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Leaders: You are receiving this version of the newsletter that includes all PHO President messages. Physicians will receive only one message from their local PHO President.
In this issue
- Introducing PHO President Message
- Supporting You: New Provider Relations Team
- Supporting Your Practice
- Epic Updates
- How Epic Connect Can Help Your Patients
Note: When accessing APP Pro links below, you may need to sign in again if you are not taken directly to the referenced page or information.
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Hear From Your PHO President | |
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Good Samaritan
Donald Steiner, MD, PHO President and emergency medicine physician
Thank you to everyone who joined us at our Annual Meeting on April 22. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We always welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
Why were immunizations/devices reduced in the APP fee schedule?
Please see the message featured in today's APP Key Messages newsletter for an update on immunization fee schedules.
Will APP help market my practice?
APP is unable to directly market physician’s practices. However, your Business Development team is happy to assist with networking and introductions. Please contact Marina Braun or Joe McCormick.
Thank you for all you do to help our patients live well.
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Illinois Masonic PHO
Jose Elizondo, MD, PHO President and family medicine physician
Thank you to everyone who joined us at our Annual Meeting on April 27. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
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Lutheran General PHO
Robert Zimmanck, MD, PHO President and internal medicine physician
Thank you to everyone who joined us at our Annual Meeting on April 20. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
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Condell PHO
Deborah L. Winiger, MD, FAAFP, PHO President and family medicine physician
Thank you to everyone who joined us at our Annual Meeting on April 19. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions or concerns that were raised at the meeting:
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Christ PHO
Emelie Ilarde, MD, PHO President and family medicine physician
Thank you to everyone who joined us at our Annual Meeting on Thursday, April 20. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
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South Suburban PHO
Ram Aribindi, MD, PHO President and orthopedic surgeon
Thank you to everyone who joined us at our Annual Meeting on May 17. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
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Trinity PHO
Wendell Wheeler, MD, PHO President and pediatrician
Thank you to everyone who joined us at our Annual Meeting on April 28. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
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Good Shepherd PHO
Dean Feldman, MD, PHO President and anesthesiologist
Thank you to everyone who joined us at our Annual Meeting on April 26. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a few questions that were raised at the meeting:
Why did APP move away from eUniversity to Workday?
Advocate Health as an enterprise decided to move to a single educational platform, Workday. This change simplifies the administration of mandatory education for all physicians and non-clinical staff. Please follow up with your medical staff with any questions or concerns.
How would physicians know or be made aware of their performance in the clinical integration program?
- The Value Based Care Advisors are assigned to each practice and provide updates on performance.
- Each physician has access to an individualized scorecard on the APP Provider website.
Thank you for all you do to help our patients live well.
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Sherman PHO
Christopher Michael, MD, PHO President and OBGYN
Thank you to everyone who joined us at our Annual Meeting on May 9. It was a meaningful time to reconnect with colleagues, share important updates and hear from you.
We welcome your feedback and questions, and the annual meeting was no exception. I want to address a question that was raised at the meeting:
Does Sherman offer patients pre-operative education describing what to expect?
Generally, the surgeon performing the procedure offers pre-operative education. Please reach out to your VBC team if you have a specific question about pre-operative education.
Can a PCP bill TCM for a surgical case?
Yes, a PCP can bill for Post Operative TCM Visit.
- Please note only one physician may bill for TCM services.
- Surgeons cannot bill TCM services within a post-operative global surgery period. TCM will not be paid if any of the 30-day TCM period falls within a global surgery period for a procedure code billed by the same practitioner.
Thank you for all you do to help our patients live well.
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Answering Your Questions - Fee Schedule Changes | |
APP experienced unprecedented losses in 2021 and 2022 on capitated products. As such, the APP fee schedule for capitated plans was reduced February 1. This included immunizations and devices without a CMS fee schedule value. In response to physician feedback, a subcommittee of the Quality Improvement Committee was appointed to do a literature review around vaccines and the broader impact on population health. Based on their review, the subcommittee recommended to the APP Finance Committee that the February 1 reimbursement rate for vaccines without a CMS Value be increased to 111% of the current GPO pricing. The 11% on top of the procurement price is to address expenses associated with vaccine storage. These changes were approved by the APP Finance Committee and will be effective on June 1. The updated vaccine reimbursement schedule will be posted to APP Pro. Additionally, in 2022, for the first time in years, physicians were not made whole to 120% as part of first draw on the Incentive fund. We hope, however, to do so for the 2023 incentive payout (paid in 2024) if our fee schedule changes generate surplus to allow this. | |
New Ways We Are Supporting You | |
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Clinical Integration updates: View the latest program updates including expanded 2023 measure sets for cardiac electrophysiology and interventional cardiology, appeals determination letters sent April 12 and more.
Population health outreach: We are conducting the following patient outreach on your behalf to support quality outcomes and close quality care gaps. Learn more.
Mandatory education: APP physicians and APCs are required to complete Mandatory Education courses on the Workday Extended Enterprise Learner platform by June 19.
Comprehensive Annual Visits: Physicians and APCs can now refer patients with chronic conditions and open care gaps for a Comprehensive Annual Visit – an in-home or virtual visit for Medicare Advantage and MSSP patients. View flyer.
Reminder! End of the COVID Public Health Emergency (PHE) update: The Federal COVID PHE has expired. View these resources on what’s changing and what will not be effected: virtual health changes, U.S. Department of Public Health and Human Resources fact sheet and the CDC website.
Supporting patients enrolled in Medicaid: For the first time since the start of the pandemic, Medicaid patients must renew their coverage.
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Please direct Medicaid patients to our helpline 1-800-326-2250 and learn more (English | Spanish).
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To support our Medicaid patients and ensure they take the required actions, we’ve launched an awareness campaign, including elevating a physician voice with our very own APP family practice physician and Advocate Trinity PHO Medical Director, Senora Nelson, MD, in a recent article highlighting the importance of this process.
COVID screening and reporting just became easier with TrackMy: Physicians and APCs must report COVID-like symptoms, exposure and positive results to Teammate Health via the TrackMy tool instead of using SafeCheck, which will no longer be available June 1. TrackMy is the tool used to verify your flu shot, so most already have a login. View how-to information, including FAQ and account instructions. You will also be responsible for obtaining and taking your own COVID tests and uploading the results to TrackMy if you test positive and were scheduled to be at an Advocate or Aurora site during your CDC-directed quarantine period. If you have difficulty locating a test kit, contact Teammate Health (855-663-4327).
Reporting blood transfusion reactions: Identifying and reporting transfusion reactions are key to the safety of the blood supply and treating the individual patient. These adverse events range in severity from minor to life-threatening and can occur during a transfusion (acute reaction) or days to weeks later (delayed reactions). The most common signs and symptoms associated after a transfusion include fever, chills, hives and itching. Please report any suspected reactions to your site Transfusion Service and enter a report in the Midas Patient Safety System.
Every second counts: Last year, our physicians and APCs cared for 6,147 stroke patients across our comprehensive stroke centers and specialized clinics. During Stroke Awareness Month, we are educating our communities about the risks and warning signs and highlighting the great work of our stroke care teams. Order educational resources for your patients here.
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How Epic Connect Can Help Your Patients | |
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Hear from Adebayo Bademosi, MD, family medicine physician from the Trinity PHO, about how implementing Epic Connect helped his practice achieve a 400% increase in CI score in only six months, an impressive quality result on top of the financial savings. If you are interested in joining Epic Connect, reach out to the Epic Connect team for more details.
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Service Line Leadership Announcements | |
Giving Back and Building the Next Generation Workforce | |
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Last week, Bill Santulli, President, Advocate Health – Midwest Region, had the honor of being the keynote speaker at Christ the King (CTK) Jesuit College Prep’s 2023 Spring Luncheon. Advocate Health Care is a founding partner of CTK’s Corporate Work Study Program, where we’ve supported 100 students and are the largest current employer of CTK students. We’re honored to have this opportunity, and it’s just one of the ways we’re supporting our local urban communities and training the next generation. View event photos.
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Continuing Medical Education | |
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MEDtalks: Science behind chronic pain - Language you can use for patient education and identification of opioid use disorders
Tuesday, May 30, noon-1 p.m.
This course will review the science behind chronic pain and pain modulation systems including pain catastrophizing, opioid-induced hyperalgesia and diagnostic criteria for opioid use disorder. In addition, learn how to use motivational interviewing. This course fulfills DEA licensure requirements.
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