Mount Sinai Health Partners
Clinically Integrated Network Newsletter
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2020 Clinical Integration (CI) Program Requirements
Mount Sinai Health System’s Clinically Integrated Network (CIN), Mount Sinai Health Partners, is now in its fifth year and, as physicians in the CIN, we have all committed to cultivating collaborative relationships with each other and improving the quality and efficiency of care we provide to our patients.
Click here
to view the full listing of requirements.
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Thank You for Attending Our CME Event: Clinical Success in Managing CHF and COPD
Thank you to everyone who joined us last month for our CME event on managing CHF and COPD. Survey feedback shows you found the course educational and you feel that you can now provide better care to your patients. If you have not yet taken the survey and received your CME certificate, please login to the
CME portal
, click “My CME” and then “Evaluations and Certificates.”
If you were unable to attend, or would like to review the materials, you can access the slide deck on our
Practice Resources page
and view the course on
CILC
. Also available on our
Practice Resources page
are the Heart Failure and COPD Ambulatory Care Pathways. These short guides provide at-a-glance pharmacological and non-pharmacological guidelines, assessments, and referral options to use alongside your clinical judgment in managing your patients with these conditions.
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COVID-19 Resource Hub Now Available
With the rapid developments in the spread and understanding of COVID-19, we recognize staying up to date on the latest information might feel overwhelming.
We have
created a dedicated web page for our clinicians to share clinical guidelines, patient handouts, webinars, and more. The Health System also regularly updates the
COVID-19 intranet page with MSHS-specific policies.
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March is Colorectal Cancer Awareness Month — Screen Your Patients
Colorectal Cancer Screening for patients aged 51-75 years is a quality measure for all CIN PCPs, so why not make closing this care gap a priority this month?
Click here
to read the full quality measure description.
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Two New Mental Health Programs at Mount Sinai
Women’s Mental Health Program
We are pleased to announce a new program from the Department of Psychiatry to care for women with mental health challenges related to the reproductive cycle. Women with histories of depression, bipolar disorder, anxiety, obsessive-compulsive disorder, or psychosis are at risk for reactivation of these conditions during pregnancy or postpartum. In addition, women without such histories may find themselves experiencing difficulty with their mental health for the first time in their lives. Our team is also available to treat women having difficulties with mood or anxiety that are related to their menstrual cycles or to the arrival of menopause.
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Veerle Bergink, MD, PhD, and
Thalia Robakis, MD, PhD, are available to see individual patients through the Mount Sinai Doctors Faculty Practice. They accept Aetna and United Health Care (UMR) Top Tier insurances, and self-pay options are available.
To make an appointment, call 212-659-1326.
The clinic at the Klingenstein Pavilion’s E level, at 1176 Fifth Avenue, serves the needs of perinatal women with Medicaid insurance. The program is run by
Matthew Dominguez, MD, in collaboration with social work director
Laudy Burgos, LCSW, Social Work Manager.
To make an appointment, call 212-241-5947.
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Learn more about this program and other behavioral health resources available to your patients from Mount Sinai.
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Treatment-Resistant Depression Program
The Department of Psychiatry has been at the forefront of research on treatment-resistant depression (TRD), aimed at understanding its biological origins and developing novel treatments to reduce severity and mortality.
Studies
show that more than one in three patients with Major Depressive Disorder fail to respond to two or more antidepressant trials. To address this challenge, the Depression and Anxiety Center for Discovery and Treatment created a specialized, evidence-based TRD program featuring therapies such as:
- Transcranial magnetic stimulation (TMS): TMS uses magnetic fields to stimulate parts of the brain, and is cleared by the FDA to treat depression in adults. We off state-of-the-art TMS, including intermittent theta burst for patients with TRD seeking non-invasive neuromodulation treatments.
- Esketamine: we are the first major academic medical institution in New York City to offer esketamine (SPRAVATO™) CIII nasal spray for TRD, approved by the FDA in 2019 for treating TRD in adults.
Learn more
about this program and other behavioral health resources available to your patients from Mount Sinai.
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Innovative Scar-Free Transoral Thryoid Removal
Traditional thyroid surgery leaves a neck scar that can be difficult to cover and leave patients feeling self-conscious.
Gustavo Fernandez-Ranvier, MD
, is accepting new patients for transoral thyroid surgery, an innovative and scarless procedure.
A retrospective analysis found that
more than 75% of patients who underwent traditional thyroid surgeries were eligible for the transoral procedure.
The best candidates are patients with:
- Benign or indeterminate thyroid nodules
- Small thyroid cancers without evidence of spread to the lymph nodes
- Primary hyperparathyroidism
- Hyperthyroidism from toxic nodules or Grave's disease
The results are comparable to traditional procedures in terms of pain, results, and recovery – patients bounce back within a day or two, and return to work within a week or two. To learn more,
click here
.
To make a referral to Dr. Fernandez-Ranvier, please call 718-808-7777 or 212-824-2350, or email
gustavo.fernandez-ranvier@mountsinai.org.
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Updated GINA Guidelines for Management of Mild Asthma
What’s the new change in the asthma guidelines?
Per the recently published
2019 Global Initiative for Asthma (GINA) guidelines
, as-needed low dose combination inhaled corticosteroid (ICS)-formoterol (budesonide-formoterol)
replaced
the use of an as-needed short acting beta-antagonist (SABA) inhaler in the treatment of mild asthma, based on the landmark
SYGMA 2 Trial
(As-Needed Budesonide-Formoterol vs Maintenance Budesonide in Mild Asthma).
The Author’s Findings:
- High dose ICS-formoterol as needed therapy demonstrated non-inferiority against budesonide maintenance inhaler and terbutaline rescue inhaler in lowering the annualized rate of severe asthma exacerbations in patients with mild asthma.
- ICS-formoterol as needed therapy is associated with less rescue therapy and glucocorticoid medication use.
- Budesonide maintenance inhaler and SABA rescue therapy is associated with about seven more reliever free days than ICS-formoterol therapy alone, improvement in baseline pre-bronchodilator FEV (33 points less), and symptom control.
In conclusion, budesonide-formoterol as needed therapy may be an option for patients with mild asthma who are non-adherent to their maintenance regimen.
How do I apply this to my current practice?
The authors provide some generalizability to real-life scenarios including, patients who have barriers with drug costs. Therefore, in our value-based healthcare system, ICS-formoterol may be an option for patients who are non-adherent to maintenance therapy to reduce inhaler burden due to cost issues.
What do I need to consider?
Although guidelines suggest the change from using SABA rescue therapy to as needed ICS-formoterol therapy in mild asthma, data regarding its superiority in clinical trials is needed.
For general patients, we recommend an ICS maintenance inhaler and short acting beta agonist as rescue therapy despite new guideline recommendations due to feasibility and cost-effectiveness.
Questions?
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New Medication Adherence Support Service for Your UnitedHealthcare Medicare Advantage Patients
We are excited to announce that we are partnering with UnitedHealthcare to expand our ambulatory pharmacy services outreach for UnitedHealthcare Medicare Advantage patients. To improve medication adherence rates,
Vidhi Shah, PharmD, BCACP, CDE, CCM, Central Pharmacist Manager
, will work with your patients to navigate compliance barriers and provide reminder phone calls and/or text messages to pick up missed fills. Dr. Shah will also review claims data biweekly and document and review outcomes with your practice.
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Mount Sinai Health Partners Podcast
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Senior Vice President and Chief Operating Officer for Population Health at MSHP, Denise B. Prince, joins Dr. Fields in the latest episode of the Mount Sinai Health Partners podcast. A self-described “serial entrepreneur,” Denise shares her background working at other startups and businesses within a healthcare bureaucracy, how Mount Sinai as an academic medical center and a health system differs, what makes a good leader, and how to find the right people to create change in a large health system.
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Cigna Updates Reimbursement, Administrative, and Precertification Policies
Cigna explains their updated policies on reimbursement, administration, and precertification in their quarterly Network Newsletter. Many of these policies have already taken effect.
Click here
to read more (pages 4-6).
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Behavioral Health Screening and Reimbursement for Your Cigna Patients
In the central role you play caring for your patients’ overall health, you are in a unique position to screen them for potential behavioral health issues. The
Body and Mind Connection page
provides screening tools, reimbursement info, CPT codes, and more.
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CIN Podiatrist, Dr. Jonathan Richards on NYS CBS
Dr. Jonathan Richards, CIN podiatrist at FOOTDRx, was on NYS CBS on February 29 explaining common foot ailments and their treatments.
Watch the segment here
and please join us in extending a congratulations to Dr. Richards.
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Do you or a colleague in the CIN have a professional achievement to share? Please
email us — we love hearing about all of the fantastic work our network does on a daily basis. With your permission we’ll give you a shout out in the next newsletter.
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P: 877-234-6667
F: 646-537-1481
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