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2020 Q2

Clinically Integrated Network News

Call to Action

Q1 Call to Action — Controlling High BP < 140/90 Ages 18 and Older

Consider using the following tools to help increase performance of your Clinically Integrated Network (CIN), controlling high blood pressure measure:

  • Take a second BP when the initial reading is ≥ 140/90; document within the second set of vitals section.
  • Utilize the BP recheck encounter for nurse blood pressure visits.

Please reach out to your provider relations specialist (PRS) with any questions and follow this link to view the Parkview Physicians Group (PPG) BP workflow (link available to Parkview providers only).

We’ll provide results next quarter!

Q1 Call to Action RESULTS: 

Based on data from the CIN for PPG - Primary Care, there were 110,182 flu vaccines given for current season (as of 3/17/2020). Great work!

Last year’s flu vaccine count was 104,232 by PPG - Primary Care through 3/31/19.

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Success Story

The CIN currently has defined measures and scorecards for PPG - Primary Care, PPG - Orthopedics, PPG - Endocrinology, PPG - OB/GYN, PPG - Cardiology, Allied Pathology, NANI, NIMA, ONE, ENT, FWN and PEP.

With the objective of improving quality outcomes, improving access and (appropriately) reducing utilization and cost of care by way of a high performing network (comprised of high performing providers), the CIN establishes and monitors agreed-upon quality measures. We have a team of Provider Relations Specialists whose role is to support our physician members and care teams, increasing potential for them to be successful with their measures. 

In 2019, we established a goal for Provider Relations Specialists that 95% of their affiliated physicians ranked above the target CIN score.  We are excited to report that 98% of the CIN physicians performed at or above that target.

Thank you to physicians and their care teams for efforts in achieving these great results.

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Diabetes Column

You are invited to attend the Primary Care Diabetes Symposium!

Saturday, August 15, 2020 from 8 a.m. – 1 p.m.

Parkview Mirro Center for Research and Innovation, Grand Hall

16022 Parkview Plaza Drive, Fort Wayne

At the completion of this program, the participant will be able to: 

  1. Describe common difficulties in the treatment of patients with diabetes and acquire practical tips for overcoming these difficulties.
  2. Understand a practical approach to medications choices available for the treatment of diabetes.
  3. Facilitate individualized goal setting for the patient with diabetes.
  4. Describe a comprehensive approach to risk reduction in the patient with diabetes.
  5. Identify available Parkview resources to support patients with diabetes.

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Provider Relations Highlight

Dr. Christopher Frazier

Our Provider Relations Specialists focus on support of our physicians and care teams, in order to support their success in the CIN. This success includes overall performance with the measures, as well as an understanding of the importance of the why behind them. With that, we are appreciative and have seen first-hand the great value of peer-to-peer engagement that a physician leader can offer. This quarter we would like to recognize Dr. Christopher Frazier for his continued collaboration with his peers and our team to aid in our network’s continued success. Thank you, Dr. Frazier!

Parkview Epic Ops

In addition to the below list of providers whose performance was exemplary in the CIN, our provider relations specialists would like to highlight the Parkview Epic Operations team and their continued collaboration with our CIN. The Parkview Epic Ops team has been responsive and collaborative when working with the CIN to appropriately address questions from providers and staff. This has helped to bridge a communication gap within our high performing network and also help to increase awareness and care for our patients. Thank you for all that you do!

Physicians performing 90% or Greater

Below is a list, by section/specialty, of physicians whose CIN year-end performance was at or above 90%. GREAT work! We appreciate you and your team’s efforts and look forward to another fantastic year.

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Frequently Asked Questions

When will the appeals guide be sent to providers so that we know what are acceptable appeals for the Diabetic Statin Therapy Measure?

Typically, appeals guides for Primary Care are sent at the beginning of Q4. However, this year we will send the appeals guide by July 1.

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Quality

Medication costs and our patients

Have you noticed a recent feature when prescribing medications that displays estimated out-of-pocket (OOP) costs to the patient, along with suggested alternatives? This is a tool called Real-time Pharmacy Benefits or RTPB. This tool requests information from the patient’s prescription payer (or Pharmacy Benefit Manager – PBM) to assist you in working together with the patient to determine the estimated costs to the patient for medications that you are attempting to prescribe for their conditions. 

The information provided through RTBP is intended to be truly ‘real-time.’ It gives estimated OOP costs to the patient, if filled at that time. Knowing these costs at the time of prescribing reduces the ‘sticker shock’ for the patient at the pharmacy counter. This also reduces ongoing communication with the provider’s office to find more affordable alternatives to prescribe or work through changes by communicating repeatedly with the insurance company. Additionally, the need for a Prior Authorization (PA) is generally also given, which may help in your decision-making process regarding the medication choices for that patient. Again, this will possibly reduce the administrative burden of unnecessary PA applications. All of this leads to improved adherence and healthcare outcomes related to medication use.

Tips to remember:

  • Pharmacy Benefits must be performed in the Rooming tab prior to prescribing for the tool to function properly. Only Pharmacy Benefits designated as the primary insurance is used by the tool.
  • Order details must be discrete (e.g. dose, frequency and SIG). Free text information does not transmit on the tool.
  • Estimated cost to the patient does appear on the After Visit Summary for the patient’s information.

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Education

It is a priority of the CIN team to assist our patients, providers and care teams. Assistance may range from gathering data about care performed outside of the CIN to eliminating duplicative care/testing. We are able to follow up with those same offices to provide the care teams with more thorough information, such as results or findings of a colonoscopy. 

The CIN has been working on a project to do just that. We have been collecting external claims data from some of our value-based contract payers in order to identify test results such as mammograms, colorectal screenings and immunizations that are completed outside the CIN. We then contact those external locations, obtain the test results and enter those into the patients’ chart to achieve a complete medical record. The completed care gaps will be reflected in our providers’ CIN scores.

If you have questions about how to identify the information in the chart or have other ideas, please don’t hesitate to reach out to your provider relations specialist.

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Contact Us

If you have questions or suggestions about measures, appeals, scorecards or other CIN tools, please contact your provider relations specialist. You may also contact Katrina Koehler, RN, CIN supervisor, at 260-266-6530 or Katrina.Koehler@parkview.com.

If you would like to join or have general questions about Parkview Care Partners, please contact Nicole Krouse, CIN director, at 260-266-3709 or Nicole.Krouse@parkview.com.

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