COREOEngagement Measure for Payment Transformation ProvidersAll PT Providers must log into the Coreo site or staff must log in using the providers’ login at least ONCE every month starting May 2018 to December 2018. IF YOU DO NOT LOG IN MONTHLY, YOUR PMPM RATE COULD BE REDUCED BY UP TO 20%. If PCPs or staff still need a login or have any issues, please contact Coreo Support at CoreoSupportHI@navvishealthcare.com or call 1 (888) 600-4672 toll-free, Monday through Friday, 8 a.m.–5 p.m.
COREO Individual Training for Payment Transformation ProvidersIf you have not yet scheduled your individual consult with Tiffany Pa for COREO training, please call Joyce at 808-797-3113 or email jvitales@ehiipa.com for availability.
Ask the EHI PharmacistHelp Pharmacists help you! Medicare Part B vs. D barriers: Add ICD 10 codes to the face of all prescriptions for your Medicare patients. Pharmacists can call for you to get overrides; they just need to provide Medicare with the diagnosis code.
Common hang-ups include:
Nebulizers and nebulizer solution (sigs for solution cannot contain “PRN” or “as directed”)
Blood Glucose meters, test strips, and lancets (DO NOT write for a brand-name, the pharmacy can select whatever brand is covered). Write “glucometer, test strips, and lancets” – make sure all sig frequencies match (bid, tid, qid)—must have ICD 10 code for DMI or DMII
Self-administered drugs in hospital outpatient settings (injectables at home)—purchased at pharmacy sig “to be injected at MD office”
Self-administered drugs in hospital outpatient settings (injectables at home or to be administered by MD)—purchased at pharmacy sig specifications “to be injected at MD office” will determine Part B coverage
Keep in mind not all pharmacies are contracted to bill Medicare, so this may lead patients to switch their pharmacy when Medicare becomes their primary drug coverage. Attached is a chart for quick review.
HMSA 2018 Steps to Better Health – Diabetes Care Member Incentive Program HMSA is mailing a mid-year update to Payment Transformation providers regarding eligible patients’ progress in this incentive program and a list of patients that are eligible and haven’t enrolled yet. Akamai Advantage members with diabetes can earn gift card rewards for getting services that help them manage their diabetes. Maximum reward potential is $75/member. Members will receive their mid-year rewards around mid-June.
HMSA Measure – Accepting NEW Patients + Demographics HMSA is asking that you complete and submit the attached form by Monday, June 4 (quarterly). This form indicates whether your practice is accepting NEW HMSA patients FOR each line of business along with updated office demographics. We would also like to know if you are accepting new patients for carriers other than HMSA. Fax to 808-935-4472 or scan and email to jvitales@ehiipa.com.
Payment Transformation Global Payment Rates – UPDATE HMSA decided to re-look at their value based payment methodology effective 10/1/18 after hearing feedback from EHI, PMAG and other IPAs. We will schedule meetings in early June to review the latest proposals and are currently gathering ideas for getting supplemental funding for our payment transformation providers. If you have any questions about the amendments effective 7/1/18 that amended current rate agreements which expire on 6/30/18, please contact Nahea Brenneman at nahea_brenneman@hmsa.com or 808-494-2069.
SBIRTStands for Screening, Brief Intervention & Referral to Treatment for alcohol & substance abuse. All offices are invited to participate. Offices who collect surveys from their patients will receive up to a $2500 honorarium. Providers and staff will receive an additional $50 per person to attend a 2-hour workshop (regardless of participation in the program). Workshop date is Friday, May 25 ONLY. June 5th workshop has been cancelled. EHI received a State Department of Health grant to support this program. Please contact Jane for more information at jbontuyan@ehiipa.com.MANY THANKS TO OFFICES WHO ARE CURRENTLY HELPING US PILOT THIS PROJECT.
Mountain-Pacific Quality Health – New Tools Available to Order Online Mountain-Pacific has new resources for patients taking blood thinners that can be ordered on their website here. Topics include caring for bruises, nosebleeds and cuts while taking blood thinners. Each tool comes in a variety of formats that can be easily shared with patients. Visit the Medication Safety Tools and Resources page to order.
Announcements:
Updated 2018 HMSA Payment Transformation Guide — Attached is the new guide for HMSA Payment Transformation providers.
Nutrition 101 Classes – Refer your patients to a FREE one-time nutrition class presented by certified dieticians from National Kidney Foundation of Hawai‘i on May 25, 9:00-11:00 AM. Please contact Mary at mvitales@ehiipa.com, 808-829-4115. Flyer attached.
Diabetes Self-Management Program – Refer your patients with diabetes to this resource. Call Mary at 808-895-2730 or fax to 808-935-4472 a list of patients to refer to the program. Mary will request a demographic sheet. This six-week class will be on Tuesdays at 9:00 AM-12:00 PM starting on June 6, 2018 at the EHI IPA office.
Advanced Healthcare Directive – IMPORTANT UPDATE: Patients need to fill out the most current form. The easiest way to tell if the AHCD is the most current form is to see if it asks for the individual’s Date of Birth on the first line; and a cell phone for the Health Care Power of Attorney. USE UPDATED FORM ATTACHED. Refer your patients to a FREE session to complete their advance healthcare directives at ADRC. Dates in the flyer attached.
22nd Annual East Hawaii IPA Healthcare Symposium – August 17-19, 2018 – Fairmont Orchid Hotel — This year’s theme is “Advancing Wellness for Patients, Providers and Organizations.” Please see attached for the latest schedule of events, topics & speakers. EHI IPA members receive a discounted rate of $75 which includes AAFP CMEs, all sessions, trade show attendance, pau hana event and two breakfasts. Please register early (flyer attached).
