What's the Plan for 2017?

Inspiration from Beacon Health COO

News You Can Use and Important Updates
February 2017
What You Need to Know about EMHS Medical Plan for 2017. Tips to Faster Reimbursement! Be Inspired by Our Latest Video. These updates and more in your February Network Newsletter!

All's Quiet at EMHS Employee Plan for 2017...

The EMHS Employee Medical Plan has not made any benefit design changes for 2017. That's good news for practices wondering what they might have to research or catch up on!
 
For a summary of EMHS Employee Plan benefits, go to our website at BeaconHealth.ME and click on Contracted Provider Network at the top. Look below and you will see the link for EMHS Employee Medical Plan Benefits where you can view or download a pdf of the benefits.  




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Three Questions
We asked our chief operating officer, Carrie Arsenault, three questions about her life at Beacon Health - here's what she had to share:

1. Describe your role in Beacon Health and a typical day for you.
 
A large portion of my time is spent ensuring that we are meeting the obligations of our agreements with payers, employers, vendors, and participating organizations and that these entities are also fulfilling their commitments and obligations. As COO, I'm involved in negotiating these agreements and then once secured, establishing, and implementing a plan to support the arrangement.
I also spend considerable time leading, coordinating, and integrating operational functions across the broad spectrum of services under the Beacon Health umbrella, including network management, communications, wellness, data analytics, and project management. Woven throughout this is the continuous process of developing and implementing the strategy that guides us all every day.
 
2. What in your background has prepared you for this leadership role in Beacon Health?
 
Population health encompasses so many elements from my past experience that have been extremely helpful navigating this new care delivery model. For example, my coding background is very relevant to understanding the reimbursement methodology and impact that diagnostic conditions have on the overall cost of care. The revenue cycle background has provided a solid foundation relative to how claims are generated, processed, and paid and this has been extremely helpful as we try to ingest and analyze claims data into actionable information. I think most of all, my experience working with providers when I was director of physician practices at EMMC. Relationships are very important as we make this transition from volume to value. Creating trusting relationships that build upon my previous experience with many of these practices has been very important to me. Having real life experience re: how a physician office functions and the many different roles within a practice, along with how the EMR is used is very valuable in understanding how we can make improvements that will be effective and sustainable.
 
3. What do you see in the future for healthcare, and for ACOs?
 
We must continue on this journey from volume-based care to value-based care as the U.S. cannot sustain healthcare expenditures accounting for 16.9 percent of its GDP.   We will explore and lead discussions around bundled payment opportunities, MACRA/MIPS evaluations and a continued focus on providing high quality care at a lower cost for the populations we serve, one patient at a time. We may not be called an ACO but we believe our work will continue.
 
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Acronyms of the Month
Decode the  healthcare acronyms below... the answers are at the end of the newsletter
  • ACGME     ______________________________________________________
  • AHRQ       ______________________________________________________
  • BPCI         ______________________________________________________
  • DNR          ______________________________________________________
  • FACHE     _______________________________________________________
  • SAMSHA  _______________________________________________________

 

 

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Empowering Employees and Engaging Patients! 

2016 is in the books and worth celebrating! We would like to thank all of you for your continued commitment to proactive personalized care - your hard work and dedication are making a difference every day.


 

We encourage you all to watch our latest video Engaging Empowering as we highlight the success of three of our partner organizations, Inland Hospital, MDI Hospital, and Blue Hill Memorial Hospital!
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Wellness Tip: 8am - 5pm Desk Fitness 
  
We spend most of our work day sitting at our desks. Here are some great and easy ways to incorporate some fitness from your desk throughout your day!
 
Morning Fitness Tip : When you sit down at your desk and you're getting ready to start your day make sure your desk and computer are adjusted properly; computer is at eye level and your elbows and hands are on the same plane.
 
Lunch Fitness Tip : Before you get up to go to lunch, how about doing some quick stretching and breathing first. Hold the left side of your chair with your left hand while you raise your right arm over your head. Inhale and lean all the way to the left. Hold this position for a six breath count. Release and repeat switching sides for max of six repetitions.
 
Afternoon Fitness Tip : If you're ready for a nap between 2-3 pm, those last few hours can drag. Here's a way to spark your productivity. Stand up, with your legs hip width apart, inhale as you reach your arms up in the air, exhale and bend at the waist reaching your arms for your feet. Repeat this five times.
 
End of the day Fitness Tip : For ten-15 minutes do something you love! You've worked hard all day, making time to stretch and breathe - who knows maybe you fit in time for a brisk walk with a coworker. Now take a few minutes to sketch a drawing, or slip on your headphones and listen to your favorite song, or read a few pages in your book. Our mental wellness is just as important as our physical health.
 
 By doing these things, you release serotonin in your body making you HAPPY!
 
Happy Wellness Friends!



Acronyms of the Month
Decode the  healthcare acronyms below... the answers are at the end of the newsletter
 
  • ACGME- Accreditation Council or Graduate Medical Education: The ACGE is the body responsible for accrediting the majority of graduate medical training programs for physicians in the United States.
  • AHRQ- Ag for Healthcare Research and QualityA government agency that supports and conducts research that evaluates the effectiveness, quality, and value of healthcare in everyday settings, uncovering the evidence and developing the knowledge and tools that yield measurable improvements to quality.
  • BPCI: - Bundled Payment or Care Improvement: The BPCI initiative is comprised of four broadly defined models of care, which link payments for the multiple services beneficiaries receive during an episode of care. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare.
  • DNR - Do Not Resuscitate: DNR, also known as no code or allow natural death is a legal order written either in the hospital or on a legal form to withhold cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) in respect of the wishes of a patient case their heart were to stop or they were to stop breathing. "No code" is a reference to the use no "code" as jargon for "calling in a Code Blue" to alert a hospital's resuscitation team. The  DNR request is usually made by the patient or healthcare power of attorney and allows the medical team taking care of them to respect their wishes. In the healthcare community, allow natural death (AND) is a term that is quickly gaining favor as it focuses on what is being done, not what is being avoided .A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatments.
  • FACHE - Fellow of the American College of Healthcare Executives: FACHE is a professional certification sponsored by the American College of Healthcare Executives (ACHE),which is headquartered in Chicago, Illinois. Candidates for the certification must meet certain educational and experience requirements, join and maintain tenure in ACHE, and pass an examination before the designation is awarded.
  • SAMSHA - Substance Abuse and Mental Health Services Administration: SAMSHA is the agency within the US Department of Health and Human Services that leads public heath efforts to advance the behavioral health of the nation. SAMSHA's mission is to reduce the impact of substance abuse and mental illness on America's communities.


 

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