A bi-weekly newsletter from your physician organization to keep you informed of today's healthcare news

The Physician Alliance continues to support member practices with connecting patients to non-medical health needs. Addressing these social determinants of health needs helps improve the health and well-being of patients.

Examples of support provided:

• Medical equipment
• Food resources
• Transportation
• Employment assistance
• Clothing, home supplies, diapers, etc.

These services are complimentary to practices participating in BCBSM’s Physician Group Incentive Program (PGIP) through TPA. TPA members can submit a request for community health resource support through the secure member portal. Log in at tpaportal.org and click on the ‘SDOH referral’ link. Complete the form and one of TPA’s community health workers will contact the patient and follow up with the practice.

Michigan State Medical Society (MSMS) recently published a white paper co-authored by TPA’s board chair, Dennis Ramus, MD. The paper, Strengthening

Health Care Delivery in Michigan: Physician Workforce Recommendations, focuses on ‘solutions to strengthen the health care system and improve population health.’

A subcommittee, led by Dr. Ramus, brought experts from organized medicine, academic medicine, health policy, and private and governmental payers and agencies together to study the primary care physician shortage and other critical pain points impacting Michigan healthcare. Dr. Ramus is a family medicine physician at Bay Area Family Physicians, a member of the MSMS board and the MSMS representative on the BCBSM board of directors. Read the full paper here.

Medical practices are evolving constantly. New vendors, new workflows, staff working remotely, and other tweaks change how practices operate on a daily basis. Most of these changes are made for good reasons. However, few are made with HIPAA in mind.

That gap is where risks accumulate.

Adding a cloud-based scheduling tool, switching to a different patient messaging platform, bringing on a new billing vendor - none of these feel like security decisions in the moment. But each affect how protected health information moves, who can access it, and where it ends up. A risk analysis that was accurate 18 months ago may not reflect how the practice actually operates today.

The Office for Civil Rights recently announced settlements connected to ransomware investigations, a pattern that underscores what regulators have been signaling for years: they want to see documentation that healthcare organizations have genuinely thought through their risks, and not just filed paperwork.

For most practices, this doesn't require a sophisticated security program. It requires honest answers to a handful of questions:

• Who can access patient records?
• Are staff connecting remotely through secured tools?
• When did someone last test the backups?
• Are business associate agreements current for every vendor?
• Have employees been trained to recognize phishing attempts?

The harder question is whether the practice has a process for revisiting these things when something changes. A risk analysis written at the start of the year can go stale quickly. New software, staffing changes, even shifts in how patients communicate. Any of the aforementioned changes can introduce vulnerabilities that weren't there before.

Keeping the analysis current isn't just about regulatory compliance. It's one of the more practical things a practice can do to reduce the likelihood of a disruptive incident and to demonstrate, if questions ever arise, that patient information was taken seriously.

Source: Rickard & Associates, one of TPA's Affiliate Partners, provides extensive legal knowledge on a variety of business issues to TPA members. For more information, contact Lori-Ann Rickard at info@larlegal.com, (586) 498-0600.

Reviewing patient gaps in care just got easier! With healthcare constantly changing, it’s helpful to have easy access to important data that can help improve patient care and practice quality.

The Physician Alliance is committed to assisting member practices in delivering high quality, patient-centered care. That’s why the secure member-only portal was expanded to include the ‘Gap App’ platform – providing an easy, user-friendly opportunity to view patients with outstanding gaps in care in one secure location.

Housed within TPA’s secure member portal, this additional data lets practices focus on closing gaps in care for all payer patient lists.

Some Gap App features include:

• access patients with gaps in care
• filter and sort patients by measures, date, physician and more
• indicate action taken by staff (scheduled appointment, entered into Healthy e-Blue, etc.)
• utilize this data to close gaps in care for improved quality measures and patient health

Accessing all patient gaps in the member portal*

1. TPA members participating in BCBSM’s Physician Group Incentive Program (through TPA) can access the patient gaps data in the secure member portal (visit tpareporting.org).
2. Once logged in, a “GapPatients” tab will be located on the left side menu. After clicking the tab, the user will view their practice’s current patient gaps in care list (PHI level reporting must be enabled to view this tab).*
3. Users can view patients with outstanding gaps in care. The data also includes specific measures (with gaps), date/deadline to close the gap for credit, assigned provider, patient contact info and more.

*Additional security factors must be implemented to access protected health information (PHI) on the portal. Please contact your practice resource member if your practice is interested in receiving PHI level reports on the portal.

The hidden disparity built into healthcare interoperability, Becker's Health IT

What You Need to Know about the Final Rules for Medicaid Work Requirements Kaiser Health News

GLP-1 Therapies Silence Spontaneous Physical Activity, Neuroscience News

Study Linking Vaccines to Autism Retracted, MedPage Today

Telehealth Booms as Demand for GLP-1s Surges and Questions Mount About Safety, Oversight, Kaiser Health News

Primary care doctors raise alarm as telehealth companies get involved in obesity drugs, NPR