America’s Physician Groups (APG) News Update   On Friday, a federal judge in Texas ruled the entire Affordable Care Act (ACA) unconstitutional based on Congress removing the law’s “individual mandate,” or penalty for those who fail to obtain insurance coverage. There have been calls for an immediate appeal of this decision. In the meantime, the Trump Administration has indicated that the ACA will remain in place until appeals and other legal challenges play out. Of particular importance to APG members and others is how this decision may impact the Center for Medicare & Medicaid Innovation (CMMI) and its work in developing and expanding value-based payment models. In an email they sent, APG shares: “The recent federal court decision is still moving through the courts and the work of the Innovation Center will continue unchanged. We remain committed to our current and future models as well as our focus on better health outcomes at lower cost.”

QUEST Survey for Pediatricians   The American Academy of Pediatrics, Hawaii Chapter, would like to get opinions and viewpoints from the EHI Pediatricians on the 4 QUEST plans. They will send a $25 gift card once the ~30-question survey is completed, which should take 15-20 minutes to complete. If you have not received the link for the survey, please contact Dr. Galen Chock at gchock@aap.net.

Hawaii Health Information Exchange (HIE)   Hawaii HIE offers to its subscribers an upgraded Health eNet solution which features expanded data contributors. Subscribers can access the data of all veterans who are participating in the data exchange and received care at any of the 152 Veterans Affairs medical centers and 1,400 community outpatient clinics in the United States, U.S. territories such as American Samoa, Guam, Puerto Rico, and the Virgin Islands, as well as the Philippines. Additionally, admission and discharge alerts are available inside the Community Health Record and customizable for your practice. To register and take advantage of the newly reduced promotional subscription fees, please fill out the attached form. Questions can be directed to Rebecca Burton, MD, Medical Director at rburton@hawaiihie.org or 808.441.1429.

HMSA Payment Transformation

Quality Performance Update – We prepared spreadsheets showing progress to date for each office. If you did not receive your spreadsheet, please contact Joyce at jvitales@ehiipa.com. The IPA will give year-end performance incentives to high performers.

Annual Provider Survey – Please complete and submit this survey online before December 31, 2018. Access the link here. HMSA funding to the IPA depends upon your completion of this survey.

Ecosystem Referrals – NOW AVAILABLE to submit attestation on Coreo. Requirement for compliance is confirmation & description of referrals to programs in the community submitted via an attestation form in Coreo by the end of the measurement year (12/31/18). To receive credit for this, please check “other” and list the programs that you refer patients to. See screenshot here. If you have completed this measure and Coreo is still not giving compliancy (bar is white), HMSA is getting reports that the field, “I also certify that I referred the following number of HMSA members to the above-mentioned programs” is 1) not being filled in and IS REQUIRED and 2) only requires a whole number/integer. No text, estimations, numerical range (i.e., 5-10), etc. Just the whole number/integer. The measure will give compliancy if the number is just 1, but will need to be confirmed in the record for audit purposes. If you have any questions feel free to call/email their support team at coreosupporthi@navvishealthcare.com or call 808-892-3428.

KTA Diabetes Prevention Program (DPP)   KTA Pharmacy will begin offering a Diabetes Prevention Program beginning January 10, 2019. They are  looking for patients with pre-diabetes who are willing to attend their year-long program. There is no referral required; all they need is their most recent A1c or fasting blood glucose test that shows that they have pre-diabetes. During the program, patients will learn how to make necessary lifestyle changes to lower their risk of developing Type 2 diabetes. Contact KTA Pharmacy at 959-2888 to enroll your patients!

Announcements:

  • CMS Quality Payment Program WEBINAR – “Eligible Clinician eCQM Preventive Care and Screening Measures” – Tuesday, January 15, 1:00-2:00 PM EST (10 AM PST). Register here.

  • Beacon Health – PCP Referral for Behavioral Health Support – Beacon Health offers behavioral health services for HMSA patients. Attached is the referral form (here), the overview of services (here), and the WHO-5 Well-Being index tool (here).

  • Refer Patients to Complete Their Advance Health Care Directive at ADRC – November-March dates attached.

  • UPDATED Aging & Disability Resource Center (ADRC) Referral Form – Please use the attached referral form to refer patients to their programs. Also attached is a list of Kupuna Care services.

  • Ola Hou I Ka Hula: Hula & Hypertension – Refer your patients to this culturally-based program for those seeking healing from health problems! Mondays & Wednesdays, 5:30-6:30 PM. Flyer attached.

  • Hilo Medical Center Diabetes Support Group – “Carbs You Can Count On.” Flyers attached here. Will continue every first Tuesday of the month from 4:00-5:00 PM for the rest of 2018.

  • Aloha Kidney 2019 Classes – Dates available. Flyer attached.