May 2018 IHP Newsletter

Letter from the President

I have had the pleasure of attending multiple presentations and meetings regarding the future of healthcare in the United States. These national speakers have each had a little bit of a different take on what we need in order to be successful in these changing times. The overall feeling you get from hearing them discuss our future course is not uplifting. The bottom line is that no one knows what will happen.

The best approach for INTEGRIS Health Partners is to be the leader for affordable, efficient and high quality healthcare. No matter what payment system we end up living with, being the best in in these areas is a winning strategy. Think about it. With this strategy we will be successful in fee-for-service, value-based payment or any other payment system that evolves. It is imperative that we extinguish inefficiencies and waste in our delivery stream. We cannot allow these to exist in the practice of medicine any longer. The payors, and more importantly, the patients, will not tolerate “business as usual”. Patients are more and more responsible for the costs of their care, and they are shopping for value and affordability. They are being guided by their insurance companies and their employers to the lowest cost providers.

Remember, put the patient in the center of everything we do. It is about them, not us. They depend on us to be their advocates. They look to us for help and comfort. They know when they are being treated with dignity and respect and when they are not. IHP should be the organization they look to for that feeling of comfort and treatment delivered in an affordable and efficient manner.

Why wouldn't we strive for that?

INTEGRIS Health Partners proudly invites you to listen and watch as Dr. Raczkowski explains his “patient first” philosophy in his own words. WATCH NOW.

Sincerely,

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


United Healthcare

Effective January 1, 2018, INTEGRIS Health Partners agreed to participate in an attribution model Accountable Care Organization (ACO) with United Healthcare of Oklahoma.Similar to the Aetna ACO, the agreement’s goals are to provide a vehicle for facilitating the clinical integration and coordination of ACO providers in order to promote quality and efficiency gains in the delivery of healthcare.United has created Incentive Programs to reward the ACO for achieving specific objective measures in the delivery of care by ACO Providers to United’s members.Key points to remember:

  • There is no downside risk to IHP.
  • Physicians will continue to be reimbursed at their current United Healthcare of Oklahoma fee schedules.

Specific quality metrics are listed below; the first performance metric results will be announced in August 2018. IHP Care Coordinators will manage United Healthcare patients already seeing an IHP PCP. Care coordinators will contact those PCPs regarding identified care gaps.

Performance Measure

Performance Measure Description

Annual Monitoring for Patients on Persistent Medications

Patients who received at least 180 treatment days of ACE Inhibitor/ARBs or digoxin or a diuretic during the measurement year and had at least one therapeutic monitoring event for the therapeutic agent in the measurement year.

Breast Cancer Screening

Women 50-74 years of age who had a mammogram to screen for breast cancer.

Cervical Cancer Screening

Women who were screened for cervical cancer using either of the following criteria: age 21-64 who had cervical cytology performed every 3 years or age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.

Chlamydia Screening in Women

Women who were identified as sexually active and who had at least one test for chlamydia during the measurement year.

Colorectal Cancer Screening

 

Patients that had appropriate screening for colorectal cancer.

Comprehensive Diabetes Care

Patients with diabetes (type 1 or type 2) that had a HbA1c test during the measurement year.

Comprehensive Diabetes Care

Patients with diabetes (type 1 or type 2) that had a nephropathy screening test or evidence of nephropathy during the measurement year.

Comprehensive Diabetes Care

Patients with diabetes (type 1 or type 2) that had eye screening for diabetic retinal disease.

Comprehensive Diabetes Care

Patients with diabetes (type 1 or type 2) with most recent HbA1c result value less than 8.0%.

Well-Child Visits in the First 15 Months of Life

Patients that had six or more well-child visits with a PCP during the first 15 months of life.

All Cause Readmits Actual: Expected

Ratio of actual 30 day all cause readmission rate to the expected 30 day all cause readmission rate

Risk Adjusted LOS Actual: Expected

Ratio of actual length of stay to expected length of stay, adjusting for the relative risk of hospital discharge.

ER Escalation Rate

The percentage of ACO Customers with ER events resulting in Admission.


Coding and Documentation Improvement Training

INTEGRIS Coding and Documentation Improvement and INTEGRIS Health Partners present an in-person educational opportunity. The presentation will give an overview of the CMS Value Based Purchasing and MS-DRG system. Learn simple tips to get credit for the severity of illness of the patients you treat AND demonstrate the quality of care you provide. Sessions are offered throughout the metro and in Enid:

· Wed. May 23, 7-8 a.m. INTEGRIS Baptist Medical Center Conference Rooms J and K

· Thur. May 24, 7-8 a.m. INTEGRIS Bass Baptist Health Center Northeast Conference Room

· Thur. May 31, 7-8 a.m. INTEGRIS Southwest Medical Center Dining Rooms 3 and 4

To register contact Annie Dunn at annie.dunn@integrisok.com or 405-949-4055.

Completing Coding and Documentation Improvement training by June 30, 2018 is a 2018 required metric for all metro hospital-based medical and surgical physicians and clinic-based specialists.


INTEGRIS Health Partners Online Education

INTEGRIS Health Partners presents online educational videos for physicians:

· Better End of Life Discussions by Gavin Enck, Ph.D.

· Chronic Pain and Opioids: Interdisciplinary Strategies by Terrance Truong, M.D. and Grace Wilson, Ph.D.

· Geriatric Medicine Update by Tomas Owens, M.D.

 

How to view a video:

• Go to integrisok.com/ihp/annual-education

• Fill out a quick form.

• Select a video.

• Once you click ‘submit,’ you will be able to view the video.

• You’ll receive a confirmation email that your form has been submitted.

 

Videos are available until Dec. 31, 2018. Viewing one IHP educational video will meet the metro physician education metric for 2018, which is required to participate in shared savings.


Save the Date for 2018 IHP Summits

Enid physicians: The Enid Summit is scheduled for Thursday, July 26, 2018, 5:30 p.m. Please look for registration instructions and more details in June.

Metro physicians: The Metro Summits are scheduled for Tuesday, June 5, 5:30 p.m., and Tuesday, October 2, 5:30 p.m. Register online now for the June session or call 405-951-2277. Registration for the October summit will be available in September.

Attending in person or viewing a summit via livestream is a required operational metric for all specialties in order to participate in shared savings.


2018 Shared Savings Metrics

INTEGRIS Health Partners Operational and Clinical metrics for metro providers are available to review.

2018 Metrics – Enid

2018 Metrics – Metro


INTEGRIS Connect Welcome

Michael Holzer, M.D., Bill Miller, M.D., Shae Samara, M.D., and Jeffrey Shoss, M.D. of Urology Specialists of Central Oklahoma are the latest independent physicians to implement INTEGRIS Connect, the Epic product for community providers. USCO physicians and staff can now access information for their shared patients throughout the Epic system. Congratulations! To learn more about INTEGRIS Connect, visit www.integrisok.com/connect. Submit an inquiry to schedule an informational meeting.


Pharmacy Update

The IHP Pharmacy Committee met recently and provides the attached handout, United Health Care Brands with Lower Cost Alternative Therapies or Generic Options.

Please contact INTEGRIS Health Partners Care Coordination at 403-951-2504 or toll free at 855-582-3003 if you have any questions.


Care Coordination: New Staff and Reassignments

INTEGRIS Health Partners Care Coordination is growing! With the addition of care coordination responsibilities for United Healthcare of Oklahoma, several new staff members have joined the team.

Heather Edwards, Pharm.D., has joined the IHP comprehensive medication management team. Heather is a board certified ambulatory care pharmacist with experience in diabetes and anticoagulation management. She enjoys educating patients about their conditions, and is especially interested in diabetes and preventative medicine. She and her husband, Brad, who is a physician assistant at INTEGRIS Family Care Southwest, have two young children. They are active in their church, where Heather plays the piano.

Rebecca Morrow

Amy Smith

Miche Wiesel, L.P.N., has been a nurse for 20 years. She most recently worked in home health admissions. In her new role as a population health coordinator for IHP members, she loves that she gets to be a part of a team to help people before they get sick. Miche has been married for seven years and has a four year old son. In her free time she enjoys spending time with her family and being crafty.

Lisa Willis, R.N. is a care coordinator for the IHP member population. Lisa spent the last seven years as an oncology nurse and has an additional 18 years of experience as a floor nurse. Married for 32 years, she and her husband share a grown daughter who is currently in culinary school. In addition to listening to music, reading, and playing with her dog and cat, Lisa is a published science fiction writer. She is looking forward to the challenge of her new role with INTEGRIS.

With the addition of United Healthcare responsibilities, care coordination has made the following reassignments:

INTEGRIS Health Partners

Tabitha Black, R.N. care coordinator

Tonia Garner, R.N. care coordinator

Deann Jackson, R.N. care coordinator

Lisa Willis, R.N. care coordinator

Rochelle White, L.P.N. population health coordinator

Miche Wiesel, L.P.N. population health coordinator

Aetna

Susan Adams, R.N. care coordinator

Chesley Clayton, population health coordinator

Amy Foreman, L.P.N. population health coordinator

United Health Care

Kerra Whaley, RN, care coordinator

K. C. Chansombat, population health coordinator


New Physicians and Providers

Max G. Cates MD

Max G Cates MD

Family Medicine

220 SW 89th Street Suite A

Oklahoma City, OK 73139

405-616-7070

Carlos Garcia MD

Southwestern Dermatology

Dermatology

4805 S. Western Avenue

Oklahoma City, OK 73109

405-636-1506

Janie L. Howard PA

Summit Medical Center

Family Medicine

7221 W. Hefner Road

Oklahoma City, OK 73162

405-470-6900

Tommy Ibrahim MD

Internal Medicine, Hospitalist

INTEGRIS Medical Group

3300 NW Expressway

Oklahoma City, OK 73112

405-713-7403

Zeeshan Khan MD

Interventional Cardiology

INTEGRIS Cardiovascular Physicians

4221 S. Western Avenue

Suite 2010

Oklahoma City, OK 73109

405-644-5120

Elizabeth Kinzie MD

Internal Medicine

Waynoka Family Clinic

1084 Nickerson

Waynoka, OK 73860

580-824-2291

Jack Lake DO

Radiology

Norman Radiology Associates

4401 S. Western Avenue

Oklahoma City, OK 73109

405-596-0359

Vibitha Mani MD

Pediatrics

Just Kids Pediatrics

2921 SW 89th Street

Oklahoma City, OK 73159

405-757-7818

Elizabeth McCabe MD

Pediatrics

Just Kids Pediatrics

2921 SW 89th Street

Oklahoma City, OK 73159

405-757-7818

Irene Perez-Young MD

Radiology

INTEGRIS Southwest

4401 S. Western Avenue

Oklahoma City, OK 73109

Meredith Pruitt PA-C

Allergy Immunology

Allergy, Asthma and Clinical Research Center

4200 W. Memorial Road

Suite 206

Oklahoma City, OK 73018

405-752-0393

Andrea Sestak MD

Pediatric Rheumatology

Oklahoma Institute of Allergy and Asthma

728 Mustang Road

Yukon, OK 73099

405-265-1949

Margo Short MD

Family Medicine

4 R Families Medical Clinic

330 S. 5th Street Suite 202

Enid, OK 73701

580-297-5340

Paul Tiwana DDS MD

Oral and Maxillofacial Surgery

Profiles Oral Facial Surgery Experts

1000 N. Lincoln Blvd. Suite 2000

Oklahoma City, OK 73104

405-271-4955

Cori Wadley PA-C

Family Medicine / Urgent Care

MedOK Mustang

1616 S. Mustang Road

Yukon, OK 73099

405-256-0501

Melisa Weaver APRN

Family Medicine

WeightWise Bariatrics

1800 S Renaissance Blvd.

Suite 200

Edmond, OK 73013

405-359-2475