments are distributed based on a provider’s CI Index score, and are also dependent on the amount of available funds and the physician’s performance relative to their peers within the Clinically Integrated Network (CIN).
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Your Q1 2022 Care Coordination Payment Arriving Soon
You can expect to receive your care coordination payment for Q1 2022 in connection with your participation in one or more of MSHP Care Management Agreements soon. You should also expect to receive your panel report via secure email detailing all of your patients that are attributed to your practice so you know how your Care Coordination payment was calculated.
Please note that the Q1 2022 care coordination payments will be arriving before the 2021 Annual Clinical Integration Incentive payment (if you qualify). You can expect to receive additional information about the 2021 incentive payment soon.
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Biden Administration Renews Public Health Emergency
HHS has announced that the COVID-19 Public Health Emergency will be extended another 90 days, through October 13, 2022. As a reminder, this renewal extends various federal waivers including those that allow for reimbursement of telehealth services under Medicare.
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Save the Date: Next MSHP Town Hall Gathering is September 8, 2022
Join Mount Sinai Health Partners for a virtual Town Hall Gathering on September 8, 2022. During this Town Hall MSHP will discuss:
- Mount Sinai Health System Updates
- Viral Diseases update (COVID-19 and Monkeypox)
- Quality, CDQI and Efficiency Performance to Date, Next Steps for 2022
- Payer Updates
Registration details coming soon!
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Join Us! Mind Matters ECHO
Mount Sinai Health Partners is hosting our next Mind Matters ECHO meeting on August 10, 2022 from 5:30-7:00 pm. We will begin with a case-based discussion before Dr. Katie Angelova gives a didactic presentation on difficulty sleeping and depression.
Mind Matters ECHO is appropriate for any clinician who encounters behavioral health needs or challenges in their practice.
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Submit a Case to Mind Matters ECHO
Do you have a patient struggling with depression or substance use with whom you're unsure how to proceed? Submit their case to Mind Matters! Email Anitha Iyer, PhD to discuss your potential case.
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Board Bulletin
MSHP Board of Managers Spotlight: Dr. Sonia Gidwani
Meet our Mount Sinai Health Partners’ Board Member, Sonia Gidwani, MD. Dr. Gidwani is a pediatrician at Our Kids' MD and has served on MSHP’s board for five years. We recently caught up with Dr. Gidwani to learn more about her as an MSHP Board member!
What do you like most about serving on MSHP’s Board of Managers?
I like that it encourages physicians to join the CIN and provide better quality care to patients to achieve better outcomes.
What do you hope to accomplish while serving on MSHP's Board of Managers?
I hope to support initiatives that align with increasing physician satisfaction and decreasing physician burnout with the hopes of providers continuing to deliver high quality care and not feel the need to provide high volume care. Additionally, I hope to increase communication between physicians to improve outcomes in patient care.
What are your interests/hobbies outside of work?
I enjoy traveling and hiking.
We look forward to Dr. Gidwani continuing to serve on MSHP’s Board of Managers!
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Interested in becoming involved in MSHP’s governance?
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New Podcast with Dr. Robert Fields: Health Equity Conversations
Rob Fields, MD, MHA, and Executive Vice President and Chief Population Health Officer for Mount Sinai Health Partners joins Dr. Joshua Liao on this episode of Health Equity Conversations, a series featuring people and groups around the country working to improve equity and health through payment and other systems change. Dr. Fields discusses the link between value-based care and health equity.
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Provider Compensation Modeling Learning Discussion
Join the National Association of ACOs (NAACOS) on July 25, 2022 at 3:00pm for a virtual discussion on provider compensation modeling.
Dr. Robert Fields is the featured speaker for this event which will look into the ways value-based systems can change incentives to motivate behavior change and drive performance on quality and savings. Dr. Fields will discuss Mount Sinai’s approach to physician compensation to promote value-based care operations and performance using a risk-adjusted panel size model of productivity.
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In Memory of Gregg Felice, LCSW
On Tuesday, July 5, 2022 our colleague and member of our CIN, Gregg Felice, passed away peacefully in his home. Gregg spent his career in healthcare and felt fortunate to assist individuals and families with his training as a Licensed Clinical Social Worker. Most recently he worked for Trellus Health as Manager of Community Outreach and Strategic Partnerships.
We are keeping Gregg's friends, family, and colleagues in our thoughts during this difficult time.
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Empire Shares 2022 Advanced Illness and Frailty Quality Exclusion Codes
For those with limited life expectancy or advanced illness, the services identified in some measures may not be relevant or in line with the patient’s goals of care. Exclusions also aim to ensure that frail older adults are not burdened with unnecessary tests or treatments that would benefit them little and may even pose harm.
You can capture this exclusion by including the relevant diagnosis codes in your claim – please note that these codes need to be captured annually.
We encourage you to review these resources:
- Key details on HEDIS measure for advanced illness and frailty exclusions
- Codes for advanced illness exclusions and dementia medication descriptions and names
- Codes for frailty exclusions
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Emblem June Provider Newsletter
- Telehealth reimbursement policy
- E&M coding reimbursement
- Provider Portal access information
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Cigna Reimbursement Policy Update: Implementation Delay for Modifier 26 Professional Component Change in Payment
You may have recently received a letter from Cigna informing you about a planned policy update for CPT codes billed with modifier 26 when the professional component/technical component payment indicator is 3 or 9. Cigna is currently reevaluating this reimbursement policy change which will delay implementation. It did not go into effect on July 1, 2022 as originally scheduled.
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Chronic Condition Management |
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Managing Hypertension Prevents Worsening Chronic Kidney Disease |
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Uncontrolled blood pressure is the second leading cause of kidney failure in the United States, and approximately 20% of adults with hypertension may also have chronic kidney disease (CKD).*
Treatment includes both lifestyle modifications and medication management.
Ideal characteristics of medication treatment include:
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Evidence-based in relation to morbidity/mortality prevention
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Use once-daily regimen whenever possible, which provides 24-hour blood pressure control
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Treatment should be affordable and/or cost-effective relative to other agents
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Treatments should be well-tolerated
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For older adults (≥65 yr of age) with hypertension and a high burden of comorbidity and frailty/limited life expectancy, clinical judgment, patient preference, and a team-based approach to assess risk/benefit are reasonable for decisions regarding intensity of BP lowering and choice of antihypertensive drugs
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Connect with a Community Ophthalmologist to Streamline Diabetic Eye Exam Referrals
Ophthalmologists can perform a comprehensive, dilated eye exam. It is important for your patients with diabetes to be examined by an ophthalmologist every 1-2 years, even if you perform diabetic eye exams in your practice.
To find an ophthalmologist or other specialty care provider in your area, use our Provider Search tool.
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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
Lourdemillard Bellevue, MD
Pediatrics
Village Pediatric Group
Tuckahoe, NY
Zobidatte Moussa, MD
Internal Medicine
Bethany Medical Clinic of New York, PLLC
New York, NY
Sanford B. Ratner, MD
Internal Medicine
Primary PartnerCare Physicians, PLLC
Bayside, NY
Specialty Care
Michael Alleva, MD
Otolaryngology
ENT and Allergy Associates
Forest Hills, NY
Piera P. D'Armetta, AUD
Audiology
ENT and Allergy Associates
Astoria, NY
Joanna B. D'Elia, MD
Otolaryngology
ENT and Allergy Associates
Bronx, NY
Alyssa M. Erb, Do
Obstetrics & Gynecology
Cohen Medical Practice, PC
New York, NY
Laura J. Fitzpatrick, MD
Dermatology
Bodhi Medical Care, LLC
New York, NY
Maria L. Franzone, AUD
Audiology
ENT and Allergy Associates
Babylon, NY
Janice S. Hart, AUD
Audiology
ENT and Allergy Associates
Auburndale, NY
Jennifer J. Hartman, AUD
Audiology
ENT and Allergy Associates
Forest Hills, NY
Patricia K. Herz, AUD
Audiology
ENT and Allergy Associates
Babylon, NY
Dooho Kim, AUD
Audiology
ENT and Allergy Associates
Bayside, NY
Mallory J. Kislow, AUD
Audiology
ENT and Allergy Associates
Levittown, NY
Debra K. Krowicki, AUD
Audiology
ENT and Allergy Associates
Fresh Meadows, NY
Deanna L. Levy, AUD
Audiology
ENT and Allergy Associates
Massapequa, NY
Lauren G. Martin, AUD
Audiology
ENT and Allergy Associates
Fresh Meadows, NY
Ashlei Mathew, MD
Allergy & Immunology
ENT and Allergy Associates
Plainview, NY
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Michael Naarendorp, MD
Rheumatology
Harlem Rheumatology, LLC
New York, NY
John K. Nia, MD
Dermatology
Bobby Buka MD, PC
New York, NY
Emily M. Norton, AUD
Audiology
ENT and Allergy Associates
Melville, NY
Amanda K. Parks, AUD
Audiology
ENT and Allergy Associates
Commack, NY
Keidy G. Sanchez, AUD
Audiology
ENT and Allergy Associates
Jackson Heights, NY
Krupi Shah, AUD
Audiology
ENT and Allergy Associates
Commack, NY
David H. Simon, DPM
Foot Surgery
Simon Podiatry PLLC
Brooklyn, NY
Jessica A. Spinelli, AUD
Audiology
ENT and Allergy Associates
Bronx, NY
Miodrag Velickovic, MD
Neurology
Miodrag Velickovic MD PC
Yorktown Heights, NY
Jessica A. Verkhovsky, AUD
Audiology
ENT and Allergy Associates
Forest Hills, NY
Jennifer M. Walia, MD
Obstetrics & Gynecology
Uptown OB/GYN of NY
New York, NY
Michelle Waller, AUD
Audiology
ENT and Allergy Associates
Islandia, NY
Advanced Care Practitioners
Jessica R. Carbone, NP
Nurse Practitioner
Frank Scafuri III, DO, PC
Staten Island, NY
Christine Fang, PA
Physician Assistant
Bethany Medical Clinic of New York, PLLC
New York, NY
Angela Ferin, CNM
Certified Nurse Midwife
Lower Manhattan Medical Care PC
Brooklyn, NY
Austin J. Hampton, PA
Physician Assistant
Bethany Medical Clinic of New York, PLLC
New York, NY
Alyssa F. Ludwin, PA
Physician Assistant
ENT and Allergy Associates
Poughkeepsie, NY
Karen E. Paul, PA
Physician Assistant
ENT and Allergy Associates
Middletown, NY
Amanda Segilia, CNM
Certified Nurse Midwife
Lower Manhattan Medical Care PC
New York, NY
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If you have any questions about any of our announcements, please contact your Population Health Manager, email Mount Sinai Health Partners at mshp@mountsinai.org or call us at 877-234-6667.
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P: 877-234-6667
F: 646-537-1481
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