Welcome to Summit Health
Welcome to the March 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:
Visit archived newsletters here.
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
The Medicare Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS) has started earlier this month and will take place through June. This survey will include a sample of Summit Health members, drawn by the Centers for Medicare and Medicaid Services (CMS), that could include your patients.
With recent changes to the Medicare Stars Program, CMS has increased the importance of member and patient experience. The Medicare CAHPS will measure access to care and prescription drugs, provider care coordination, rating of the heath and drug plan, and rating of health care quality.
At Summit Health, we are committed to providing the highest quality of services and care to our members, and by extension, we are proud to have provider partners that share in this commitment with us. We encourage you to remind your patients to complete their CAHPS survey if they are selected as part of the sample.
We know how important staying connected with a PCP can be to improving and maintaining overall health. We have recently sent out personalized care guides to remind members to schedule their preventive services.
We ask that you also outreach to your patients to complete their Medicare Annual Wellness Visits (AWV) and/or Annual Physical Exams. Closing these care gaps can lead to better health outcomes for your patients and impact your financial incentives in our Medicare Advantage Primary Care Incentive Program (MAPCIP) for 2023.
Your Summit Health patients have a covered AWV (once every calendar year) and an Annual Physical Exam (once every calendar year) at no cost. 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.
Colorectal cancer is the third most common cancer in men and women in the U.S., and it is also the third leading cause of cancer-related deaths for men and women. Screenings are effective at detecting colorectal polyps before they develop into cancers, when treatment has the highest chances of success.
Continue to use the outreach rosters on the Summit Health provider progress reports to identify your patients, ages 45 to 75, that are due for a colorectal cancer screening.
Our Summit members 45 and older have no cost-sharing when seeing in-network providers for the following. However, a separate cost sharing may apply if additional diagnostic testing or procedure services are provided.
Ensure patients are provided with all their colorectal cancer screening options and discuss what is most appropriate for each patient. Access more resources and information about colorectal cancer at the American Cancer Society. To find information on Medicare coverage for colorectal cancer screening tests and appropriate billing codes, visit the Medicare Learning Network.
Our EOCCO and Summit Health Quality Improvement (QI) team will be conducting clinic trainings on the 2023 Medicare Advantage Primary Care Incentive Program (MAPCIP) and quality measures. These will be held in-person or virtual, depending on your clinic’s preference.
Please contact EOCCOmetrics@modahealth.com to schedule.
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
Last updated Mar. 13, 2023
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