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August 2015

 

 

INTEGRIS Health Partners

INTEGRIS Health Partners

 

 


August 2015 Update

Inside this issue:

Letter from IHP President

2015 Metrics – Metro

ICD-10 Coding Education

PACE Program

New Care Coordination Staff

2014 Shared Savings Update

Added Benefit: Medical Staffing Network

Pharmacy Task Force Recommendations

New Physicians

IHP Staff

 

Letter from the President

Dear colleagues,

The future has arrived. INTEGRIS Health Partners is an integral part of the first commercial Accountable Care Organization in the state of Oklahoma through a partnership with Aetna. This marks the beginning of a new era of healthcare delivery in the Oklahoma City metro area. INTEGRIS Health Partners is the sole provider network for the Aetna Whole Health plan. This product is co-branded with INTEGRIS Health Partners, and we will manage the health of the members. We learned how to provide this type of care through experience from managing the health of INTEGRIS employees over the last three years and have proved the concept. Others have noticed and want to be part of what we do.

One of the more interesting comments we have heard as we meet with employers, brokers and human resource directors is that access is most important. Getting people into the most efficient and appropriate care setting will be job one. We have expanded our staff in Care Coordination and Population Health Management to ensure success and will continue to expand as the need grows. Patients will have access to this experienced team to help navigate the system and access needed resources. It is imperative that we, as providers, answer the call to facilitate excellent patient experiences and to deliver quality care.

The Aetna Whole Health product is just one of the many exciting collaborations we have put in place. INTEGRIS Health Partners leadership has met with numerous employers, insurance brokers and insurers to tell our story of success. The response has been remarkable. We are clearly well-positioned to participate in the changing healthcare environment. We are committed to providing our members with unique opportunities and the tools to succeed.

It is time to take IHP to the next level. We will all have to be on task and paying attention to be successful. You will be receiving more information about Aetna Whole Health and other products in the coming weeks. Please take time to look at them and be engaged. This is a great opportunity for which we have worked very hard. The time is now to press ahead and strive for even more success.

Sincerely,

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


2015 INTEGRIS Health Partners Metrics – Metro

 

SPECIALTY

METRIC

GOAL

% OF SHARED SAVINGS

SURGERY

Attend one of two IHP education sessions (ICD10 training is first option. See below.)

Attendance is required to participate in shared savings

25%

Use CPOE for medication

75% or better

12.5%

Perform pre-surgical time-out

100% of the time

12.5%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

25%

Generic drug utilization

78.5% or better

25%

MEDICAL –INPATIENT-BASED

Attend one of two IHP education sessions (ICD10 training is first option. See below.)

Attendance is required to participate in shared savings

25%

Use CPOE for medication

75% or better

25%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

25%

Generic drug utilization

78.5% or better

25%

MEDICAL – NO INPATIENT (OFFICE-BASED)

Attend one of two IHP education sessions (ICD10 training is first option. See below.)

Attendance is required to participate in shared savings

33.34%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

33.3%

Generic drug utilization

78.5% or better

33.3%

PRIMARY CARE – FAMILY & INTERNAL MEDICINE

Attend one of two IHP education sessions (ICD10 training is first option. See below.)

Attendance is required to participate in shared savings

25%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

10%

Generic drug utilization

78.5% or better

25%

Diabetic patients age 18-75 have annual HgA1c

91% or better

10%

Diabetic patients age 18-75 have annual LDL-C

85% or better

10%

Female patients age 40-69 with mammogram in past 24 months

70.6% or better

10%

Patients age 50-75 have appropriate colorectal cancer screening

63.2% or better

10%

PRIMARY CARE – PEDIATRICS

Attend one of two IHP education sessions (ICD10 training is first option. See below.)

Attendance is required to participate in shared savings

25%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

25%

Generic drug utilization

78.5% or better

25%

Patients have 6 well child exams by age 15 months

90% or better

25%

 


ICD-10 Coding Education

On Oct. 1, 2015, INTEGRIS will go live with ICD-10-CM code sets replacing the ICD-9-CM code sets that are currently used to report medical diagnoses and inpatient procedures. The ICD-10-CM code sets represent a fundamental overhaul of the current system.

Online Training for Physicians

INTEGRIS is offering our physician community free ICD-10-CM/PCS training focusing on clinical documentation.

•        Training will focus on documenting for ICD-10-CM/PCS, by specialty.

•        Online, self-paced, bite-sized and at no charge.

•        Accessible on any device with a web browser.

•        CME certification available upon completion of ICD-10 training.

ICD-10 training is an approved educational metric opportunity for INTEGRIS Health Partners. 2015 metrics require INTEGRIS Health Partners physicians to complete one of two sponsored education sessions. Please log in and begin training now.

Classroom Training for Coders and Clinical Staff

Educational meetings for coders and clinical staff will be held in August and September at INTEGRIS Baptist Medical Center and INTEGRIS Southwest Medical Center. Registration is required by calling the INTEGRIS HealthLine at 405-951-2277. A schedule of class dates, times, and topics is available online.


PACE: Program of All-inclusive Care for the Elderly

VarietyCare is working with the Oklahoma Housing Authority and the Centers for Medicare and Medicaid Services to develop a PACE Program (Program of All-inclusive Care for the Elderly) for the Oklahoma City metro area. This program helps people meet their health care needs in the community instead of going to a nursing home. VarietyCare is interested in contracting with INTEGRIS Health Partners specialists to provide services to PACE members. Director of the PACE program for VarietyCare, Elanor Wallis, will be reaching out to IHP specialists to negotiate agreements. If you have specific questions about the program, please contact Elanor at 405-632-6688, extension 10160.


Introducing the New Care Coordination Staff

INTEGRIS Health Partners has more than DOUBLED the Care Coordination staff in order to better serve our patients and support our providers. Please welcome our new team members!

K. C. Chansombat MA, Population Health Coordinator

K.C. comes to the Care Coordination team from the INTEGRIS Access Center where she worked for INTEGRIS Medical Group Referral Services and Central Scheduling. Prior to that role she assisted in the hepatitis C clinic at the INTEGRIS Nazih Zudhi Transplant Center. She also brings previous experience working in orthopedic, family medicine, and urgent care clinics. K.C. is a Certified Medical Assistant currently pursuing a degree in business healthcare management.

Born in Laos, she immigrated to the United States at age two. Her family settled in Oklahoma, so she is now an official “Okie”!

K.C. loves going to track meets with her daughter, and enjoys volunteering as a mentor and doing community outreach. She is excited to put her skills and experience to work with the care coordination team, and hopes to contribute new ideas to the goals of the group. She looks forward to being a part of helping to keep patients healthy and meet their healthcare needs.

Chesley Clayton MA, Population Health Coordinator

Chesley spent four and a half years as a medical assistant for INTEGRIS Neurology with Dr. Ashish Masih. She hopes to return to school and become a registered nurse.

A life-long Oklahoman, Chesley has two children, Cory, age six, and Kelsey, age three. She enjoys spending time with her youngsters and playing with their new puppy, Pluto. She cheers for the Cowboys, the Sooners, AND the Thunder.

Chesley looks forward to working with the INTEGRIS Health Partners team and its physicians and staff to improve the health of the people we care for.

Kimberly Nelson-Tyrrell RN, Care Coordinator

Kimm has been a nurse for almost 18 years working in the specialty of rehab: inpatient (acute rehab), outpatient (care management), and home health (case manager). She initially completed an associate degree, then went back to earn a bachelor of science in nursing. She is Reiki certified.

A life-long resident of Lincoln, Nebraska (but not a Husker!), she and her husband moved to Oklahoma 18 months ago with her husband’s job. Their two grown-ish daughters stayed in Lincoln to finish degrees at the University of Nebraska. One finished up in May; one will graduate in a year. In her spare time, Kimm enjoys yoga, walking, live music, seeing her girls at least every month, traveling to new and beloved places, and most any activity outside.

She hopes to keep up the good work of the care coordination team while contributing her own experience and talents.

Kerra Whaley RN, Care Coordinator

Kerra has been a registered nurse for 24 years. She has experience as a medical/surgical staff nurse and in case management in the hospital setting and for an insurance company. Most recently she spent 12 years on the night shift as house supervisor at INTEGRIS Southwest Medical Center. She holds several clinical certifications.

Kerra has lived in Oklahoma all of her life, most of it in Moore. Her two grandchildren, ages one and five, are the loves of her life, and she spends every spare moment with them.

She is excited about her new role with INTEGRIS Health Partners, though the adjustment to working during the day may take some time. She looks forward to growing as a care coordinator and working with all the knowledgeable and talented people in the department.

Rochelle White LPN, Population Health Coordinator

Rochelle has been a nurse for 23 years and brings to IHP a wealth of experience in patient education. She earned an associate degree in diversified studies, is currently working to complete a bachelor of science in nursing, and has plans to pursue a master’s of science in nursing, as well. She holds numerous certifications and qualifications.

Born and raised in Oklahoma City, Rochelle likes to spend time with her three children, 25, 23, and 16, and her first grandbaby. She enjoys reading, listening to music, and traveling. Last year she was introduced to the excitement of NFL tailgating in Pittsburgh, so now cheers for the Steelers!

Rochelle hopes to help educate patients, teach them to engage in their healthcare, and see them utilize the benefits and services available to them.


2014 Shared Savings Distribution Timeline

INTEGRIS Health Partners has received the analysis of 2014 claims data from Mercer, LLC, the company with whom we contracted to analyze the claims experience for the INTEGRIS Health Plan. Thanks to the hard work of network providers, INTEGRIS Health Partners has achieved a third consecutive year of shared savings. The INTEGRIS Health Partners Finance Committee will meet soon to discuss the final analysis of 2014 claims and will submit a report to the Board in September for approval. Subsequently, individual physician scorecards will be reviewed in order to distribute the savings to qualifying physicians.


Added Benefit: Medical Staffing Network Healthcare Services

INTEGRIS Health has partnered with Medical Staffing Network for 16 years to provide staffing services through a joint venture. As a comprehensive healthcare staffing company, Medical Staffing Network provides nursing, allied healthcare, pharmacy, clinical research, anesthesia, advanced practice and case management professionals. Now INTEGRIS Health Partners clinics can access their services as an added benefit of participation in the network. For more information please contact MSN locally at 405-947-3456.


Pharmacy Task Force Recommendations

At their recent meeting the INTEGRIS Health Partners pharmacy task force reviewed high cost generics. Those medications may cost more beginning July 2015. If possible, please ask for a three month supply to reduce the cost to patients. The INTEGRIS Health Partners Pharmacy Task Force asks that providers also consider the following exchanges:

BRAND DRUG

EXCHANGE

INFORMATION

Lyrica

Gabapentin

Not all patients will find gabapentin to be equally efficacious or tolerable, but many will.  Gabapentin is not a controlled drug --Lyrica is.  The dosage range is quite wide, from 100mg twice daily to 1200 mg three times daily.  At higher dosages, doubling the dose does not double the effect.

Pristiq ER

Venlafaxine HCL
ER/desvenlafaxine succinate

 

 

If you have any questions about the task force or its recommendations please contact INTEGRIS Health Partners Care Coordination at 405-951-2504 or toll free at 855-582-3003.


New Physicians

Abid, Humaira MD
Psychiatry
4401 S Western Avenue
Oklahoma City, OK 73109
405/427-2441

Adams, DiAnne DO
Family Medicine/Sports Medicine
2821 N Van Buren, Suite A
Enid, OK 73703
580/213-9799

Bass, Eryn DO
Family Medicine
620 S Madison, Suite 209
Enid, OK 73701
580/548-1544

Bodily, Jerry B. MD
Emergency Medicine
3300 NW Expressway
Oklahoma City, OK 73112
405/951-2541

Bohn, David R. MD
Radiology
3330 NW 56th Street, Suite 206
Oklahoma City, OK 73112
405/945-4740

Carter, Steven MD
Colon & Rectal Surgery
3433 NW 56th Street, Suite 760
Oklahoma City, OK 73112
405/948-0640

Cook, Christopher R. DO
Anesthesiology
1111 N Lee Avenue, Suite 236
Oklahoma City, OK 73103
405/272-9641

Dasharathy, Gayathri MD
Psychiatry
5300 N Independence
Oklahoma City, OK 73112
405/427-2441

Fitzgerald, Lauren L. MD
Anesthesiology
3330 NW 56th Street, Suite 612
Oklahoma City, OK 73112
405/601-8810

Garton, Theresa MD
Psychiatry
5100 N Brookline, Suite 900
Oklahoma City, OK 73112
405/717-9800

Gilchrist, John Mark MD
Otolaryngology
501 E. 15th Street, Suite 300A
Edmond, OK 73013
405/562-1810

Gunderson, Robert DO
Orthopedic Surgery
13313 N Meridian Avenue,
Suite A-1
Oklahoma City, OK 73120
405/751-1766

Guniganti, Uma M. MD
Cardiology
1127 E Owen K. Garriott Road
Enid, OK 73701
580/234-7320

Krishna, Phari MD
Neurosurgery
2821 N Van Buren, Suite A
Enid, OK 73703
580/213-9799

Krishna, Raja MD
Hospitalist
3300 NW Expressway
Oklahoma City, OK 73112
405/713-7403

Lepere, Kristopher DO
Internal Medicine
3400 NW Expressway, Suite 700
Oklahoma City, OK 73112
405/949-3816

Moss, Roy MD
Radiology
4401 S. Western Avenue
Oklahoma City, OK 73109
405/713-7403

Motley, Cody A. MD
Anesthesiology
4131 NW 122nd Street
Oklahoma City, OK 73120
405/775-9350

Norris, Andrea DO
Infectious Disease
4221 S Western Avenue,
Suite 4010
Oklahoma City, OK 73109
405/644-6464

Phelps, Jeremy MD
Spine & Neurological Surgery
3705 NW 63rd Street, Suite 212
Oklahoma City, OK 73116
405/552-0401

Pillow, Jonathan M. MD
Otolaryngology
501 E. 15th Street, Suite 300-A
Edmond, OK 73013
405/562-1810

Regmi, Anil MD
Nephrology
3400 NW Expressway, Suite 700
Oklahoma City, OK 73112
405/949-3816

Starkey, Brad A. MD
Anesthesiology/Pain Management
5101 W. Memorial Road
Oklahoma City, OK 73142
405/752-9600

Stierlen, Loyal DO
General Surgery
3400 NW Expressway, Suite 420
Oklahoma City, OK 73112
405/713-9935

Swisher, Karen K. MD
Internal Medicine
3048 SW 89th Street, Suite B
Oklahoma City, OK 73159
405/692-6600

Thompson, Chad G. MD
Radiology
3330 NW 56th Street, Suite 206
Oklahoma City, OK 73112
405/945-4740

Uba, Emenike MD
Hospitalist
4401 S Western  Avenue
Oklahoma City, OK 73109
405/713-7403

Vanhooser, Jonathan Ross MD
Radiology
600 S Monroe
Enid, OK 73701
580/233-2300

Wang, Wenbao MD
Pain Management
401 S 3rd Street
Enid, OK 73701
580/237-7246

 

 


INTEGRIS Health Partners Staff

Administrative Leadership Team

Carl Raczkowski, MD, President
405-642-4340 or carl.raczkowski@integrisok.com

Jeffrey Cruzan, MD, Medical Director
405-773-6415 or jeffrey.cruzan@integrisok.com

Jeff M. Brown, FACHE, Vice President
405-552-0413 or jeff.brown@integrisok.com

Lisa Anderson, Assistant Vice President
405-951-2529 or lisa.anderson@integrisok.com

Mindy Eggleston, Executive Assistant
405-713-4476 or mindy.eggleston@integrisok.com

Evan Galt, MHA, Operations Manager
405-951-2553 or evan.galt@integrisok.com

Kari Govier-Brown, MHA, Provider Relations Consultant
405-312-7605 or kari.govier-brown@integrisok.com

Deidre R. Horn, MHR, Provider Relations Consultant
405-550-3499 or deidre.horn@integrisok.com

 

Care Coordination Team

Susan Adams, RN, Care Coordinator
405-552-2854 or susan.adams@integrisok.com

Tabatha Black, RN, Care Coordinator
405-713-5582 or tabatha.black@integrisok.com

K.C. Chansombat, Population Health Coordinator
405-552-2967 or
khammueng.chansombat@integrisok.com

Chesley Clayton, MA, Population Health Coordinator
405-552-2958 or chesley.clayton@integrisok.com

Tonia Garner, RN, Care Coordinator
405-552-2852 or tonia.garner@integrisok.com

DeAnn Jackson, RN, Care Coordinator
405-552-0864 or deann.jackson@integrisok.com

Kimberly Nelson-Tyrrell RN, Care Coordinator
405-552-2923 or
kimberly.nelson-tyrrell@integrisok.com

Kerra Whaley, RN, Care Coordinator
405-552-2858 or kerra.whaley@integrisok.com

Rochelle White, LPN, Population Health Coordinator
405-552-2966 or rochelle.white@integrisok.com

 

IntegrisHealthPartners@integrisok.com

integrisok.com/ihp

405-713-4476



© 2017 INTEGRIS Health Pencil
Oklahoma's largest hospital network
3300 N.W. Expressway
Oklahoma City, OK 73112 Phone: (405) 951-2277
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