Home / INTEGRIS Health Partners / Newsletter / Newsletter Archive 2016 / April 2016

April 2016

 

April 2016

Letter from the President

2016 Employee Wellness

INTEGRIS Connect: New Program Director

Shared Savings Update

Pharmacy Update

New Physicians

 

 

 

 

 

Letter from the President

Dear colleague:

At the recent inaugural INTEGRIS Health Partners Townhall meeting we reviewed and discussed how and why IHP was formed and what our current state is today. INTEGRIS and the providers aligned with the system needed a cohesive strategy to deal with a rapidly approaching tidal wave of change. IHP is the surfboard we have used to ride this wave. It is fascinating that of the 14 predictions of significant changes in healthcare that our consultants foresaw in early 2011, 12 1/2 have come true. We have seen change come at a pace faster than anyone can remember.

IHP has been the leader in this market in clinical integration and alignment of the healthcare system and physicians. We are uniquely positioned to deal with these difficult times. CMS is planning to base 50% of our reimbursement on value-based measures by 2018. Just imagine how difficult it would be if we had not laid the groundwork to deal with these changes. Practicing medicine, balancing the books, and maintaining a sane schedule is becoming increasingly difficult. As physicians, we are being pulled in many directions.

Unfortunately, I think there is more pain and misery to come. Medicaid cuts, continued layoffs in the energy sector, bankruptcies, and the inability of patients to pay their part of the bill due to increasing deductibles and copays is complicating everything we do. Most of you are aware that INTEGRIS recently announced plans to reduce expenses. INTEGRIS is not alone. We just witnessed a large national health system drop out of the S&P 500, and another large system’s share price dropped 70% in the last nine months. No one is immune to the difficulties of the business of medicine today. This coupled with the incredible complexity of the science side makes this job daunting.

It is imperative that we strive to continue to deliver appropriate, timely and efficient healthcare. IHP was formed to address the Triple Aim – improve quality, reduce costs, and improve the patient experience. These are key to our long-term survival and ensuring our patients receive the care they need. I have written many times about being an advocate for our patients. We must also advocate for our profession. We must engage our political leadership and demand the best for our patients by developing sound healthcare policy. Our national and state representatives will listen to us, and it is our duty to shape the discussion. If not, we will be forced to practice in an environment that is even more difficult. The stakes have never been higher. Even though we have made great strides, we have a lot more to do. It won’t be easy but it will be worth it.

Sincerely,

Carl Raczkowski, M.D.
President, INTEGRIS Health Partners


2016 Employee Wellness for INTEGRIS Employees

The 2016 INTEGRIS Employee Wellness program has begun. Due to the upcoming Epic go-live for metro and Miami and Grove INTEGRIS Medical Group clinics 2016 will be a transitional year. For this year only, no online health risk assessment is required for INTEGRIS employees.

All employees and their covered spouses who qualified for preferred pricing for CY 2016 will automatically receive it again for CY 2017. For employees and their covered spouses who did not receive preferred pricing in 2015 they will have an opportunity to do so this year.

The $250 wellness dollars awarded in 2016 to employees who met wellness guidelines or successfully completed health improvement programs will not be available this year. This was a difficult decision but allows a standard program for all employees during this transitional year. Employees will still have access to a wide range of health improvement programs.

Provider workflow –
  • Order lab & schedule wellness exam
  • Collect vitals & other routine measurements
  • Review lab with the patient
  • Perform age and gender appropriate exam
  • Provide counseling and recommendations for continued health or risk reduction
  • Provide Wellness Rx (see pad)
  • Make Health Improvement program recommendations
  • Review preventive care checklist
  • Modifier IH MUST be added if WebTPA patient

Questions regarding the INTEGRIS Wellness Program:

INTEGRIS HR Customer Service 405-949-4045 or 888-546-8347 (toll-free) or Anissa Chadick at 405-717-9828

Coding guidelines –
  • Primary Diagnosis – Routine Physical z00.00
  • Preventive Care under INTEGRIS Health Plan is covered at 100 percent
  • INTEGRIS Health Well Visit Only - use G0439 IH
  • INTEGRIS Health Well Visit and Physical – use CPT Code 99381-99397 with IH modifier on WebTPA only
  • INTEGRIS Health Well Visit and Sick Visit or Chronic Disease Follow-up – use G0439 IH and 99201-99215
  • INTEGRIS Health Well Visit, Physical and Sick Visit or Chronic Disease Follow-up – use 99381-99397 with IH modifier and 99201-99215
  • Modifier IH MUST be added

Questions regarding billing procedures and processing:

Clark Willis 405-840-8519


INTEGRIS Connect: New program director

INTEGRIS Health Partners is happy to introduce T. C. Hartman, program director for INTEGRIS Connect. T. C. has a long career with INTEGRIS beginning in 1989; his interview was a pick-up basketball game. He worked in material management in various roles through the early to mid-2000’s. He also worked for Oklahoma Management Services, which managed physician practices and provided physician billing services to providers and other entities throughout central Oklahoma. During this time physician billing was becoming more automated and systems were becoming more computerized. Mr. Hartman’s team implemented some of the latest technology available at the time, ISDN data lines (128k) and 56k modem lines for people working offsite. As technology continued to progress they implemented the original Medic electronic medical record across multiple clinics.

In 2008 Mr. Hartman worked as director of business development for Legacy Medical Management, which began one of the first subscription EMR reseller companies in Oklahoma. They built the practice management/EMR subscription line of business from the ground up, as well as designed marketing, cost structures, training, implementation and support.

He came back to INTEGRIS full time in 2009 to begin a project working with Jeff Brown, now vice president of INTEGRIS Health Partners, to implement electronic health records in every INTEGRIS regional clinic, as well as support the practices after implementation. He helped develop the three to four year plan to implement Allscripts Enterprise, which was the EMR system in use by INTEGRIS at that time. By 2014 his team had successfully implemented Allscripts in all INTEGRIS regional clinics.

Along the way CMS instituted the meaningful use program. Mr. Hartman was responsible for configuring the system, as well as meeting, attesting and preparing for CMS meaningful use audits for all regional providers. INTEGRIS began attesting for meaningful use in 2012 and has attested successfully every year since. In 2014 Mr. Hartman took on meaningful use responsibilities for all INTEGRIS ambulatory providers, attesting in the 90th percentile every year and never failing a CMS audit. In 2015 the team achieved attestation at 99%.

Mr. Hartman looks forward to the challenge of INTEGRIS Connect, realizing the magnitude of the undertaking and the reward of achievement by working with a new and diverse group of people. He believes integration and health management are key to the future of healthcare. A successful rollout of INTEGRIS Connect has the potential to give INTEGRIS a major market advantage in managing the health and welfare of the communities we serve. He is convinced that physician alignment will be vitally important to INTEGRIS; Connect is a vehicle to align with providers of all types. It allows small practices to have access to one of the premier electronic record systems available today, something that financially would otherwise be far out of reach.

Mr. Hartman can be reached by email. Information about INTEGRIS Connect is available on the INTEGRIS Connect website, where you can also submit an inquiry form.


Shared Savings Update

2014 – After months of diligent work distribution of 2014 shared savings checks to every physician in INTEGRIS Health Partners is nearing completion. This was the first year every physician received a payment! Thank you for your patience as the IHP team has worked through many contracts and updated W-9 forms. If you have changed office locations or practices in the past year and have not provided IHP an updated W-9,  we may have difficulty processing your payment. Please contact our provider relations consultants for assistance with W-9 or contract requests – Kari Govier-Brown or Deidre Horn. If you have not yet received your payment (or you are unsure), please contact Evan Galt.

2015 – Now that the claims run-out (through March 31st, 2016) has been completed, claims data is being evaluated by Mercer Health and Benefits, LLC., a contracted vendor.  Their analysis will determine if savings were achieved. The plan will then be audited by our internal audit partner, Protiviti, to evaluate the findings and finalize individual shared savings. By mid-year, INTEGRIS Health Partners will be able to announce if the network attained savings and begin processing payments.

2016 – A complete list of metrics by specialty is now available on the IHP website.  Metrics are available for both IHP- Metro physicians and IHP - Enid physicians.

For shared savings questions, please contact Evan Galt, INTEGRIS Health Partners operations manager at evan.galt@integrisok.com or 405-420-4689.


Pharmacy Update

The INTEGRIS Health Partners Pharmacy Committee recommends that Jublia not be prescribed.  They recommended using over the counter medications instead. 


New Physicians

Deborah Blalock, MD
Gastroenterology
Blalock GI Care
10914 Hefner Pointe Drive
Suite 304
Oklahoma City, OK 73120

Thara Damodaran, MD
Infectious Disease
3300 NW Expressway
Oklahoma City, OK 73112
480-720-8744

Agnel Raparthi, MD
Hospitalist
INTEGRIS Hospitalists
3300 NW Expressway
Oklahoma City, OK 73112
405-713-7403

Mamoon Rasheed, MD
Nephrology
Kidney Specialists of Central Oklahoma
3366 NW Expressway
Building D, Suite 550
Oklahoma City, OK 73112
405-942-5442

Cynthia S. Redding, MD
Nephrology
Nephrology Care
3366 NW Expressway
Building D, Suite 730
Oklahoma City, OK 73112
405-945-4905

Brianna Riccobono, MD
Internal Medicine
Zuhdi Transplant Physicians
3300 NW Expressway
Oklahoma City, OK 73112
405-949-3349

Hanna A. Saadah, MD
Sleep Medicine
Hanna Saadah MD Inc.
5701 N Portland Avenue
Suite 225
Oklahoma City, OK 73112
405-600-1210

Kamal Sawan, MD
Plastic & Reconstructive Surgery
Sawan Surgical Aesthetics PLLC
209 Lilac Drive, Suite 200
Edmond, OK 73034
405-285-7666

Scott Shadfar, MD
Otolaryngology
INTEGRIS ENT Edmond
4509 INTEGRIS Parkway
Suite 200
Edmond, OK 73034
405-657-3950

Gargi Shah, MD
Internal Medicine
INTEGRIS Family Care Northwest
6601 W Hefner Road
Oklahoma City, OK 73162
405-728-7692

K. Anthony Shanbour, MD
Obstetrics & Gynecology
5720 W. Memorial Road
Oklahoma City, OK 73142
405-694-0522

Jordan Stabinski, MD
Anesthesiology
Northwest Anesthesia
3300 NW Expressway, 2nd Floor
Oklahoma City, OK 73112
405-951-2815

Geetika Verma, MD
Child & Adolescent Psychiatry
INTEGRIS Mental Health
2601 N Spencer Road
Spencer, OK 73084
405-427-2441

 

 

 

 

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Oklahoma's largest hospital network
3300 N.W. Expressway
Oklahoma City, OK 73112 Phone: (405) 951-2277
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