A bi-weekly newsletter from your physician organization
Friday, June 4, 2021
Key quality metrics targeted for improvement
Physicians play an integral role in ensuring the use of evidence-based medicine when making health care stewardship decisions. Patients trust their physician to recommend the most appropriate and necessary care.

Managing health care costs is also important. Conversations between physicians and patients can help promote better implementation of care while working to lower costs for patients.

The following quality metrics offer room for improvement by The Physician Alliance members. Being aware of the appropriate use of these health services can improve patient care, costs and metrics. Key quality metrics to focus on include:

GOAL: Decreasing imaging for low back pain
Decreasing the use of imaging for low back pain within the first four weeks of symptoms promotes the use of evidence-based medicine when making health care stewardship decisions.

Helpful patient education:
  • 6 tips for managing low back pain poster
  • Rx ‘non-prescription pad’ (low back pain) flyer

GOAL: Appropriate testing for children with pharyngitis
The National Committee for Quality Assurance (NCQA) encourages appropriate testing for children ages 3 and older with a diagnosis of pharyngitis. This diagnosis is the leading cause of outpatient care and can be viral or bacterial infection. Most cases of pharyngitis resolve without treatment, however, antibiotics continue to be inappropriately prescribed even though viral pharyngitis does not need antibiotic treatment. Appropriate testing would help reduce unnecessary use of antibiotics.

Helpful patient education:

GOAL: Decreasing antibiotic use of upper respiratory infection
More than 90% of upper respiratory infections are viral and antibiotics do not help improve these infections. Unnecessary antibiotic use may cause antibiotic resistance and other side effects. Non-prescription options should be used to ease symptoms of an upper respiratory infection.

Helpful patient education:
  • 6 facts you should know about using antibiotics for bronchitis poster
  • Rx ‘non-prescription pad’ (antibiotics) flyer
  • Rx ‘non-prescription pad’ (antibiotics/pediatrics) flyer
New coding section on website offers tips and more
Appropriate coding plays an important role in managing patient populations, improving quality scores and increasing practice revenue. The Physician Alliance is committed to assisting members succeed in these areas.

TPA created a variety of coding education, tip sheets and more. To highlight the importance of this topic and make it easier for members to access this information, a new section dedicated to coding was created on the website. The Coding Tips webpage provides easy access to tip sheets, videos and more. Upcoming education programs are also available under the Events tab.
Summit addresses obesity management, offers incentives
Michigan has one of the highest rates of obesity in the nation, with 36 percent of adults and 17 percent of children being obese, according to the Michigan Department of Health and Human Services. In an effort to address this epidemic, the Michigan Bariatric Surgery Collaborative and Blue Cross Blue Shield of Michigan (BCBSM) are hosting an Obesity Summit on Oct. 29, 2021 in Lansing (in-person at this time; adjusted if needed). 
 
At the Obesity Summit, "experts will present on best practices for obesity management in behavior modification, diet, and pharmacology. Attendees will forge ideas and partnerships to address obesity, and identify ways for PCPs and surgeons to collaborate." Primary care practices with a higher proportion of obese patients should benefit from the exchange of information at the conference.
 
AMA Category 1 Continuing Medical Education credits will be offered. To support this important education initiative, BCBSM is also offering incentives to primary care practice physicians and non-physician staff who attend the Summit:
 
Physician practice unit incentive: To compensate PCPs to participate in the Summit
  • $1000 maximum per practice unit (2 or more PCPs in attendance); OR
  • $500 per practice unit (only 1 PCP in attendance)

Non-physician clinician staff within the practice (i.e. nurses, dieticians, etc.)
  • $500 per practice unit (please limit to 3 total in attendance per practice)
  • Non-physicians should be encouraged to attend along with PC

Click here for more information and to register.
Don't forget risk scores reset every year
Patient risk scores reset and need to be coded every year. Demystify coding challenges and gain valuable insight into Hierarchical Condition Category (HCC) by attending The Physician Alliance's Lunch with the Coder webinar. Register today!

Lunch with the Coder: Hierarchical Condition Category and Risk Coding – Risk Scores Reset Every Year
Wednesday, June 16, 2021; 12-1pm

The webinar will address key coding topics, including:

  • What is HCC? What is risk coding?
  • Which diagnosis codes should be added for risk coding?
  • What should be documented in the medical record to support these diagnoses?
  • How do HCC and risk coding affect specialists?

Target audience: primary care and specialty physicians, coders, billers, practice directors and office managers

Presenter: Mary Mallory, CEMC, ambulatory coding education specialist, The Physician Alliance

This event is complimentary and open to TPA members only.

Register here! The webinar link will be emailed after registration.
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