Contract & Network Update
A Look at Adirondacks ACO compared to other ACOs
In past newsletter articles and at the Adirondacks ACO Provider Meeting, we showed the network our quality and utilization results compared to our payer benchmarks, but how do we compare to other ACOs? Although ACOs can be very different, we do have two comparisons – a small group of multi-payer ACOs in New York State (NYS) and Medicare Shared Savings Program (MSSP) ACOs which is just Medicare results compared to other MSSP ACOs.
For more information on how Adirondacks ACO compares, Click HERE
Adirondacks ACO Compliance Training Sessions
We have scheduled three (3) 1-hour “live/virtual” compliance training’s this year. You can participate in through a Teams Meeting, which you can access through the email that was sent on 11/20/20
The virtual training dates are as follows –
Wednesday, December 2, 2020 – 8:00am – 9:00am
Wednesday, December 9, 2020 – 12:00pm – 1:00pm
Wednesday, December 16, 2020 – 8:00am – 9:00am
If you have any questions or concerns about the ADKs annual compliance training, please do not hesitate to reach out to Justin Frazer, Compliance Officer at jfrazer@mazarsusa.com or myself at kashline@cvph.org.
Quality & Performance Update
HEDIS has eased some quality measure specifications to address the changes in the health care landscape that telehealth has brought about this past year. The following are just a few of the changes that affect the measures that ADKs ACO is accountable for:
Controlling Blood Pressure Measure:
- Diagnosis of hypertension can be captured via telehealth, telephone visit, e-visit, virtual check-in or outpatient visit;
- Specifications have been revised to include telephone visits, e-visits and virtual check-ins as appropriate settings for blood pressure readings
- Blood pressure readings must be documented in the medical record
- Preferred way to close gap in care is to capture blood pressure by claims
- Blood pressures can be taken by any remote device
- Blood pressures can be reported or taken by the patient
- Postpartum care services can now be provided via telephone, e-visit, or virtual check-in.
- Revised the measure name from Well-Child Visits in the First 15 months of Life
- Retired the 0, 1, 2, 3, 4 and 5 well child visit rates.
- Two reporting rates:
- Rate 1: Well-Child Visits in the First 15 Months.Children who turned 15 months old during the measurement year and had 6 or more well-child visits.
- Rate 2: Well-child Visits for Age 15 Months – 30 Months.Children who turned 30 months old during the measurement year and had 2 or more well-child visits.
- Well-child visits can be conducted by real-time interactive audio and video telecommunications.
- The measure is a combination measure that replaces the former “Well-child Visits in the Third, Fourth, Fifth and Sixth years of Life” and “Adolescent Well-Child Visits” measures.
- Added patients age 7-11 years of age.
- Well-Child visits can be conducted by real-time interactive audio and video telecommunications.
These are just a few of the changes that have been made with more expected. We will continue to see changes in the HEDIS metrics, as we begin moving quickly towards electronic clinical quality measurement. Please see the links for supplemental information provided by BSNENY during a quality webinar to guide your practice on the technical specification changes made by HEDIS, as well as incentive opportunities tied to closing clinical quality gaps offered by BSNENY. Stay tuned for future webinars featuring collaboration with BSNENY.
For More Information:
2020 Pay for Outcomes Program (P4O), Click HERE
Value-Based Reimbursement Program, Click HERE
HEDIS MY 2020 Technical Specification Changes, Click HERE
Data Update
COVID Dashboard
The COVID Dashboard is based on claims data from our five primary payers: MSSP, Fidelis, Empire, CDPHP, and Excellus, representing the majority of our population.
We currently are tracking 12 indicators and their quarterly utilization for 2019 and 2020. The indicators cover multiple perspectives from facility to professional and post-acute care. For example, inpatient admission, ED visit, SNF, home health, and COVID confirmed cases. The ACO will be using the COVID dashboard as a reference for future payer contract negotiation and outcome tracking for some of our workgroup’s initiatives. We are also open to any other ideas you may have for this dashboard.
November is National Diabetes Awareness Month
November is a month to raise awareness in our region about diabetes. The NYS Community Health Indicator Reports show that between 7.5% (Hamilton) and 14.3% (Essex) of adults in our counties have physician-diagnosed diabetes. There are Diabetes Self-Management programs and other community resources available in our region to support your patients.
For more information:
American Diabetes Association site for Professionals
American Diabetes Association search for accredited self-management programs
We don’t have regional data on prediabetes, but the CDC estimates that 84 million people have prediabetes, and 84 percent don’t know they have it.
For more information on regional resources to support your patients that you identify with prediabetes:
National Diabetes Prevention Program description
List of Programs
Self Test for Prediabetes
Now is the time for diabetes awareness
With COVID-19 resurfacing across the region, now is the time to make sure our communities understand the impact of COVID-19 on people with diabetes.
The CDC believes that people with type 2 diabetes are at an increased risk of severe illness from the virus, causing COVID-19. People with type 1 diabetes may be at increased risk. The CDC reports that diabetes was noted as an underlying condition for approximately 4 in 10 patients with COVID-19. For more information on diabetes and COVID-19, Click HERE
Webinars & Training’s
Empower your clients as they navigate the fluid nature of change with motivational interviewing (MI).
Making life changes is hard. But it helps to know why you do what you do. That’s where MI – collaborative conversations to engage and support individual change processes – can make a big difference.
Whether you’re a clinician at a mental health or addiction treatment facility, a supervisor trying to boost staff morale, or a nurse helping patients manage diabetes, MI can help you create conversations that inspire meaningful changes and foster higher rates of engagement and behavioral change across all areas of your clients’ work and life.
If you’re new to MI or looking for a refresher course, join Pam Pietruszewski, an integrated health consultant at the National Council, for this virtual training program designed to maximize engagement and interaction.
Choose the date and time that’s most convenient for you. This four-hour training is available for $79 per person and space is limited for each training, so register today!