4th Quarter - 2021
Inside this Issue:
  • Flu Vaccine Notification and Reminders
  • Patient/Provider Experience
  • VillageCareMAX Physician Network Pharmacy Corner
VillageCareMAX Provider Flu Vaccination Notification
We are now entering Flu season. Each year, millions of people are infected with Flu, as well as hundreds of thousands hospitalized due to complications from the Flu and unfortunately tens of thousands have serious complications including death.

The risk of getting the Flu can be significantly reduced by getting a flu vaccine.

The Centers for Disease Control and Prevention (CDC) has stated that it is safe to administer a COVID-19 vaccination simultaneously with other vaccines, including the Flu vaccine.

As a health care professional, your strong recommendation is a critical factor that affects whether our members get an influenza vaccine. Most adults believe vaccines are important, but they need a reminder from you to get vaccinated. Please follow up with each patient during subsequent appointments to ensure the patient received an influenza vaccine. If the patient is still unvaccinated, repeat the recommendation to try to identify and address any questions or concerns.

The Centers for Disease Control and Prevention (CDC) suggests using the SHARE method to make a strong vaccine recommendation and provide important information to help patients make informed decisions about vaccinations:

SHARE the reasons why the influenza vaccine is right for the patient given his or her age, health status, lifestyle, occupation, or other risk factors.

HIGHLIGHT positive experiences with influenza vaccines (personal or in your practice), as appropriate, to reinforce the benefits and strengthen confidence in influenza vaccination.

ADDRESS patient questions and any concerns about the influenza vaccine, including side effects, safety, and vaccine effectiveness in plain and understandable language.

REMIND patients that influenza vaccines protect them and their loved ones from serious influenza illness and influenza-related complications.

EXPLAIN the potential costs of getting influenza, including serious health effects, time lost (such as missing work or family obligations), and financial costs.

We thank you for collaborating with us on improving the care and the quality of life forour members.
VillageCareMAX Patient/Provider Experience

Consistent patient/provider engagement is a priority for the VillageCareMAX provider network. We are committed to supporting our providers in delivering the highest quality care and experience. 

On an annual basis the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) conducts a survey asking patients about their experiences with their providers. The survey includes questions about provider communication, ease of access to health care services, and coordination of care. This survey is conducted each year between March and June. 

Member experience continues to become increasingly important, as CMS will be increasing the weight given to member experience measures when determining a health plan’s Medicare Star Rating. Positive member experience improves clinical outcomes and leads to enhanced quality of life for members. 

VillageCareMAX’s goal is to collaborate with you to help improve the member experience and raise the quality score on our CAHPS measures. Key measures and actions that will help us improve scores include: 

  • Provide your members with a pneumococcal vaccine if they are eligible in addition to the flu shot
  • Make scheduling an appointment as easy as possible and assure patients receive reminders about their appointments
  • Communicate with the patient upon arrival in the office and offer explanations if you are running late
  • Ensure patients don’t feel rushed when talking about their care and ask patients how you can help them improve their health
  • Share test results with members and findings from other specialist that have been provided and discuss and review the patients current medications
  • Partnering with our providers is key to the patient experience and we are here to support you.
VillageCareMAX Physician Network Pharmacy Corner
MedImpact’s Specialty Pharmacy Network

MedImpact offers VillageCareMAX participating physicians a direct delivery program to the office setting for a select list of specialty medications. Examples include Prolia, Invega, etc. Please see link for a complete list on the formulary section below.

Direct delivery to the practice reduces the administrative burden of office staff and eliminates the need to buy and bill. A clinical pharmacist will assist the physician team in shipping the medication just in time for the members’ medical office appointment.

Refills will be managed by the MedImpact team who will contact your office in advance of all deliveries to ensure the regimen is current and accurate.

For additional information on how to enroll and participate in this program go to: https://www.medimpact.com or call toll-free at 1-855-873-8739 (TTY dial 711)

Customer Service Hours
Monday-Friday: 7:00 am - 7:00 pm Central Time
Saturday: 8:00 am - 4:00 pm Central Time
Real Time Benefit Check

Save time by improving care efficiency and cost management:
Real Time Benefit Check is a new program implemented by CMS in early 2021 for all Medicare Part D plans. The program was designed to assist clinicians with real-time patient specific point of care prescribing information using technology. Real Time Benefit Check (RTBC) offers member-specific cost and coverage details, including low-cost therapeutic alternative drugs and preferred alternative pharmacy networks, to help reduce member/plan cost and improve formulary adherence. Please feel free to contact MedImpact at [email protected] should you have any questions.

This program is a collaboration of PBMs and electronic medical records (EMRs) to help address the challenges faced regarding preferred formulary medications, prior authorization rules and identifying the most cost effective pharmacy to dispense the medication. This includes retail, mail order and specialty pharmacies. Getting patients the right medication, faster, with no interruption to care and at the best price will improve care overall and result in less disruption to the physician office

Please watch out for messages or flags from your EMR regarding formulary and pharmacy alternatives when prescribing for our members.

Please refer to our website for pharmacy information for a complete list of covered prescription medications (formulary) which includes the most current information on Step-Therapy (ST), Prior Authorizations (PA) and Quantity limits (QL).

VillageCareMAX 2021 Formulary

VillageCareMAX 2022 Formulary

Included in this update:
  • Drug Cost Management
  • Medication Adherence Matters
VillageCareMAX Provider Portal
As a reminder, the VillageCareMAX Provider Portal is a quick, convenient and secure way to verify member eligibility, review claim status, verify authorization status and much more.
The portal is available 24 hours a day, 7 days a week and can be accessed by visiting: