HCI Primary Care Medical Provider Monthly Newsletter
October 2021
BREAST CANCER AWARENESS MONTH

Breast cancer is the second most common cancer among women in the United States, behind skin cancer. An estimated 281,550 new cases of breast cancer will be diagnosed in U.S. women in 2021, according to the American Cancer Society. Breast cancer accounts for 15 percent of all new cancer diagnoses and 7 percent of all cancer deaths each year. Finding breast cancer early and getting state-of-the-art cancer treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that’s found early, when it’s small and has not spread, is easier to treat successfully. Getting regular screening tests is the most reliable way to find breast cancer early. Below are educational resources and fact sheets.

LOOKING TO IMPLEMENT TEAM BASED CARE?

The Colorado Health Foundation is offering funding opportunity to support safety net clinics in receiving technical assistance (TA) to improve their clinical and business capacity so they can offer high-quality, team-based comprehensive primary care. The Foundation will fund clinics up to $125,000 over the two-year period to support clinic staff participation in the funding opportunity and any education and travel-related expenses associated with implementing team-based care.
 
Have questions? They are available to talk through your ideas and encourage you to connect with them before applying for funding. If you don’t already work with a program officer, please reach out by email at funding@coloradohealth.org or by phone at 303-953-3600, and be sure to note the county you work in and the focus area of interest.
 
Deadline for application is October 15, 2021. Here is the link to the opportunity.
HEALTH COLORADO FY2021-2022 PRACTICE TRANSFORMATION INCENTIVES

For FY21-22 Health Colorado will focus on the following milestones for incentives through Practice Transformation:

  •   Milestone 1 - Quality Improvement Teams--Incentive - $2,500  
  •   Milestone 2 - Rewards and Recognition for staff/QI Team--Incentive - $3,000  
  •   Milestone 3 - Patient Satisfaction--Incentive - $3,000 
  •   Milestone 4 - Team Based Care-- Incentive - $1,500  
  •   Milestone 5 - Data Visualization--Incentive - $3,000
 
As you obtain each of the milestones, you can earn more incentives. If you obtain all the milestones for FY21-22, you have the potential to receive a total of $13,000 in incentives.
For additional information on the milestones and incentives, please contact your Practice Transformation coach:

OR

View the HCI FY21-22 Practice Transformation Incentive document here.
CONDITION (DISEASE) MANAGEMENT PROGRAMS

Health Colorado’s Condition Management Programs will address multiple conditions in several ways by impacting the following:
  •   Practice Transformation impacts providers at the practice level
  •   Care Coordination impacts specific population segments at the regional level
  •  Together, both can improve self-management support, care navigation, and care transitions

What are the key components of condition management?
  •  Predictive Analytics – used to identify at risk populations and efficiently provide resources
  •  Standard Work – standardize screenings, interventions, and care planning
  •  Manage transitions – help to manage member transitions between Specialty and Acute care
  •  Self-Management Support – offer help with planning, coaching, motivation, goals, and tools
  • Community Partnerships – help to manage barriers to access and social determinants of health

Examples of Condition Management Programs:

Diabetes Management Program, focused on goals such as:
  • Help members get regular A1C testing
  • Help members get regular foot exams
  • Improve member understanding of the disease process
  • Improve member blood sugar self-monitoring
  • And… many more

Maternity Care Management program, focused on pregnancy and postpartum
  • Utilization of the STORK Score to identify high risk pregnancies
  • Utilization Care Management to ensure pregnant women can access appropriate health services during all phase of pregnancy
  • My Advocate - a communications program that provides relevant education during each week of pregnancy through postpartum
  • Offer the Health Rewards Incentive Program - a no-cost program for members to earn money in their Healthy Rewards account for completing healthy activities, i.e. earning $25 for a prenatal visit in the first trimester

View the Condition Management Programs document here.
NEW PRESCRIBER TOOL FOR COLORADO MEDICAID

The Prescriber Tool empowers providers with real-time information on prescription drug costs and affordable alternatives. The goals of the Prescriber Tool are to help improve patient health outcomes and service, reduce administrative burden for prescribers, improve prescription drug affordability for Coloradans, employers and the state, and support providers with value-based payments  that reward them for addressing the number one contributor to rising health care costs – rising prescription drug costs
 
The following affordability functionalities are in approximately 100 electronic health records (EHRs), representing 85% of Medicaid providers, with no click charges: 
 
·   Real-Time E-Prescribing: Prescribers can now send prescriptions electronically to pharmacies for Medicaid patients, increasing convenience and saving time for patients, prescribers and pharmacies.    
·   Real-Time Benefits Inquiry: Prescribers now have rapid insight into preferred medications from the Medicaid preferred drug list, empowering them with drug affordability and cost options.    
·   Real-Time Prior Authorization: Prescribers can now get rapid prior authorizations, reducing workload and avoiding manual entry, forms, faxes, lists and rework.  
  
Enabled for both your Medicaid and commercially covered patients, the Prescriber Tool reduces rework and administrative burden for providers by enabling e-Prescribing and e-Prior Authorization while improving convenience for patients, too. Our intention is to reward prescribers beginning in July of 2022 for using the tool and generating savings during this fiscal year beginning July 2021.
 
Please visit The Prescriber Tool Project for more information.
PMPM PAYMENT

A monthly spreadsheet will be sent to the primary care medical providers outlining the PMPM payment you received for that month. Here is a breakdown of the payment structure:

  • Non-utilizers: $0
  • Utilizing Members: $9
  • Plus $35 for assigned work on meeting the required extended care coordination of complex members.

Should you have questions, please contact Coproviderrelations@beaconhealthoptions.com.
PRESCRIPTION DRUG MONITORING PROGRAM AND CONTROLLED SUBSTANCE
From the Colorado Department of Regulatory Agencies

Effective October 1, 2021, Medicaid providers permitted to prescribe controlled substances must query the Colorado Prescription Drug Monitoring Program (PDMP) before prescribing controlled substances to Medicaid members, in accordance with Section 5042 of the “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and the Communities Act (SUPPORT Act)”.
The requirement to check the PDMP do not apply when a member:

  • Is receiving the controlled substance in a hospital, skilled nursing facility, residential facility, or correctional facility
  • Has been diagnosed with cancer and is experiencing cancer-related pain
  • Is undergoing palliative care or hospice care
  • Is experiencing post-surgical pain that, because of the nature of the procedure, is expected to last more than 14 days
  • Is receiving treatment during a natural disaster or during an incident where mass casualties have taken place
  • Has received only a single dose to relieve pain for a single test or procedure

Visit the About the PDMP Program web page for more information about the PDMP Program.
Upcoming Events and Webinars
PRACTICE TRANSFORMATION QUARTERLY LEARNING COLLABORATIVE

LET OUR MEMBER ENGAGEMENT TEAM BE A RESOURCE

Beacon's Colorado member engagement team would like to recognize our amazing providers that continue to provide stellar services to our community! Many of you have worked with our practice transformation team to select QI measures and goals related to preventative care. We want to come along side as a resource. Did you know that we offer live Getting Started ZOOM meetings on the first Thursday of the month at 11am that your patients and their families, or even your staff, can attend to learn about benefits and ask questions in real time?

Use this hyperlink, or copy and paste into your browser, to join.


Or to join by phone: Dial: 1-669-900-6833
Meeting ID: 939 7458 4539
Passcode: 230480
HEALTH EQUITY: LGBTQ+ ONLINE COURSE - FALL 2021
From the Colorado School of Public Health

Eliminating health disparities and improving health among Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals is imperative to achieving health equity. This introductory online course is about understanding the issues - we will examine ourselves and work to better understand the experience of those in the LGBTQ community.
This six-week online learning experience approaches the issue of LGBTQ health from multiple perspectives. It will provide information and an opportunity for personal reflection, and ends with an introduction to action steps public health and health care can take to improve health outcomes for LGBTQ individuals.

This course starts September 15 and there is no fee. Click here for more information and to register.
HEALTH EQUITY GUIDE ONLINE COURSE - FALL 2021
From the Colorado School of Public Health

“Health equity” is an increasingly popular topic in public health conferences, events, and publications. This course is based on a guidebook developed by the Metro Denver Partnership for Health. The guidebook and this course are intended as tools for public health practitioners who are serious about walking their health equity talk but aren’t quite sure how to get started. It aims to prepare its users to close gaps in health status that result from systemic, avoidable, and unjust policies and practices that create barriers to opportunity for certain people. 

This is a six week course on Thursdays from 9am - 10am starting on September 23. There is no fee. Click here for more information and to register.
IDENTIFYING AND TREATING TREMOR, PARKINSON'S AND CHOREA--WEBINARS
From ECHO Colorado

As our population ages, so does the prevalence of neurodegenerative disease like Parkinson’s Disease (PD), which is responsible for nearly three million disability adjusted life years globally and this has been increasing rapidly since the early 1990s. This series will introduce participants to quick exam techniques to assess tremor and rapidly narrow your differential diagnosis. You will also learn about treatment basics in PD and when to refer. The series will cover reliable recognition and differential diagnosis of chorea, including many medical and metabolic causes, and will highlight the most common genetic cause of chorea, Huntington’s Disease (HD), as well as effective new treatments for chorea.

There will be five weekly virtual sessions on Tuesdays from 12pm-1pm starting September 21. Click here for more information and to register.
PEDIATRIC PSYCHIATRY IN PRIMARY CARE: CORE ESSENTIALS
From ECHO Colorado AND CoPPCAP

CoPPCAP, the Colorado Pediatric Psychiatry Consultation & Access Program, is offering this 8-session ECHO series to give participants the baseline knowledge and skills to assess and treat pediatric mental/behavioral health conditions in primary care. Topics covered include: Assessment & Screening, “What is Therapy”, ADHD, Anxiety, Depression, Suicide and NSSI, Trauma, and consideration of how to address behavioral health concerns in the very busy primary care setting. Each session is designed to provide a brief didactic overview of the topic followed by participant initiated robust case-based discussion.

This series meets weekly on Thursdays from 7:30am - 8:30am (MST) starting on September 30, 2021. Click here for more information and to register.
PEDIATRIC PSYCHIATRY IN PRIMARY CARE: BEYOND CORE ESSENTIALS
From ECHO Colorado AND CoPPCAP

CoPPCAP, the Colorado Pediatric Psychiatry Consultation & Access Program, is offering this free, eight-session ECHO series to give participants the baseline knowledge and skills needed to assess and treat pediatric mental/behavioral health conditions in primary care. Topics include SSRIs for anxiety and depression, stimulants and ADHD, non-suicidal self-injury (NSSI), comorbidity, and suicide. Each session will include a brief didactic overview of the topic followed by participant-initiated, robust case-based discussion.

This series meets weekly on Thursdays from 12pm - 1pm (MST) starting on September 30, 2021.
Click here for more information and to register.
ADOLESCENT REPRODUCTIVE HEALTH FOR PRIMARY CARE PROVIDERS
From ECHO Colorado

This series offers clinically relevant topics for primary care providers who provide or are looking to build, expand, and improve care to preteens through young adults. Once completed, participants will be able to evaluate and manage common conditions in adolescent reproductive health. Over the course of six sessions, the series will include an overview of adolescent reproductive health issues, best practices in adolescent contraception and common adolescent gynecology concerns.

There will be six weekly virtual sessions on Thursdays from 7am - 8am starting on October 14, 2021.
Click here for more information and to register.
EFFECTIVE MESSAGE FRAMING: HOW TO BUILD TRUST AND RAPPORT WITH A YOUNG PERSON--WEBINAR

Engaging young people in conversations related to health behaviors, especially substance use, can be challenging even for trained professionals. To prepare providers for such discussions, the National Council developed a message framework for delivering substance use prevention messages, the foundation of which is building rapport and a trusting relationship with youth. In this webinar, attendees will learn:
• How to frame conversations and deliver substance use prevention messages to youth.
• Recognize the role of building rapport and trust with youth in delivering messages and discussing health related behaviors.

  • Friday, October 15, 2021 12:30pm (MST)
  • Click here to register.
CULTURAL COMPETENCY--A free, comprehensive online training provided by The U.S. Department of Health & Human Services

  • Click here for more information and to sign up.
COVID
PRIMARY CARE VACCINATION PROGRAM--GRANT FUNDING

Starting September 2, 2021, primary care providers can receive grant funding ranging from up to $60,000 to $120,000 (depending on practice size) to support the distribution of COVID-19 vaccines. Click here for details on the COVID-19 Primary Care Vaccination Program and how to apply. 
CDC AND FDA FULLY APPROVE PFIZER VACCINE

On August 23rd, the Food and Drug Administration (FDA) gave its full approval to the Pfizer-BioNTech COVID-19 vaccine for those 16 years of age and older. It was also announced that the Pfizer vaccine will be marketed as Comirnaty (koe-mir’-na-tee). The vaccine is still available for those 12 to 15 years old and for use as a booster for certain immunocompromised individuals under the FDA’s Emergency Use Authorization. While Comirnaty is the first to receive FDA full approval, all available COVID-19 vaccines have been proven safe, effective, and authorized for emergency use against the virus. For more information, see the Colorado Department of Public Health and Environment news release and/or the announcement from the Food and Drug Administration.
 
With this news, it is anticipated that there will be an increase in the demand for the vaccine. Please enroll with CDPHE to become a vaccine provider today!
COLORADO COVID-19 HEALTH CARE PROVIDER VACCINE INFORMATION TOOLKIT

In an effort to best organize and make readily available the wide array of health care provider vaccine resources, trainings and materials related to the COVID-19 vaccination program, Colorado Department of Public Health and Environment CDPHE has created the online Colorado COVID-19 Health Care Provider Vaccine Information Toolkit. The toolkit has a variety of robust elements. Please share!
PROVIDERS ADVISED TO VACCINATE EVERY ELIGIBLE PERSON

To ensure all Coloradans have every opportunity to be fully vaccinated, the Colorado Joint Vaccine Task Force is joining the CDC in new guidance that advises that providers should not miss any opportunity to vaccinate every eligible person who requests a COVID-19 vaccination. Click here for more information.
Member Resources
LIFE CARE PLANNING ADVANCE DIRECTIVES VIRTUAL WORKSHOP
A monthly workshop hosted by Health Colorado and Beacon

  • Providers, Care Coordinators, and Members are invited to participate in this "working" workshop where forms are available for members to state their wishes if they were unable to communicate them.
  • The last Thursday of each month
  • 2 sessions are available: 11:30am-1:00pm AND 6:30pm-8:00pm
  • Click here for the call-in information and to access to the materials.