Copy
View this email in your browser

September 2018 Newsletter

Want to learn more about North Carolina's transition to Medicaid managedcare and its impact on you as a provider?


Please join the SEAHEC practice support team along with state and
local leaders for an engaging disucssion on
October 11 at 5pm at the Wilmington Convention Center.

To view the event brochure and register, click here.
Space is limited! Advance registration is required. 

Here is an anticipated timeline for the transition:
  • August 9, 2018 - NC DHHS officially released the Request for Proposal (RFP) for manage care carriers.
  • October 2018 - NC DHHS will accept proposals through October.
  • February 2019 - Final selections will be announced. 
  • Fall 2019 - Managed care will officially begin.

Here is a Medicaid fact sheet for clinicians and Here is a recorded webcast.
Are you planning to attest this year?  

We are now past mid year for 2018 Meaningful Use work.
As a reminder, there is a two-part process to attest this year:
  1. Part 1 is to be completed before December 31 (ideally by October!), and includes attesting for everything except your CQMs:
    • Patient volume
    • CEHRT
    • License
    • MU objectives
  2. Part 2 requires you to submit your CQM data for Jan-Dec 2018 (full year) and email the signed attestation packet and CQM report.
Be sure your providers are meeting the core measures to receive the incentive payment.They need to meet all of either Modified Stage 2 OR Stage 3 measures. If you need help running reports or improving your numbers,
email us!
What is a Hierarchical Condition Category (HCC) and Risk Adjustment Model, and What Does Mean for YOU!

Cost is now playing an increasingly important role in value-based reimbursement. What is driving this? The CMS-HCC risk adjustment models are used to calculate risk scores, which predict individual beneficiaries’ health care expenditures, relative to the average beneficiary. HCC-associated risk scores are added to a base demographic risk score to arrive at a risk adjust factor (RAF) for each patient. The RAF is a depiction of patient acuity and allows CMS to better make appropriate and accurate payments to plans for enrollees with differences in expected costs. 

Key take-aways of the CMS-HCC Risk Adjustment Model:
  • Diagnoses included on claims in the prior year are used to predict costs in the following year.
  • The HCC model follows a calendar year (CY) and may change from year to year.
  • All ongoing conditions need to be addressed, documented and included on claims at least once each CY.
  • Diagnoses are from encounter that are face-to-face only.
  • Must use current ICD-10 coding guidelines.
  • The HCC risk score is determined based upon an individual’s health conditions and demographics (other factors such as disability status and Medicaid eligibility can play a role).
  • The MEAT – Monitor, Evaluate, Assess or Treat the conditions, have to be documented.
The SEAHEC Practice Support team has additional resources and information to help ensure that you are coding optimally—please reach with any questions!
 
TIP:  When thinking about documenting Congestive Heart Failure (CHF), remember to always include:
  • Acuity (acute, chronic, acute on chronic)
  • Phase of cardiac cycle impaired
    • Systolic (or HFrEF)
    • Diastolic (or HFpEF)
    • Mixed/Combined systolic/diastolic
  • Co-morbidities
HCC Related Education
  • This CMS Provider Minute video helps practitioners understand the importance of medical record documentation to support services billed, and discusses the most common reasons for documentation errors. Learn what providers can do to more thoroughly document the patient's medical record. 
     
  • HCC's for Coders: An In-Depth Look
    Are you wanting to know more about Hierarchical Condition Categories (HCCs)? Gain knowledge and experience while working through real-world examples in this interactive four-hour session. November 8 from 8:30-1:00 SEAHEC will be live streaming this event held at Charlotte AHEC, and will provide the link to register soon.  Here is more information, including related eLearning opportunities to complete in advance!
Other Education and Professional Development
  • This article outlines transitional steps on how practices can or should start reducing the administrative burden of health care today.
     
  • Did you know that Empty, Positive Language, Patient, Clarity in Communication, and Continuous Improvement were among the top 5 customer service skills that cultivate loyalty and happiness? If you want to improve your practice's customer services skills, click here to learning more including tips on how to develop them across your whole team!
Cardiovascular & Cerebrovascular Disease Conference
  • September 19-21 NHRMC will be hosting a conference for health care providers to review the most current evidence-based medical information for diagnosing, treating, and preventing cardiovascular and cerebrovascular disease. More information and registration, click here.
Advance Care Planning Lunch & Learn
  • Save The Date -  September 26, 12-12:30 SEAHEC Support Services will host a lunch & learn webinar on Advance Care Planning (ACP) in the context of the Annual Wellness Visit. More information and registration coming soon.
Important reminders on texting and
emailing your patients

Health care providers can communicate with patients via text, but only if:
  1. The communication is encrypted or sent via a secure messaging system, or
  2. The patient is warned beforehand regarding the risk associated with unencrypted communication and the patient still prefers to communicate via unsecured text or email.

If a provider sends an email or text message that is encrypted or sent over a secure messaging system, such as a secure patient portal, the message may include protected health information (PHI).

What if a patient sends an unsolicited text to me?
When a patient initiates communication with a provider by email or a text message, the provider can assume that email or text is an acceptable form of communication to the patient. A patient may send health information to a healthcare provider using an unsecure email or text. Once this health information is received by the provider, however, it becomes PHI.

Can I send texts regarding patient care to other health care providers?
Yes, you can send PHI to other healthcare providers, but only if the information is sent via a secure messaging system or is encrypted.

Can I text orders to members of the health care team?
No, CMS and the Joint Commission explicitly prohibit healthcare providers from texting orders.

Here you can find more information.
Copyright © 2018  South East Area Health Education Center, All rights reserved.
Practice Support Services Newsletter

Our mailing address is:
2511 Delaney Ave., Wilmington, NC 28403

Want to change how you receive these emails?
You can update your preferences or unsubscribe from this list.

 






This email was sent to <<Email Address>>
why did I get this?    unsubscribe from this list    update subscription preferences
SEAHEC · 2511 Delaney Ave · Wilmington, NC 28403-6003 · USA

Email Marketing Powered by Mailchimp