Summit Provider Newsletter - February 2023

HEDIS annual chart collection and preventive services for your patients

Welcome to the February issue of the Summit Health Newsletter. As a valued Summit Health partner, we appreciate your commitment to providing the highest quality care to our members.

Below is a preview of the articles you will find in this month's issue:

• HEDIS Annual Chart Collection
• Care Guides for Your Patients
• February is American Heart Month

Visit archived newsletters here.

Your voice matters

To ensure we are providing the information you need to deliver better care to your patients, we would love to hear from you. Please let us know if you have any questions, concerns or recommendations on topics that we can include in future issues.

Thank you,

Your Summit Health Team

HEDIS Chart Review 

Beginning in early February and ending in early May, Summit Health and our chart retrieval partners will begin reaching out to our provider partners to collect charts for the upcoming Healthcare Effectiveness Data and Information Set (HEDIS) season. 

Summit Health uses both Cotiviti and KDJ Consultants for chart retrieval. So, you may get requests from either vendor. These are valid requests, and we ask that you please provide the medical charts requested from these vendors. They are essential to the yearly HEDIS project and are protected through HIPAA as an operational function between Summit and our providers. 

These charts can be provided through Electronic Health Records (EHR) remote access, on-site retrieval, fax, or mail. For ease and efficiency, we encourage the use of remote access through EHRs. 

If you have any questions about this process, or would like to set up remote access, please contact HEDIS@modahealth.com. We appreciate your assistance in helping us to fulfill these annual CMS and NCQA requirements.

Care Guides for Your Patients

Summit Health sent our first-quarter care guide earlier this month to educate and help your patients schedule their recommended preventive services. We ask that you work with your patients on their open gaps in care and complete those that are appropriate for their overall health management.
 
These guides are personalized for your patients based on their medical and pharmacy claims information. They will remind your patients about services for which they may be due, including Annual Wellness Visits, cancer screenings, routine diabetes care, and more.
 
Many of these are directly tied to Star Measures, and others have an indirect opportunity to impact quality measures. Closing these care gaps can lead to better health outcomes for your patients and are also tied to our Summit Heath Medicare Advantage Primary Care Incentive Program (MAPCIP). 

An AWV and the Annual Physical Exam can be completed at the same visit and can also be combined with a problem visit, but a cost-share would apply if combined with a problem visit. Please be sure to code services accurately, for both your own reimbursement and quality measure reporting. Refer to our Summit Health guide to Preventive Visits to review details about coding, talking points for scheduling, and other helpful tips. Learn more about Medicare Preventive Services at the Medicare Learning Network.

Upcoming Events & Training

Novillus Care Gap Management Application (CGMA) Information Session & Demonstration

We invite you to attend the upcoming introductory webinar with the Novillus and Summit Health teams to learn more about the CGMA.

• When: Thursday, February 23rd from 12 to 1 pm PT
• Where: This event will be held virtually. Participants must register via the link below in order to receive the event invitation.
• What: This webinar will cover:
  • How clinics can view and close care gaps related to Medicare Stars measures
  • Explain how the platform can help clinics manage their patient roster and reassign members to another PCP
  • Show examples of real time performance towards Summit incentive program
  • And more!

Register for the CGMA Information Session here.

We look forward to seeing you on February 23rd!

February is American Heart Month

Focusing on your patients’ heart health has never been more important. Heart disease is the leading cause of death in the United States. It also increases the risk for severe illness from COVID-19 and their risk for heart disease, stroke, and other comorbidities.

We encourage you to use the outreach rosters on the Summit Health provider progress reports to identify your patients with high blood pressure or use an alternative patient registry to proactively manage your patient population with heart disease.

Our Summit members have no cost-sharing when seeing in-network providers for blood tests for detection of cardiovascular disease (once every 5 years) and also one visit per year with their PCP to help lower their risk for cardiovascular disease. During this visit, you may discuss aspirin use (if appropriate), check blood pressure, and offer nutritional and lifestyle recommendations.

Controlling Blood Pressure is a Medicare Star Measure defined as the percent of members who had a diagnosis of hypertension and whose blood pressure is adequately controlled (<140/90). Ensure patients with an elevated blood pressure have scheduled follow-up visits and develop a personal care plan to work towards controlled blood pressure through lifestyle changes and medication adherence, if appropriate.

Access more resources and information for health care professionals related to American Heart month at the Centers for Disease Control and Prevention (CDC).

Questions?

Questions related to EOCCO & Summit Health Quality Measures?
Please email EOCCOmetrics@modahealth.com

Questions for Provider Relations?
Please email Noah Pietz at ProviderRelations@yoursummithealth.com

Questions related to Risk Adjustment?
Please email risk@yoursummithealth.com