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Clinically Integrated Network Newsletter
February 22, 2023
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Outreach Patients with Open Care Gaps with Your Full Patient Panel Report
At the end of January we uploaded your practice's January 2023 Full Patient Panel report to your practice's main OneDrive account. This report includes all patients who are attributed to your practice based on the latest information we have from payors. Highlighted in the report are patients in your panel who have care gaps, including no PCP visit in the past 12 months, quality care gaps, and CDQI opportunities. Use the report to inform your patient outreach strategy.
To learn more about the data and how to access the reports, review this communication we sent on January 27.
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New! View Your Payments on the Provider Portal
On February 8, we announced the launch of My Payments, a new web-based tool that allows you to view and download an accounting of value-based payments your practice has received from MSHP based on eligibility, such as care coordination payments and performance-based annual incentive payments.
To learn more, review this communication or download these user guides for detailed instructions on how to use the tool.
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COVID-19 Public Health Emergency Set to Expire May 11, 2023
At the end of January, the Biden administration announced their intent to end the public health emergency (PHE) and COVID-19 national emergency on May 11. The Kaiser Family Foundation outlines the changes providers and patients should be aware of.
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Submit a Case to Mind Matters ECHO | |
What makes a good case for Mind Matters ECHO?
The most important element is a desire to learn from and implement feedback from your peers to improve the patient's care and outcomes. Any patient with behavioral health needs (diagnosed or suspected) with barriers or difficulties to treatment can make for a great learning opportunity, and cases do not need to be overly complex to foster valuable discussion.
Examples of potential cases:
- Choosing the best SSRI
- Encouraging patients to seek psychotherapy and supporting them in the meantime
- Assessing whether substance use is problematic and/or disordered
Learn more about submitting a case.
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MSHP Board of Managers Spotlight: Dr. Michael Frey
Meet our new Mount Sinai Health Partners’ Board Member, Michael Frey, MD. Dr. Frey is an obstetrician-gynecologist at Mount Sinai Doctors Westchester. We recently caught up with Dr. Frey to learn more about him as a new MSHP Board member!
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What do you like most about serving on MSHP’s Board of Managers?
I am a new Board Member so I am excited to find that out!
What do you hope to accomplish while serving on MSHP's Board of Managers?
I hope to learn how best to apply my knowledge and skills to this position. I am excited to represent our doctors as one of the non-Manhattan members. I am very eager to serve the board and I am passionate about population health.
What are your interests/hobbies outside of work?
Spending time with my family and playing with my dog.
We welcome and look forward to Dr. Frey serving on MSHP’s Board of Managers!
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Interested in becoming part of MSHP's governance? Join a committee today! Reach out to Lauren Hertan at Lauren.Hertan@mountsinai.org to learn more about how you can participate.
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Chronic Condition Management | |
Use SGLT2-Inhibitors Across All Categories of Heart Failure
Current guidelines recommend use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in management across all heart failure (HF) categories.
Recent studies have demonstrated a reduction in heart failure hospitalization and CV death in patients with and without type 2 diabetes (T2DM).
Prescribe a SGLT-2 inhibitor (dapaglifozin, empaglifozin, or canaglifozin) for your heart failure patients with eGFR >30 regardless of whether or not they have diabetes.
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ICD-10 Coding for Outpatient Heart Failure Management
Ensure that your patients' true levels of complexity are accurately reflected by using accurate and specific documentation and coding. This is not only essential to performance in value-based care reimbursement but also helps ensure that future quality of care and appropriate support services are made available.
Code for chronic systolic heart failure, chronic diastolic heart failure, and chronic combined systolic and diastolic heart failure.
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Systolic heart failure is typically recognized as LVEF <50%. For patients with HFrEF, HFmrEF, and HFimpEF with recent LVEF <50%, consider documenting and coding for systolic heart failure.
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Diastolic heart failure should be diagnosed for patients with clinical signs of heart failure with EF >50%. For patients with HFimpEF with recent LVEF >50%, consider documenting and coding for diastolic failure.
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For patients with diastolic dysfunction on imaging without clinical heart failure, consider using codes for diastolic dysfunction.
For any questions about coding and documentation, please email Donna Malone, Director of Clinical Documentation and Quality Improvement.
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2023 Preferred Laboratories
Choose in-network laboratories to help reduce out-of-pocket costs for your patients. View and download our 2023 Preferred Laboratories Quick Guide.
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Mount Sinai's Relationship with UnitedHealthcare's Community Plan
On February 10, we provided an update on Mount Sinai’s difficult decision to end our participation with UnitedHealthcare (United) Community Plan products in 2023. The communication shares the timing of Mount Sinai exiting from all Community Plan products: Dual Complete, Medicaid, Child Health Plus and Essential Plan. Mount Sinai will continue to participate in non-Community Plan United products including, Commercial products, Medicare products and Mount Sinai’s employee plan administered by UMR.
While Mount Sinai Health Partners IPA does not contract with these Community Plan products, we want to keep you informed. As a community-based provider affiliated with Mount Sinai, you may be wondering whether or how this may affect any direct contract your practice may have with United’s affected Community Plan products. To learn more, review this communication. You can also check mountsinai.org/united for updates.
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Cigna Updates
Cigna Public Health Emergency Period to End May 11, 2023
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Following the announcement made by the Biden administration, Cigna Commercial and Cigna Medicare Advantage intend to extend their cost-share waiver for diagnostic COVID-19 tests and related office visits through at least May 11, 2023, subject to any further announcements or guidance from the administration. Learn more.
Certain Humana Associates to Access Cigna PPO Network
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Effective January 1, 2023, some Humana employees and their dependents will have access to Cigna's PPO network. ID cards will now include both the Humana and Cigna logo on the front. Providers should follow the contact information on the back of the card to verify eligibility and where to submit claims. Learn more.
Cigna Offers Discounted Rates on Language Assistance Services
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To help improve communication and health outcomes for your patients with limited English proficiency (LEP), Cigna has contracted with professional language assistance service vendors to offer discounted rates of up to 50 percent for language assistance services. Learn more here.
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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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