July 2017
Top Story 

Answers to Recent MIPS Participation, Exemption and Reporting Questions   

In recent weeks, our Network Team has received a number of questions about participation, exemptions and reporting requirements for MIPS APM, the Medicare payment model that applies to participants in the MaineHealth ACO's Medicare Shared Savings Program (MSSP) contract. (MIPS APM, by the way, stands for Merit-based Incentive Payment Program Advanced Payment Model). Since these questions are probably common among our participants, we wanted to share answers with you here. 

ACO In Action 

Kelly Williams and Bethany Sanborn helped lead the lung health effort 
Improving the Care of Patients with Lung Health Issues 

Imagine not being able to breathe after taking only a few steps.  Or avoiding public places like theaters because of your chronic cough. Think how frightened you would be if you woke up from a deep sleep gasping for breath. These are the challenges that people with lung conditions, like COPD, face every day. And in Maine, many people with COPD have the additional burden of being geographically isolated and poor. 

Measure of the Month 

Depression Screening 

Welcome to Measure of the Month, a series of articles that explores key MaineHealth ACO quality measures and provides tips and resources to help you achieve the measure goal. 

This month, we take an in-depth look at the depression screening measure, one of our Top Ten Quality Goals. 

Screening for depression in primary care is a quick and easy way to identify patients experiencing symptoms.  Often most patients do not disclose that they have symptoms of depression without being asked.  While it may be somewhat easy to detect depression in patients who have moderate to severe symptoms, those suffering from milder symptoms are more difficult to detect. 

N eed To Know: Important Updates

Proposed 2018 Quality Payment Program Rule Changes Will Impact MIPS APM Reporting

CMS has released the 2018 Proposed Rule for the Quality Payment Program. The proposed rule, if adopted for the 2018 payment year as-is, will make about half a dozen changes to reporting for the MIPS APM, the payment model that applies to providers participating in the MaineHealth ACO's Medicare Shared Savings Program contract. 

In our estimation, the most significant proposed changes are:
  • The addition of December 31 as a fourth "snapshot" date to determine MSSP contract participation.
  • Removal of an earlier proposed 2018 requirement that Advancing Care Information data be submitted only through 2015 Edition Certified EHR Technology. Either 2014 Edition of 2015 Edition CEHRT will continued to be accepted as in 2017.
  • Multiple submission mechanisms will be allowed within a performance category.
CMS is accepting public comment on the proposed rule through August 21.


Get Ready for New Medicare Cards and ID Numbers

CMS is planning to issue new Medicare cards with new ID numbers beginning in April 2018. By that date, all Medicare providers will need to update their systems to accept the new numbers. Learn more about this change and how to prepare.

Remember to Complete Your Required Annual Medicare Revalidation 

CMS has established an online system to allow Medicare providers to complete their annual required enrollment revalidation process using PECOS, the Provider Enrollment Chain and Ownership System. To determine a provider's revalidation due date, visit the  Medicare Revalidation List.

Learn more at the  CMS revalidation website page.

Anthem Releases New Provider Manual Effective August 1 
Anthem BlueCross BlueShield's new Provider Manual for Maine includes updates to the Utilization Management peer review process, credentialing program standards, Quality Improvement Program and member health & wellness programs.


Peer-to-Peer Innovation Sharing:
Diabetic A1c, Let's Get Low!

Wednesday, July 19,  Noon - 1:OO pm

Our new monthly peer learning series is a great opportunity to learn directly from your fellow ACO participants. 

On Wednesday, July 19, join your peers from around the state, along with the MaineHealth Center for Health Improvement, to discuss tactics to work diabetic A1c panels, and share useful treatment algorithms.

Save the Date: 2017 MaineHealth ACO-Wide Quality Forum Sept. 19
Omar Hasan
Join us as we share strategies to promote sustainability and spread of both quality initiatives and efforts to decrease low value care across the MaineHealth ACO. Practice leaders, physicians, and care team members will benefit from learning new approaches, sharing their own success stories with others, and networking with colleagues from across the MaineHealth ACO network. 
When: Tues., Sept. 19, 2017 - 8:30am - 3:30pm
Where: MaineHealth - 110 Free Street, Portland, ME 
Keynote Speaker: Omar Hasan, MBBS, MPH, FACP - Senior VP, Chief Quality & Safety Officer MaineHealth, Maine Medical Center 
Registration information coming soon! 

6th Annual Let's Go National Obesity Conference

On September 28  and 29, join Let's Go! to explore the key role of physical activity to improve your patients' health. Using the National Physical Activity Plan as a framework, we will explore how to use physical activity in the prevention, management, and treatment of obesity and related health conditions. We have an exciting line up of speakers from near and far! 

Medical Assistant Training - Free to All

2017 Training Dates and Locations
August 2nd & 3rd, MaineHealth, 110 Free St., Portland
Septe mber 6th & 7th, MaineHealth, 110 Free St., Portland
October 4th & 5th, MaineHealth, 110 Free St., Portland
November 1st & 2nd, MaineHealth , 110 Free St., Portland

Click here for details and registration
Questions? Contact Claire Schreiber, Program Coordinator

Advanced Medical Assistant Training - Free to All 
2017 Training Dates and Locations
A ugust 23rd , Western Maine Health Care
September 20th,    MaineHealth , 110 Free St., Portland
October 25th , Waldo County General Hospital
November 8th , MaineHealth , 110 Free St. Portland

Click here for details and registration
Questions? Contact  Claire Schreiber , Program Coordinator

Care Management Training - Free to MaineHealth ACO Participants & $100 for non-participants

August 1st, 8th, 15th, 22nd, MaineHealth, 110 Free Street Portland
October 3rd, 10th, 17th, 24th, MaineHealth, 110 Free Street Portland
November 28th, December 5th, 12th, 19th,  MaineHealth, 110 Free Street Portland

Click here for registration
Questions? Contact  Claire Schreiber , Program Coordinator

Free CME Course: Challenging Conversations about Dementia 

The Alzheimer's Association recently developed a free CME program for physicians to help in discussing dementia and memory concerns with patients. The five-module online course takes approximately 75 minutes to complete and covers:
  1. Counseling the Worried Well Patient: Review of Alzheimer's Disease and Dementia Risk Factors
  2. Diagnosing the Cause of Dementia: Why Is This Important?
  3. The Road Ahead to a Differential Diagnosis: What Can the Patient Expect?
  4. Caring for a Patient Newly Diagnosed with Alzheimer's Disease: What Needs to be Addressed?
  5. Driving Retirement: Challenging Conversations in Community Mobility

A1c and Eye Exams, but What else Matters for Patients with Diabetes?

In addition to maintaining blood sugars in target range and referring your patients for an annual eye exam, additional screenings are critical to prevent further complications for your patients with diabetes. This is not a new concept, but sometimes it is easy to overlook a screening test (especially one not tied to a quality measure). This chart includes recommended screenings for adults with diabetes based on the American Diabetes Association Standards of Medical Care in Diabetes - 2017.   

FMI: Contact Elizabeth Nalli

In-person, Customized Tobacco Treatment and Referrals to the Maine Tobacco Helpline: Trainings for Staff

Are you looking for a way to provide information to staff on evidence-based tobacco dependence clinical practice guidelines, including how to conduct a brief intervention and manage treatment medications?  Perhaps you are looking into how to integrate direct referrals to the Maine Tobacco Helpline into your practice?  MaineHealth's Center for Tobacco Independence has a team of tobacco treatment educators who are available to offer customized tobacco treatment training for all members of the care team. Trainings are offered as requested and a menu of training opportunities is available.  

FMI:  Please contact Linda Craig ( 207) 662-7150.

Maine's Opioid Prescribing Law: Current Fact Sheets

Two provisions of Chapter 488, Maine's opioid prescribing law, went into effect on July 1:
  • New and existing opioid prescriptions are limited to 100 Morphine Milligram Equivalents, down from 300 MMEs previously
  • All prescribers "with the capability" must prescribe opioids electronically
Learn more about the law by viewing these recently updated fact sheets:

Maine Medical Association Fact Sheet: Implementation of Public Law Chapter 488
FAST FIVE: ACO Spotlight

Joel Botler, MD 
Chief Medical Officer, Maine Medical Center
Interim President, Maine Medical Partners

Each month, we ask an ACO stakeholder five quick questions about their work and life. This month, we catch up with Dr. Joel Botler.