October 27, 2022

In this issue

• Top 3 priorities
• Supporting your practice: CI update, RSV, language services, flu vaccine
• Epic updates: Daylight savings, upgrade
• COVID testing attribution logic
• CME



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Reminder! Top 3 Priorities

Don Calcagno, President, APP | SVP, Population Health & Managed Care

Alvia Siddiqi, Interim Chief Medical Officer, APP

As we head into the end of the year, we want to remind you of our top three areas of focus to improve patient care and maximize performance. 

Quality:

• Screenings: It’s important to ensure patients to have all appropriate annual screenings, many of which are measured for Medicare Advantage Stars. We send targeted communications to your patients through our robust patient outreach program. Please continue to address when you see your patients.
• Medicare Advantage Stars: In addition to screening measures, there is a focus on condition control and medication adherence. A key strategy is to write 90-day prescriptions refillable for a year.

Chronic Condition Management:

• Chronic Condition Refresh: This is essential to close care gaps, ensure conditions are well managed and connect patients to various care and disease management programs. Our consultants are here to support you.
• Medicare Wellness Visit (MWV): These highly reimbursed visits are important to close care gaps and reevaluate chronic conditions.

Readmissions/Utilization: 

• Transitional Care Management (TCM): It’s critically important to get patients in for a TCM visit shortly after a hospital discharge, ideally within 2-7 days. Care transitions nurses help you meet the requirements of this visit by making an initial TCM call for patients who are at high risk for readmission to make sure they have a TCM visit scheduled after discharge. It's important for you to perform these visits on all patients. 

As always, thank for delivering the highest quality care for our patients.

Clinical Integration weekly update: View the latest program update. 

Patient outreach: We are conducting patient outreach on your behalf to support quality outcomes and close quality care gaps. Read more.

Language Services: Did you know that under the Affordable Care Act of 2016, all practices must provide interpreter services to patients with limited English proficiency? Click here for details and important resources.

Respiratory Syncytial Virus (RSV) update: RSV is the leading cause for pediatric hospital admission in the US. Advocate Aurora Health is currently experiencing an early peak and surge of RSV cases. Performing good hand hygiene, frequent cleaning of high-touch surfaces and staying home when sick can help reduce the spread.

Critical shortage of Albumin 5% and 25%: There is currently a nationwide shortage of albumin 5% and albumin 25% vials and bags. View SBAR and prioritize albumin use for those patients most likely to benefit.

COVID masking reminder: We're continuing universal masking in all Advocate Aurora patient care areas. Masking remains optional in areas where patients are not present, including breakrooms, libraries, cafeterias and administrative offices. 

Advocate Aurora Employee Health Flu Clinics close Friday: APP aligned physicians on staff at Advocate Aurora Health hospitals are required to receive a flu vaccine by Nov. 9. Advocate Aurora Employee Health Flu Clinics are now open through Oct. 28. If you choose to obtain a vaccine at on offsite location, be sure to bring a vaccine verification form. This year validating your flu shot received at an outside location has also been made easier with TrackMy. 

Pixel tracking technology breach: Like many others in our industry, Advocate Aurora used internet tracking technology called pixels to improve the consumer experience across our websites and encourage scheduling necessary preventive care. We recently learned that pixels installed on our patient portals and some scheduling widgets may have transmitted patient information to third-party vendors such as Meta and Google. In response, we’ve disabled pixels and issued a public data breach notification. We are not aware of any misuse of information arising from this incident. Learn more.

Breast cancer screening: It's Breast Health Awareness Month and it's easy for patients to learn more about their risks with Advocate Aurora's online breast health assessment (English | Spanish) and to schedule screening mammograms with simple scheduling via the LiveWell app, online or by phone.

Documenting Decisional Capacity: Assessment and documentation of decisional capacity for patients who are believed to lack capacity is required by law and ensures we are providing safe, high quality care. Patients are regarded as decisional unless this action is taken. The Epic ACP tab enables this documentation, which is required of physicians. Learn more.

Watch the Oct. 20 Connecting with Jim: Tune in for report card review, an update on our Atrium Health combination and more.

Daylight savings time in Epic: The fall daylight savings time event will occur on Nov. 6. Like last year, Epic will not be taken down during the daylight savings time transition period. The repetition of the 1 a.m. hour may result in unique situations that those accessing Epic during this time should be prepared to manage. Learn more.

Next Epic upgrade Dec. 14: To continuously improve our use of Epic in providing safe and efficient care for our patients, we conduct periodic upgrades. Watch for more information, including education dates and materials and additional resources. 

Epic Update: Ambulatory Epic Connect: Referral process, CRM workflow update and more.

Epic Update: Hospital edition for Physicians and APCs: Fall daylight savings time, isolation orders paneled with lab orders, inpatient lab order frequencies update and more.

COVID Testing Attribution Logic

Several APP offices established COVID walk-in testing services open to the public and are reporting Clinical Integration (CI) patient attribution is occurring for those non-APP patients who only received COVID testing services.

The APP attribution logic includes logic to exclude persons who only received a COVID test when claims are billed using ICD-10 codes Z20.828 or Z20.822 as the PRIMARY/DX1 code. 

• These are the ONLY codes that trigger the exclusion of a claim from the attribution logic in the CI registries and must be billed in the DX1 position. 
• If a provider is using COVID codes outside of these two specific codes (Z20.828 or Z20.822), attribution for a non-APP patient will occur and the provider will be expected to meet any registry requirements.
• Patients who are not excluded through this attribution exclusion process can challenge patient attribution as an appeal to the CI Program at year end if the provider does not meet the minimum CI score (65%/70%). 

APP encourages all providers who offer COVID tests to the public to review and revise their billing practices as needed. 

Advancing Research

Journal of Patient-Centered Research and Reviews: Read about the new editor-in-chief and visit aah.org/jpcrr to submit original manuscripts for editorial consideration.

New research intern policy: Physician investigators are encouraged to consider intern support for academic research. This policy provides details on the new application and approval process.

Continuing Medical Education

Electrophysiology for Primary Care

Sat. Nov. 5, 8 a.m.– 2:30 p.m.

Learn the latest on arrhythmia disorders, including frontier exploration, promoting improved patient outcomes and time prioritized for discussion, questions and interaction between primary care and electrophysiologists. 

Upcoming CME



Nov. 2: Project ECHO Memory Care

Nov. 4: Family Medicine Fall Conference

Nov. 4: National Acute Care for Elders (ACE) Conference

Nov. 4: 10th Annual Advanced Heart Failure Symposium 

Nov. 4: 18th Annual Trauma Symposium

Nov. 5: Electrophysiology for Primary Care

Nov. 9: Ethics & Boundaries: Understanding DE&I to leverage cultural humility

Nov. 9: Multidisciplinary Echocardiology Conference

Nov. 11: Blinded by Bias

Nov. 14: Trauma Informed Care with Isabel Wilkerson (Pulitzer Prize winner & author)

Nov. 17: MEDtalks: South Asian cardiovascular disease & center

Nov. 18: 13th Annual Pulmonary Hypertension Symposium