Welcome to Summit Health
Welcome to the September 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 is partnering with Everly Health, a virtual care provider that uses advanced diagnostics and telehealth to improve early detection and prevention of disease. Together, we will be mailing eligible Summit Health members a fecal immunochemical test (FIT) and/or a hemoglobin A1c at-home test kits.
Members are eligible for this outreach if they are noncompliant for the Colorectal Cancer Screening and/or the Diabetes Care – HbA1c Controlled Star Measures for Measurement Year 2023. These kits are at no cost to your Summit Health patients, if their enrollment is still active when the kit is received for processing.
The kits can be completed at the convenience of their home and returned to Everly Health using an enclosed, prepaid, and pre-addressed return envelope. Lab results are mailed to the patient. And as their primary care provider, you will receive mailed results and a Direct Trust electronic message, if available. Everly Health will also conduct live telephonic outreach to any patient that has a result outside of the normal range to discuss the results and recommend a follow-up with their doctor.
We ask that you encourage your patients to complete these kits if received, and we hope that this is an impactful way to help keep your Summit Health patients up-to-date with their preventive services and connect them back to your clinic office for any needed follow-up.
In support of the Summit Health Medicare Advantage Primary Care Incentive Program (MAPCIP), we are excited to announce that we are launching a comprehensive pharmacy quality program to support pharmacy quality measures.
Summit Health is partnering with AdhereHealth to impact Medication Adherence and Statin Star Measures. Although the Summit MAPCIP only includes the Statin measures, we know that there is a strong correlation between the Statin and Medication Adherence Star Measures and overall patient health outcomes.
AdhereHealth is a healthcare technology leader in medication adherence insights and health outcomes. They have experience supporting CMS Stars to MCOs and ACOs since 2006. They have a unique SDOH-first focused approach that enables their teams to drive adherence for members to over 100 health plans nationwide. AdhereHealth employs a team of nationwide clinicians, including pharmacy technicians, pharmacists, nurses, nurse practitioners, and certified diabetes educators.
The program conducts patient, provider, and pharmacist outreach in support of medication adherence and appropriate statin fills for patients with diabetes and/or cardiovascular disease. The reason the outreach program may include three touch points (patient, provider, and pharmacist) is to ensure there is coordination and appropriate addressing of any barriers. Not all instances will require outreach to all three. We look forward to helping to support your patients with this new pharmacy quality program.
In order to support our Summit Health patients with diabetes and removing any potential financial barriers to managing their condition, Summit Health will be updating A1c lab services to be administered at $0 patient cost share when completed with an in-network provider.
Additionally, we will be reprocessing all in-network A1c lab claims from 1/1/2023 to year-to-date that had a cost share greater than $0 to reflect a member cost share of $0. The balance will be paid to providers for distribution to their Summit Health patients.
Moving forward, all A1c lab services completed with an in-network provider will be processed with a $0 cost share to the member.
Our EOCCO and Summit Health Quality Improvement (QI) team provides concierge support through dedicated QI staff, clinic trainings, and regular touchpoints.
Please contact EOCCOmetrics@modahealth.com to schedule a meeting, if interested.
Questions related to EOCCO & Summit Health Quality Measures?
Please email EOCCOmetrics@modahealth.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 Aug. 23, 2023
H2765_4006
Call 844-827-2355 (TTY users, please call 711).
Our customer service team is available from 7 a.m.– 8 p.m. (Pacific Time), seven days a week October 1 – March 31 (closed on Thanksgiving and Christmas), and weekdays April 1 – September 30. Your call will be handled by our automated phone systems outside business hour.