An update about what is happening within Coordinated Care:
If you have news or announcements to share with network colleagues, please send to [email protected] and include Provider Insider News in the subject line.
We are pleased to welcome new members to the network:
- CU Urology – South Denver (July 2018)
- CU South Metro OBGYN (Oct. 2018)
- CU Orthopedics – Broomfield (Dec. 2018)
- UCHealth Sterling Ranch Medical Center (Sept. 2018)
- UCHealth Primary Care – Yosemite (Dec. 2018)
Coordinated Care is composed of primary care and specialty practices from Pueblo to Steamboat Springs and includes UCHealth Medical Group, CU Medicine, Associates in Family Medicine, UCHealth Family Medicine Center- Fort Collins, and several independent practices. These entities represent more than 3,000 providers and 100,000 attributed lives.
As we continue to grow Coordinated Care’s footprint in Colorado, we improve patient accessibility and increase our value to those whom we serve.
Each year, Anthem publishes a Measurement Period Handbook that details upcoming changes to the EPHC program. From that handbook, Coordinated Care’s clinical committee identifies those quality measures the network will prioritize as areas of focus for the coming year. A summary of general changes follows.
Note: All current measures of focus are included in the 2019 program; however, confirmation of those measures on which the network will focus in 2019 will be forthcoming.
Quality Scorecard Enhancements:
- Retired measures: Diabetes Eye Exam, Annual Monitoring for Patients on Persistent Medications: ACE/ARB and Diuretics, New Episode of Depression Effective Acute Phase Treatment and Effective Continuation Phase Treatment, Proportion of Days Covered (PDC) Oral Diabetes and Hypertension (ACE or ARB), Well Child Visits 12-21 Years Old and Ambulatory Care Sensitive Conditions.
- Please note: There are references to Ambulatory Care Sensitive Conditions within the Enhanced Personal Health Care Program Description. On and after January 1, 2019, these references will no longer be applicable due to the changes made to the MPH. The next Program Description will delete all such references.
- Revised measures: Medication Management for People with Asthma for Adults and Pediatrics has been revised and renamed to “Asthma Medication Ratio.”
- Potentially avoidable ER metric: New listing of more diagnoses codes will be implemented.
- National Centers for Quality Assurance (NCQA): Removed references to Patient Centered Medical Home NCQA throughout the MPH as it is no longer part of the scorecard.
BlueCard membership will be included in the benchmark risk score calculation and also in the Physician Quality included in the Performance Scorecard for measurement periods July 1, 2018 and forward.
65 and Older Attribution Inclusion:
Starting October 1, 2018 MP and forward, the 65 and older actively working adults will be allowed into attribution of all commercial programs to provide the benefit of care coordination to Members and Shared Savings opportunities to Providers.
A geriatric risk adjuster has been put in place to normalize the PMPMs for risk. The Quality and Utilization Metrics below could now include the 65 and older population as they are now included in your attribution.
Earlier this fall, the Coordinated Care Board of Directors agreed to voluntarily exit the Track 3 Medicare Shared Savings Program (MSSP) offered through the Centers for Medicare & Medicaid Services (CMS). The decision followed a shared loss in 2017 and protects the network from further financial risk in this program.
Following the board’s decision, Chief Population Health Officer Jean Haynes notified participating providers and has distributed subsequent communications answering frequently asked questions and detailing related CMS closeout procedures.
This decision does not in any way impact the network’s long-term commitment to improving the health of the populations we serve, and we will continue actively managing more than 100,000 unique lives across multiple payers and programs.
Please contact [email protected] with any questions.
The Coordinated Care Engagement Summit has been rescheduled for January 31, 2019.
We welcome you to join us for this event. Please register your attendance here, as space is limited and reservations are required.
- Discover Coordinated Care’s strategies for effective population health management.
- Participate in round-table discussions addressing questions from network providers.
- Hear from a panel of your peers as they share their achievements in improving ED utilization.
- Learn more about the value of integrated clinical pharmacy and how to leverage analytics to improve patient care.
- Engage with your partner providers, and find out how others are using evidence-based data to reshape practice infrastructure.
Breakfast, lunch and refreshments provided. Validated parking.
Network administration staff updates.
Coordinated Care is growing, and so is its administrative team. The following individuals recently joined us in supporting the network:
- Joselyn Benabe, PharmD, BCACP – Clinical Pharmacy Specialist
- Valerie Carter – Care Manager RN
- Anne Docimo, MD, MBA – Chief Medical Officer
- Kate Lipstein – IT Program Manager
- Nicole Petersen – Administrator Special Programs
- Kassandra Salazar – Administrative Support