February 2021 Newsletter

Contract & Network Update

Empowering Patients to Make Decisions about Their Healthcare – 
Medicare Beneficiaries Voluntary Alignment Process

 
Voluntary alignment is the process that lets Medicare FFS Beneficiaries select “voluntarily align” with a primary clinician. CMS believes that Voluntary alignment will strengthen beneficiaries’ engagement in their health care and empower Clinicians to better coordinate care.

When to start: There’s no enrollment window for an ACO to exercise the voluntary alignment option for attribution. 2018 was the first year in which beneficiaries could be assigned to an ACO based on their designation of a primary clinician in the ACO is responsible for coordinating their care.  CMS will include all Beneficiaries who have voluntarily aligned with their primary clinician by logging into MyMedicare.gov prior to 9/30 of the year preceding the performance year.

This means that for any Medicare FFS Beneficiary who elects to complete their voluntary primary clinician election between 10/1/20 – 09/30/21 for an ACO Participating Provider, these Beneficiaries will be attributed to the ACO for 2022.

How it works: Beneficiaries have to log in to MyMedicare.gov to select their primary clinician. They must have one visit with the Participant to be eligible for ACO attribution.

What will happen: The beneficiary’s selection will override prospectively the claims-based assignment methodology. Beneficiaries may change their designation at any time through MyMedicare.gov and the changes will be incorporated into the next performance year when CMS counts the assignment.

See the Voluntary Alignment ACO Fact Sheet for participating providers (link here) for additional details.

ACO participating providers must ensure that Medicare FFS beneficiaries are notified about their ability to, and the process by which, to identify or change identification of the individual he or she designated as their primary clinician for purposes of voluntary alignment.

The Patient ACO Voluntary Alignment Fact Sheet can be given to Medicare FFS Beneficiaries to register their primary clinician and make changes as appropriate.

Impact on Beneficiaries: It’s important to note that voluntary alignment is optional for beneficiaries and does not affect their Medicare benefits or restrict their ability to choose a doctor in any way. Regardless of ACO assignment or designation of a primary clinician, Medicare FFS beneficiaries may continue to see any Medicare provider.

For more information regarding this information and the opportunity for voluntary alignment, please reach out to Karen Ashline at kashline@cvph.org.

Northwinds is excited to share their collaboration with Aspenti Health to offer our members and ACO partners access to a new educational series, Responsible Opioid Administration Solution (ROAS).
ROAS provides 3 Micro Certifications, each offering 1.5 CME credit hours. A description of each certification;
  • Micro Certification #1 – ‘Foundations in Opioid Administration’ highlighting the evolution of the Opioid Crisis, best practices for Opioid administration, screening tools for substance misuse, HIPAA and 42 CFR Part 2 review and AdministeringNaloxone
  • Micro Certification #2 – ‘Opioid Misuse’ covers Substance Addiction 101, approaching individuals suspected of misuse and effective use of urine drug testing. Overview and Discussion of Medication Assisted Treatment withpatients
  • Micro Certification #3 – ‘Opioids and Pain Management’ Provides an overview of Acute and chronic Pain, Opioid prescribing guidelines and recommendations, risk and benefits of Opioid use, Alternatives to Opioids for pain and techniques for Compassionatetapering.

These unique offerings are tailored around the challenges that health providers and administration are facing in the Opioid, Addiction and Behavioral health crisis.

Additionally, the large library provided by HealthStream beyond the ROAS Micro Certifications will enhance the  Opioid Use Disorder (OUD) services across our region and is accessible to our network and partners under this collaboration.

If you are interested in this opportunity and would like access to ROAS or other content, please email Carissa Parot for more information.

Quality & Performance Update

Hixny can receive SDoH data—and we encourage you to share this valuable information using Hixny!
 
Sharing information about patients’ social determinants of health through the health information network is important for
  • Meeting the needs of patients by offering the right community-based services and referrals
  • Ensuring adequate staffing given the underlying medical and social complexity of your patient panel
  • Identifying population health-related trends that might be addressed through non-traditional, system-wide relationships beyond your office
As a reminder, new E/M Codes took effect on January 21.  Providers are now able to factor SDoH into the “medical decision making” component of E/M visits. Like other coding for diagnoses, Hixny accepts ICD-10-CM Z codes for identifying a patient’s SDoH. Read more.

Fidelis and ADKs ACO Collaborative – With Jill LaRose, Provider Partnership Assoc.
Date: 
February  23, 2021
Time: 12:15-1:00 pm
How to Join: Click here to join the meeting

Agenda:

  • Introductions
  • Fidelis Attribution – How to work collaboratively to engage patients or align patients with the providers they are seeing
  • Gap Closures – How to facilitate gap closures through claims  Ex. Well Child 0-15 months
  • Open Forum
We have heard over the years the difficulties regarding engagement of auto assigned patients and/or the difficulties having patients reach out to Fidelis to be assigned to the provider they are seeing.  Jill will discuss how she and her team can assist with this process.  She will discuss the process of closing gaps through their claims process.
Excellus and ADKs ACO Collaborative – With Ann Marie Mesick, Value Based Clinical Consultant
Date: March 24, 2021    
Time: 12:15 – 1:00 pm
How to Join: Click here to join the meeting
 

Agenda:
  • Introductions
  • Cologuard – Benefits, Process and Follow up
  • Coding – How to properly close colorectal cancer gaps when through coding past history of screenings
  • Excellus – Outreach to assist with closing gaps
  • Open Forum
The pandemic certainly presented many challenges in closing quality gaps and colorectal cancer screening was one of them.   Cologuard will present how they have worked with several of the ADKs ACO practices over the last couple of years, their process and lessons learned.  Ann Marie and her team will then discuss the opportunities to capture colorectal cancer screenings through coding and coding past history of screenings.  She will then highlight the initiative they have to assist our practices on outreach and follow up for colorectal cancer screening.

ACO Spotlight

Cardiovascular Disease in New York State
  • CVD accounted for nearly 40% of all deaths statewide in 2014.
  • An estimated 7.4% of adults in New York State reported they have had a heart attack, angina/coronary heart disease, or stroke in 2014.
  • One out of five (20.9%) New Yorkers aged 65 and older reported having some type of CVD in 2014.
  • To access more data on heart disease and stroke in New York State, visit the Cardiovascular Disease Data and Statistics page.

For More Information On:
Clinical Resources for Hypertension Control, Click Here.
Public Health Resources for Hypertension Control, Click Here.
Hypertension Control Resources for Individuals and Patients, Click Here.
New York State Heart Disease and Stroke Prevention, Click Here.

Resources 

Medication Options for Treatment of Stimulant Use Disorders:
Optimistic Update and New Research
Tuesday, March 2, 2021; 1-2 p.m.

Overdose deaths associated with illicit stimulants (cocaine and methamphetamine) have surged in the past eight years, according to a recent study by the National Institutes for Health (NIH). While there are currently no FDA-approved medications for the treatment of individuals who are dependent on stimulants, new treatments utilizing readily available medications are showing encouraging empirical support.

Join us Tuesday, March 2, at 1 p.m. ET, for “Medication Options for Treatment of Stimulant Use Disorders: Optimistic Update and New Research,” when we’ll examine the latest groundbreaking research in the context of current increases in stimulant use. Marc Fishman, MD, medical director of Maryland Treatment Centers, a member of the psychiatry faculty of the Johns Hopkins University School of Medicine, and a member of the National Council’s Medical Director Institute will share his expertise as an addiction medicine specialist to bring the latest information to help you:

  • Understand the current epidemiology of stimulant use in the U.S.
  • Address the most common clinical challenges in treating people with stimulant use disorders.
Explore new research that provides evidence for potential treatment of stimulant use disorder treatment.


Register HERE

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