The PULSE of The Physician Alliance
Friday, May 10, 2019
Help diabetic patients control chronic condition, live a healthier life
With more than 100 million Americans living with diabetes or prediabetes, it has become a leading health crisis. Diabetes kills more Americans every year than AIDS and breast cancer combined, according to the American Diabetes Association. Properly managing patients with diabetes and prediabetes can improve a population's health and lower cost of care.

Below are suggestions for improving outcomes for diabetic patients:
  • Robust bi-directional communication between the specialists (endocrinologists, nephrologists) and the patient’s primary care physician.
  • Compliance with quality standards of care as outlined in HEDIS guidelines.
  • Embed a care manager in your practice to assist patients in navigating their care.
  • Engage care managers in all practices that touch the diabetic patient to coordinate care.
  • Implement self-management processes in your practice to educate patients on how to manage their chronic condition.
  • Refer patients to a diabetic education program such as the Diabetes Personal Action Toward Health (PATH) program (click for information on this program)
  • Screen for and address social determinants of health!
  • Share TPA's diabetic education materials with your patients. Click here to download and/or order online.
  • Accurately code for comprehensive diabetic care - this HEDIS condition specific tip sheet can help.
Website offers pediatric resources
The Physician Alliance provides materials for practices to educate and communicate with patients of all ages, including the younger generation (and parents). There are asthma self-management and healthy lifestyle self-management forms and non-prescription antibiotic pads (to help not prescribe unnecessary antibiotics) available on TPA's website .

If there are patient education materials that would be useful to practices for improving patient education, communication and quality metrics, please send suggestions to the corporate communications department for consideration.

HEDIS tip sheets are also available on TPA's Learning Center .
Provider Delivered Care Management seminar slides available
The Physician Alliance recently hosted a Provider Delivered Care Management seminar in partnership with Blue Cross Blue Shield of Michigan.The seminar touched on validating eligibility for PDCM services, improved proficiency in the billing of the 12 PDCM codes and 2019 changes.

Click here to view the presentation slides now available on TPA's website.
Managing medication errors and liability
Medication-related errors and liability are cited as the fourth most common root cause of claims, after diagnostic, surgical/procedural, and medical management issues, and ahead of obstetrics-related issues.

Here are some tips and information to help lower your liability risk:

  1. Problems are most likely to arise in the first and last steps of the medication episode of care: ordering and monitoring/management. Common themes include computational and prescribing errors and medication reconciliation.
  2. Different patients face different risks. Our littlest, largest, youngest, and oldest patients are at highest risk of medication errors.
  3. The implementation of appropriate safety measures, systems, technologies, and training saves lives. Practitioners need support if they are to make vast reductions in the incidence and severity of medication-related errors. That support comes from nearly every place in the organization, including IT and HR.
  4. Different settings create different opportunities and challenges. Forty-two percent of medication errors occur in an office or clinic setting and 31 percent are related to inadequate monitoring of a patient’s medication regimen, according to Coverys claims data. The majority of medication-related claims stem from general medicine (internal, family, etc.) followed by sub-specialties.
  5. Opioids and anticoagulants are unlike any other types of medication. These drugs perform vital functions, yet carry grave risks. As the use of opioids and anticoagulants continues to be increasingly common in the U.S., so too are the injuries and deaths that result from vulnerabilities in the ordering, dispensing, administration, and management and monitoring of these drugs.

Did you know? The U.S. Food and Drug Administration makes 400-500 clinically relevant changes to previously approved drug labels each year. Sign up for the PDR Alert Network at to receive email alerts when substantive changes are made to medication labeling—such as warnings not to prescribe a specific drug to certain patients or information about drug interactions. You can also earn CME credit by taking short quizzes to demonstrate knowledge of information shared in the alerts.

Read the complete article and more tips.

Source: Coverys , a member of TPA's Affiliate Partners Program, offers medical malpractice insurance, risk analytics and risk management services.
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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. - (586) 498-3555