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The PULSE of The Physician Alliance
Friday, Sept. 27, 2019
Electronic community resource system helps assist at-risk patients
Screening patients to address social determinants of health helps improve health outcomes in populations. Quickly sharing appropriate community resource referrals can help address barriers to improve patient health.

In an effort to support practices and patients, NowPow , a secure, HIPAA-compliant community resource information system, was selected to address social determinants of health issues identified from patient screenings. 
 
The NowPow database provides resources based upon a patient’s zip code location. These include food, shelter, transportation, affordable medications, mental health support and more. Community resources are screened and validated prior to being added to the directory, and then vetted twice annually. Practices can share resources with patients through printed copies, email or text messages.

There is currently no charge for practices to access NowPow, however, licenses are limited and consistent use of the tool is expected to maintain a license. There are two steps to get started with NowPow:

  1. Click here to complete a short registration survey.
  2. A one-hour training webinar must be completed before a username and password is issued. Due to the limited availability of licenses, usernames and passwords will only be issued to office managers. Dates for upcoming registrations are as follows:
  • Oct. 8, 12pm: Click here to register for this date 
  • Oct. 24, 12pm: Click here to register for this date
  • Nov. 12, 12pm: Click here to register for this date
  • Nov. 21, 12pm: Click here to register for this date
 
Please feel free to contact Francine Burley at Francine.burley@thephysicianalliance.org  or Roseanne Paglia at Roseanne.paglia@ascensionn.org for additional information.
Quality webinar focuses on emergency department utilization
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Join The Physician Alliance on Tuesday, Oct. 1 from 12-1pm for a special quality webinar on decreasing emergency department utilization. The target audience is primary care practices.

Contact Sharon Kraydich at sharon.kraydich@thephysicianalliance.org to register for the webinar (access information will be provided after registering).
TPA staff fights cancer in Washington, DC
In early September, Heather Hall, vice president of communications for The Physician Alliance, and Darcy Schaefer, palliative care coordinator at Ascension Michigan, participated in a cancer advocacy event in Washington, DC.

Heather and Darcy are the constituent team lead volunteers for the American Cancer Society Cancer Action Network in their respective Congressional districts, serving as the key contacts for state and federal legislators in the fight against cancer. During this event, they met with U.S. senators and representatives to discuss the need for increased funding for cancer research, palliative care training for healthcare workers, closing the loophole in colorectal cancer screening in Medicare patients, and tobacco control.
Coding Corner: Risk Adjustment & HCC coding
In fee-for-service medicine, physician services are paid based on the fee associated with the procedure code(s) submitted to the payer. The diagnosis code supports the medical necessity for the service and tells the payer why the service was performed.

Insurance companies measure the acuity of a group of patients by demographic distribution and by diagnosis coding submitted for payment. As healthcare systems transition from fee-for-service to pay-for-performance, more groups will have these types of adjustments made to their overall payments.

Hierarchical condition category ( HCC) diagnosis codes reported on your claims directly influence a patient’s risk score. HCC codes (as with any additional diagnoses ) require MEAT documentation. All additional diagnoses require one element of “M.E.A.T.” documentation that pertains to: Monitoring, Evaluating, Assessing, and/or Treating.

Two diagnostic coding guidelines to remember:
  1. “Chronic diseases treated on an ongoing basis may be coded and reported as many times as the patient receives treatment and care for the condition(s).”
  2. “Code all documented conditions that coexist at the time of the encounter/visit and require or affect patient care treatment or management. Do not code conditions that were previously treated and no longer exist.”

There are three types of diagnosis codes:
  1. Low level: diagnosis codes that are not chronic conditions
  2. Mid-level: chronic conditions that do NOT carry weight towards HCC coding
  3. High level: HCC codes
 
Example of Dermatology patient documentation with HCC codes:
  • Monitor: HgbA1c 5.5 (Diabetes), BMI 42.3 (BMI Z68.41) and (Morbid Obesity E66.01)
  • Evaluate: Patient follows with psychiatrist; Compliant on oral medications; reports stable mood (Major Depression)
  • Assess: Neutropenia, due to inherent immune abnormalities - Lupus. Follow-up with HemOnc (Neutropenia) (Lupus)
  • Treat: Cleansed wound at the base of the stump with saline, applied skin barrier film to surrounding skin, applied Kaltostat to pressure ulcer base and covered wound with Duoderm (Pressure Ulcer)(Acquired Absence of limb)

Source: Ethica, a wholly-owned subsidiary of TPA, offers diagnostic coding services. Visit www.ethicaholdings.com for more information.
Are you ready to retire?
Does your vision of retirement align with the facts? Here are some noteworthy financial and lifestyle facts about life after 50 that might surprise you. 
 
Retirees get a slightly larger standard deduction on their federal taxes. T his is true for all taxpayers aged 65 and older, whether retired or not. The current standard deduction for an individual taxpayer in this age bracket is $13,500, compared to $12,200 for those 64 or younger.  
     
Retirees can still use IRAs to save for retirement. There is no age limit for contributing to a Roth IRA, just an inflation-adjusted income limit. A retiree can keep directing money into a Roth IRA for life, provided they are not earning too much, and can potentially contribute to a traditional IRA until they turn 70½.
 
A significant percentage of retirees are carrying education and mortgage debt. The Consumer Finance Protection Bureau says that the population of U.S. borrowers aged 60 and older who have outstanding student loans grew by at least 20% in every state between 2012 - 2017. In more than half of the 50 states, the increase was 45% or greater. The Federal Reserve's recent Survey of Consumer Finance found that more than a third of those aged 65-74 have outstanding home loans; nearly a quarter of Americans who are 75 and older are in the same situation.
           
About one in three seniors who live independently also live alone. The Institute on Aging notes that nearly half of women older than age 75 are on their own. Compared to male seniors, female seniors are nearly twice as likely to live without a spouse, partner, family member, or roommate.
   
Around 64% of women say that they have no "Plan B" if forced to retire early. A survey from the Transamerica Center for Retirement Studies found most women would have to completely readjust and reassess their vision of retirement and redetermine their sources of retirement income.
   
What financial facts should you consider as you retire? What monetary realities might you need to acknowledge as your retirement progresses from one phase to the next? If you have not met with a financial professional about your retirement savings and income needs, you may wish to do so. When it comes to retirement, the more information you have, the better.  
 
Source: VantagePointe is a member of TPA’s Affiliate Partners Program. For more information on these tips and the special benefits available to TPA members, click here .
News You Can Use
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The Pulse is the bi-weekly e-newsletter from The Physician Alliance, one of Michigan's largest physician organizations serving more than 2,200 primary care and specialty physicians.
www.thephysicianalliance.org - (586) 498-3555