Keys to Success in Value-based Care Systems

By Carlos Jackson, Ph.D. and Paul Mahoney, Community Care Physician Network

2022 Alliance sponsor feature article courtesy of Community Care of North Carolina

The movement to value-based payment systems occurring simultaneously with a pandemic and, in North Carolina, sweeping changes to Medicaid, has made for an incredibly challenging environment for medical practices, particularly independent practices. This new environment requires new workflows and new approaches to managing patient panels.

The good news is that, working together, independent practices can still thrive in this new environment. In supporting the more than 900 practices in the Community Care Physician Network (CCPN), we’ve identified four critical keys to success, highlighted in the graphic below. At CCPN we work with practices where they are, share best practices pioneered by similarly-situated practices and help them find practical solutions to daily challenges.

CCPN exists to help member practices thrive financially, provide high-value care, and enable providers and patients to maximize their satisfaction with the practice of medicine. CCPN is governed by practicing, community-based physicians.

We have found that for many practices, the most challenging piece of this puzzle is making the best use of data. Practices are awash in data, but can they parse it intelligently to pull out what is actionable, and identify the information critical to hitting the metrics that drive present and future revenue?

Click on image to enlarge

CCPN has made significant investments in tapping into the potential of EHR clinical data without practice staff needing to devote significant time in making sense of it all. Through new tools and innovative partnerships, we have built an infrastructure to help our network practices identify opportunities to close care gaps, improve quality and patient engagement and ultimately hit metrics that satisfy payer bonus arrangements, generating significant additional revenue critical to the long-term financial viability of the practice.

Practice Perfect^SM Dashboard
Designed with busy practices in mind, Practice Perfect^SM is a Tableau-based business intelligence tool that distills complex information from multiple data sources, identifying actions you can take right now to boost quality and improve performance. Recommended Actions^SM are an efficient and unique way of viewing worklists taking multiple patient and practice factors into account in order to help you prioritize long lists of care gaps.

The dashboard synthesizes claims, hospital visits, and individual risk scores to prioritize patient needs, as well analyzes the cost, utilization, and disease burden of a practice’s Medicaid patient panel. The dashboard also provides monitoring of performance on contract measures to inform practices of their progress on meeting contract measures. Users can quickly create targeted patient lists to determine where to best focus resources and improve performance. Additionally, Recommended Actions^SM integrate with clinical and scheduling data, as well as ADT and immunization feeds from outside vendors, for more actionable and up-to-date guidance. The dashboards are organized in a way to not overwhelm the provider and offer just enough information to help them be successful.

VirtualHealth™ Provider Portal
The VirtualHealth^TM Provider Portal connects practices with their CCNC Care Management team – partners for improving patient outcomes. This provides secure access to Medicaid patient care management documentation, comprehensive needs assessments, and care plans. Through the portal, clinicians can make referrals to care management and enjoy secure communication with patient care teams. Clinicians can view patient history from claims, pharmacy, and hospital data – keeping them “in the know” regarding what care patients are receiving from outside their practices.

Value-based Informatics Program (VIP^SM)
CCPN has significantly upgraded technology that supports practice success under value-based contracts across all payers and populations – at no additional cost to our CIN practices. We pull clinical data from practice EHRs to measure quality more easily. This greatly helps practices generate bonus payments from insurers. Our system also gathers appointment data to help practices better capitalize on Recommended Actions^SM. We alert practices to care gaps and opportunities to improve the accuracy of RAF scoring. We do this by joining EHR data with claims data for a more comprehensive view of patient care that yields improved insights. These tools also reduce administrative burden on practice staff. We are also piloting some in-line prompting tools that will provide practices with real-time alerts at the point of care. We believe that putting information in the hands of providers at the right time is one of the keys to success in value-based contracting.

While the environment for primary care practice won’t get easier anytime soon, help is available from your peers and CCNC. Together, we can help you find a path to financial strength and greater satisfaction with the practice of medicine for you, your staff, and your patients.

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Community Care Physician Network (CCPN)
CCPN is a physician-led, clinically-integrated network that helps independent primary care physicians deliver high-quality, cost-effective care. CCPN priorities are helping practices thrive financially, provide high value care, maximize provider and patient satisfaction, and take charge of their own destiny.

Efficient and Effective Pathways to Value-based Care

By Dr. Kenneth Persaud

2021 Alliance sponsor feature article courtesy of Sharecare

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Partnering to Create an Expandable Framework
for Value-based Care Success

Summary:

White-Wilson Medical Center Fort Walton Beach, Florida employs 80 physicians and advanced practice clinicians and had a goal to move to value-based care contracts with payors to improve care and reimbursement.

About White-Wison:

Founded in 1946, White-Wilson Medical Center occupies a unique position on Florida’s Emerald Coast as the largest, multi-specialty, outpatient physician group in the region. With locations in Fort Walton Beach, Crestview, Destin, Navarre, and Niceville, White-Wilson has the community’s largest team of physicians, specializing in more than 20 areas of medicine. In addition to primary and specialty care, White-Wilson offers immediate care services for any urgent care needs at each of its clinics.

The amount we learned from Sharecare is incredible. I can’t say enough about how much they taught us about the value-based care business, the market, and how to apply that learning going forward. Sharecare has been crucial to that process.

Mark Wiacek, Chief Operating Officer, White-Wilson Medical Center

The challenge:

Decreasing reimbursements from the fee-for-service model was limiting growth in revenue and patient outcomes and satisfaction. It was critical to the practice to remain independently owned in a competitive market. Value-based care contracts with Medicare and other payers offered a path to greater growth and better patient care, but the White-Wilson team had no experience in this area and needed expert resources to help them drive these programs. They found that just hiring people didn’t work – they needed processes and technologies to support this transition to value-based care.

Creating an ACO involves putting a framework, including a governing board, into place to provide the coordinated, high-quality, efficient, and effective care that is the goal of the ACO program. The program also offers benefits to providers: when an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program. The program is not without risk, however, as ACOs that do not deliver effective care can lose money. Sharecare engaged as a full partner in this case, offering a contract that shared both risk and reward.

In addition, the coordinated care that is at the core of an ACO program increases emphasis on patient services that positively impact outcomes, such as wellness visits and transition care upon hospital release. These services also offer expanded opportunities for reimbursement and revenue growth.

Sharecare’s team offered expertise, guidance, processes, and technologies to support White-Wilson in their transition to value-based care. In 2016, White-Wilson started their journey by participating in the Medicare merit-based incentive payment system (MIPS), with Sharecare offering technologies that augmented the White-Wilson electronic health record (EHR) systems to produce the data required for value-based care. By 2017, the team had the data benchmarks they needed to create the White-Wilson ACO. In 2018, White-Wilson added risk-adjustment audit services to their ACO contract with Sharecare. By 2019, White-Wilson had won a value-based service contract with a major payor in the market.

Consultative collaboration was the key to success.

The augmentation of the White-Wilson EHR system with Sharecare technology bridged deficiencies in the EHR system to enable the value-based care reporting required by the MIPS program while putting off a costly upgrade to the EHR system that would otherwise have been necessary. The collaboration ensured that White-Wilson’s MIPS program stayed out of penalty and was awarded a “Top Performer” bonus.

The White-Wilson ACO, now serving around 100,000 patients, demonstrated quality improvement scores in the 94th percentile in each year, cost reductions of more than $3M over three years, and improved patient-satisfaction scores through the program along with over $6M in revenue on value-based payments with other payors. White-Wilson was able to put the necessary systems into place to ensure that they avoided penalties, and in those three years, 2017-2019, they saved between $700,000-$1,400,000 a year with Medicare.

White-Wilson’s ACO generated substantial revenue gains by doubling annual wellness visits and post hospitalization transition visits over the same period, with 2021 already on track to continue this trend. Most importantly, White-Wilson’s patients have received better, more coordinated, and effective care through these programs.

White-Wilson was able to develop payor-agonistic strategies and has already expanded the framework to private-payor value-based contracts. With this framework, they found that they could build an organization to manage a larger population and generate higher revenue without adding any full-time employees. In 2019, White-Wilson landed a sizeable multi-year agreement that will bring significant revenue to the practice. The momentum is built in the direction of more of these kinds of private-payor contracts in the future.

White-Wilson has adopted other Sharecare solutions, including diabetes management programs to optimize care, close gaps, and maximize revenue for their more than 24,000 eligible diabetes patients. The practice is also an early adopter of the Sharecare telehealth platform, which allows them to address patients’ important healthcare needs safely and conveniently remotely.

In the future, White Wilson is planning to expand to commercial private-payor value-based contracts and continue the partnership with Sharecare to offer more services to patients and expand revenue in key markets.

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Image 1 (left): Sharecare Value-based care patient population view
Image 2 (right): Sharecare Individual patient care gap closure view
(Click on each image for a larger view)

About Sharecare:

Sharecare value-based care enables payors to work with providers to offer the right care at the right time, improve population outcomes and the member experience while reducing per capita costs for healthcare. Sharecare is an all-inclusive value-based payments platform to help achieve better and more sustainable financial outcomes.

Sharecare offers the strength of many trusted individual solutions, with options to bundle each component and create unified actionable metrics that drive intelligent decision support for the entire healthcare ecosystem.

All together, better.

Want to know more about how to duplicate White-Wilson’s success? Contact us!

The 411 on HITECH and HIPAA IT Compliance

By Judi Grassi

2020 Alliance sponsor feature article courtesy of Carolinas IT: A Logically Company

Most group practices and clinics have adopted the Electronic Health Record (EHR). If you’re one of these organizations, you know how imperative it is to keep your Electronic Protected Health Information (EPHI) safe. Both HIPAA and the HITECH Act lay out very specific requirements about data protection and regardless of your size, you are required to keep your Protected Health Information (PHI) data secure. This is especially imperative if your organization electronically transmits health information for financial or administrative reasons, such as claims processing, benefit eligibility, referral authorization requests, and other transactions defined under the HIPAA Transactions Rule.

Three Areas of HIPAA IT Compliance

HIPAA IT compliance is the responsibility of every administrative and clinical staff member in your organization. To make compliance requirements easier to digest, HHS established three areas of HIPAA IT compliance.

1. 1. Administrative — These measures ensure the integrity of patient data and accessibility only to authorized parties. It requires HCOs to:
      • Implement a security management process that identifies potential risks to EPHI and appropriate security measures to reduce risks and vulnerabilities.
      • Designate a security official who is responsible for ensuring HIPAA and HITECH compliance.
      • Identify who has authorized access to EPHI.
      • Provide appropriate security training to employees and follow through with appropriate sanctions against any employee who violates security policies.
      • Perform a periodic assessment to assess the effectiveness of your security policies.
   2. Physical — These measures ensure the security of facilities and devices that contain EPHI. It provides HCOs to:
      • Limit physical access to their facilities to authorized personnel only and protect against physical intrusion.
      • Ensure secure access to workstations and electronic media. This includes procedures for the transfer, removal, disposal, and re-use of electronic media to ensure appropriate protection of EPHI.
   3. Technical — These measures ensure that your IT systems and networks are secure from data breaches and unauthorized access. It requires HCOs to:
      • Protect their IT systems against digital intrusion and ensure that EPHI is transmitted over a secure network.
      • Only allow authorized individuals to access EPHI and ensure IT systems provide an audit trail to track EPHI access.
      • Ensure EPHI is not improperly or erroneously altered or destroyed.

HITECH Compliance

The HITECH Act of 2009 shored up these privacy and security provisions:

• HCOs, business associates, and service providers are all responsible for the security of EPHI.
• HCOs must promptly notify affected individuals whose PHI was compromised.
• HCOs must report any security breach that affects more than 500 individuals to the HHS Secretary.
• HCO business associates must notify the HCO of any breach at or by the business associate.
• Breaches affecting fewer than 500 individuals must be reported to the HHS Secretary on an annual basis.

How to Comply with HIPAA and HITECH Technical Measures
Whether you are a hospital, clinic, medical practice, HCO business associate, or HCO service provider, you will need to address the following in order to comply with HIPAA and HITECH technical measures.

• Develop policies and procedures for data backup and recovery.
• Back up your data on a regular, frequent basis and ensure you can retrieve exact copies of EPHI and restore any lost data. Follow the 3-2-1 backup rule: 3 copies of your data across 2 media with 1 copy stored offsite.
• Establish acceptable but aggressive Recover Time Objectives (RTOs) and Recovery Point Objectives (RPOs) and develop a disaster recovery plan that meets these objectives.
• Periodically test your disaster recovery plan to be sure it works before a real disaster happens.
• Perform an annual risk assessment to determine whether your systems and data are a security risk and how vulnerable you are to attack.
• Develop a data breach response plan to identify who is responsible for what when a breach occurs, how to communicate with individuals whose PHI was compromised, how to handle the media, minimize further data loss, and remediate the breach.
• Encrypt EPHI data in transit and at rest.
• Ensure HCO business associates and service providers meet HIPAA and HITECH security requirements.

Noncompliance Fines
If you are found in noncompliance with HIPAA and HITECH regulations, it can cost you. Fines are based on the violation category or level of perceived negligence and can range from $100 to $50,000 per violation, with a maximum penalty of $1.5 million per year for each violation (see Figure 1).

Figure 1

If you are breached and fined, your organization is listed on the HHS Office for Civil Rights (OCR) Breach Portal and “Wall of Shame” if the breach involves 500 or more individuals. If your organization has a breach of this magnitude, the name of your HCO will be permanently listed.

Final Thoughts

HCOs have two choices when it comes to HIPAA IT compliance requirements: DIY (Do It Yourself) or hire an IT Managed Service Provider (MSP). Whether you are a large or small HCO, you may find that you have limited IT resources and/or skills in-house to ensure your EPHI is private and secure. Therefore, many HCOs look to HIPAA-compliant MSPs to back up their systems, ensure the privacy of EPHI, and provide the best protection from security breaches.

Figure 1: Categories of Violations and Respective Penalty Amounts Available. Source: https://www.federalregister.gov/documents/2013/01/25/2013-01073/modifications-to-the-hipaa-privacy-security-enforcement-and-breach-notification-rules-under-the#h-95

MGMA to Congress: Lift the ban on unique patient identifier

MGMA joined 68 leading healthcare organizations calling on Congress to reject the inclusion of outdated language in Fiscal Year 2021 Appropriations legislation that prohibits HHS from spending any federal dollars to adopt a national unique patient identifier (UPI). Last year, the US House of Representatives voted to remove the ban but the Senate opposed the measure. Removing the prohibition will permit HHS to evaluate a range of solutions that protects patient privacy and is cost-effective, scalable, and secure. Deployment of a UPI would allow practices to more effectively match patient records, decrease medical errors, and facilitate EHR interoperability.

The Cloud and Your Practice

2019 Alliance sponsor article provide courtesy of TriMed Technologies

Is your practice ready to move to the cloud? That can be a tough question to answer. Most respond with, “What exactly is the cloud?” It’s a phrase you hear frequently, but what does it actually mean? We will dive into defining what the cloud means for your practice, then identify the positives and negatives of cloud storage to see if it’s the right fit for you. As you will see, the cloud offers many benefits that simply are not available when you host your own software.

Pretend, for a second, that you take all of the servers in your practice and place them in a secure storage facility. Things work exactly like they did before, but all of your hardware and data are simply hosted somewhere else. Many people believe that this is “the cloud.” In reality, what’s described above – the “your stuff, somewhere else” approach – is simply colocation. Colocation is your data securely stored in server racks with other’s data. This is not a bad option as it allows you to offload physical security and storage, but “the cloud” is so much more than colocation.

The best cloud solutions offer all of the benefits of colocation, but also take full advantage of cloud architecture. With multiple redundant databases for every client, your data is safe in the cloud. The same set of data in your primary zone is simultaneously written to redundant facilities spread across the country. In the event of a catastrophic failure, where one data center is lost, your data would be secure in another location.

A good cloud solution is not dependent on any one server. When load is spread across an array of servers in the cloud, any individual server can experience performance issues (or even crash completely) without affecting users. The affected users will automatically be routed to healthy servers in the array at the first sign of trouble. If you host a server at your practice, this type of setup is not possible. If any one of your primary premise servers crash, your system can go down for hours or even days. In a good cloud environment, the user is completely unaware of the crash.

The cost structure of managing your data completely changes in the cloud. For starters, there is no upfront cost to buy a new server. Practices sink thousands of dollars into on-premise servers that depreciate quickly over time. It is also costly to maintain the operating system on those in-house servers. Then, when you take into account electrical costs, software for protecting your data, and paying an IT company to manage your server, the cost escalates quickly. In the cloud, you pay a monthly fee based on the size of your data. As you grow, your storage space in the cloud grows. Need more storage for your data? The servers automatically scale to fit your needs. You never have to worry about buying a new server, operating system updates, or running out of space.

So what’s the catch? There has to be a negative in moving to the cloud, right? That answer is really practice specific. If you have an extremely weak internet connection, the cloud might not be for you. Luckily, it is rare for a practice to not have access to a reliable internet connection in 2020. Many practices even double up on internet service providers, ensuring that they will have backup access in the unlikely event that their primary internet service goes down. Another drawback could be hardware you already own going unused. If you have recently purchased or upgraded hardware that would be unnecessary in the cloud, this sunk cost could be a tough pill to swallow.

From the software vendor point of view, the cloud provides endless possibilities to improve how you provide healthcare to your patients. Software updates can be turned around in a fraction of the time when compared to updates on-premise servers and they can be applied with no downtime. Bug fixes are similarly painless which resolves client frustration in a fraction of the time it would take on-premise servers. New features can also be flagged as optional for the end user, eliminating the days of practices being forced into software updates that they do not want. The cloud is the future of computing, and the future is bright.

Have questions about how TriMed’s EHR cloud solution could directly benefit your practice? Reach out to us using sales@trimedtech.com or by calling 866-874-6339 x802 and we will be happy to assist!

Primary Care Risk Scoring and Stratification – A Guide for Getting Started

By Joy Key, Director of Provider Services, Emtiro Health

2019 Alliance sponsor feature article courtesy of Emtiro Health

One of the goals set forth by Medicaid Managed Care in North Carolina is to build upon previous successes by “innovating and evolving to improve the health of North Carolinians.”¹ Stated another way, North Carolina aims to address Population Health at a macro level through innovation at the provider level: using robust data and pioneering service delivery to improve care for Medicaid beneficiaries. More specifically, Tier 3 Advanced Medical Home practices will be responsible for risk scoring and risk stratifying all of their Medicaid patients to achieve these goals and to match patient needs to the optimal level of care management at the right time. Resources can be best allocated using a clear and consistent method of patient stratification.

Accurate risk scoring and risk stratification of patients are two foundational principles of successful population health strategies. At the individual level, accurate risk scoring is the first step in developing a person-centered care plan. At the population level, risk stratification allows providers to develop care models that address the needs of distinct patient subsets with similar complexity and care needs, improving health outcomes for both the individuals involved as well as the overall population.

As our health care system moves away from fee-for-service payment and toward value-based reimbursement, providers and payers will have to fully understand the risks of their patient population in order to optimize care delivery. A risk score is simply a metric that attempts to predict aspects of a patient’s care (i.e. cost, Emergency Department utilization, inpatient readmission, etc.) based upon his/her clinical history and compared to a larger, average population. Sounds simple enough. However, risk scoring and patient stratification are data-driven, iterative processes that should involve providers, data analysts, and care management professionals to be the most successful. Methodologies need near constant evaluation to improve accuracy and increase value to the overall Care Management process and Population Health strategies.

A simple search online will reveal a large number of risk scoring and risk stratification methodologies – some very complex and expensive. While appropriate in some systems or populations, bigger isn’t always necessarily better and one size doesn’t fit all. The first step in choosing or designing risk models is a thorough understanding of the population being served.

Understanding the population will help determine how many risk “levels” are appropriate and what factors to include. In the earliest days of risk scoring, health systems used age and gender as simple factors. As large amounts of clinical data became more accessible, chronic disease measures and utilization rates were added to the risk formulas.

Simple scoring could be “Level 1, Level 2, Level 3”; “Tier A, Tier B, Tier C”; etc. A simple methodology might include condition counts, prescriptions, ED utilization, social determinants of health screening, etc. Again, the key to developing an effective risk scoring and risk stratification system is first understanding the patient population.

The second step in designing appropriate models is access to accurate, reliable patient data. Providers and their staff must use high quality data sources to ensure data integrity. Also, understanding subtle differences in types of data is essential – mortality versus morbidity, claims versus diagnostic data, etc. Risk scoring is only as good as the underlying data. A simple cautionary example is diagnostic data. Ample clinical and diagnostic data elements are likely already readily available from a practice’s own electronic health record (EHR), but any variation among providers in clinical documentation and HCC coding from standardized practices could skew results. Missing or inaccurate clinical data will cause the risk scoring and risk stratification to also be inaccurate and inconsistent.

Other considerations for effective Tier 3 advanced Medical Home risk scoring and risk stratification include:

1. Conduct a thorough and realistic assessment of internal resources and capabilities. Developing and implementing risk scoring and risk stratification methodologies will require significant staff time as well as significant expertise in analytics and statistics. If your practice plans to rely upon risk scoring modules within the EHR, Quality, IT, and Care Management staff members must still thoroughly understand the algorithms and understand how to modify them to address your practice’s unique patient population. Additionally, each iteration of the risk models will require staff retraining.
2. Conduct an inventory of the reporting capabilities of your EHR. All of the data you need to risk score and risk stratify attributed patients may be available from payers or it may lie within the clinical documentation system. If staff cannot retrieve actionable data, the risk scoring and risk stratification models will become stagnant and ineffective. Custom reporting may be available, but it should be determined if that strategy is sustainable for the long run.
3. A Tier 3 practice’s risk scoring and risk stratification methodology must be able to incorporate risk scores from each contracted Prepaid Health Plan. Combined with a practice’s own clinical perspective, the risk stratification system yields a broader view of patients’ needs and health status.
4. Whatever risk scoring and risk stratification methodology is selected, it must be used consistently by the entire care team. Everyone must be onboard with the process and understand how to use the information.
5. Evaluate the published aims and objectives of North Carolina’s Medicaid Managed Care Quality Strategy in order to have a complete understanding of what is to be achieved and which enrollees fall into “priority populations.”²

Ultimately, risk scoring and stratification improve outcomes for both providers and patients, which is why it has become a requirement for Tier 3 Advanced Medical Homes. While risk scoring and stratification are complex undertakings, with thoughtful examination of available data, resource capabilities and care delivery goals your organization can succeed in developing a workable system that best suits your patients’ needs and your overall vision for improved population health.

¹North Carolina’s Quality Strategy for Medicaid Managed Care, pg 5, March 20, 2018.
²The Department defines “priority populations” as: enrollees with Long Term Services and Supports (LTSS) needs; Adults and children with Special Health Care Needs; Individuals identified by the Prepaid Health Plan (PHP) as at Rising Risk; Individuals with high unmet resource needs; At-risk Children (0-5); High-Risk Pregnant Women; and other priority populations as determined by the PHP.

NCDHHS Partnering with Appriss Health to Provide Controlled Substances Reporting System Integration

Appriss Health press release published November 26, 2018

The North Carolina Department of Health and Human Services (NCDHHS) will utilize Appriss Health‘s PMP Gateway integration service to provide NarxCare and North Carolina Controlled Substances Reporting System (CSRS) information to prescribers and pharmacists in the state directly within electronic health record and pharmacy management systems.

PMP Gateway is a managed service enabling the integration of the NarxCare platform and prescription drug monitoring program (PDMP) information into electronic health record (EHR) and pharmacy management systems, and other clinical information systems.

NarxCare utilizes, analyzes, and presents information from North Carolina’s CSRS to enable clinicians to better identify patients that may be at risk for substance use disorder, overdose, and death. NarxCare equips these clinicians and care teams with advanced analytics, tools, technology, and invaluable insights that are presented and accessed within clinical workflow. NarxCare provides machine learning and artificial intelligence-based patient risk scores and other information in a visually interactive format to aid prescribers and pharmacists with clinical decision support. NarxCare also helps clinicians connect patients with additional resources within their community if needed, such as medication-assisted treatment.

By delivering NarxCare and CSRS information within workflow through PMP Gateway, this one-click process eliminates the need for prescribers and pharmacists to manually log into the CSRS website separately and then enter a patient’s name and demographics to search for them. By providing easy, instant access to real-time information and insights, Appriss Health helps healthcare providers and pharmacists to better evaluate and quickly intervene on the behalf of patients.

“We are committed to doing everything possible to address North Carolina’s opioid epidemic,” said Mandy Cohen, M.D., Secretary of the N.C. Department of Health and Human Services. “I encourage prescribers and pharmacies to take advantage of these tools, which can save lives by identifying patients in need of treatment.”

By giving prescribers and pharmacists direct access to the state’s PDMP information and NarxCare, North Carolina is further enhancing its aggressive, multi-pronged approach to curbing the opioid epidemic in the state. NCDHHS’ data shows that almost 1,700 unintentional opioid-related deaths occurred in 2017. By enabling NarxCare in clinical workflow, North Carolina is demonstrating its dedication to creating a more useful and powerful technology infrastructure, delivering innovative insights that go beyond basic CSRS data, and defining a care strategy that is necessary when dealing with patients impacted by the opioid epidemic. NarxCare in workflow can help clinicians identify when a potential problem with a patient arises, and alerts clinicians to respond.

“We commend the state and public health officials in North Carolina for all that they have done this year to help confront and control the opioid epidemic,” said Rob Cohen, President of Appriss Health. “It is clear that access to information and insights will continue to be a powerful asset in the fight against drug addiction, and improving the careful management, care, and treatment for those who need it most.”

To learn more about the immediate availability of NarxCare and CSRS information in clinical workflow for all prescribers and pharmacists in North Carolina, visit, please visit https://www.ncdhhs.gov/divisions/mhddsas/ncdcu/csrs/integration.

Which EHR Vendor is Next?

2018 Alliance sponsor article courtesy of Azalea Health

Like the saying goes, the only constant is change. We have come to expect changes in our personal lives, but when it comes to business, unexpected changes can be unwelcomed and disruptive. As the healthcare industry continues to evolve and develop, healthcare executives have sought out mergers and acquisitions as a way of survival. EHR vendor mergers and acquisitions though can be quite disruptive to physician practices. We have seen major EHR vendor transactions in 2018, with the NueMD, AdvancedMD, and Marlin Equity activity being the most recent.

According to a recent Black Book Research report, 30% of physician practices are looking to replace their EHR within 3 years. These EHR replacements happen for various reason, including:

• existing EHR does not meet ONC standards;
• current vendor “sunset” or replaced their EHR;
• current vendor sold or merged company;
• poor customer service

But not all physicians replace their EHR out of despair. Some are proactively looking for an EHR solution that fits their workflow better and has modern, advanced features to take them into the next decade.

With technology critical to the business functions of your practice, it is important to keep a close eye on these five signals that your EHR vendor is serious about planning for the future:

1. Cloud-based
2. Telehealth
3. Interoperability
4. Regulatory Upkeep
5. Patient Engagement

For detailed information on evaluating vendors based on these five factors, download Azalea Health’s eBook, Ensuring Your Future Success: Five Signs Your EHR Vendor Is Sticking Around.

 

June 1, 2018, is the Deadline to Initiate Connection to NC HealthConnex

Message from Dave Richard, Deputy Secretary for Medical Assistance

On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record (EHR) system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.

Providers who cannot meet the deadline may receive an extension for their connection. To request an extension, providers must:

1. Complete and sign an NC HIEA Participation Agreement;
2. Have NC HIEA countersign the agreement; and
3. Begin the onboarding process to connect to NC HealthConnex.

Providers Who Do Not Initiate Connection to NC HealthConnex by June 1, 2018 
Medicaid will work collaboratively with providers to comply with the June 1, 2018, deadline, and will initiate corrective action, including requiring corrective action plans, to ensure all providers come into compliance. At this time, all providers will continue to be enrolled as Medicaid providers and, as they file claims, will receive reimbursements for services and treatment of Medicaid beneficiaries.

Medicaid appreciates the many providers across the state who have initiated a connection and are making data available through the system. We will continue to work closely with the HIEA to ensure that NC HealthConnex develops to support your priorities and enable all of us to better serve patients and families.

Currently NC HealthConnex houses 4.8 million unique patient records, allowing providers to access their patients’ comprehensive records across multiple providers, and review consolidated lists of items including labs, diagnoses, allergies and medications.

Contact NC HIEA staff at hiea@nc.gov or Medicaid at Renee.McCoy@dhhs.nc.gov with questions.

February 5th CMS Webinar: The Merit-based Incentive Payment System (MIPS)

The Merit-based Incentive Payment System (MIPS):
Annual Call for Measures and Activities

February 5, 2018
2:30 PM – 3:30 PM ET

The Annual Call for Measures and Activities process allows clinicians and organizations, including but not limited to those representing eligible clinicians such as professional associations, and medical societies, and other stakeholders such as researchers and consumer groups to identify and submit for consideration:

• Quality measures for the quality performance category;
• EHR measures for the advancing care information performance category; and
• Activities for the improvement activities performance category.

To register for this webinar, please follow this link:
https://engage.vevent.com/index.jsp?eid=3536&seid=997