Welcome to Summit Health
Welcome to the October 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
Summit Health has recently sent our final care guides earlier this month to remind your patients to 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 (AWV), 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. Many of the reminders are also tied to our Summit Health 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.
The Centers for Disease Control and Prevention’s (CDC) flu vaccination campaign this year is promoting the message of Help Them Fight Flu. Although COVID has been the primary focus during the pandemic, flu continues to pose a health concern, especially to our Medicare population. The CDC reports that people 65 years and older experience the greatest burden of severe flu disease, including hospitalizations and deaths.
We ask that you encourage your patients to get their flu vaccines and staying up to date on other routine immunizations including COVID vaccines and boosters. Summit Health members have flu and COVID-19 vaccines covered at no cost to them when seeing in-network providers.
The best way for patients to protect against the flu or COVID is to get their vaccinations to prevent potentially serious complications. Both the flu and COVID vaccines (or booster) can be given at the same time.
Summit Health is excited to share an upcoming training opportunity for those interested in learning more about Risk Adjustment.
Register for the ‘Risk Adjustment 101’ Training here
We look forward to seeing you on October 25th!
Ryan Dodson, CRC - Chief Operation Officer and Co-Founder New Vision Healthcare Solutions
Ryan’s background is in management and operational processes for 15 years. He began working in the Risk Adjustment arena 12 years ago. Ryan has proven himself by helping Medical Groups raise their RAF scores to their proper levels. He directed the movement of a 10,000 member group up 43% over a two year period, and an 1,800 member group up 53% in the first year. Ryan achieves these results through chart documentation audits, provider and staff documentation training, and provider relationship building. In his most current role Ryan works with multiple groups to optimize their RAF score, while at the same time achieving CMS 5 Star quality. Ryan explains to these groups that getting their RAF score to the correct level will not only drive revenue, but it will also lead to better patient care with improved documentation habits. Ryan is a Certified Risk Adjustment Coder (CRC) credential through the AAPC.
The CDC reports that breast cancer is the second most common cancer among women in the United States, and although rare, about 1 out of every 100 breast cancers diagnosed in the United States is found in a man.
Mammograms are the best method for early detection and diagnosis of breast cancer.
In 2021, approximately only 60 percent of Summit Health patients within the recommended age range for routine mammograms completed their screenings. We urge you to speak with your patients that are high risk for breast cancer to get screened. Early detection when breast cancer is most easily treatable can save lives.
Summit Health members have a covered mammogram once every year at no cost. Learn more about Medicare Preventive Services at the Medicare Learning Network.
Our EOCCO and Summit Health Quality Improvement (QI) team will be conducting clinic trainings this Fall to review year-to-date clinic performance against MAPCIP incentive measures and discuss year-end strategies. 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
Questions related to HEDIS Chart Collection?
Please email HEDIS@modahealth.com
If you would like to be added or removed from this email list, please let us know at ProviderInquiry@yoursummithealth.com
Last updated Oct. 1, 2023
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