ACN Advance: Provider Newsletter

As we begin our 10th year in the market and execute on the strategic priorities the physician and administrative leadership established for ACN during our most recent planning cycle, it’s rewarding to look back on the highlights of a successful 2021:

• Primary care practices continue earning substantial quarterly incentives and annual shared savings distributions for engaging patients in preventive care, and effectively relying on fellow ACN specialists and facilities to meet their patients’ advanced care needs;
• Specialists who participate with ACN are receiving better information about their facility alignment and increasing role in serving patients covered under ACN payer arrangements; and
• Several new exclusive network and/or value-based payer arrangements, segments which collectively bring more value to ACN providers and the patients they serve:
  • Medicare Advantage (Aetna, Alignment Health Plan, Humana)
  • ACA Exchange (Medica Pinnacle); and
  • Commercial (Employers Health Network/Whole Foods Markets, Humana)

Our standards are higher than ever, and it is critically important that we remain a valuable advocate and partner for all provider organizations that participate with ACN.

The feedback we received from our recent “Value in Participating” questionnaire will guide us as we continually seek ways to improve the effectiveness and efficiency of our network in 2022 and beyond.

As always, our Care Coordination team is ready to support chronic patient care with resources and services. You may always contact your Clinical Performance Consultant, who is dedicated to providing your practice with information and education that supports your success.

Thank you for participating with ACN!

Todd Ricotta
CEO

The Centers for Medicare & Medicaid Services (CMS) requires accountable care organizations to mail an annual notification letter to all Medicare beneficiaries attributed to the network.

Per CMS guidelines, more than 35,000 Medicare lives covered under the Global and Professional Direct Contracting (GPDC) Model are expected to receive a notification confirmation letter by May 31.

The letter will notify beneficiaries that his/her primary care doctor participates in Arizona Care Network. The letter also lists the benefits and special programs available to beneficiaries at no additional cost. This includes care coordination, home visits, concierge services, and more.

In addition to the notification letter, CMS allows ACN to include custom materials for members. In this year’s mailing, we are including:

• ACN Preferred Providers listings
• Care Coordination information (pending CMS approval)

For questions or more information, please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org.

To further support your patient care, Arizona Care Network will launch an additional value-added service on behalf of your practice in 2022 through patient outreach via text message and/or email at no additional cost to your practice.

These optional communications provide your practice with an alternative, convenient outreach to help reduce scheduling burdens and potentially help close quality gaps.

Here are a few important aspects of this service:

• This optional communication outreach is scheduled to begin during Q3 of 2022.
• Message content will be related to appointment scheduling and/or care gaps.
• All patient email addresses and/or phone numbers are collected (when available) in claims data from participating payors, or from members opting in to receive ACN’s email newsletter.
  • Contact information may be updated for patients by reviewing a patient’s medical record in the Electronic Medical Records (EMR), only if/when ACN receives approved remote EMR access from your practice.
  • Your practice may also provide a Microsoft Excel spreadsheet of patient names and contact information.
• Patients can opt-out of receiving text messages and/or email reminders at any time.
  • Additionally, your practice may identify patients to remove from an outreach list when the patient identifies to your practice that he/she does not wish to be contacted.
• Outreach may include quality gap reminders (i.e., A1C, cancer screening(s), etc.) and wellness visit reminders where a HIPAA-secure texting service and HIPAA-secure email platform are utilized
• Patients may contact through us through text or call our Concierge team directly at (602) 406-7226 for assistance in scheduling any appointment(s).

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with any questions or feedback related to this initiative.

To further ease your practice’s staffing and administrative burdens, Arizona Care Network can support your patient care through secure, remote EMR access that allows a specific ACN Quality Team member to identify possible Hierarchical Conditioning Category (HCC) coding opportunities for Medicare members, and potentially identify/close quality gaps.

HCC Reconciliation Program

ACN can help your practice identify HCC opportunities for your Medicare patient population through our Hierarchical Conditioning Category (HCC) Reconciliation Program.

ACN’s support in HCC coding allows your practice staff to focus on other tasks.

This ICD-10 based diagnosis categorization/classification system is used by CMS to establish financial benchmarks and improve quality by ensuring your practice accurately depicts any expected cost(s) of caring for your patient population.

This information helps calculate a Risk Adjustment Factor Score (RAF Score), which conveys how sick the patient population is, thus the expected cost of caring for the population.

• The higher the RAF Score of a population, the greater the expected cost to CMS and likelihood to earn shared savings.
• Lower RAF scores equate to a healthier population, or that the health of the population has not been coded to the highest level of specificity.

ACN’s HCC team will review patient medical records daily and identify risk adjustment coding opportunities for your providers to consider during a patient’s appointment.

• Practices that wish to participate will need to provide remote EMR access and establish a direct point-of-contact to provide your HCC opportunities.
• Upon receiving remote EMR access from your practice, our HCC team member will access and review your daily appointment schedule for risk adjustment coding opportunities for patients scheduled three (3) days in advance.
• Our HCC team member will communicate any identified HCC opportunities via email (or your preferred communication method) to your practice’s direct point-of-contact one (1) day before the appointment.

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org if your practice wishes to participate.

Quality Gaps

Remote EMR access also allows for faster, more efficient data abstraction. This reduces the admin workload of your practice in responding to medical record request faxes from Arizona Care Network and abstracting the medical records. In addition, Arizona Care Network can turn around payor requests during short quality reconciliation time frames. Arizona Care Network can review more medical records with remote EMR access and overall, have a higher chance in achieving quality targets for shared savings for the provider network.

The additional benefit of remote EMR access is we can expand the HCC Reconciliation program and assist you in identifying ACN members and their quality gaps. A Quality team member will review your daily appointment schedule and send you an ACN member’s quality gaps before their appointment.

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org if your practice wishes to participate.

In addition, Quality measure tip sheets are available from your Clinical Performance Consultant:

• Colorectal cancer screening
• Depression screening and follow-up
• Diabetes (A1C, Eye Exam, Nephropathy)
• Social Determinants of Health (SDOH)
• Tobacco screening

These 1-page tip sheets (.PDF) include best practices, documentation requirements, and codes for your practice to help close quality gaps.

Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive any or all tip sheets.

Thanks to your feedback, Arizona Care Network made improvements to both the Specialist Performance Reports and Medical Neighborhood Maps originally made available to your practices last year.

Quarterly Specialist Performance Reports

To further improve upon your practice’s patient data, a new detailed spreadsheet of each patient’s medical claim(s) seen by your provider(s) is available. This care journey breakdown (via Excel spreadsheet) is available upon request from your Clinical Performance Consultant. It includes:

• Facility name
• Facility network status (INN/OON)
• Facility service type (Inpatient/Outpatient)
• Provider service type (Office, Hospital, Surgical Center, et al.)
• Provider’s diagnosis and procedure codes

These quarterly reports already include:

• Detailed summary of unique ACN members seen quarterly beginning in 2021 (as applicable), broken down by practice location and individual provider;
• Overview of network utilization for inpatient and outpatient facilities, and services performed on ACN members at the group and servicing provider level.

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive these reports, schedule an opportunity to review them with your CPC, or if you have any questions.

Medical Neighborhood Maps

To further improve network utilization and in-network care coordination opportunities, each Medical Neighborhood Map now includes a handshake image indicator for any practice with an in-network utilization greater than 50 percent.

The maps and listings are updated quarterly, and feature nearby hospitals and urgent care centers, along with a listing of the most-commonly-referred specialty types, including a special denotation for our Medicare ACO Preferred Providers.

Eight neighborhood maps are available:

• Biltmore (including Central and South Phoenix)
• Chandler/East Valley (including Ahwatukee and Tempe)
• Gilbert/Mesa (including SE Valley)
• Goodyear (including Glendale and Litchfield Park)
• Peoria (including Glendale)
• Scottsdale (including Paradise Valley)
• Sonoran (North Phoenix and Cave Creek)
• Surprise (including Sun City)

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive these maps, or if you have any questions.

Since 2016, Arizona Care Network has been Intel’s exclusive network partner in the Phoenix market, covering nearly 30,000 Intel employees and dependents under the Connected Care plan.

Thanks to Dignity Health’s sponsorship and approval, along with an increase in Annual Physical Exams during 2021, the incentives for annual physicals will continue for 2022. This incentive was introduced last year as an opportunity to drive additional access to primary care services for Intel members and provide quality gap closure opportunities for providers. The base reimbursement and incentive amounts in effect for the remainder of 2022 are identical to 2021.

View the codes and reimbursement rates for primary care providers and specialist providers.

This incentive is now formally incorporated in your Participation Agreement with ACN, and no other action is required to receive this reimbursement.

If you have any questions, please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org.

Thank you for your continued commitment to ACN and your Intel Connected Care patients!

• • Follow us on Facebook, Twitter, and LinkedIn for additional news, health-related content for providers and patients, organizational updates, and more.
  • Learn more about ACN’s Care Coordination program and services designed to partner and support your practice in achieving healthy, cost-effective patient outcomes in this video.
  • Margarita “Maggie” Gonzalez was named ACN’s new Manager of Clinical Performance Consultants. Maggie started with ACN as a Clinical Performance Consultant in 2017. Her clinical background helped practices improve quality outcomes, and led the implementation of ACN’s Provider Portal among primary care practices. Maggie’s appointment follows Jonee Christensen, who is the new VP of Provider Network and Government Relations with ACN. Additionally, Jessica Vickers is ACN’s newest Clinical Performance Consultant, working with practices from the Biltmore area of Phoenix north through North Scottsdale and Cave Creek.
  • A continuing medical education (CME) opportunity is available for PCPs, PAs, NPs, PTs, ATs, and residents. Orthopedic sports medicine providers with musculoskeletal specialties will discuss common foot and ankle injuries/causes/treatments, on May 12 (Crowne Plaza San Marcos Resort in Chandler) and May 18 (Creighton University Health Science Complex in Phoenix). Attendance includes dinner, dessert, and two alcoholic beverages. You only need to attend one evening to receive credit. More information and registration is available here
  • Dignity Health Southwest Division President/CEO Linda Hunt retired after 51 years of service in health care. Hunt, a member of ACN’s Board of Managers, began as a Walgreens clerk before pursuing a nursing career. She moved to Phoenix and joined Dignity Health in 1998 and became St. Joseph’s president a year later. Since 2009, she led Dignity Health’s Southwest Division, which is anchored by 11 hospitals in Arizona and Nevada, and served on more than a dozen state and national boards. Tim Bricker, whose 30 years of health care leadership experience includes serving as president of Chandler Regional and Mercy Gilbert Medical Center (2011-2017), was named the interim CEO of Dignity Health’s Southwest Division.
  • Brian Tiffany, MD, PhD, is Dignity Health’s new chief physician executive for the Southwest Division. Dr. Tiffany has been a member of the Dignity Health team for nearly 20 years, including serving as chief medical officer for Dignity Health’s Arizona General Hospital (AGH) Phoenix since 2018. An emergency medicine physician since 1990, Dr. Tiffany joined Dignity Health in 2003 as a member of the medical staff at Dignity Health Chandler Regional and Mercy Gilbert Medical Centers, and served as chairman of emergency medicine for Maricopa Medical Center.
  • CommonSpirit Health had a recent article about retinal disease and Age-related Macular Degeneration published in the New England Journal of Medicine Catalyst Innovations in Health Care Delivery. The article highlights results from previous AMD initiatives related to three common retinal disease medications used by Medicare Part B patients.
  • Abrazo Health acquired property to develop a medical campus on 27 acres near the southwest corner of Interstate 10 and Verrado Way in Buckeye. The initial phase is expected to break ground later in 2022. Plans for the campus include a medical office building, ambulatory services, and an acute care hospital.
  • Abrazo Arizona Heart Hospital was the first facility in the Valley to perform a procedure using the recently approved Amulet device for patients at risk for ischemic stroke due to atrial fibrillation (AFib). FDA-approved in 2021, Amulet has a wide range of sizes for different patient anatomies and is repositionable to help ensure optimal placement.
  • Abrazo Arrowhead added the CORI Surgical System for partial and total knee replacement. The robot-assisted surgical system, which is controlled by the surgeon, uses artificial intelligence to help accurately size and place implants. A hand-held instrument with computer guidance that enables physicians to sculpt the patient’s knee to receive the implant. The robot is designed to provide accuracy in bone resection and alignment through intraoperative planning, smart mapping, and full range-of-motion.

• Advanced Spine and Pain (Valley wide)
• Arizona Colorectal Experts (Chandler)
• Cardiovascular and Arrhythmia Institute (Chandler, Mesa, Queen Creek)
• Comprehensive Breast Center of Arizona (Avondale, Gilbert)
• Desert Sky Urology (Chandler)
• HealthyU Family Medicine (Avondale, Mesa, Phoenix)
• Scottsdale Endoscopy Center (Scottsdale)
• Virginia G. Piper Cancer Care Network (Valley wide)

You can also view a list of practices and providers no longer participating with ACN in 2022.