HCI Primary Care Medical Provider Monthly Newsletter
September 2021
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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.
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NATIONAL CHILDHOOD OBESITY AWARENESS MONTH
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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.
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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.
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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
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ONLINE PCP TOOLKIT AVAILABLE FOR BEHAVIORAL HEALTH CARE MANAGEMENT
The Beacon Quality team in collaboration with Medical, Clinical, Peers, Provider Relations and additional key stakeholders across the organization expanded our PCP toolkit online resource. The PCP toolkit is intended to support primary care clinicians by providing a quick guide to access behavioral health resources. This toolkit is also beneficial for behavioral health providers and Beacon health plan partners. The toolkit is useful for managing populations with co-occurring disorders. The toolkit promotes an integrated healthcare approach encouraging whole person health by providing PCPs and other practitioners additional resources beneficial to clients, including screening tools.
The toolkit includes enhanced resources for the management of:
· Depression
· Substance use disorders
· Anxiety
· Schizophrenia
Additionally, four new topics have been added: Social Determinants of Health, Autism Spectrum Disorder, COVID 19, and Medication. We are committed to continuing to promote the integration of medical and BH services with the goal of improving patient outcomes.
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COLORADO DEPARTMENT OF HEALTH CARE POLICY & FINANCING PROGRAMS
The Colorado Department of Health Care Policy & Financing offers many different programs for members, each with a set of benefits.
The List of Programs web page is a useful resource for members and providers which includes links to information about the programs offered.
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Upcoming Events and Webinars |
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PRACTICE TRANSFORMATION QUARTERLY LEARNING COLLABORATIVE
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PROGRAM IMPROVEMENT ADVISORY COUNCIL (PIAC)
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BEACON HEALTH OPTIONS PROVIDER WEBINARS
Beacon hosts several provider geared webinars throughout the month that you may find helpful for staff and billing personnel. Click here for the current monthly list as well as archives.
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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
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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.
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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.
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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.
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CULTURAL COMPETENCY--A free, comprehensive online training provided by The U.S. Department of Health & Human Services
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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.
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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!
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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!
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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.
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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
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2 sessions are available: 11:30am-1:00pm AND 6:30pm-8:00pm
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Click here for the call-in information and to access to the materials.
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HEALTH AND HUMAN SERVICES LAUNCHES HOTLINES TO IMPROVE ACCESS TO COVID VACCINES FOR PEOPLE WITH DISABILITIES
The U.S. Department of Health and Human Services (HHS) announced the launch of a first-of-its-kind national hotline to connect people with disabilities to information and services to improve access to COVID-19 vaccines. The Disability Information and Access Line (DIAL) is now available to help people with disabilities find vaccination locations in their communities, assist callers with making vaccination appointments, and connect callers to local services – such as accessible transportation – to overcome barriers to vaccination. The hotline also can provide information and resources to answer questions and address concerns about the vaccines and can connect callers to information and services that promote independent living and address fundamental needs, such as food, housing, and transportation.
For more information, visit acl.gov/dial or call 888-677-1199.
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