Please note: This is an internal Advocate Aurora Health newsletter and safe to open. |
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In this issue
- COVID-19 Vaccine
- CI Program
- Clinical Risk Adjustment
- EpicCare Link
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Message from the President & CEO |
Watch Jim Skogsbergh's video update on COVID-19 and a conversation with Chief Operating Officer Bill Santulli. This video, while slightly longer than our regular CEO updates, covers important topics, including what’s in store for 2021, as well as details on goals and Transformation 2025.
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On-demand COVID-19 Webinar: Latest on vaccines and other important updates
We know it is challenging to keep up with emails to stay informed and up-to-date on Advocate Aurora Health’s response to COVID-19, including our vaccination program. Watch our latest on-demand webinar – we’ve broken the key topics into shorter segments for your convenience.
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Additional Updates
- COVID-19 vaccine patient outreach
- Educating our communities
- Limited Visitor Guidelines in place for all hospitals Feb. 8
- New identifier for patients and visitors who cannot wear masks
- Remdesivir use criteria updated
- Revised treatment guidelines for COVID
- Monoclonal infusion services available
- FDA convalescent plasma updates
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Clinical Integration Program |
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New this year: Electronic Appeals
We are improving the appeals submission process by moving it online to ensure patient data confidentiality and provide you with a simplified experience. View the User Guide on APP Pro.
We use the most widely available data sources – eligibility received from payers, administrative claims (billing) records and supported EMR data – to measure patient care quality. We understand that incomplete claims data may result in inaccuracies in performance outcomes. If you believe your information is incorrect, you can request a patient-level correction by submitting an appeal between Feb. 21 – Mar. 12.
Additional CI Reminders
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Quality & Financial Performance
There are several ways you can help drive performance that improves quality for your patients and rewards you for your hard work. It’s your important work that builds the APP Single Incentive Fund.
One way is through Clinical Risk Adjustment. To help our patients live well, we must accurately capture their conditions so they can receive the benefit of various disease management programs. In addition, complete and accurate documentation aligns revenue to the work effort of treating MSSP, Blue Care Direct and Medicare Advantage (MA) patients. In 2019 and 2020 we failed to refresh ~40% of our patients known chronic conditions. Improving our chronic condition refresh rates and documentation practices to national standards, could result in up to $35M in additional SIF funding.
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Government and Value-Based Programs
MSSP patient notification: Per CMS requirements, we will be sending this notice to patients assigned to our Medicare Shared Savings Program (MSSP) Accountable Care Organization at the end of this month. The mailer will also include a cover flyer. If you receive questions about this mailer from patients, please direct them to Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
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EpicCare Link
- Workflow for physician signatures as this function is not available through ECL
- Where to view claims
- Upcoming site verification for all practices using ECL
- Latest guides and video modules
Epic upgrade coming March 28
To continuously improve our use of Epic in providing safe and efficient care for our patients across Advocate Aurora hospitals/sites, we conduct periodic upgrades. This year, upgrades are moving to a quarterly cadence with the goal of reducing downtimes. Review the safety and efficiency enhancements in store with this upgrade. Users can expect education to begin the week of March 8.
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Blue Cross Mass Mailing – MA plans: APP physicians recently received contracts to sign from BCBSIL for its Medicare Advantage products. Please note APP is contracted with BCBSIL for its HMO and PPO products and those contracts extend to all APP physicians. As a result, these proposals are duplicative. If you have any questions about APP managed care agreements or whether your APP aligned practice participates in a particular product, please contact your Field Operations Advisor.
Experian update: Access to Experian has been a resource provided by APP to aligned practices for many years. However, we have been notified that this arrangement is under review by Experian. Experian is not able to resolve issues reported by aligned practices at this time. We will keep you apprised of this situation as it develops.
More medical record transparency for patients coming Feb. 23: Advocate Aurora is on the leading edge of making information in a patient’s record available to them. On Feb. 23, in compliance with the federal 21st Century Cures Act, more provider notes and test results will be visible to patients and their proxies in their LiveWell or MyAdvocateAurora account. Learn what’s changing and what’s not. As a reminder, patients asking about a correction to their medical record should be directed to contact HIM.
Helping your patients live well: We continually conduct patient outreach on your behalf to support quality outcomes and close care gaps for routine health maintenance and screenings including mammogram reminders. Learn more
Pharmacy and Therapeutics: Review the summary and decisions made at the January Ambulatory and System Pharmacy and Therapeutics Committee meetings.
CDC guidance on Gonococcal Infection: The CDC recently revised its treatment guidelines regarding Gonococcal Infection. See the latest guidance
HMR Weight Management Program goes virtual: Refer your patients to this nationally recognized, evidence-based weight management program which Advocate Aurora has utilized at in-person sites prior to COVID-19, but now is available to patients virtually. Read more
Virtual health insurance coverage and professional billing: Refer to the payer overview and summary outlining the latest virtual health insurance coverage changes. The date under “expiration date” is when virtual health services will no longer be covered for both COVID and non-COVID related care. It is important to stay on top of this information.
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Advocate Aurora Health celebrates Black History Month as we double down on our efforts to build a diverse and inclusive environment committed to closing gaps and ensuring consistent, equitable health outcomes for our communities, team members and clinicians. This month we are featuring many of our team member and clinician stories, sharing articles about health inequities, and showcasing unique artwork commissioned by local artist, Dorian Sylvain, to display the culture and history of Black Americans.
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Your Courage is Legendary |
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One day we will all tell stories about this last year. But others will tell stories about you - your courage and compassion and how you gave us all hope for a brighter day. You and your colleagues have impacted countless lives. You have been there for our patients, our communities, and each other. That’s why we’re honoring you in our latest TV spot that debuted during the Super Bowl. View the TV spot.
For an optimum viewing experience, please open this video in Chrome.
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Advocate Aurora Research Institute has named Amit Acharya, PhD, as chief research officer.
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Your research is changing lives: Read this month’s Advocate Aurora Research Institute enewsletter which includes the latest clinical studies conducted throughout Advocate Aurora.
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Continuing Medical Education |
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CME Website: Webinars & Recordings |
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