October 2017
Top Story 

New Population Health Management Tool Rollout Begins 

The new Arcadia population health management tool  
A group of clinical and administrative leaders representing both independent and MaineHealth-owned practices across all of the ACO's regions will gain early access to the ACO's new Arcadia Healthcare Solutions population health management tool later this month. These "early adopters" will receive training and begin exploring the utilization module of the tool, the first of five modules planned to go live over the next year. The early adopters will provide user feedback and help identify individuals in their regions who would become experts in the module and act as a resource for local users learning the capabilities of the system. 
Arcadia's utilization module combines frequently updated claims data from multiple payers to reveal significant and actionable utilization patterns and metrics. Users at the practice and provider level will be able to create their own data queries and create custom reports on demand. Future modules, with more of a clinical focus, will come online as EHR data from around the ACO's regions is loaded into the tool.
"Arcadia gives us something we didn't have before: access to current claims data from multiple payers all in one place. That's a powerful resource that will make major contributions to our critical focus areas, including reducing ED utilization and readmissions," says MaineHealth ACO President and CEO Betsy Johnson, MD. "I'm excited to share this tool with our participants."
ACO In Action

Melissa Caminiti
New Skilled Nursing Facility "Membership Model" Aims to Reduce Readmissions & ED Transfers

Through participation in MaineHealth Healthy Aging's Senior Living Collaborative, MaineHealth ACO staff members have helped contribute to improvements in post-acute care. Through partnerships with skilled nursing facilities, the Collaborative has helped reduce the length of stay of patients at those facilities, reducing cost and improving patient experience. (See the ACO's online annual report for more on length-of-stay reduction). Recently, the Collaborative has been addressing readmissions and ED transfers from skilled nursing facilities, another area that promises to have significant impact on cost and patient experience.

Perhaps the most ambitious of the Collaborative's readmission and ED utilization reduction strategies is the development of a scorecard and "membership model" that recognizes and incentivizes facilities that use protocols and systems that reduce the number of patients returning to the hospital. Melissa Caminiti, RN, MPH, MaineHealth ACO's Post-Acute Care Program Manager, coordinated the development of the membership model initiative and is working on the ground to implement it.

Measure of the Month 

Pediatric BMI and 5210

Measure of the Month is a series of articles that explores key quality and utilization goals and provides tips and resources to help you achieve success. 

This month we take an in-depth look at the Pediatric BMI and 5210 measure, one of our Top Ten Quality Goals. 

The epidemic of youth overweight and obesity continues to have major implications for the health of the entire population, from infancy to adulthood. Primary Care can play a pivotal role in addressing these conditions by not only monitoring weight problems in children and adolescents, but also providing guidance on how to maintain a healthy weight and lifestyle. 

N eed To Know: Important Updates

CMS Mails Letters Detailing Transition to New Medicare Numbers and Cards 

CMS, through its Medicare Administrative Contractors (MACs), recently mailed letters to all Medicare fee-for-service providers about their work to assign new numbers (know as Medicare Beneficiary Identifiers or MBIs) and issue new Medicare cards to all Medicare beneficiaries beginning in April 2018.

P roviders should carefully review the letter and accompanying fact sheet to learn how to prepare to accept the new number beginning in April 2018. Each provider's letter will contain specific information for their MAC that will enable them to look up their Medicare patient's new Medicare number through their MAC's secure web portal stating June 2018. 

Providers that don't already have access to their MAC's portal can  sign up now.

Providers  c an  v i e sample letter  and print-friendly fact sheet.  

CMS alsrecentlunveilethe  new Medicare card design  and issued a  press release with more information about thproject

Anthem to Review Emergency Department MRIs and Some CT Scans 

Anthem has announced that it will conduct post-service review of MRIs and pelvis and abdomen CT scans given to their members in emergency departments beginning on December 1, 2017. Payment for those studies that do not meet the AIM Specialty Health® appropriateness criteria will be denied as not medically necessary. In a statement, Anthem said the reviews are a response to "significant increases in the utilization of all types of high-tech imaging over the past few years. In particular, magnetic resonance imaging (MRI) and computed topography (CT) is increasingly being done in the ED."
FAST FIVE: ACO Spotlight

Joel Wirth, MD 
MaineHealth ACO Physician Liaison Officer
Director of Pulmonary and Critical Care Medicine, MMC
Senior Physician, Chest Medical Associates

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

Geisinger's Dr. Glenn Steele keynotes this year's PRISM
National Healthcare Innovator Dr. Glenn Steele to Keynote October 19 PRISM Conference 
PRISM 2017
Blazing the Trail from Volume to Value: 
Where We Go from Here

Thursday, October 19, 2017, 8:30 am - 3:30 pm
MaineHealth Conference Center
110 Free Street, Portland

At this year's PRISM conference, we'll look both within and beyond healthcare to further explore our journey from volume to value. Please join us for a thought-provoking and inspiring day of learning and networking.

Keynote Speaker:
Dr. Glenn Steele, former president and CEO of Geisinger Health Systems, current chairman of xG Health Solutions
Special Guest Speakers:
Police Chief Michael Sauschuck, City of Portland
Mike Sobol, Co-Founder and CEO, Venture Hall startup accelerator
Bill Caron, President and CEO, MaineHealth
Dr. Joan Boomsma, CMO, MaineHealth
Dr. Betsy Johnson, President and CEO, MaineHealth ACO
Susannah Swihart, Chair, MaineHealth Board of Directors


Physician Liaison Tom Pulling hosts the next Listening Dinner
Be Heard at the MaineHealth ACO Listening Dinner in Farmington on December 7th

What part of your work is most important to you?  What gets in the way of achieving your goals? What does a good day look like at your practice? We'd like to know.
Farmington-area healthcare providers participating in the ACO are invited to join us at the Homestead for our second regional Listening Dinner.
The dinner is hosted by Dr. Tom Pulling, the MaineHealth ACO's Physician Liaison for the Franklin County region.
There is no cost to attend, but space is limited. Please register today. 

Medical Assistant Trainings - Free to All

Due to popular demand, we are working on adding two new MA Advance Trainings to our fall schedule - dates below! 

"It was very informative, you don't realize how much you don't know about chronic diseases until someone teaches you! Thank you!"
"I found the program extremely organized"
"Provided great knowledge. Binders are a great 'take home' tool to have in practice to refer back to as reference."

Advanced MA Training   
November 14th, MaineHealth, Portland - NEW DATES 

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

MA Foundational  Training 
November 1st & 2nd - Register now - few spots remaining! 

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

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

October 17th, 24th, MaineHealth, 110 Free Street Portland
November 28th,  MaineHealth, 110 Free Street Portland
December 5th, 12th, 19th,  MaineHealth, 110 Free Street Portland

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

Martin's Point Offers Opioid Prescribing CME Opportunity

The Opioid Epidemic and Best Prescribing Practices
Tues., Nov. 7, 2017
12:30 - 6:30 PM
Woodlands Club, Falmouth

Join Martin's Point for this timely CME event featuring Robert Stutman, former Special Agent of 25 years with the US Drug Enforcement Agency, and Judge Jodi Debbrecht Switalski, a former Metro Detroit felony prosecutor who has operated highly successful sobriety and drug courts as they and others present the most up-to-date legal and practical issues for opioid prescribers and their practices as they support patients affected by this epidemic.
This event fulfills the educational requirement in recent Maine legislation requiring licensees who prescribe controlled substances to complete three CME credit hours every two years on the prescribing of opioid medication. The first three hours must be completed by Dec. 31, 2017.

Two Events, One Day: 7th Annual Emergency Medicine Educational Symposium & Emergency Provider Skills Refresher Course
Friday, Nov. 3, 2017
Symposium: 8:00 am - 12:00 pm  Information and registration
Refresher Course: 1:00 pm - 5:00 pm Information and registration

Flu Season Information for Practices and Providers

CMS has released a Special Edition MLN Matters┬« article with 2017-2018 flu season provider resources and information, including payment allowances, immunization billing chart, preventive services chart and other educational products. 

Martin's Point Launches Online Benefit Eligibility Tool 

Martin's Point has released a new online tool for practices that allows direct access to benefit, eligibility and authorization info for patients enrolled in Martin's Point Generations Advantage, Medicare Advantage and U.S. Family Health Plan. The tool is meant to eliminate the need to call the Provider Inquiry line. Registered users of the Martin's Point provider portal can use their credentials to log onto the tool using this link

Those without portal credentials may call (888) 732-7364 to set up access.