NEPHO News – March 2018

NEPHO NEWS

March 2018 (click to print pdf)
OPTUM Newsletter:  March Focus – Nutrition

 


PHYSICIAN & PRACTICE CHANGES/UPDATES


New Providers

  • Marc Manganiello, MD has joined Lahey Institute of Urology, 75 Herrick Street Suite 219, Beverly, MA 01915 978-927-0714 (F) 978-927-9135.

Physician/Practice Changes

  • Effective 3/12/18, Brandon Connell, MD, a Hospitalist with Northeast Medical Practice has terminated his affiliation with NEPHO.
  • Effective 3/12/2018, Alison Green, MD of Family Medicine Associates, Manchester has terminated her affiliation with NEPHO.
  • Effective 3/12/2018, Paul Silveri, MD of Family Medicine Associates, Manchester has terminated his affiliation with NEPHO.
  • Effective 4/3/2018, Kenneth Branton, MD and George Lantz, MD of Pain Modulation Associates will be opening a second practice location at 298 Washington Street, 4th Floor Gloucester, MA 01930 978-304-8601 (F) 978-304-8621.

 


SAVE THE DATE


MD Orientation
Date:  April 9, 2018 @5:30 P.M.
P
lace: 500 Cummings Center, Suite 6500
Good Harbor Conference Room
Beverly, MA  01915
RSVP: Alycia Messelaar 978-236-1784 or via e-mail at Alycia.Messelaar@Lahey.org

 


IPA / POD MEETING SUMMARIES 


2018 Risk Share Program Update
Dr. Di Lillo shared the key components of the finalized NEPHO PCP and Specialist Risk Share program for 2018.

  • The percentage split between efficiency and quality funds remain the same as in 2017.
  • Physicians who were required to participate in the Performance Improvement Program for Patient Experience will be required to continue the program for 2018.
  • PCP incentives will continue to be earned through Out-of-PHO (OOPHO) Referral Rates, ED Visits/1000, BCBS Ambulatory Gate Score and Patient Experience “Likelihood to recommend provider”.
  • For the specialist risk sharing model, there is no longer an incentive to submit a cost savings idea.  The cost savings idea amount (20%) will be split 70/30 between the incentive and non-incentive pools.
  • Incentives are in place for select specialties that can impact the AQC quality measures; the distribution methodology remains the same as in 2017.

The distribution methodology for the ACO measures was also reviewed for both PCPs and Specialists.

OOPHO Update
Dr. Di Lillo shared that NEPHO’s overall OOPHO referral rate has reduced over the last 2 years.  As was done with last round of POD meetings, patient level OOPHO detail by provider was made available to providers.

Hypertension Intervention Program (HIP)
Liz Isaac, Carol Freedman and Alison Gustafson reviewed details of a new initiative to drive hypertension measures in the AQC population.

  • The financial driver is that 2 of the hypertension outcome measures accounts for 15 points each for AQC, 3x more than the process measures.   In other words, there is a greater reward for achieving better outcomes.
  • The clinical driver is that the AHA recommendations were updated last year, and they present an opportunity for a more compelling conversation about BP lowering goals with patients who have hypertension and/or diabetes.

The goal of HIP is to partner with providers to offer patient-specific  recommendations and patient support until therapy is optimized and goal BP is achieved.

2018 ACO Quality Measures
Liz Isaac reviewed the ACO quality measures dashboard that LCPN provides monthly.

  • Screening measures that need improvement include but not limited to BMI, Falls, Tobacco, Depression.   Epic has best practice advisories (BPA) to help drive these measures.
  • PHO staff will be providing updates monthly to the practices on how the BPAs are being used (or not).
  • Paper workflows may have to be created for non-Epic practices but need to be addressed this year.
  • More education on the measures is also necessary and will be done in person as well as through use of an ACO measures cheat/reference sheet.

2018 MHQP/Patient Experience
The following patient experience topics were discussed:

  • Liz Isaac reviewed the AQC dashboard which contains the Patient Experience thresholds set by BCBS.
  • Dr. Di Lillo shared a summary of a meta-analysis which linked efficiency and quality measures to patient experience.

 


NEW! PRACTICE INCENTIVE PROGRAM


The Northeast PHO is pleased to announce a new recognition program for employees in your practices. It takes a team to improve our performance, and we hope this program will show your team members that we value their efforts and results.

Each month, we will select practice employees (excluding physicians, nurse practitioners and physician assistants) who help meet our contract goals:

  • Provide excellent patient experience based on patient comments
  • Assist with providing access for patients who need specialty services in our network
  • Help patients meet their quality goals

Each winner will receive a $25 gift card and recognition in the NEPHO Newsletter and website.

 


BE ON THE LOOKOUT…


It’s that time again! We are coordinating the 2018 NECoMG Annual Meeting which will be held on June 21, 2018 at 7:00 a.m. in the Beverly Hospital Lecture Hall and video-conferenced to Lahey Outpatient Center Danvers and Addison Gilbert Hospital.

During this meeting we conduct the NECoMG Board of Directors election. There are two Primary Care Physician (Class P) and one Specialty Care Physician (Class S) 3-year term Director seats expiring this year. All physicians should receive a memo from the Nominating Committee requesting nominees for this election via the US Mail or delivered directly to your department.

If you wish to nominate a colleague or yourself, we would like to hear from you. If nominating a colleague to represent your Shareholder class, please confirm their willingness to serve if elected and provide the candidate’s name to Stacey Keough, NEPHO Executive Director, 978-816-2010 or (fax) 978-236-1777 or email: Stacey.Keough@Lahey.org no later than April 26, 2018.  Office Managers please ask your physicians if they have received their mailing; if they did not, please contact Judy O’Leary at Judith.O’Leary@Lahey.org so we may make sure they get the information.

 


CME OPPORTUNITIES


Click here for an overview of upcoming CME events offered by Boston Children’s Hospital – both live and online.

 


QUALITY



CONGRATULATIONS NEPHO PRACTICES for earning Honor Roll status in Harvard Pilgrim’s 2018 Honor Roll program.

About the Honor Roll program:

  • The actual 2017 performance of NEPHO practices on 16 measures in 3 clinical domains was compared to expected performance, and it was noted whether the performance was at the national 90th or 75th percentile
  • The 3 domains are:
    • Acute Care (examples are Appropriate Treatment for Adults with Acute Bronchitis, Avoiding Imaging in Low Back Pain without clinical red flags)
    • Chronic Care (Appropriate care of patients with diabetes and asthma) and
    • Preventive Care domain (Adolescent Well Care visits, Cancer Screenings)
  • In 2 domains, Acute Care and Preventive Care, NEPHO’s performance combining all measures in each domain was at the 90th percentile
  • In the Chronic Care Domain, we narrowly missed the 90th percentile, earning us points for making the 75th percentile.

In short, we know we have opportunity for improvement for certain measures within each domain, and this is an area of focus for 2018.  For now, please give yourselves a well-deserved pat on the back!

 


PATIENT EXPERIENCE COMMENTS


BEACON FAMILY MEDICINE

  • I love Dr. Aimee Hromadka! She is very kind & caring.  I rate her 10!!!  Always treats my health with such knowledge and compassion.
  • Dr. Erin Heiskell is really nice thoughtful/unrushed, a good listener.  Makes me feel safe to share concerns. She’s great, as is Dr. Aimee Hromadka.
  • I have a lot of confidence in Dr. Curtis Ersing.
  • I have great confidence in Dr. Erin Heiskell.  She seems to know me and understand me.  Dr. Curtis Ersing has been very good – thorough when prescribing medication.

LAHEY HEALTH PRIMARY CARE, DANVERS – 140 Commonwealth Avenue, Suite 201

  • Dr. Mauri Cohen is professional, caring and extremely knowledgeable.

NORTH SHORE PEDIATRICS

  • Dr. Shannon Dufresne did an excellent job caring for my very sick 2 yr. old, sent us to the hospital and followed up with us immediately upon discharge. She was terrific!
  • I like that no matter who I see for the kids, decision making is a team effort & providers explain options & reasoning behind everything.

PATTON PARK MEDICAL CENTER

  • Always a good experience at this practice.

SPENCER R. AMESBURY, M.D.

  • Dr. Spencer Amesbury always provides competent, skilled, supportive health care!

THOMPSON MEDICAL ASSOCIATES

  • Dr. Candace Thompson is a warm caring doctor, good experience, if not, sends to another doctor with expertise in area needed – always with a smile!  Good knowledge.

ZAVEN JOUHOURIAN, M.D.

  • Dr. Zaven Jouhourian is a caring, compassionate physician who has been my physician for 20+ years.  I depend on him for providing excellent health care.