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December 2014 Newsletter
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Beacon Inks Deal with United-Oxford

We are excited to announce that we have just signed an agreement with UHC-Oxford. There is an IPA, enhanced rate component that will be tied to a Total Cost of Care (ACO - Shared Savings) program. The new fees will begin in January for those opting in, and the Shared Savings part is targeted for an April 1st go-live.

Be on the look out for an email from our Executive Director, Jonathan Goldstein with details.

Medicare Shared Savings Program Attribution

The Beacon ACO Portal has been updated with the 3rd Quarter Medicare Shared Savings Program Attribution.
 
Please review your lists and make note of the additions and removals.
 
We understand that changes that occur this late in the year make it difficult to complete all of the Quality Measures by the end of the year. Please do your best to complete whatever you can.
 
As part of the Assignment Process that takes place with each new quarterly attribution, we have NOT reassigned any patients for whom a Quality Measure has been completed. For patients who were removed and a Quality Measure was completed, the QM will stay with that patient in the event the patient is reattributed back to us in a later quarter. This is especially important as we have seen a large number of patients who had previously dropped off the list, return this quarter.
 
Finally, we have collected Data Sharing Preferences (DSP) from a vast majority of our attributed patients through mailings and your hard work. In fact, another mailing is scheduled to go out by the end of this month for the newly attributed patients. For those patients with a red stop sign or who still have an “M” in the red circle, we need to give them the DSP packet or confirm with them at the next office visit that they have received the mailing and are OK with us receiving their claims data from Medicare.
 
If you need any help, need new forms or have any other questions, please contact Charlene Prismy or Tameka Robinson.
Annual Wellness Visits

As 2015 approaches and practices review their patient lists to start scheduling their annual visits, please review the components and reimbursements below when performing your Annual Wellness Visits. Not only is the reimbursement higher than a regular follow up visit, it is the perfect time to capture the Quality Measures. When billed with the addition of the unreimbursed CPT II codes below, the extraction of data to populate the QMs for you becomes much easier and more efficient.
 
Description CPT Code M/C
Allowable
AWV – Established G0439 $129.42
Audiometry 92552 $37.53
EKG 93000 $19.84
Mini-Mental Exam 96116 $106.31
Counseling for Obesity G0447 $29.70
Depression Screening G0444 $20.86
Flu Vaccine Q2038 $12.04
Admin of Flu Vaccine G0008 $29.60
Systolic BP < 140 G8752 $0
Diastolic BP < 90 G8754 $0
Document Current Meds G8427 $0
 Total Visit Reimbursement   $385.30

Let us know if you need more information on the Annual Wellness Visit or the full list of CPT II Codes.
PCMH Update

Congratulations to Dr. Lawrence Crafa and his team for achieving Level 3 PCMH Recognition from NCQA! The dedication and efforts put forth in developing methods of patient centeredness will continue to benefit the patients and staff of Advanced Family Medicine as well as the whole community. Keep up the great work!
Aetna PCMH Update
Congratulations to the Beacon network at large.
We just reviewed our Aetna PCMH Q1-Q2 2014 report which highlights that we achieved significant improvement in ED utilization, hospital admissions and in-network utilization.
Work still to be done for readmissions rates. Please remember to leverage the support of the Beacon care management team as soon as you become aware of hospital discharges.
On the quality side, areas that need more focus are:
1) Preventive: breast and cervical cancer screening.
2) Disease specific: diabetic eye exam and microalbumin screening.
In 2015, Aetna will be providing us actionable data, with patient specific gaps in care to better support our care management and practice outreach initiatives.
Care Management
Success of the Month 
A Story of Transitions in Care
The Beacon Care Coordination Team received a referral from Dr. Fitzmaurice for a husband and wife, Mr. and Mrs. J., both experiencing needs in the community but at different levels of care. The daughter of these patients was trying to manage her mother and father’s care, with her mother in the hospital and her father now alone at home. Beacon Health Coach, Jennifer Torres became involved and assessed both patients for their needs.
               Jennifer first made a referral for Home Care services for Mr. J. to ensure his safety in the home. He began receiving Physical Therapy, Skilled Nursing, Home Health Aide and necessary equipment to prevent falls. This allowed Mr. J.’s daughter to concentrate her efforts on her mother who was hospitalized at LIJ.
               Mrs. J. was in LIJ being treated for sepsis. Jennifer was able to communicate with the hospital discharge planner in order to assist Mrs. J. and her daughter through the transition to their rehab of choice. Once in rehab, Jennifer continued to communicate with Mrs. J.’s daughter and began planning for the transition home with the SNF discharge planner. Jennifer made that discharge planner aware of the services that Mr. J. was receiving at home so that the referral could be made to the same agency for better continuity of care.
               Mrs. J. was successfully discharged home with Catholic Home Care and she and Mr. J. continue to receive services from this agency in the home. Mr. and Mrs. J.’s daughter has expressed her utmost gratitude for the Care Coordination provided by Jennifer as she never felt alone in the process of juggling her parents’ needs.
               The Beacon Care Coordination team is not always aware when a patient enters the hospital and therefore the transitions in care can be difficult for a family and lead to higher rates of readmission. Great job by Dr. Fitzmaurice and Jennifer, identifying and coordinating the care of this family!
Our own Dr. Bernadette Sheridan's blogpost "A walk in Central Park: Contemplating physician burnout" was picked up earlier this month on KevinMD.com, a highly read physician blog. You can read this great post here.
Welcome New Physicians
 
Diamond Medical Group
Michael Barth, MD
Jordan Rush, MD
Eric Barth, MD

GastroCare LI
Bradley Rieders, MD
Gautam Reddy, MD

New York Bariatric Group
Eric Sommer, MD
Nikhilesh Sekhar, MD
John Angstadt, MD
Spencer Holover, MD
Design Thinking

This month Beacon's Design Thinking Committee will be focusing on Physician Engagement.  A primary goal of Beacon is maximizing the value we bring to your practice. Physician engagement is key to our success as an organization. We have tried different ways to get our Physician Practices more involved (i.e. networking events, office manager seminars, educational seminars), but we know we can do better.  Your feedback is important and we are open to any suggestions you may have.  Some of you may have completed our Physician Engagement survey online, at the holiday party or during a quarterly meeting.  If you have not completed the survey yet, please take click here.
Calendar of Events
 
Beacon Orientation Session I
Thursday, January 8th
Monday, February 2nd
Tuesday, March 3rd
6 pm - 7:30 pm
Location: 1600 Stewart Avenue Westbury, NY 11590
For all new practices, attendance at one session is mandatory. 
Open to all new physicians, office managers and other office personnel.
To RSVP, click on the date you want to attend.


Physician Meet and Greet
Thursday, January 22nd 
Tuesday, February 24th
Tuesday, March 31st
6 pm - 9 pm
Location: Each month these will be held in a different geographic area TBD
(Open to all physicians)
To RSVP, click on the date you want to attend.

Office Manager Seminars
ICD-10 Presentation
Wednesday, January 21st 

6 pm - 8 pm
What It Means to be a Manager
Wednesday, February 18th
4 pm - 7 pm
Managing Staff Performance - Coaching and Prgressive Discipline
Wednesday, March 18th
4 pm - 7 pm
Location for all seminars is 1600 Stewart Avenue Westbury, NY 11590

To RSVP, click on the seminar you want to attend.

Beacon General Membership Meeting
Thursday, February 12th
7 pm - 9 pm
Location: TBD
Beacon Holiday Party Pictures
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WESTBURY, NY 11590

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