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Clinically Integrated Network Newsletter
March 25, 2022
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All You Need to Know about the 2022 Clinical Integration Program
This year, the CI Program has three components:
- Quality Performance Metrics (QPM) Program (no changes from 2021)
- Clinical Documentation Metrics (CDM) Program (updated from 2021)
- New in 2022: Efficiency Performance Metrics (EPM) Program
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Submit a Patient Case for an Upcoming Mind Matters ECHO Session
Do you have a case to present? Email Anitha Iyer, PhD to discuss your potential case. We're seeking cases related to suspected or diagnosed depression. Submit your case to the MSHP Behavioral Health Team.
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Register for upcoming meetings
April 13, 2022
May 11, 2022
June 8, 2022
July 13, 2022
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Dr. Bruce Chung on Managing Behavioral Health Needs in Primary Care
We asked Dr. Bruce Chung, MD of City Care Family Practice about his experience participating in Mind Matters ECHO and managing behavioral health needs as a primary care physician.
What do you think are some of the strengths primary care providers have in managing behavioral health care needs?
Probably the biggest advantage primary doctors have is that they take insurance. Many psychologists or psychiatrists do not accept insurance so patients cannot afford a visit.
But, when they are in the office for their physical, a sick visit or a chronic problem there is an opportunity to engage them regarding their mental health issue. Having a good approach and the confidence to follow through can help many patients get through their problem.
Of course it is important to learn how to code for these extra services that you are providing so that you can be paid for the time spent managing behavioral health.
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Schedule the mobile mammography van to visit your practice
Mount Sinai's mobile mammography van visits all five boroughs* and provides breast cancer screening services for women 40 and over who have not had a mammogram in the past year and show no signs or symptoms of the disease.
We offer high-quality, state-of-the-art, digital 3D mammography technology, called digital breast tomosynthesis. It produces images of breast tissue in one-millimeter-thin layers.
Call EZMAMMO (844-396-2666) to schedule. Remember that breast cancer screening is a quality metric for all PCPs in the CIN.
*The mobile mammography van cannot visit Long Island at this time
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Payer Plan Quick Guide for Voluntary Practices
Use this grid to see which products you are participating with through each health plan via your enrollment in the CIN. Please note that providers are required to check eligibility/verify coverage before care is provided.
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Oral Antiviral COVID-19 Treatment of Non-Hospitalized Patients with Paxlovid is Available
Paxlovid is 88% effective in preventing progression to severe COVID-19. Eligible patients are high risk patients age 12 or older, and it should be given within 5 days of symptom onset, with positive COVID-19 test, vaccinated or unvaccinated. Use the COVID-19 Therapeutics Locator to find a distributing pharmacy.
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SARS-CoV-2: Three Leading Microbiologists Discuss the Path Forward
Peter Palese, PhD, Horace W. Goldsmith Professor and Chair of the Department of Microbiology, and Florian Krammer, PhD, Mount Sinai Professor in Vaccinology— weigh in on the future of SARS-CoV-2 and its place in our lives. They, and their colleague, Adolfo García-Sastre, PhD, the Irene and Dr. Arthur M. Professor of Medicine, recently created a low-cost COVID-19 vaccine that can be manufactured wherever influenza vaccines are made—particularly in low-and-middle-income countries. The scientists are also working on a universal flu vaccine, which would confer immunity without having to be administered annually.
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Board Bulletin
MSHP Board of Managers Spotlight: Dr. Stephen Sisselman
Meet our newly elected Board of Managers Member, Stephen Sisselman DO. Dr. Sisselman is a member of MSHP’s clinically integrated network and practices internal medicine at the Sisselman Medical Group PC. We recently caught up with Dr.Sisselman to learn more about him as he begins his journey as an MSHP Board member!
What do you hope to accomplish while serving on MSHP’s Board of Managers?
I hope to work with the Board on improving the population health of the communities we serve while enhancing the quality of the physician experience within our clinically integrated network. I am passionate about population health and have extensive executive board experience in helping to guide organizations in becoming and staying successful in value-based care.
What are your interests/hobbies outside of work?
I enjoy learning to play golf. I'm also interested in medical technology and its uses in improving the practice - doctor - patient interaction.
We look forward to Dr. Sisselman serving on MSHP’s Board of Managers!
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Interested in becoming involved in MSHP’s governance?
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View Your Health Plan Participation Summary
Did you know that you can view what payers you are participating with and the date that you are active with each payer? Sign in to the MSHP Provider Portal and click on the “Payer Contracts” tile and then the “Health Plan Participation Summary” link to view your customized report. Keep in mind that MSHP’s provider data is sent to each payer on a schedule and that your participation date with a payer is dependent on the payer’s data processing. It can take 60-90 days for a payer to update their provider roster after MSHP’s submission. If you are a Practice Administrator who would like to request access to the Health Plan Participation Summary report, please contact your Provider Support Specialist or the MSHP Provider Services team at MSHP@mountsinai.org or 1-877-234-6667.
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Updates to UnitedHealthcare Claim Payments
Effective June 1, 2022, UnitedHealthcare is no longer sending paper checks for claim payments. Learn more.
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Welcome New MSHP Providers!
We'd like to extend a warm welcome to all new provider members who recently joined our clinically integrated network.
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Primary Care
Sophia Y. Arain, MD
Pediatrics
Metropolitan Pediatrics NYC PC
New York, NY
Asra Hussain, MD
Family Medicine
Bethany Medical Clinic of New York, PLLC
New York, NY
Specialty Care
Joseph A. Hanono, MD
Diagnostic Radiology
Radiology Associates of Brooklyn
Brooklyn, NY
Anna W. Kong, MD
Family Medicine
Telemedicine Associates, PC
Brooklyn, NY
Elizabeth J. Loewy-Vukic, MD
Allergy & Immunology
Elizabeth J Loewy-Vukic
New York, NY
Samantha B. Lowe, DO
Obstetrics & Gynecology
Goncharov Medical PC
New York, NY
Alfred Shtainer, MD
Urology
Alfred Shtainer, MD, PC
New York, NY
Usama Syed, MD
Dermatology
Bobby Buka MD, PC
New York, NY
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Patrice T. Thorpe, MD
Family Medicine
Telemedicine Associates, PC
Brooklyn, NY
Frederick M. Wang, MD
Ophthalmology
Frederick M. Wang
New York, NY
Sophia Wu, MD
Obstetrics & Gynecology
Goncharov Medical PC
New York, NY
Advanced Care Practitioners
Jordan Beyar, NP
Nurse Practitioner
Frank Scafuri III, DO, PC
Staten Island, NY
Richard D. Devera, NP
Nurse Practitioner
Frank Scafuri III, DO, PC
Staten Island, NY
Trixie Kioko-Kamps, CNM
Certified Nurse Midwife
Lower Manhattan Medical Care PC
Brooklyn, NY
Nicole Meade, CNM
Certified Nurse Midwife
Lower Manhattan Medical Care PC
Brooklyn, NY
Arina Zudenko, PA
Physician Assistant
Upper East Side Medical, PC
New York, NY
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Communicate appropriate ED use and ways to access same-day care with patients
To reduce unnecessary ED utilization, ensure your patients understand when it's appropriate to go to the ED, and what alternatives they have to access same-day care. Whether that's at an urgent care center or in your practice, educating your patients can help reduce unnecessary visits to the ED.
Share this flyer to help your patients know where to go for care.
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Chronic Condition Management |
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Updated! Mount Sinai Heart Failure Ambulatory Care Pathway
- SGLT2i have been added to recommended medication dosing and figures, as the American College of Cardiology (ACC) has updated their guideline
- When to refer to device therapy
- When to refer to cardiac rehab
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Pediatricians: Review Your Customized Reports
Voluntary pediatricians in our network received customized value-based care performance reports in their One Drive accounts on February 28. Please be sure to view these reports to see how you’re performing on efficiency and quality metrics for Value Based Care patients. The patient opportunity report includes patient-level information on care and documentation gaps. Use this report to inform your patient outreach strategy.
Coming soon: Reports for PCPs who treat adults will be available at the end of March.
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Medical Malpractice Insurance Discount
As members of MSHP’s clinically integrated network, you are eligible to receive discounted rates on medical malpractice insurance offered by TDC Group, an organization founded and led by physicians. Please refer to this flyer for more information on this offer, including examples of premium rates. You may request a quote at thedoctors.com/nyquote or by contacting Brian Dalton at TDC Group at Brian.Dalton@thedoctors.com.
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If you have any questions about any of our announcements, please contact your Population Health Manager, email Mount Sinai Health Partners at mshp@mountsinai.org or call us at 877-234-6667.
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P: 877-234-6667
F: 646-537-1481
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