FROM THE DESK OF LINDA S. EFFEREN, MD
Interim Chief of Operations and VP, Medical Director 
Suffolk Care Collaborative

November, 2017
Issue 2
 
Clinical Alert:  November 2017

On an as needed basis we will use a "CLINICAL ALERT" to bring to your attention critically important measures or issues.  The HEDIS measures highlighted in this alert are not specific to the DSRIP program and they may be measures that you are also held accountable for through quality programs with payers.  In the DSRIP program, Measurement Years for performance start on July 1 and end June 30.

We are currently in DSRIP Measurement Year 4 (MY4), which encompasses the period of July 1, 2017, through  June 30, 2018.  We have 8 months to make an impact on measures that were missed in the prior measurement year and to focus on access measures that can influence outcomes.  We ask your assistance in ensuring that within your practice the following measures are met  for all eligible patients as applicable for this measurement year.
RENEWED FOCUS!  T hese measures were not achieved--there is a need for renewed efforts to try to close the gaps in care related to these measures:  

HEDIS Measure
Action

Children Prescribed ADHD Medications
Three (3) follow-up visits for  patients 6-12 years old who receive a prescription for ADHD medication as a new diagnosis or history of prior medication administration but without any dispensed for a period of 120 days or more:
  • 1 visit within 30 days of medication being dispensed with a practitioner with prescribing authority    
            and
  • 2 follow-up visits within 9 months of the initial visit with any practitioner

Routine Preventive Care
All adults and children are expected to have at least one preventive or ambulatory care visit (adults) or one primary care visit (children) during the measurement year.  Providers should be aware that Managed Medicaid beneficiaries are assigned to PCPs via their MCO. Providers may access the full panel of patients that are assigned to them through the MCO. 

To access Tips to Manage your Medicaid MCO Assigned Panel visit our website at:   

GOOD NEWS!  Through everyone's focused attention and hard work, we are on track and achieving the below measurement goals.  Continued efforts will maintain the gain:

HEDIS Measurements for Patients ages 18 to 64 years:

Action
Glucose or HbA1c - Test completed during measurement year
HbA1c and LDL-C - Tests completed during measurement year
LDL-C - Test completed during measurement year

Thank you for your continued efforts and collaboration on behalf of your patients.  Please let me know if you or your staff need further information or assistance.  We at the Suffolk Care Collaborative are here to assist and support your efforts.
For questions please contact:
 
 
Linda S. Efferen, MD, MBA
Interim Chief of Operations and VP, Medical Director
631-638-1397